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SARS-CoV-2 seroprevalence and asymptomatic viral carriage in healthcare workers: a cross-sectional study

SARS-CoV-2 seroprevalence and asymptomatic viral carriage in healthcare workers: a cross-sectional study
SARS-CoV-2 seroprevalence and asymptomatic viral carriage in healthcare workers: a cross-sectional study

OBJECTIVE: To determine the rates of asymptomatic viral carriage and seroprevalence of SARS-CoV-2 antibodies in healthcare workers.

DESIGN: A cross-sectional study of asymptomatic healthcare workers undertaken on 24/25 April 2020.

SETTING: University Hospitals Birmingham NHS Foundation Trust (UHBFT), UK.

PARTICIPANTS: 545 asymptomatic healthcare workers were recruited while at work. Participants were invited to participate via the UHBFT social media. Exclusion criteria included current symptoms consistent with COVID-19. No potential participants were excluded.

INTERVENTION: Participants volunteered a nasopharyngeal swab and a venous blood sample that were tested for SARS-CoV-2 RNA and anti-SARS-CoV-2 spike glycoprotein antibodies, respectively. Results were interpreted in the context of prior illnesses and the hospital departments in which participants worked.

MAIN OUTCOME MEASURE: Proportion of participants demonstrating infection and positive SARS-CoV-2 serology.

RESULTS: The point prevalence of SARS-CoV-2 viral carriage was 2.4% (n=13/545). The overall seroprevalence of SARS-CoV-2 antibodies was 24.4% (n=126/516). Participants who reported prior symptomatic illness had higher seroprevalence (37.5% vs 17.1%, χ2=21.1034, p<0.0001) and quantitatively greater antibody responses than those who had remained asymptomatic. Seroprevalence was greatest among those working in housekeeping (34.5%), acute medicine (33.3%) and general internal medicine (30.3%), with lower rates observed in participants working in intensive care (14.8%). BAME (Black, Asian and minority ethnic) ethnicity was associated with a significantly increased risk of seropositivity (OR: 1.92, 95% CI 1.14 to 3.23, p=0.01). Working on the intensive care unit was associated with a significantly lower risk of seropositivity compared with working in other areas of the hospital (OR: 0.28, 95% CI 0.09 to 0.78, p=0.02).

CONCLUSIONS AND RELEVANCE: We identify differences in the occupational risk of exposure to SARS-CoV-2 between hospital departments and confirm asymptomatic seroconversion occurs in healthcare workers. Further investigation of these observations is required to inform future infection control and occupational health practices.

clinical epidemiology, infection control, respiratory infection, viral infection
0040-6376
1089-1094
Shields, Adrian
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Faustini, Sian E
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Perez-Toledo, Marisol
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Jossi, Sian
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Aldera, Erin
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Allen, Joel D
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Al-Taei, Saly
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Backhouse, Claire
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Bosworth, Andrew
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Dunbar, Lyndsey A
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Ebanks, Daniel
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Emmanuel, Beena
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Garvey, Mark
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Gray, Joanna
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Kidd, I Michael
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McGinnell, Golaleh
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McLoughlin, Dee E
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Morley, Gabriella
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O'Neill, Joanna
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Papakonstantinou, Danai
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Pickles, Oliver
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Poxon, Charlotte
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Richter, Megan
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Walker, Eloise M
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Wanigasooriya, Kasun
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Whalley, Celina
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Zielinska, Agnieszka E
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Crispin, Max
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Wraith, David C
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Beggs, Andrew D
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Cunningham, Adam F
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Drayson, Mark T
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Richter, Alex G
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Shields, Adrian
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Faustini, Sian E
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Perez-Toledo, Marisol
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Jossi, Sian
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Aldera, Erin
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Allen, Joel D
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Al-Taei, Saly
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Backhouse, Claire
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Bosworth, Andrew
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Ebanks, Daniel
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Emmanuel, Beena
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Garvey, Mark
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Gray, Joanna
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Kidd, I Michael
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McGinnell, Golaleh
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McLoughlin, Dee E
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Morley, Gabriella
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O'Neill, Joanna
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Papakonstantinou, Danai
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Pickles, Oliver
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Poxon, Charlotte
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Richter, Megan
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Walker, Eloise M
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Wanigasooriya, Kasun
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Watanabe, Yasunori
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Whalley, Celina
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Zielinska, Agnieszka E
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Crispin, Max
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Wraith, David C
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Beggs, Andrew D
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Cunningham, Adam F
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Drayson, Mark T
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Richter, Alex G
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Shields, Adrian, Faustini, Sian E, Perez-Toledo, Marisol, Jossi, Sian, Aldera, Erin, Allen, Joel D, Al-Taei, Saly, Backhouse, Claire, Bosworth, Andrew, Dunbar, Lyndsey A, Ebanks, Daniel, Emmanuel, Beena, Garvey, Mark, Gray, Joanna, Kidd, I Michael, McGinnell, Golaleh, McLoughlin, Dee E, Morley, Gabriella, O'Neill, Joanna, Papakonstantinou, Danai, Pickles, Oliver, Poxon, Charlotte, Richter, Megan, Walker, Eloise M, Wanigasooriya, Kasun, Watanabe, Yasunori, Whalley, Celina, Zielinska, Agnieszka E, Crispin, Max, Wraith, David C, Beggs, Andrew D, Cunningham, Adam F, Drayson, Mark T and Richter, Alex G (2020) SARS-CoV-2 seroprevalence and asymptomatic viral carriage in healthcare workers: a cross-sectional study. Thorax, 75 (12), 1089-1094. (doi:10.1136/thoraxjnl-2020-215414).

Record type: Article

Abstract

OBJECTIVE: To determine the rates of asymptomatic viral carriage and seroprevalence of SARS-CoV-2 antibodies in healthcare workers.

DESIGN: A cross-sectional study of asymptomatic healthcare workers undertaken on 24/25 April 2020.

SETTING: University Hospitals Birmingham NHS Foundation Trust (UHBFT), UK.

PARTICIPANTS: 545 asymptomatic healthcare workers were recruited while at work. Participants were invited to participate via the UHBFT social media. Exclusion criteria included current symptoms consistent with COVID-19. No potential participants were excluded.

INTERVENTION: Participants volunteered a nasopharyngeal swab and a venous blood sample that were tested for SARS-CoV-2 RNA and anti-SARS-CoV-2 spike glycoprotein antibodies, respectively. Results were interpreted in the context of prior illnesses and the hospital departments in which participants worked.

MAIN OUTCOME MEASURE: Proportion of participants demonstrating infection and positive SARS-CoV-2 serology.

RESULTS: The point prevalence of SARS-CoV-2 viral carriage was 2.4% (n=13/545). The overall seroprevalence of SARS-CoV-2 antibodies was 24.4% (n=126/516). Participants who reported prior symptomatic illness had higher seroprevalence (37.5% vs 17.1%, χ2=21.1034, p<0.0001) and quantitatively greater antibody responses than those who had remained asymptomatic. Seroprevalence was greatest among those working in housekeeping (34.5%), acute medicine (33.3%) and general internal medicine (30.3%), with lower rates observed in participants working in intensive care (14.8%). BAME (Black, Asian and minority ethnic) ethnicity was associated with a significantly increased risk of seropositivity (OR: 1.92, 95% CI 1.14 to 3.23, p=0.01). Working on the intensive care unit was associated with a significantly lower risk of seropositivity compared with working in other areas of the hospital (OR: 0.28, 95% CI 0.09 to 0.78, p=0.02).

CONCLUSIONS AND RELEVANCE: We identify differences in the occupational risk of exposure to SARS-CoV-2 between hospital departments and confirm asymptomatic seroconversion occurs in healthcare workers. Further investigation of these observations is required to inform future infection control and occupational health practices.

Full text not available from this repository.

More information

Accepted/In Press date: 11 August 2020
e-pub ahead of print date: 11 September 2020
Keywords: clinical epidemiology, infection control, respiratory infection, viral infection

Identifiers

Local EPrints ID: 444296
URI: http://eprints.soton.ac.uk/id/eprint/444296
ISSN: 0040-6376
PURE UUID: 47d039cc-cda5-4afa-b76e-f0b0a1a002c3
ORCID for Max Crispin: ORCID iD orcid.org/0000-0002-1072-2694

Catalogue record

Date deposited: 09 Oct 2020 16:34
Last modified: 01 May 2021 01:53

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Contributors

Author: Adrian Shields
Author: Sian E Faustini
Author: Marisol Perez-Toledo
Author: Sian Jossi
Author: Erin Aldera
Author: Joel D Allen
Author: Saly Al-Taei
Author: Claire Backhouse
Author: Andrew Bosworth
Author: Lyndsey A Dunbar
Author: Daniel Ebanks
Author: Beena Emmanuel
Author: Mark Garvey
Author: Joanna Gray
Author: I Michael Kidd
Author: Golaleh McGinnell
Author: Dee E McLoughlin
Author: Gabriella Morley
Author: Joanna O'Neill
Author: Danai Papakonstantinou
Author: Oliver Pickles
Author: Charlotte Poxon
Author: Megan Richter
Author: Eloise M Walker
Author: Kasun Wanigasooriya
Author: Yasunori Watanabe
Author: Celina Whalley
Author: Agnieszka E Zielinska
Author: Max Crispin ORCID iD
Author: David C Wraith
Author: Andrew D Beggs
Author: Adam F Cunningham
Author: Mark T Drayson
Author: Alex G Richter

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