1
|
Bamber HN, Kim JJ, Reynolds BC, Afzaal J, Lunn AJ, Tighe PJ, Irving WL, Tarr AW. Increasing SARS-CoV-2 seroprevalence among UK pediatric patients on dialysis and kidney transplantation between January 2020 and August 2021. Pediatr Nephrol 2023; 38:3745-3755. [PMID: 37261514 PMCID: PMC10233184 DOI: 10.1007/s00467-023-05983-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/29/2023] [Accepted: 04/07/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) was officially declared a pandemic by the World Health Organisation (WHO) on 11 March 2020, as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread rapidly across the world. We investigated the seroprevalence of anti-SARS-CoV-2 antibodies in pediatric patients on dialysis or kidney transplantation in the UK. METHODS Excess sera samples were obtained prospectively during outpatient visits or haemodialysis sessions and analysed using a custom immunoassay calibrated with population age-matched healthy controls. Two large pediatric centres contributed samples. RESULTS In total, 520 sera from 145 patients (16 peritoneal dialysis, 16 haemodialysis, 113 transplantation) were analysed cross-sectionally from January 2020 until August 2021. No anti-SARS-CoV-2 antibody positive samples were detected in 2020 when lockdown and enhanced social distancing measures were enacted. Thereafter, the proportion of positive samples increased from 5% (January 2021) to 32% (August 2021) following the emergence of the Alpha variant. Taking all patients, 32/145 (22%) were seropositive, including 8/32 (25%) with prior laboratory-confirmed SARS-CoV-2 infection and 12/32 (38%) post-vaccination (one of whom was also infected after vaccination). The remaining 13 (41%) seropositive patients had no known stimulus, representing subclinical cases. Antibody binding signals were comparable across patient ages and dialysis versus transplantation and highest against full-length spike protein versus spike subunit-1 and nucleocapsid protein. CONCLUSIONS Anti-SARS-CoV-2 seroprevalence was low in 2020 and increased in early 2021. Serological surveillance complements nucleic acid detection and antigen testing to build a greater picture of the epidemiology of COVID-19 and is therefore important to guide public health responses. A higher resolution version of the Graphical abstract is available as Supplementary information.
Collapse
Affiliation(s)
- Holly N Bamber
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Jon Jin Kim
- Department of Paediatric Nephrology, Nottingham University Hospitals, Nottingham, UK
- Centre for Kidney Research and Innovation, University of Nottingham, Nottingham, UK
| | - Ben C Reynolds
- Department of Paediatric Nephrology, Royal Hospital for Children, Glasgow, UK
| | - Javairiya Afzaal
- Department of Paediatric Nephrology, Nottingham University Hospitals, Nottingham, UK
| | - Andrew J Lunn
- Department of Paediatric Nephrology, Nottingham University Hospitals, Nottingham, UK
| | - Patrick J Tighe
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - William L Irving
- School of Life Sciences, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
- Wolfson Centre for Global Virus Research, The University of Nottingham, Nottingham, UK
- Microbiology, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Alexander W Tarr
- School of Life Sciences, University of Nottingham, Nottingham, UK.
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK.
- Wolfson Centre for Global Virus Research, The University of Nottingham, Nottingham, UK.
- Microbiology, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
| |
Collapse
|
2
|
Helou M, Zoghbi S, El Osta N, Mina J, Mokhbat J, Husni R. COVID-19 infection and seroconversion rates in healthcare workers in Lebanon: An observational study. Medicine (Baltimore) 2023; 102:e32992. [PMID: 37115042 PMCID: PMC10143398 DOI: 10.1097/md.0000000000032992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 04/29/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) infection is a recent pandemic. Healthcare workers (HCW) are at high risk of acquiring the infection and transmitting it to others. Seroprevalence for COVID-19 among HCW varies between countries, hospitals in the same country and even among different departments in the same hospital. In this study, we aim to determine the prevalence of severe acute respiratory syndrome coronavirus 2 antibodies and the seroconversion among the HCW in our hospital. A total of 203 HCW were included. The rate of conversion to seropositive was 19.7% in total, with a rate of 13.4% in female versus 25% in male. The seropositivity in the House keeping group was 83%, followed by 45% in the COVID Floor while the seropositivity in the Anesthesia was 4% and the Infection Control 0%. The highest seropositivity rate in the COVID floor, and in the intensive care unit was explained by the long time spent with the patients. While in the inhalation team and the anesthesia, the lower rates of seropositivity was due to the N95 mask wearing the whole time. Seropositivity for COVID-19 in HCW is a major public health concern. Policies should be implemented to better protect HCWs.
Collapse
Affiliation(s)
- Mariana Helou
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Sanaa Zoghbi
- Division of Infection Control, Lebanese American University Medical Center, Beirut, Lebanon
| | - Nour El Osta
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Jonathan Mina
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Jacques Mokhbat
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Rola Husni
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| |
Collapse
|
3
|
Galán MI, Velasco M, Casas ML, Goyanes MJ, Rodríguez-Caravaca G, Losa-García JE, Noguera C, Castilla V. Hospital-Wide SARS-CoV-2 seroprevalence in health care workers in a Spanish teaching hospital. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:302-309. [PMID: 35680348 PMCID: PMC9168001 DOI: 10.1016/j.eimce.2020.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 11/27/2020] [Indexed: 11/29/2022]
Abstract
Introduction Methods Results Conclusions
Collapse
Affiliation(s)
- Mª Isabel Galán
- Occupational Health Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - María Velasco
- Infectious Diseases and Research Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
| | - Mª Luisa Casas
- Laboratory Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Mª José Goyanes
- Microbiology Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | - Juan E Losa-García
- Infectious Diseases Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Carmen Noguera
- Nurse Subdirector, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Virgilio Castilla
- Medical Director, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| |
Collapse
|
4
|
Dewhurst RE, Heinrich T, Watt P, Ostergaard P, Marimon JM, Moreira M, Houldsworth PE, Rudrum JD, Wood D, Kõks S. Validation of a rapid, saliva-based, and ultra-sensitive SARS-CoV-2 screening system for pandemic-scale infection surveillance. Sci Rep 2022; 12:5936. [PMID: 35395856 PMCID: PMC8990279 DOI: 10.1038/s41598-022-08263-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/02/2022] [Indexed: 12/23/2022] Open
Abstract
Without any realistic prospect of comprehensive global vaccine coverage and lasting immunity, control of pandemics such as COVID-19 will require implementation of large-scale, rapid identification and isolation of infectious individuals to limit further transmission. Here, we describe an automated, high-throughput integrated screening platform, incorporating saliva-based loop-mediated isothermal amplification (LAMP) technology, that is designed for population-scale sensitive detection of infectious carriers of SARS-CoV-2 RNA. Central to this surveillance system is the "Sentinel" testing instrument, which is capable of reporting results within 25 min of saliva sample collection with a throughput of up to 3840 results per hour. It incorporates continuous flow loading of samples at random intervals to cost-effectively adjust for fluctuations in testing demand. Independent validation of our saliva-based RT-LAMP technology on an automated LAMP instrument coined the "Sentinel", found 98.7% sensitivity, 97.6% specificity, and 98% accuracy against a RT-PCR comparator assay, confirming its suitability for surveillance screening. This Sentinel surveillance system offers a feasible and scalable approach to complement vaccination, to curb the spread of COVID-19 variants, and control future pandemics to save lives.
Collapse
Affiliation(s)
- Robert E Dewhurst
- Perron Institute for Neurological and Translational Science, Perth, WA, 6009, Australia
- Avicena Systems Ltd, West Perth, WA, 6005, Australia
| | - Tatjana Heinrich
- Perron Institute for Neurological and Translational Science, Perth, WA, 6009, Australia
- Avicena Systems Ltd, West Perth, WA, 6005, Australia
| | - Paul Watt
- Avicena Systems Ltd, West Perth, WA, 6005, Australia
- Telethon Kids Institute, University of Western Australia, Perth, WA, 6009, Australia
| | | | - Jose M Marimon
- Biodonostia Health Research Institute, Infectious Diseases Area, Osakidetza Basque Health Service, Donostialdea Integrated Health Organization, San Sebastián, Spain
| | - Mariana Moreira
- Lancs Lamp Laboratory, Heatley House, Bowran Street, Preston, PR1 2UX, UK
| | | | - Jack D Rudrum
- Perron Institute for Neurological and Translational Science, Perth, WA, 6009, Australia
- Avicena Systems Ltd, West Perth, WA, 6005, Australia
| | - David Wood
- University of Western Australia, Perth, WA, 6009, Australia
| | - Sulev Kõks
- Perron Institute for Neurological and Translational Science, Perth, WA, 6009, Australia.
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, 6150, Australia.
- Prion Ltd, 50410, Tartu, Estonia.
| |
Collapse
|
5
|
Darvishian M, Sharafkhah M, Mohammadi Z, Sadeghniiat-haghighi K, Abdollahi A, Jafary M, Talaschian M, Tabarsi P, Baghai P, Mardani M, Shayanrad A, Shafighian F, Markarian M, Roozafzai F, Zamani M, Alvand S, Hariri S, Sadeghi A, Poustchi H, Malekzadeh R. SARS-CoV-2 Seroprevalence Among Health Care Workers in Major Private and Public Hospitals With COVID-19 Patient's Referral in Tehran, Iran. Front Public Health 2022; 10:832003. [PMID: 35400056 PMCID: PMC8987007 DOI: 10.3389/fpubh.2022.832003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/22/2022] [Indexed: 12/24/2022] Open
Abstract
Estimating the prevalence of SARS-CoV-2 antibody seropositivity among health care workers (HCWs) is crucial. In this study, the seroprevalence of anti-SARS-CoV-2 antibodies among HCWs of five hospitals of Tehran, Iran with high COVID-19 patient's referrals from April to June, 2020, was assessed. In this cross-sectional study, HCWs from three public and two private hospitals, selected randomly as a pilot, were included. Participants were asked questions on their demographic characteristics, medical history, hospital role, and usage of personal protective equipment (PPE). Iran FDA-approved SARS-CoV-2 ELISA kits were used to detect IgG and IgM antibodies in blood samples. The seroprevalence was estimated on the basis of ELISA test results and adjusted for test performance. Among the 2,065 participants, 1,825 (88.4%) and 240 (11.6%) HCWs were recruited from public and private hospitals, respectively. A total of 340 HCWs were tested positive for SARS-CoV-2-specific IgG or IgM antibodies, and 17.9% of seropositive individuals were asymptomatic. The overall test performance-adjusted seroprevalence estimate among HCWs was 22.6 (95% CI: 20.2–25.1), and PPE usage was significantly higher among HCWs of public vs. private hospitals (66.5 vs. 20.0%). This study found that seroprevalence of SARS-CoV-2 among HCWs was higher in private hospitals (37.0%; 95% CI: 28.6–46.2) than public hospitals (20.7%; 95% CI: 18.2–23.3), and also highest among assistant nurses and nurses, and lowest among janitor or superintendent categories. The PPE usage was especially suboptimal among HCWs in private hospitals. Continued effort in access to adequate PPE and regular screening of hospital staff for detecting asymptomatic personnel, especially during the upcoming wave of infection, are warranted.
Collapse
Affiliation(s)
- Maryam Darvishian
- Cancer Control Research, BC Cancer Research Centre, Vancouver, BC, Canada
| | - Maryam Sharafkhah
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Mohammadi
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Alireza Abdollahi
- Department of Pathology, School of Medicine, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mona Talaschian
- Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Payam Tabarsi
- Clinical Tb and Epidemiology Research Center, NRITLD, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvaneh Baghai
- Clinical Tb and Epidemiology Research Center, NRITLD, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Mardani
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amaneh Shayanrad
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Shafighian
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Melineh Markarian
- Digestive Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzin Roozafzai
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Zamani
- Digestive Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Saba Alvand
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanam Hariri
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Digestive Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Hossein Poustchi
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Reza Malekzadeh
| |
Collapse
|
6
|
Puchades A, Daniel R, Geen J, Peden J, Lewis H, Nnoaham K. SARS-CoV-2 sero-prevalence in the workforces of three large workplaces in South Wales: a sero-epidemiological study. BMC Public Health 2022; 22:162. [PMID: 35073884 PMCID: PMC8785373 DOI: 10.1186/s12889-021-12478-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/16/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Sero-prevalence studies quantify the proportion of a population that has antibodies against SARS-CoV-2, and can be used to identify the extent of the COVID-19 pandemic at a population level. The aim of the study was to assess the sero-prevalence of SARS-CoV-2 antibodies in the workforce at three workplaces: a food factory, non-food factory and call-centre. METHODS Nine hundred ninety-three participants were recruited from three workplaces in South Wales. Participants completed a questionnaire and had a lateral flow point-of-care SARS-CoV-2 antibody test administered by a healthcare professional. The data were analysed using multivariable logistic regression, both using complete records only and following multiple imputation. RESULTS The sero-prevalence of SARS-CoV-2 antibodies ranged from 4% (n = 17/402) in the non-food factory to 10% (n = 28/281) in the food factory (OR 2.93; 95% CI 1.26 to 6.81). After taking account of confounding factors evidence of a difference remained (cOR comparing food factory to call centre (2.93; 95% CI 1.26 to 6.81) and non-food factory (3.99; 95% CI 1.97 to 8.08) respectively). The SARS-CoV-2 antibody prevalence also varied between roles within workplaces. People working in office based roles had a 2.23 times greater conditional odds (95% CI 1.02 to 4.87) of being positive for SARS-CoV-2 antibodies than those working on the factory floor. CONCLUSION The sero-prevalence of SARS-CoV-2 antibodies varied by workplace and work role. Whilst it is not possible to state whether these differences are due to COVID-19 transmission within the workplaces, it highlights the importance of considering COVID-19 transmission in a range of workplaces and work roles.
Collapse
Affiliation(s)
- Alice Puchades
- Public Health Wales, Number 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, UK.
| | - Rhian Daniel
- Division of Population Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK
| | - John Geen
- Clinical Biochemistry Department, Cwm Taf Morgannwg University Health Board, Merthyr Tydfil, CF47 9DT, UK
| | - Jo Peden
- Public Health Wales, Number 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, UK
| | - Heather Lewis
- Public Health Wales, Number 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, UK
| | - Kelechi Nnoaham
- Cwm Taf Morgannwg University Health Board, Navigation Park, Unit 3 Ynysmeurig House, Abercynon, CF45 4SN, UK
| |
Collapse
|
7
|
Riccò M, Gualerzi G, Ranzieri S, Peruzzi S, Valente M, Marchesi F, Bragazzi NL, Signorelli C. Occurrence of SARS-CoV-2 infection among healthcare personnel: results from an early systematic review and meta-analysis. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021311. [PMID: 34738585 PMCID: PMC8689308 DOI: 10.23750/abm.v92i5.10438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND SARS-CoV-2 infection has become a global public health concern globally. Even though Healthcare Workers (HCWs) are supposedly at increased risk for SARS-CoV-2 infection, to date no pooled evidence has been collected. MATERIALS AND METHODS We searched online electronic databases (PubMed, Embase, medRxiv.org for pre-prints) for all available contribution (up to May 20, 2019). Two Authors independently screened articles and extracted the data. The pooled prevalence of SARS-CoV-2 was analyzed using the random-effects model. The possible sources of heterogeneity were analyzed through subgroup analysis, and meta-regression. RESULTS The overall pooled prevalence of SARS-CoV-2 was 3.5% (95%CI 1.8-6.6) for studies based on molecular assays, 5.5% (95%CI 2.1-14.1) for studies based on serological assays, and 6.5% (95%CI 2.5-15.6) for point-of-care capillary blood tests. Among subgroups, serological tests identified higher risk for SARS-CoV-2 seropositivity in physicians than in nurses (OR 1.436, 95%CI 1.026 to 2.008). Regression analysis indicated the possible presence of publication bias only for molecular tests (t -3.3526, p-value 0.002648). CONCLUSIONS The overall pooled prevalence of SARS-CoV-2 was lower than previously expected, but available studies were affected by significant heterogeneity, and the molecular studies by significant publication bias. Therefore, further high-quality research in the field is warranted.
Collapse
Affiliation(s)
- Matteo Riccò
- Azienda USL di Reggio EmiliaV.le Amendola n.2 - 42122 REServizio di Prevenzione e Sicurezza negli Ambienti di Lavoro (SPSAL)Dip. di Prevenzione.
| | - Giovanni Gualerzi
- 2 Department of Medicine and Surgery, School of Medicine, University of Parma, 43123 Parma (PR), Italy.
| | - Silvia Ranzieri
- 3 Department of Medicine and Surgery, School of Occupational Medicine, University of Parma, I-43123 Parma (PR), Italy.
| | - Simona Peruzzi
- 4 AUSL-IRCCS di Reggio Emilia, Laboratorio Analisi Chimico Cliniche e Microbiologiche, Ospedale Civile di Guastalla, I-42016 Guastalla (RE), Italy.
| | - Marina Valente
- Department of Medicine and Surgery, Unit of Clinical Surgery, University of Parma, I-43123 Parma (PR), Italy.
| | - Federico Marchesi
- Department of Medicine and Surgery, Unit of Clinical Surgery, University of Parma, I-43123 Parma (PR), Italy.
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada.
| | - Carlo Signorelli
- University "Vita e Salute", San Raffaele Hospital, 20132 Milan (MI), Italy.
| |
Collapse
|
8
|
Affiliation(s)
- Philip Zachariah
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA.
| |
Collapse
|
9
|
Kagucia EW, Gitonga JN, Kalu C, Ochomo E, Ochieng B, Kuya N, Karani A, Nyagwange J, Karia B, Mugo D, Karanja HK, Tuju J, Mutiso A, Maroko H, Okubi L, Maitha E, Ajuck H, Mukabi D, Moracha W, Bulimu D, Andanje N, Aman R, Mwangangi M, Amoth P, Kasera K, Ng'ang'a W, Nyaguara A, Voller S, Otiende M, Bottomley C, Agoti CN, Ochola-Oyier LI, Adetifa IMO, Etyang AO, Gallagher KE, Uyoga S, Barasa E, Bejon P, Tsofa B, Agweyu A, Warimwe GM, Scott JAG. Anti-Severe Acute Respiratory Syndrome Coronavirus 2 Immunoglobulin G Antibody Seroprevalence Among Truck Drivers and Assistants in Kenya. Open Forum Infect Dis 2021; 8:ofab314. [PMID: 34660838 PMCID: PMC8519263 DOI: 10.1093/ofid/ofab314] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/09/2021] [Indexed: 11/14/2022] Open
Abstract
In October 2020, anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G seroprevalence among truck drivers and their assistants (TDA) in Kenya was 42.3%, higher than among healthcare workers and blood donors. Truck drivers and their assistants transport essential supplies during the coronavirus disease 2019 pandemic, placing them at increased risk of being infected and of transmitting SARS-CoV-2 over a wide geographical area.
Collapse
Affiliation(s)
| | | | | | - Eric Ochomo
- KEMRI Centre for Global Health Research (CGHR), Kisumu, Kenya
| | - Benard Ochieng
- KEMRI Centre for Global Health Research (CGHR), Kisumu, Kenya
| | - Nickline Kuya
- KEMRI Centre for Global Health Research (CGHR), Kisumu, Kenya
| | - Angela Karani
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | | | - Daisy Mugo
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - James Tuju
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Agnes Mutiso
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Hosea Maroko
- KEMRI Centre for Infectious and Parasitic Diseases Control Research, Busia, Kenya
| | - Lucy Okubi
- KEMRI Centre for Infectious and Parasitic Diseases Control Research, Busia, Kenya
| | | | | | | | | | | | | | - Rashid Aman
- Ministry of Health, Government of Kenya, Nairobi, Kenya
| | | | - Patrick Amoth
- Ministry of Health, Government of Kenya, Nairobi, Kenya
| | | | - Wangari Ng'ang'a
- Presidential Policy and Strategy Unit, The Presidency, Government of Kenya, Nairobi, Kenya
| | - Amek Nyaguara
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Shirine Voller
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mark Otiende
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Christian Bottomley
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | - Ifedayo M O Adetifa
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Katherine E Gallagher
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sophie Uyoga
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Edwine Barasa
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Philip Bejon
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.,Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | | | | | - George M Warimwe
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.,Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | - J Anthony G Scott
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | | |
Collapse
|
10
|
Alfano G, Ferrari A, Magistroni R, Fontana F, Cappelli G, Basile C. The frail world of haemodialysis patients in the COVID-19 pandemic era: a systematic scoping review. J Nephrol 2021; 34:1387-1403. [PMID: 34417996 PMCID: PMC8379591 DOI: 10.1007/s40620-021-01136-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/24/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Patients undergoing in-centre haemodialysis (HD) are particularly exposed to the dire consequences of COVID-19. The present systematic scoping review aims to identify the extent, range, and nature of articles related to COVID-19 and maintenance HD: it reports specifically the prevalence of the COVID-19 pandemic in the HD population, implementation of strategies for the prevention, mitigation and containment of the COVID-19 pandemic in HD centres, demographic and clinical characteristics, and outcomes of the pediatric and adult HD patients. METHODS A multi-step systematic search of the literature in Pubmed, Scopus, Ovid Medline, Embase and Web of Science, published between December 1, 2019, and January 30, 2021 was performed. Two authors separately screened the titles and abstracts of the documents and ruled out irrelevant articles. A report of the papers that met inclusion criteria was performed; then, a descriptive analysis of the characteristics of the included articles and a narrative synthesis of the results were performed. RESULTS The review process ended with the inclusion of 145 articles. Most of them were based on single-centre experiences, which spontaneously developed best practices. Most studies were conducted in high-income countries (69.7%) and a part of them (9.6%) were not in English. Prevalence of COVID-19 among dialysis patients accounted for 0%-37.6%. Preventive measures were reported in 54% of the included articles, with particular emphasis on education, triage, hygiene, and containment measures. Patients experienced a heterogeneous spectrum of symptoms that led 35%-88.2% of them to hospital admission. Median and mean hospital length of stay ranged from 8 to 28.5 and 16.2 to 22 days, respectively. Admission to intensive care units varied widely across studies (from 2.6% to 70.5%) and was associated with high mortality (42.8%-100%). Overall, prognosis was poor in 0%-47% of the hospitalized patients. CONCLUSIONS This systematic scoping review provides an overview of the current knowledge on the impact of COVID-19 on the frail world of HD patients. Furthermore, it may help to implement the existing strategies of COVID-19 prevention and provide a list of unmet needs (safe transport, testing, shelter). Finally, it may be a stimulus for performing systematic reviews and meta-analyses which will form the basis for evidence-based guidelines.
Collapse
Affiliation(s)
- Gaetano Alfano
- Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Modena, Italy
- Nephrology, Dialysis and Transplant Unit, University Hospital of Modena, Modena, Italy
- Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Annachiara Ferrari
- Nephrology and Dialysis Unit, AUSL Reggio Emilia-IRCCS S. Maria Nuova, Reggio Emilia, Italy
| | - Riccardo Magistroni
- Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Modena, Italy
- Nephrology, Dialysis and Transplant Unit, University Hospital of Modena, Modena, Italy
| | - Francesco Fontana
- Nephrology, Dialysis and Transplant Unit, University Hospital of Modena, Modena, Italy
| | - Gianni Cappelli
- Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Modena, Italy
- Nephrology, Dialysis and Transplant Unit, University Hospital of Modena, Modena, Italy
| | - Carlo Basile
- Division of Nephrology, Miulli General Hospital, Via Battisti 192, Acquaviva delle Fonti, 74121 Taranto, Italy
- Associazione Nefrologica Gabriella Sebastio, Martina Franca, Italy
| |
Collapse
|
11
|
Soffer S, Glicksberg BS, Zimlichman E, Efros O, Levin MA, Freeman R, Reich DL, Klang E. The association between obesity and peak antibody titer response in COVID-19 infection. Obesity (Silver Spring) 2021; 29:1547-1553. [PMID: 33945220 PMCID: PMC8242567 DOI: 10.1002/oby.23208] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/16/2021] [Accepted: 04/29/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Obesity is associated with severe coronavirus disease 2019 (COVID-19) infection. Disease severity is associated with a higher COVID-19 antibody titer. The COVID-19 antibody titer response of patients with obesity versus patients without obesity was compared. METHODS The data of individuals tested for COVID-19 serology at the Mount Sinai Health System in New York City between March 1, 2020, and December 14, 2021, were retrospectively retrieved. The primary outcome was peak antibody titer, assessed as a binary variable (1:2,880, which was the highest detected titer, versus lower than 1:2,880). In patients with a positive serology test, peak titer rates were compared between BMI groups (<18.5, 18.5 to 25, 25 to 30, 30 to 40, and ≥40 kg/m2 ). A multivariable logistic regression model was used to analyze the independent association between different BMI groups and peak titer. RESULTS Overall, 39,342 individuals underwent serology testing and had BMI measurements. A positive serology test was present in 12,314 patients. Peak titer rates were associated with obesity (BMI < 18.5 [34.5%], 18.5 to 25 [29.2%], 25 to 30 [37.7%], 30 to 40 [44.7%], ≥40 [52.0%]; p < 0.001). In a multivariable analysis, severe obesity had the highest adjusted odds ratio for peak titer (95% CI: 2.1-3.0). CONCLUSION COVID-19 neutralizing antibody titer is associated with obesity. This has implications on the understanding of the role of obesity in COVID-19 severity.
Collapse
Affiliation(s)
- Shelly Soffer
- Internal Medicine BAssuta Medical CenterAshdodIsrael
- Goldman Medical SchoolBen‐Gurion University of the NegevBe'er ShevaIsrael
| | - Benjamin S. Glicksberg
- Hasso Plattner Institute for Digital Health at Mount SinaiIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Department of Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Eyal Zimlichman
- Hospital managementSheba Medical CenterTel HashomerIsrael
- Sackler Medical SchoolTel Aviv UniversityTel AvivIsrael
- Sheba Talpiot Medical Leadership ProgramTel HashomerIsrael
| | - Orly Efros
- Sackler Medical SchoolTel Aviv UniversityTel AvivIsrael
- Thrombosis & Hemostasis UnitSheba Medical CenterTel HashomerIsrael
| | - Matthew A. Levin
- Department of Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Institute for Healthcare Delivery ScienceDepartment of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Department of AnesthesiologyPerioperative and Pain MedicineIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Robert Freeman
- Institute for Healthcare Delivery ScienceDepartment of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - David L. Reich
- Department of AnesthesiologyPerioperative and Pain MedicineIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Eyal Klang
- Sackler Medical SchoolTel Aviv UniversityTel AvivIsrael
- Sheba Talpiot Medical Leadership ProgramTel HashomerIsrael
- Department of Diagnostic ImagingSheba Medical CenterTel HashomerIsrael
| |
Collapse
|
12
|
The front-line during the coronavirus disease 2019 pandemic: healthcare personnel. Curr Opin Infect Dis 2021; 34:372-383. [PMID: 34227581 DOI: 10.1097/qco.0000000000000734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW An estimated four to 11% of reported coronavirus disease 2019 (COVID-19) cases occurs in healthcare personnel (HCP). HCP are at high risk of acquiring and transmitting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) given their close contact with individuals with recognized and unrecognized COVID-19. We summarize the literature to date describing the epidemiology, identifying risk factors associated with COVID-19, and analyzing clinical characteristics and outcomes of SARS-CoV-2 infection in HCP. RECENT FINDINGS The prevalence of SARS-CoV-2 antibodies among HCP ranges from 0.7 to 45%. Although there is heterogeneity in the seroprevalence rate reported in the literature, HCP may be at increased risk of SARS-CoV-2 infection from exposure to patients with COVID-19. The literature supports that this can be minimized with adequate personal protective equipment (PPE) supply, proper hand hygiene, appropriate PPE use, and other infection prevention measures. In addition, infections in HCP are commonly acquired in the community as well as in nonclinical care settings including break rooms or work rooms. SUMMARY While much focus has been on minimizing patient-to-HCP transmission of SARS-CoV-2, additional efforts are needed to prevent exposures in nonclinical care settings and in the community.
Collapse
|
13
|
Torres JP, Piñera C, De La Maza V, Lagomarcino AJ, Simian D, Torres B, Urquidi C, Valenzuela MT, O'Ryan M. Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Prevalence in Blood in a Large School Community Subject to a Coronavirus Disease 2019 Outbreak: A Cross-sectional Study. Clin Infect Dis 2021; 73:e458-e465. [PMID: 32649743 PMCID: PMC7454451 DOI: 10.1093/cid/ciaa955] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 07/07/2020] [Indexed: 01/22/2023] Open
Abstract
Background A SARS-CoV-2 outbreak affecting 52 people from a large school community in Santiago, Chile was identified (March 12), nine days after the first country case. We assessed the magnitude of the outbreak and the role students and staff played using a self-administered antibody detection test and survey. Methods The school was closed on March 13, and the entire community was placed under quarantine. We implemented a home-delivery, self-administered, IgG/IgM antibody test and survey to a classroom stratified sample of students and all staff from May 4-19. We aimed to determine overall seroprevalence rates by age group, reported symptoms, contact exposure and to explore dynamics of transmission. Results Antibody positivity rates were 9.9% (95%CI: 8.2-11.8) for 1,009 students and 16.6% (95%CI: 12.1-21.9) for 235 staff. Among students, positivity was associated with younger age (P=0.01), lower grade level (P=0.05), prior RT-PCR positivity (P=0.03), and history of contact with a confirmed case (P<0.001). Among staff, positivity was higher in teachers (P=0.01) and in those previously RT-PCR positive (P<0.001). Excluding RT-PCR positive individuals, antibody positivity was associated with fever in adults and children (P=0.02; P=0.002), abdominal pain in children (P=0.001), and chest pain in adults (P=0.02). Within antibody positive individuals, 40% of students and 18% of staff reported no symptoms (P=0.01). Conclusions Teachers were more affected during the outbreak and younger children were at higher infection risk, likely because index case(s) were teachers and/or parents from preschool. Self-administered antibody testing, supervised remotely, proved to be a suitable and rapid tool. Our study provides useful information for school re-openings.
Collapse
Affiliation(s)
- Juan Pablo Torres
- Departamento de Pediatría Oriente, Facultad de Medicina, Universidad de Chile, Providencia, Santiago, Chile
| | - Cecilia Piñera
- Departamento de Pediatría Sur, Facultad de Medicina, Universidad de Chile, San Miguel, Santiago, Chile
| | - Verónica De La Maza
- Dirección de Innovación, Facultad de Medicina, Universidad de Chile, Independencia, Santiago, Chile
| | - Anne J Lagomarcino
- Dirección de Innovación, Facultad de Medicina, Universidad de Chile, Independencia, Santiago, Chile
| | - Daniela Simian
- Subdirección de Investigación, Dirección Académica, Clínica Las Condes, Las Condes, Santiago, Chile
| | - Bárbara Torres
- Dirección de Innovación, Facultad de Medicina, Universidad de Chile, Independencia, Santiago, Chile
| | - Cinthya Urquidi
- Departamento de Salud Pública y Epidemiología, Facultad de Medicina, Universidad de Los Andes, Las Condes, Santiago, Chile
| | - María Teresa Valenzuela
- Departamento de Salud Pública y Epidemiología, Facultad de Medicina, Universidad de Los Andes, Las Condes, Santiago, Chile
| | - Miguel O'Ryan
- Programa de Microbiología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Independencia, Santiago, Chile.,Millenium Institute of Immunology and Immunotherapy, Faculty of Medicine, University of Chile, Santiago, Chile
| |
Collapse
|
14
|
Al-Maani A, Al Wahaibi A, Al-Sooti J, Al Abri B, Al Shukri I, AlRisi E, Al Abri L, AlDaghari K, Al Subhi M, AlMaqbali S, AlBurtamani S, AlAbri A, Al Salami A, Al-Beloushi I, Al-Zadjali N, Alqayoudhi A, Al-Kindi H, Al Shaqsi K, Al-Jardani A, Al-Abri S. The role of supporting services in driving SARS-CoV-2 transmission within healthcare settings: A multicenter seroprevalence study. Int J Infect Dis 2021; 107:257-263. [PMID: 33930541 PMCID: PMC8078034 DOI: 10.1016/j.ijid.2021.04.071] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/20/2021] [Accepted: 04/23/2021] [Indexed: 12/30/2022] Open
Abstract
Objective To determine the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in healthcare workers (HCWs) based on risk of exposure to COVID-19 patients. Method This was a SARS-CoV-2 seroprevalence cross-sectional study in risk-stratified HCWs randomly selected from three main district hospitals in Oman. Results 1078 HCWs were included, with an overall SARS-CoV-2 seroprevalence of 21%. The seropositivity rates in low-, variable-, and high-risk groups were 29%, 18%, and 17%, respectively (p-value < 0.001). The study found higher positivity in males (crude odds ratio [COR] 1.71, 95% confidence interval [CI] 1.28–2.3), and workers residing in high-prevalence areas (COR 2.09, 95% CI 1.42–3.07). Compared with doctors, workers from supporting services, administration staff, and nurses were more likely to test positive for SARS-CoV-2 antibodies (COR 9.81, 95% CI 5.26–18.27; 2.37, 95% CI 1.23–4.58; 2.08 95% CI 1.14–3.81). The overall rate of previously undetected infection was 12%, with higher values in low-risk HCWs. High district prevalence was a driving factor for seropositivity in the low-risk group (adjusted odds ratio [AOR] 2.36, 95% CI 1.0–5.59). Conclusion Low-risk supporting services workers can drive SARS-CoV-2 transmission in hospitals. More attention and innovation within this area will enhance the safety of health care during epidemics/pandemics.
Collapse
Affiliation(s)
- Amal Al-Maani
- Directorate-General for Diseases Surveillance and Control (DGDSC), MoH, Muscat, Oman; Department of Infection Prevention and Control, DGDSC, MoH, Muscat, Oman.
| | - Adil Al Wahaibi
- Directorate-General for Diseases Surveillance and Control (DGDSC), MoH, Muscat, Oman; Surveillance Department, DGDSC, MoH, Muscat, Oman
| | - Jabir Al-Sooti
- Directorate-General for Diseases Surveillance and Control (DGDSC), MoH, Muscat, Oman; Department of Infection Prevention and Control, DGDSC, MoH, Muscat, Oman
| | - Bader Al Abri
- Directorate-General for Diseases Surveillance and Control (DGDSC), MoH, Muscat, Oman; Surveillance Department, DGDSC, MoH, Muscat, Oman
| | - Intisar Al Shukri
- Directorate-General for Diseases Surveillance and Control (DGDSC), MoH, Muscat, Oman; Central Public Health Laboratory, DGDSC, MoH, Muscat, Oman
| | - Elham AlRisi
- Sohar Hospital, Governorate of North Batinah, Oman
| | | | | | | | | | | | - Asma AlAbri
- Sohar Hospital, Governorate of North Batinah, Oman
| | | | - Iman Al-Beloushi
- Directorate-General for Diseases Surveillance and Control (DGDSC), MoH, Muscat, Oman; Department of Infection Prevention and Control, DGDSC, MoH, Muscat, Oman
| | - Najla Al-Zadjali
- Directorate-General for Diseases Surveillance and Control (DGDSC), MoH, Muscat, Oman; Department of Infection Prevention and Control, DGDSC, MoH, Muscat, Oman
| | - Abdullah Alqayoudhi
- Directorate-General for Diseases Surveillance and Control (DGDSC), MoH, Muscat, Oman; Department of Infection Prevention and Control, DGDSC, MoH, Muscat, Oman
| | - Hanan Al-Kindi
- Directorate-General for Diseases Surveillance and Control (DGDSC), MoH, Muscat, Oman; Central Public Health Laboratory, DGDSC, MoH, Muscat, Oman
| | | | - Amina Al-Jardani
- Directorate-General for Diseases Surveillance and Control (DGDSC), MoH, Muscat, Oman; Central Public Health Laboratory, DGDSC, MoH, Muscat, Oman
| | - Seif Al-Abri
- Directorate-General for Diseases Surveillance and Control (DGDSC), MoH, Muscat, Oman
| |
Collapse
|
15
|
Papasavas P, Olugbile S, Wu U, Robinson K, Roberts AL, O'Sullivan DM, McLaughlin T, Mather JF, Steinberg AC, Orlando R, Kumar A. Seroprevalence of SARS-CoV-2 antibodies, associated epidemiological factors and antibody kinetics among healthcare workers in Connecticut. J Hosp Infect 2021; 114:117-125. [PMID: 33930487 PMCID: PMC8076763 DOI: 10.1016/j.jhin.2021.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) are at the front line of the ongoing coronavirus 2019 (COVID-19) pandemic. Comprehensive evaluation of the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) among HCWs in a large healthcare system could help to identify the impact of epidemiological factors and the presence of symptoms on the immune response to the infection over time. AIM To determine the seroprevalence of SARS-CoV-2-specific antibodies among HCWs, identify associated epidemiological factors and study antibody kinetics. METHODS A longitudinal evaluation of the seroprevalence and epidemiology of SARS-CoV-2-specific antibodies was undertaken in approximately 30,000 HCWs in the largest healthcare system in Connecticut, USA. FINDINGS At baseline, the prevalence of SARS-CoV-2 antibody among 6863 HCWs was 6.3% [95% confidence interval (CI) 5.7-6.9%], and was highest among patient care support (16.7%), medical assistants (9.1%) and nurses (8.2%), and lower for physicians (3.8%) and advanced practice providers (4.5%). Seroprevalence was significantly higher among African Americans [odds ratio (OR) 3.26 compared with Caucasians, 95% CI 1.77-5.99], in participants with at least one symptom of COVID-19 (OR 3.00, 95% CI 1.92-4.68), and in those reporting prior quarantine (OR 3.83, 95% CI 2.57-5.70). No symptoms were reported in 24% of seropositive participants. Among the 47% of participants who returned for a follow-up serological test, the seroreversion rate was 39.5% and the seroconversion rate was 2.2%. The incidence of re-infection in the seropositive group was zero. CONCLUSION Although there is a decline in the immunoglobulin G antibody signal over time, 60.5% of seropositive HCWs had maintained their seroconversion status after a median of 5.5 months.
Collapse
Affiliation(s)
- P Papasavas
- Department of Surgery, Hartford Hospital, Hartford, CT, USA.
| | - S Olugbile
- Cancer Institute, Hartford HealthCare, Hartford, CT, USA
| | - U Wu
- Administration, Hartford HealthCare, Hartford, CT, USA
| | - K Robinson
- Department of Emergency Medicine, Hartford Hospital, Hartford, CT, USA
| | - A L Roberts
- Department of Clinical Laboratory Services: Microbiology, Hartford HealthCare, Hartford, CT, USA
| | | | - T McLaughlin
- Department of Surgery, Hartford Hospital, Hartford, CT, USA
| | - J F Mather
- Hartford Healthcare Research Program, Hartford, CT, USA
| | - A C Steinberg
- Department of Medical Affairs, Hartford HealthCare, Hartford, CT, USA
| | - R Orlando
- Department of Academic Affairs, Hartford HealthCare, Hartford, CT, USA
| | - A Kumar
- Clinical Affairs, Hartford HealthCare, Hartford, CT, USA
| |
Collapse
|
16
|
Abstract
Background Chronic kidney disease patients show a high mortality in cases of a severe acute respiratory syndrome coronavirus-2 (SARS-CoV‑2) infection. Thus, information on the sero-status of nephrology personnel might be crucial for patient protection; however, limited information exists about the presence of SARS-CoV‑2 antibodies in asymptomatic individuals. Methods We examined the seroprevalence of SARS-CoV‑2 IgG and IgM antibodies among healthcare workers of a tertiary care kidney center during the the first peak phase of the corona virus disease 2019 (COVID-19) crisis in Austria using an orthogonal test strategy and a total of 12 commercial nucleocapsid protein or spike glycoprotein-based assays as well as Western blotting and a neutralization assay. Results At baseline 60 of 235 study participants (25.5%, 95% confidence interval, CI 20.4–31.5%) were judged to be borderline positive or positive for IgM or IgG using a high sensitivity/low specificity threshold in one test system. Follow-up analysis after about 2 weeks revealed IgG positivity in 12 (5.1%, 95% CI: 2.9–8.8%) and IgM positivity in 6 (2.6%, 95% CI: 1.1–5.6) in at least one assay. Of the healthcare workers 2.1% (95% CI: 0.8–5.0%) showed IgG nucleocapsid antibodies in at least 2 assays. By contrast, positive controls with proven COVID-19 showed antibody positivity among almost all test systems. Moreover, serum samples obtained from healthcare workers did not show SARS-CoV‑2 neutralizing capacity, in contrast to positive controls. Conclusion Using a broad spectrum of antibody tests the present study revealed inconsistent results for SARS-CoV‑2 seroprevalence among asymptomatic individuals, while this was not the case among COVID-19 patients. Trial registration number CONEC, ClinicalTrials.gov number NCT04347694 Supplementary Information The online version of this article (10.1007/s00508-021-01848-5) contains supplementary material, which is available to authorized users.
Collapse
|
17
|
Seroprevalence of hospital staff in a province with zero COVID-19 cases. PLoS One 2021; 16:e0238088. [PMID: 33793556 PMCID: PMC8016267 DOI: 10.1371/journal.pone.0238088] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 03/04/2021] [Indexed: 12/31/2022] Open
Abstract
Background COVID-19 seroprevalence data, particularly in less developed countries with a relatively low incidence, has been scant. We aimed to explore the seroprevalence of hospital staff in the area with zero confirmed COVID-19 case to shed light on the situation of COVID-19 infection in zero or low infection rate countries where mass screening was not readily available. Methods A locally developed rapid immunoglobulin M (IgM)/immunoglobulin G (IgG) test kit was used for hospital staff screening of Ranong hospital which is located in a province with zero COVID-19 prevalence in Thailand from 17th April to 17th May 2020. All staff was tested, 100 of which were randomly invited to have a repeating antibody test in one month. (Thai Clinical Trials Registry: TCTR20200426002) Results Of 844 hospital staff, 82 were tested twice one month apart (response rate for repeating antibody test 82%). Overall, 0.8% of the participants (7 of 844) had positive IgM, none had positive IgG. Female staff had 1.0% positive IgM (95% CI: 0.5–2.1%) while male had 0.5% positive IgM (95% CI: 0.1–2.6%). No participants with a history of travel to the high-risk area or close contact with PCR-confirmed COVID-19 case developed SARS-CoV-2 antibodies. Among 844 staff, 811 had no symptoms and six of them developed IgM seropositive (0.7%) while 33 had minor symptoms and only one of them developed IgM seropositive (3.0%). No association between SARS-CoV-2 IgM status and gender, history of travel to a high-risk area, close contact with PCR-confirmed or suspected COVID-19 case, presence of symptoms within 14 days, or previous PCR status was found. None of the hospital staff developed SARS-CoV-2 IgG. Conclusions COVID-19 antibody test could detect a considerable number of hospital staff who could be potential silent spreaders in a province with zero COVID-19 cases. Accurate antibody testing is a valuable screening tool, particularly in asymptomatic healthcare workers. Trial registration: This study was approved by the Institutional Review Board of Chulalongkorn University (IRB No.236/63) and the Institutional Review Board of Ranong Hospital. (Thai Clinical Trials Registry: TCTR20200426002).
Collapse
|
18
|
Lazzerini M, Sforzi I, Trapani S, Biban P, Silvagni D, Villa G, Tibaldi J, Bertacca L, Felici E, Perricone G, Parrino R, Gioè C, Lega S, Conte M, Marchetti F, Magista A, Berlese P, Martelossi S, Vaienti F, Valletta E, Mauro M, Dall'Amico R, Fasoli S, Gatto A, Chiaretti A, Dragovic D, Pascolo P, Pilotto C, Liguoro I, Miorin E, Saretta F, Trobia GL, Di Stefano A, Orlandi A, Cardinale F, Lubrano R, Testa A, Binotti M, Moressa V, Barbi E, Armocida B, Mariani I. Characteristics and risk factors for SARS-CoV-2 in children tested in the early phase of the pandemic: a cross-sectional study, Italy, 23 February to 24 May 2020. Euro Surveill 2021; 26:2001248. [PMID: 33834960 PMCID: PMC8034058 DOI: 10.2807/1560-7917.es.2021.26.14.2001248] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/19/2020] [Indexed: 12/14/2022] Open
Abstract
BackgroundVery few studies describe factors associated with COVID-19 diagnosis in children.AimWe here describe characteristics and risk factors for COVID-19 diagnosis in children tested in 20 paediatric centres across Italy.MethodsWe included cases aged 0-18 years tested between 23 February and 24 May 2020. Our primary analysis focused on children tested because of symptoms/signs suggestive of COVID-19.ResultsAmong 2,494 children tested, 2,148 (86.1%) had symptoms suggestive of COVID-19. Clinical presentation of confirmed COVID-19 cases included besides fever (82.4%) and respiratory signs or symptoms (60.4%) also gastrointestinal (18.2%), neurological (18.9%), cutaneous (3.8%) and other unspecific influenza-like presentations (17.8%). In multivariate analysis, factors significantly associated with SARS-CoV-2 positivity were: exposure history (adjusted odds ratio (AOR): 39.83; 95% confidence interval (CI): 17.52-90.55; p < 0.0001), cardiac disease (AOR: 3.10; 95% CI: 1.19-5.02; p < 0.0001), fever (AOR: 3.05%; 95% CI: 1.67-5.58; p = 0.0003) and anosmia/ageusia (AOR: 4.08; 95% CI: 1.69-9.84; p = 0.002). Among 190 (7.6%) children positive for SARS-CoV-2, only four (2.1%) required respiratory support and two (1.1%) were admitted to intensive care; all recovered.ConclusionRecommendations for SARS-CoV-2 testing in children should consider the evidence of broader clinical features. Exposure history, fever and anosmia/ageusia are strong risk factors in children for positive SARS-CoV-2 testing, while other symptoms did not help discriminate positive from negative individuals. This study confirms that COVID-19 was a mild disease in the general paediatric population in Italy. Further studies are needed to understand risk, clinical spectrum and outcomes of COVID-19 in children with pre-existing conditions.
Collapse
Affiliation(s)
- Marzia Lazzerini
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Idanna Sforzi
- Department of Pediatric Emergency Medicine and Trauma Center, Meyer Children's University Hospital, Florence, Italy
| | - Sandra Trapani
- Department of Health Sciences and Meyer Children's University Hospital, Florence, Italy
| | - Paolo Biban
- Department of Neonatal and Paediatric Critical Care, Verona University Hospital, Verona Italy
| | - Davide Silvagni
- Department of Neonatal and Paediatric Critical Care, Verona University Hospital, Verona Italy
| | - Giovanna Villa
- Pediatric Emergency Unit, IRCCS Gaslini Children's Hospital, Genoa, Italy
| | - Jessica Tibaldi
- Pediatric Emergency Unit, IRCCS Gaslini Children's Hospital, Genoa, Italy
| | - Luca Bertacca
- Pediatric Emergency Unit and Department of Pediatric and Neonatology, Misericordia Hospital, Grosseto, Italy
| | - Enrico Felici
- Pediatric and Pediatric Emergency Unit, The Children Hospital, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Giuseppina Perricone
- Pediatric and Pediatric Emergency Unit, The Children Hospital, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Roberta Parrino
- Pediatria d'Urgenza e Pronto Soccorso P.O.G. Di Cristina, Palermo, Italy
| | - Claudia Gioè
- Pediatric Infectious diseases, P.O.G. Di Cristina, Palermo, Italy
| | - Sara Lega
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Mariasole Conte
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | | | | | - Paola Berlese
- Department of Pediatrics, Treviso Hospital, Treviso, Italy
| | | | - Francesca Vaienti
- Department of Pediatrics, G.B. Morgagni-L. Pierantoni Hospital, Forlì, Italy
| | - Enrico Valletta
- Department of Pediatrics, G.B. Morgagni-L. Pierantoni Hospital, Forlì, Italy
| | - Margherita Mauro
- Department of Pediatrics and Neonatology, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | - Roberto Dall'Amico
- Department of Pediatrics and Neonatology, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | | | - Antonio Gatto
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Chiaretti
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Danica Dragovic
- Department of Pediatrics, San Polo Hospital, ASUGI, Monfalcone (GO), Italy
| | - Paola Pascolo
- Department of Pediatrics, San Polo Hospital, ASUGI, Monfalcone (GO), Italy
| | - Chiara Pilotto
- Division of Paediatrics, Department of Medicine DAME, Academic Hospital Santa Maria della Misericordia, University of Udine, Udine, Italy
| | - Ilaria Liguoro
- Division of Paediatrics, Department of Medicine DAME, Academic Hospital Santa Maria della Misericordia, University of Udine, Udine, Italy
| | | | | | - Gian Luca Trobia
- Pediatric and Pediatric Emergency Room Unit Cannizzaro Emergency Hospital, Catania, Italy
| | - Antonella Di Stefano
- Pediatric and Pediatric Emergency Room Unit Cannizzaro Emergency Hospital, Catania, Italy
| | - Azzurra Orlandi
- Giovanni XXIII Pediatric Hospital, Department of Pediatrics, University of Bari, Bari, Italy
| | - Fabio Cardinale
- Giovanni XXIII Pediatric Hospital, Department of Pediatrics, University of Bari, Bari, Italy
| | - Riccardo Lubrano
- Department of Pediatrics Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy
| | - Alessia Testa
- Department of Pediatrics Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy
| | - Marco Binotti
- Neonatal and Pediatric Intensive Care Unit, Maggiore della Carità University Hospital, Novara, Italy
| | - Valentina Moressa
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Egidio Barbi
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
- University of Trieste, Trieste, Italy
| | - Benedetta Armocida
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Ilaria Mariani
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| |
Collapse
|
19
|
Etemadi J, Bordbar S, Soltani-Zangbar MS, Hajivalili M, Aghebati-Maleki L, Motavalli R, Mahmoodpoor A, Shahmohammadi-Farid S, Abedi Azar S, Niknafs B, Roshangar L, Babaloo Z, Ahmadian Heris J, Hosseini M, Shareghi-Oskoue O, Parhizkar F, Khosroshahi HT, Yousefi M. Prevalence of SARS-CoV-2 Specific Antibodies in Asymptomatic Hemodialysis Patients. Immunol Invest 2021; 51:993-1004. [PMID: 33752550 DOI: 10.1080/08820139.2021.1899202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background: Since the outbreak of the new coronavirus pandemic, the importance of carrying out an infection check to prevent acquisition and transmission among end-stage renal disease patients (ESRD) under maintenance hemodialysis (MHD) has become a major concern in the health care system. Applying serology screening tests could enlighten the view with regards to disease prevalence in dialysis wards.Methods: We subjected 328 end-stage renal disease patients to maintenance hemodialysis. After dividing patients into suspicious and non-suspicious groups for COVID-19 infection based on their clinical manifestation, they were investigated for SARS-CoV-2 specific IgM and IgG screening against nucleoprotein (NP), spike protein (SP), and receptor-binding domain (RBD), utilizing our recently developed ELISA tests.Results: We found that approximately 10.1% of asymptomatically tested cases were antibody positive. Although IgG positivity showed a higher prevalence than IgM across all three virus antigen subunits, there were no significant differences among mentioned immunoglobulins of the studied groups. The most prevalent antibody was from the IgG subtype against virus nucleoprotein (NP), while the lowest prevalence was attributed to receptor-binding domain (RBD) IgM.Conclusion: High seropositive rate among asymptomatic end-stage renal disease patients, as a sample of high-risk population, reflected the importance of considering SARS-CoV-2 specific antibody screening for disease containment.
Collapse
Affiliation(s)
- Jalal Etemadi
- Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shima Bordbar
- Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Sadegh Soltani-Zangbar
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahsa Hajivalili
- Department of Immunology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Roza Motavalli
- Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ata Mahmoodpoor
- Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sima Shahmohammadi-Farid
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sima Abedi Azar
- Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahram Niknafs
- Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Roshangar
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zohreh Babaloo
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Javad Ahmadian Heris
- Department of Allergy and Clinical Immunology, Pediatric Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Hosseini
- Department of Immunology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | | | - Forough Parhizkar
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mehdi Yousefi
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
20
|
Mishra M, Chaudhry R, Rana F, Nag DS, Rai S. Serosurveillance of Health Care Workers in a COVID Hospital: Immune Response, and Its Longevity. Cureus 2021; 13:e14020. [PMID: 33898113 PMCID: PMC8057696 DOI: 10.7759/cureus.14020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective: We aimed to study the seroprevalence of coronavirus disease 2019 (COVID-19) and sustainability of the immune response in health care workers (HCWs). A cross-sectional study was conducted between October 7 and November 30, 2020, in a multi-specialty hospital in Eastern India designated as COVID hospital during this pandemic. Study participants included 2,110 HCWs, including those who have recovered from COVID infection. Method: HCWs were required to complete a questionnaire and give written consent to participate in the study. Their venous blood sample was collected for serum analysis of IgG antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by chemiluminescent immunoassay. Results: Positive IgG antibodies were seen in 924 participants with a point prevalence of 43.79%. Slightly higher reactivity was seen in males. History of COVID-19 infection was noted in 10.9%, with the highest antibody response in 81% cases. A maximum of 87.9% reactivity was seen in the first two months, and a significant fall was noted in the fourth month, with reactivity seen in only 50% of the study participants. Conclusion: SARS-CoV-2 infection is associated with a variable immune response in the infected population. The declining trend of the antibodies correlates with short-lived protective immunity and the possibility of re-infection. Further studies are needed to explore the probable reasons for varied seroprevalence.
Collapse
Affiliation(s)
| | | | - Farah Rana
- Pathology, Tata Main Hospital, Jamshedpur, IND
| | | | - Sudhir Rai
- Surgery, Tata Main Hospital, Jamshedpur, IND
| |
Collapse
|
21
|
Khatri M, Islam S, Dutka P, Carson J, Drakakis J, Imbriano L, Jawaid I, Mehta T, Miyawaki N, Wu E, Yang S, Ali N, Divers J, Grant C, Masani N. COVID-19 Antibodies and Outcomes among Outpatient Maintenance Hemodialysis Patients. KIDNEY360 2021; 2:263-269. [PMID: 35373027 PMCID: PMC8740990 DOI: 10.34067/kid.0006292020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 12/09/2020] [Indexed: 02/04/2023]
Abstract
Background Patients on maintenance hemodialysis are particularly vulnerable to infection and hospitalization from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Due to immunocompromised patients and the clustering that occurs in outpatient dialysis units, the seroprevalence of COVID-19 antibodies in this population is unknown and has significant implications for public health. Also, little is known about their risk factors for hospitalization. Methods Three outpatient maintenance hemodialysis units affiliated with a major teaching hospital in the New York area were studied. We determined rates of SARS-CoV-2 positivity via nasopharyngeal, real-time, reverse-transcriptase PCR (RT-PCR); SARS-CoV-2 IgG seropositivity; hospitalization; and mortality. Results Of 367 patients, 28% had either SARS-CoV-2 seropositivity or PCR positivity. Prevalence across the three respective units was 7%, 32%, and 70%. Those who were either antibody or PCR positive were significantly younger (65 versus 69 years, P=0.05), and had a higher prevalence of Black race (43% versus 30%, P=0.001) and Hispanic ethnicity (32% versus 12%, P<0.001) compared with those who tested negative. Higher positivity rates were also observed among those who took taxis and ambulettes to and from dialysis, compared with those who used personal transportation. Antibodies were detected in all of the patients with a positive PCR result who underwent serologic testing. Of those that were seropositive, 32% were asymptomatic. The hospitalization rate on the basis of either antibody or PCR positivity was 35%, with a hospital mortality rate of 33%. Aside from COPD, no other variables were more prevalent in patients who were hospitalized. Conclusions We observed significant differences in rates of COVID-19 infection within three outpatient dialysis units, with universal seroconversion. Among patients with ESKD, rates of asymptomatic infection appear to be high, as do hospitalization and mortality rates.
Collapse
Affiliation(s)
- Minesh Khatri
- Division of Nephrology, Department of Medicine, New York University Long Island School of Medicine, Mineola, New York
| | - Shahidul Islam
- New York University Winthrop Research Institute, New York University Long Island School of Medicine, Mineola, New York
| | - Paula Dutka
- Division of Nephrology, Department of Medicine, New York University Long Island School of Medicine, Mineola, New York
| | - John Carson
- Division of Nephrology, Department of Medicine, New York University Long Island School of Medicine, Mineola, New York
| | - James Drakakis
- Division of Nephrology, Department of Medicine, New York University Long Island School of Medicine, Mineola, New York
| | - Louis Imbriano
- Division of Nephrology, Department of Medicine, New York University Long Island School of Medicine, Mineola, New York
| | - Imran Jawaid
- Division of Nephrology, Department of Medicine, New York University Long Island School of Medicine, Mineola, New York
| | - Tapan Mehta
- Division of Nephrology, Department of Medicine, New York University Long Island School of Medicine, Mineola, New York
| | - Nobuyuki Miyawaki
- Division of Nephrology, Department of Medicine, New York University Long Island School of Medicine, Mineola, New York
| | - Elain Wu
- Division of Nephrology, Department of Medicine, New York University Long Island School of Medicine, Mineola, New York
| | - Stephen Yang
- Division of Nephrology, Department of Medicine, New York University Long Island School of Medicine, Mineola, New York
| | - Nicole Ali
- Division of Nephrology, Department of Medicine, New York University Grossman School of Medicine, New York, New York
| | - Jasmin Divers
- New York University Winthrop Research Institute, New York University Long Island School of Medicine, Mineola, New York
| | - Candace Grant
- Division of Nephrology, Department of Medicine, New York University Long Island School of Medicine, Mineola, New York
| | - Naveed Masani
- Division of Nephrology, Department of Medicine, New York University Long Island School of Medicine, Mineola, New York
| |
Collapse
|
22
|
Canas JJ, Starr MC, Hooks J, Arregui S, Wilson AC, Carroll AE, Saxena V, Amanat F, Krammer F, Fill J, Schade A, Chambers A, Schneider J, Schwaderer AL, Hains DS. Longitudinal SARS-CoV-2 seroconversion and functional heterogeneity in a pediatric dialysis unit. Kidney Int 2021; 99:484-486. [PMID: 33509357 PMCID: PMC7830216 DOI: 10.1016/j.kint.2020.11.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/28/2020] [Accepted: 11/03/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Jorge J Canas
- Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA; Department of Microbiology and Immunology, Indiana University, Indianapolis, Indiana, USA
| | - Michelle C Starr
- Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - Jenaya Hooks
- Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - Samuel Arregui
- Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - Amy C Wilson
- Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - Aaron E Carroll
- Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - Vijay Saxena
- Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - Fatima Amanat
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jeffrey Fill
- Clinical Diagnostics Laboratory, Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Andrew Schade
- Clinical Diagnostics Laboratory, Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Antonio Chambers
- Clinical Diagnostics Laboratory, Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Jack Schneider
- Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | | | - David S Hains
- Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA; Department of Microbiology and Immunology, Indiana University, Indianapolis, Indiana, USA.
| |
Collapse
|
23
|
Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Seroprevalence of SARS-CoV-2 antibodies and associated factors in healthcare workers: a systematic review and meta-analysis. J Hosp Infect 2021; 108:120-134. [PMID: 33212126 PMCID: PMC7668234 DOI: 10.1016/j.jhin.2020.11.008] [Citation(s) in RCA: 215] [Impact Index Per Article: 71.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 11/10/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Healthcare workers (HCWs) represent a high-risk population for infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). AIM To determine the seroprevalence of SARS-CoV-2 antibodies among HCWs, and identify the factors associated with this seroprevalence. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were applied for this systematic review and meta-analysis. Databases including PubMed/MEDLINE and preprint services (medRχiv and bioRχiv) were searched from inception to 24th August 2020. FINDINGS Forty-nine studies including 127,480 HCWs met the inclusion criteria. The estimated overall seroprevalence of SARS-CoV-2 antibodies among HCWs was 8.7% (95% confidence interval 6.7-10.9%). Seroprevalence was higher in studies conducted in North America (12.7%) compared with those conducted in Europe (8.5%), Africa (8.2) and Asia (4%). Meta-regression showed that increased sensitivity of antibody tests was associated with increased seroprevalence. The following factors were associated with seropositivity: male gender; Black, Asian and Hispanic HCWs; work in a coronavirus disease 2019 (COVID-19) unit; patient-related work; front-line HCWs; healthcare assistants; shortage of personal protective equipment; self-reported belief of previous SARS-CoV-2 infection; previous positive polymerase chain reaction test; and household contact with suspected or confirmed cases of COVID-19. CONCLUSION The seroprevalence of SARS-CoV-2 antibodies among HCWs is high. Excellent adherence to infection prevention and control measures; sufficient and adequate personal protective equipment; and early recognition, identification and isolation of HCWs infected with SARS-CoV-2 are imperative to decrease the risk of SARS-CoV-2 infection.
Collapse
Affiliation(s)
- P Galanis
- Faculty of Nursing, Centre for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece.
| | - I Vraka
- Department of Radiology, P & A Kyriakou Children's Hospital, Athens, Greece
| | - D Fragkou
- Faculty of Nursing, Centre for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
| | - A Bilali
- Hospital Waste Management Unit, P & A Kyriakou Children's Hospital, Athens, Greece
| | - D Kaitelidou
- Faculty of Nursing, Centre for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
24
|
Mostafa A, Kandil S, El-Sayed MH, Girgis S, Hafez H, Yosef M, Saber S, Ezzelarab H, Ramadan M, Algohary E, Fahmy G, Afifi I, Hassan F, Elsayed S, Reda A, Fattuh D, Mahmoud A, Mansour A, Sabry M, Habeb P, Ebeid FS, Elanwar A, Saleh A, Mansour O, Omar A, El-Meteini M. SARS-CoV-2 seroconversion among 4040 Egyptian healthcare workers in 12 resource-limited healthcare facilities: A prospective cohort study. Int J Infect Dis 2021; 104:534-542. [PMID: 33484863 PMCID: PMC7817419 DOI: 10.1016/j.ijid.2021.01.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/31/2020] [Accepted: 01/10/2021] [Indexed: 12/21/2022] Open
Abstract
Background We examined Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) seroconversion incidence and risk factors 21 days after baseline screening among healthcare workers (HCWs) in a resource-limited setting. Methods A prospective cohort study of 4040 HCWs took place at 12 university healthcare facilities in Cairo, Egypt; April-June 2020. Follow-up exposure and clinical data were collected through online survey. SARS-CoV-2 testing was done using rapid IgM and IgG serological tests and reverse transcriptase–polymerase chain reaction (RT-PCR) for those with positive serology. Cox proportional hazards modelling was used to estimate adjusted hazard ratios (HR) of seroconversion. Results 3870/4040 (95.8%) HCWs tested negative for IgM, IgG and PCR at baseline; 2282 (59.0%) returned for 21-day follow-up. Seroconversion incidence (positive IgM and/or IgG) was 100/2282 (4.4%, 95% CI:3.6-5.3), majority asymptomatic (64.0%); daily hazard of 0.21% (95% CI:0.17-0.25)/48 746 person-days of follow-up. Seroconversion was: 4.0% (64/1596; 95% CI:3.1-5.1) among asymptomatic; 5.3% (36/686; 95% CI:3.7-7.2) among symptomatic HCWs. Seroconversion was independently associated with older age; lower education; contact with a confirmed case >15 min; chronic kidney disease; pregnancy; change/loss of smell; and negatively associated with workplace contact. Conclusions Most seroconversions were asymptomatic, emphasizing need for regular universal testing. Seropositivity was three-fold that observed at baseline. Cumulative infections increased nationally by a similar rate, suggesting HCW infections reflect community not nosocomial transmission.
Collapse
Affiliation(s)
- Aya Mostafa
- Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Sahar Kandil
- Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Manal H El-Sayed
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt; Clinical Research Center (MASRI-CRC), Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Samia Girgis
- Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hala Hafez
- Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mostafa Yosef
- Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Saly Saber
- Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hoda Ezzelarab
- Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Marwa Ramadan
- Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Eman Algohary
- Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; Ain Shams University Specialized Hospitals, Egypt
| | - Gehan Fahmy
- Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; Ain Shams University Specialized Hospitals, Egypt
| | - Iman Afifi
- Infection Control Unit, Ain Shams University Hospitals, Cairo, Egypt
| | | | - Shaimaa Elsayed
- Infection Control Unit, Ain Shams University Hospitals, Cairo, Egypt
| | - Amira Reda
- Infection Control Unit, Ain Shams University Hospitals, Cairo, Egypt
| | - Doaa Fattuh
- Infection Control Unit, Ain Shams University Hospitals, Cairo, Egypt
| | - Asmaa Mahmoud
- Infection Control Unit, Ain Shams University Hospitals, Cairo, Egypt
| | - Amany Mansour
- Infection Control Unit, Ain Shams University Hospitals, Cairo, Egypt
| | - Moshira Sabry
- Infection Control Unit, Ain Shams University Hospitals, Cairo, Egypt
| | - Petra Habeb
- Infection Control Unit, Ain Shams University Hospitals, Cairo, Egypt
| | - Fatma Se Ebeid
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt; Clinical Research Center (MASRI-CRC), Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ali Elanwar
- Ain Shams University Specialized Hospitals, Egypt; Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ayman Saleh
- Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ossama Mansour
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ashraf Omar
- Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mahmoud El-Meteini
- Department of Hepatobiliary Surgery & Liver Transplantation, Ain Shams Center for Organ Transplantation (ASCOT), Faculty of Medicine, Ain Shams University, Cairo, Egypt
| |
Collapse
|
25
|
Affiliation(s)
- Robert T Schooley
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, San Diego, CA
| | - Ferric C Fang
- Departments of Laboratory Medicine and Pathology, and Microbiology, University of Washington, Seattle, WA
| |
Collapse
|
26
|
Gómez-Ochoa SA, Franco OH, Rojas LZ, Raguindin PF, Roa-Díaz ZM, Wyssmann BM, Guevara SLR, Echeverría LE, Glisic M, Muka T. COVID-19 in Health-Care Workers: A Living Systematic Review and Meta-Analysis of Prevalence, Risk Factors, Clinical Characteristics, and Outcomes. Am J Epidemiol 2021; 190:161-175. [PMID: 32870978 PMCID: PMC7499478 DOI: 10.1093/aje/kwaa191] [Citation(s) in RCA: 415] [Impact Index Per Article: 138.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/25/2020] [Accepted: 08/28/2020] [Indexed: 12/16/2022] Open
Abstract
Health care workers (HCW) are at the frontline response to the new coronavirus disease 2019 (COVID-19), being at a higher risk of acquiring the disease, and subsequently, exposing patients and colleagues. Searches in eight bibliographic databases were performed to systematically review the evidence on the prevalence, risk factors, clinical characteristics, and prognosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among HCW. Ninety-seven studies (All published in 2020), including 230,398 HCW, met the inclusion criteria. From the screened HCW using RT-PCR and the presence of antibodies, the estimated prevalence of SARS-CoV-2 infection was 11% (95%CI; 7%-15%) and 7% (95% CI; 4%-11%), respectively. The most frequently affected personnel were the nurses (48%. 95%CI; 41%-56%), while most of the COVID-19 positive medical personnel were working in hospitalization/non-emergency wards during the screening (43%, 95%CI;28%-59%). Anosmia, fever and myalgia were identified as the only symptoms associated with HCW SARS-CoV-2 positivity. Among RT-PCR positive HCW, 40% (95%CI;17%-65%) did not show symptoms at the time of diagnosis. Finally, 5% (95%CI;3%-8%) of the COVID-19 positive HCW developed severe clinical complications, and 0.5% (95% CI; 0.02%-1.3%) died. HCW suffer a significant burden from COVID-19, with HCW working in hospitalization/non-emergency wards and nurses being the most infected personnel.
Collapse
Affiliation(s)
- Sergio Alejandro Gómez-Ochoa
- Research Division, Cardiovascular Foundation of Colombia, Floridablanca, Colombia
- Public Health and Epidemiological Studies Group, Cardiovascular Foundation of Colombia, Floridablanca, Colombia
| | - Oscar H Franco
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Lyda Z Rojas
- Research Division, Cardiovascular Foundation of Colombia, Floridablanca, Colombia
- Research Group and Development of Nursing Knowledge (GIDCEN-FCV), Research Institute, Cardiovascular Foundation of Colombia, Floriadablanca, Santander, Colombia
| | - Peter Francis Raguindin
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Institute of Child Health and Human Development (ICHHD), National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Zayne Milena Roa-Díaz
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Research Group and Development of Nursing Knowledge (GIDCEN-FCV), Research Institute, Cardiovascular Foundation of Colombia, Floriadablanca, Santander, Colombia
| | - Beatrice Minder Wyssmann
- Public Health & Primary Care Library, University Library of Bern, University of Bern, Bern, Switzerland
| | | | | | - Marija Glisic
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Taulant Muka
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Correspondence to Dr. Taulant Muka, MD, MPH, PhD; Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland (e-mail: )
| |
Collapse
|
27
|
Crisci T, Arregui S, Canas J, Hooks J, Chan M, Powers C, Schwaderer AL, Hains DS, Starr MC. Placement on COVID-19 Units Does Not Increase Seroconversion Rate of Pediatric Graduate Medical Residents. Front Pediatr 2021; 9:633082. [PMID: 33996685 PMCID: PMC8116566 DOI: 10.3389/fped.2021.633082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/02/2021] [Indexed: 01/02/2023] Open
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated disease COVID-19 (coronavirus disease 2019) has presented graduate medical education (GME) training programs with a unique set of challenges. One of the most pressing is how should hospital systems that rely on graduate medical residents provide appropriate care for patients while protecting trainees. This question is of particular concern as healthcare workers are at high risk of SARS-CoV-2 exposure. Objective: This cross-sectional study sought to assess the impact of hospital COVID-19 patient placement on pediatric graduate medical residents by comparing rates of SARS-CoV-2 seroconversion rates of residents who worked on designated COVID-19 teams and those who did not. Methods: Forty-four pediatric and medicine-pediatric residents at Riley Children's Hospital (Indianapolis, IN) were tested for SARS-CoV-2 immunoglobulin M (IgM) and IgG seroconversion in May 2020 using enzyme-linked immunosorbent assays (Abnova catalog no. KA5826), 2 months after the first known COVID-19 case in Indiana. These residents were divided into two groups: those residents who worked on designated COVID-19 teams, and those who did not. Groups were compared using χ2 or Fisher exact test for categorical variables, and continuous variables were compared using Student t testing. Results: Forty-four of 104 eligible residents participated in this study. Despite high rates of seroconversion, there was no difference in the risk of SARS-CoV-2 seroconversion between residents who worked on designated COVID-19 teams (26% or 8/31) and those who did not (31% or 4/13). Eleven of 44 residents (25%) tested positive for SARS-CoV-2 IgG, whereas only 5/44 (11.4%) tested positive for SARS-CoV-2 IgM, without a detectable difference between exposure groups. Conclusion: We did not observe a difference in SARS-CoV-2 seroconversion between different exposure groups. These data are consistent with growing evidence supporting the efficacy of personal protective equipment. Further population-based research on the role of children in transmitting the SARS-CoV-2 virus is needed to allow for a more evidence-based approach toward managing the COVID-19 pandemic.
Collapse
Affiliation(s)
- Timothy Crisci
- Medicine-Pediatric Residency, Indiana University, Indianapolis, IN, United States
| | - Samuel Arregui
- Division of Nephrology, Department of Pediatrics, Indiana University, Indianapolis, IN, United States
| | - Jorge Canas
- Division of Nephrology, Department of Pediatrics, Indiana University, Indianapolis, IN, United States
| | - Jenaya Hooks
- Division of Nephrology, Department of Pediatrics, Indiana University, Indianapolis, IN, United States
| | - Melvin Chan
- Medicine-Pediatric Residency, Indiana University, Indianapolis, IN, United States
| | - Cory Powers
- Medicine-Pediatric Residency, Indiana University, Indianapolis, IN, United States
| | - Andrew L Schwaderer
- Division of Nephrology, Department of Pediatrics, Indiana University, Indianapolis, IN, United States
| | - David S Hains
- Division of Nephrology, Department of Pediatrics, Indiana University, Indianapolis, IN, United States
| | - Michelle C Starr
- Division of Nephrology, Department of Pediatrics, Indiana University, Indianapolis, IN, United States
| |
Collapse
|
28
|
Batchi-Bouyou AL, Lobaloba Ingoba L, Ndounga M, Vouvoungui JC, Mfoutou Mapanguy CC, Boumpoutou KR, Ntoumi F. High SARS-CoV-2 IgG/IGM seroprevalence in asymptomatic Congolese in Brazzaville, the Republic of Congo. Int J Infect Dis 2020; 106:3-7. [PMID: 33370565 PMCID: PMC7833234 DOI: 10.1016/j.ijid.2020.12.065] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION The Republic of the Congo detected its first case of coronavirus disease 2019 (COVID-19) on March 14, 2020, and within several weeks, the country had introduced protective measures that were still in force in July 2020. Over the course of time, the progression in the number of clinical cases has appeared to be lower than expected, although reverse transcription polymerase chain reaction (RT-PCR) testing has been somewhat limited. In order to evaluate the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within the Congolese population, a seroprevalence study was conducted on healthy individuals from different districts of Brazzaville who were willing to know their COVID-19 infection status. METHODS Oropharyngeal swab and blood samples were collected from 754 healthy volunteers between April 2020 and July 2020. The samples were analyzed for SARS-CoV-2 using a qualitative RT-PCR assay, and Immunoglobulin G (IgG) and Immunoglobulin M (IgM) antibodies were detected using two different rapid tests. RESULTS A total of 56 participants (7.4%) tested positive for SARS-CoV-2. The remaining 698 participants (92.6%) had negative RT-PCR results; of these, 117 were found to have anti-SARS-CoV-2 antibodies using serological tests. For these RT-PCR-negative subjects, the seroprevalence of IgG and IgM was found to increase over time: from 1.7% and 2.5% in April, up to 14.2% and 17.6% in July, respectively. In April 2020, 5% of the women were found to have IgG or IgM antibodies, whereas the antibodies were not detected in any of the men. The seroprevalence in RT-PCR negative subjects was significantly higher in women within IgG (P = 0.012) and IgM (P = 0.045) over the first three months. CONCLUSION The proportion of the population who seroconvert over the course of the first wave is an important data to predict the risk of future COVID-19 waves and this will facilitate the efficient use of limited resources in a low income country like the Republic of the Congo.
Collapse
Affiliation(s)
- Armel Landry Batchi-Bouyou
- Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Congo; Faculty of Sciences and Technology, University Marien Ngouabi, Brazzaville, Congo.
| | - Line Lobaloba Ingoba
- Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Congo; Faculty of Sciences and Technology, University Marien Ngouabi, Brazzaville, Congo.
| | - Matthieu Ndounga
- Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Congo.
| | | | - Claujens Chastel Mfoutou Mapanguy
- Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Congo; Faculty of Sciences and Technology, University Marien Ngouabi, Brazzaville, Congo.
| | | | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Congo; Faculty of Sciences and Technology, University Marien Ngouabi, Brazzaville, Congo; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.
| |
Collapse
|
29
|
Galán MI, Velasco M, Casas ML, Goyanes MJ, Rodríguez-Caravaca G, Losa-García JE, Noguera C, Castilla V. Hospital-Wide SARS-CoV-2 seroprevalence in health care workers in a Spanish teaching hospital. Enferm Infecc Microbiol Clin 2020; 40:S0213-005X(20)30418-3. [PMID: 33485676 PMCID: PMC7833995 DOI: 10.1016/j.eimc.2020.11.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/23/2020] [Accepted: 11/27/2020] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Hospital-wide SARS-CoV-2 seroprevalence is rarely explored and can identify areas of unexpected risk. We determined the seroprevalence against SARS-CoV-2 in all health care workers (HCW) at a hospital. METHODS Cross-sectional study (14-27/04/2020). We determined SARS-CoV-2 IgG by ELISA in all HCW including external workers of a teaching hospital in Madrid. They were classified by professional category, working area, and risk for SARS-CoV-2 exposure. RESULTS Among 2919 HCW, 2590 (88,7%) were evaluated. The mean age was 43.8 years (SD 11.1), and 73.9% were females. Globally, 818 (31.6%) workers were IgG positive with no differences for age, sex or previous diseases. Of these, 48.5% did not report previous symptoms. Seropositivity was more frequent in high- (33.1%) and medium- (33.8%) than in low-risk areas (25.8%, p=0.007), but not for hospitalization areas attending COVID-19 and non-COVID-19 patients (35.5 vs 38.3% p>0.05). HWC with a previous SARS-CoV2 PCR-positive test were IgG seropositive in 90.8%. By multivariate logistic regression analysis seropositivity was significantly associated with being physicians (OR 2.37, CI95% 1.61-3.49), nurses (OR 1.67, CI95% 1.14-2.46), nurse assistants (OR 1.84, CI95% 1.24-2.73), HCW working at COVID-19 hospitalization areas (OR 1.71, CI95% 1.22-2.40), non-COVID-19 hospitalization areas (OR 1.88, CI95% 1.30-2.73), and at the Emergency Room (OR 1.51, CI95% 1.01-2.27). CONCLUSIONS Seroprevalence uncovered a high rate of infection previously unnoticed among HCW. Patients not suspected of having COVID-19 as well as asymptomatic HCW may be a relevant source for nosocomial SARS-CoV-2 transmission.
Collapse
Affiliation(s)
- Mª Isabel Galán
- Occupational Health Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - María Velasco
- Infectious Diseases and Research Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
| | - Mª Luisa Casas
- Laboratory Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Mª José Goyanes
- Microbiology Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | - Juan E Losa-García
- Preventive Medicine Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Carmen Noguera
- Nurse Subdirector, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Virgilio Castilla
- Medical Director, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| |
Collapse
|
30
|
Psichogiou M, Karabinis A, Pavlopoulou ID, Basoulis D, Petsios K, Roussos S, Pratikaki M, Jahaj E, Protopapas K, Leontis K, Rapti V, Kotanidou A, Antoniadou A, Poulakou G, Paraskevis D, Sypsa V, Hatzakis A. Antibodies against SARS-CoV-2 among health care workers in a country with low burden of COVID-19. PLoS One 2020; 15:e0243025. [PMID: 33270691 PMCID: PMC7714091 DOI: 10.1371/journal.pone.0243025] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/15/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Greece is a country with limited spread of SARS-CoV-2 and cumulative infection attack rate of 0.12% (95% CI 0.06-0.26). Health care workers (HCWs) are a well-recognized risk group for COVID-19. The study aimed to estimate the seroprevalence of antibodies to SARS-CoV-2 in a nosocomial setting and assess potential risk factors. METHODS HCWs from two hospitals participated in the study. Hospital-1 was a tertiary university affiliated center, involved in the care of COVID-19 patients while hospital-2 was a tertiary specialized cardiac surgery center not involved in the care of these patients. A validated, CE, rapid, IgM/IgG antibody point-of-care test was used. Comparative performance with a reference globally available assay was assessed. RESULTS 1,495 individuals consented to participate (response rate 77%). The anti-SARS-CoV-2 weighted prevalence was 1.26% (95% CI 0.43, 3.26) overall and 0.53% (95% CI 0.06, 2.78) and 2.70% (95% CI 0.57, 9.19) in hospital-1 and hospital-2, respectively although the study was underpowered to detect statistically significant differences. The overall, hospital-1, and hospital-2 seroprevalence was 10, 4 and 22 times higher than the estimated infection attack rate in general population, respectively. Suboptimal use of personal protective equipment was noted in both hospitals. CONCLUSIONS These data have implications for the preparedness of a second wave of COVID-19 epidemic, given the low burden of SARS-CoV-2 infection rate, in concordance with national projections.
Collapse
Affiliation(s)
- Mina Psichogiou
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Ioanna D. Pavlopoulou
- Pediatric Research Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Basoulis
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Sotirios Roussos
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Pratikaki
- 1st Department of Critical Care & Pulmonary Services, Medical School, National and Kapodistrian University of Athens, Evangelismos Hospital, Athens, Greece
| | - Edison Jahaj
- 1st Department of Critical Care & Pulmonary Services, Medical School, National and Kapodistrian University of Athens, Evangelismos Hospital, Athens, Greece
| | - Konstantinos Protopapas
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Leontis
- 3rd Department of Internal Medicine, Sotiria General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki Rapti
- 3rd Department of Internal Medicine, Sotiria General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Kotanidou
- 1st Department of Critical Care & Pulmonary Services, Medical School, National and Kapodistrian University of Athens, Evangelismos Hospital, Athens, Greece
| | - Anastasia Antoniadou
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Garyphallia Poulakou
- 3rd Department of Internal Medicine, Sotiria General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vana Sypsa
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Angelos Hatzakis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
31
|
Abstract
Rationale & Objective A number of serologic tests for immunoglobulin G (IgG) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are now commercially available, including multiple lateral flow immunoassays (LFIAs), which have the advantage of being inexpensive and easy to use, without the reliance on laboratory facilities. However, data on the development of humoral immunity to SARS-CoV-2 in patients with kidney disease is limited, and the utility of an LFIA to test for antibodies in these patients has not been assessed. Study Design Observational study. Setting & Participants 60 patients (40 hemodialysis and 20 kidney transplant recipients) with SARS-CoV-2 infection confirmed by viral reverse transcriptase–polymerase chain reaction (RT-PCR) testing and 88 historic negative-control samples (collected before September 2019). Test A commercially available LFIA to test for SARS-CoV-2 IgG in patients with infection confirmed by viral RT-PCR testing. Outcomes Sensitivity and specificity of the LFIA to detect SARS-CoV-2 IgG in dialysis patients and transplant recipients. Results 56/58 (96.6%) patients (38/39 hemodialysis and 18/19 transplant recipients) tested positive for SARS-CoV-2 IgG. 5/7 (71.4%) patients who were negative on preliminary testing had detectable IgG when retested more than 21 days postdiagnosis. Median times to first and second tests after diagnosis were 17 (interquartile range, 15-20) and 35 (interquartile range, 30-39) days, respectively. Calculation of test characteristics gave sensitivity of 96.6% (95% CI, 88.3%-99.4%) and specificity of 97.7% (95% CI, 92.0-99.6%). Limitations Possible exposure to other beta-coronaviruses that may cross-react with the antigen used in the LFIA cannot be excluded. Conclusions Symptomatic dialysis patients and transplant recipients commonly develop an immune response against SARS-CoV-2 infection that can be detected using an LFIA. Used diligently, an LFIA could be used to help screen the dialysis populations or confirm exposure on a patient level, especially in facilities in which laboratory resources are limited.
Collapse
|
32
|
Puylaert CAJ, Scheijmans JCG, Borgstein ABJ, Andeweg CS, Bartels-Rutten A, Beets GL, van Berge Henegouwen MI, Braak SJ, Couvreur R, Daams F, van Es HW, Franken LC, Grotenhuis BA, Hendriks ER, de Hingh IHJT, Hoeijmakers F, Ten Holder JT, Huisman PM, Kazemier G, van Kesteren F, van Kesteren J, Keywani K, Kuiper SZ, Lange MDJ, Lobatto ME, du Mée AWF, Poeze M, van Praag EM, van Rossen J, van Santvoort HC, Sedee WJA, Seelen LWF, Sharabiany S, Sosef NL, Quanjel MJR, Veltman J, Verhagen T, van de Vlasakker VCJ, Weeder PD, van Werven JR, Wesdorp NJ, van Dieren S, Han AX, Russell CA, de Jong MD, Bossuyt PMM, Quarles van Ufford JME, Prokop MW, Gisbertz SS, Prins JM, Besselink MG, Boermeester MA, Gietema HA, Stoker J. Yield of Screening for COVID-19 in Asymptomatic Patients Before Elective or Emergency Surgery Using Chest CT and RT-PCR (SCOUT): Multicenter Study. Ann Surg 2020; 272:919-924. [PMID: 33021367 PMCID: PMC7668335 DOI: 10.1097/sla.0000000000004218] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To determine the yield of preoperative screening for COVID-19 with chest CT and RT-PCR in patients without COVID-19 symptoms. SUMMARY OF BACKGROUND DATA Many centers are currently screening surgical patients for COVID-19 using either chest CT, RT-PCR or both, due to the risk for worsened surgical outcomes and nosocomial spread. The optimal design and yield of such a strategy are currently unknown. METHODS This multicenter study included consecutive adult patients without COVID-19 symptoms who underwent preoperative screening using chest CT and RT-PCR before elective or emergency surgery under general anesthesia. RESULTS A total of 2093 patients without COVID-19 symptoms were included in 14 participating centers; 1224 were screened by CT and RT-PCR and 869 by chest CT only. The positive yield of screening using a combination of chest CT and RT-PCR was 1.5% [95% confidence interval (CI): 0.8-2.1]. Individual yields were 0.7% (95% CI: 0.2-1.1) for chest CT and 1.1% (95% CI: 0.6-1.7) for RT-PCR; the incremental yield of chest CT was 0.4%. In relation to COVID-19 community prevalence, up to ∼6% positive RT-PCR was found for a daily hospital admission rate >1.5 per 100,000 inhabitants, and around 1.0% for lower prevalence. CONCLUSIONS One in every 100 patients without COVID-19 symptoms tested positive for SARS-CoV-2 with RT-PCR; this yield increased in conjunction with community prevalence. The added value of chest CT was limited. Preoperative screening allowed us to take adequate precautions for SARS-CoV-2 positive patients in a surgical population, whereas negative patients needed only routine procedures.
Collapse
Affiliation(s)
- Carl A J Puylaert
- Department of Radiology and Nuclear Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jochem C G Scheijmans
- Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Alexander B J Borgstein
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | | | | | - Geerard L Beets
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Mark I van Berge Henegouwen
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Sicco J Braak
- Department of Radiology, Hospital Group Twente, Almelo, the Netherlands
| | - Roy Couvreur
- Department of Surgery, Haaglanden Medical Center, Den Haag, the Netherlands
| | - Freek Daams
- Department of Surgery, Cancer Center Amsterdam UMC, VU University Amsterdam, Amsterdam, the Netherlands
| | - Hendrik W van Es
- Department of Radiology, Sint Antonius Hospital, Nieuwegein, the Netherlands
| | - Lotte C Franken
- Department of Surgery, Flevo Hospital, Almere, the Netherlands
| | - Brechtje A Grotenhuis
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Eduard R Hendriks
- Department of Surgery, Tergooi Hospitals, Hilversum, the Netherlands
| | | | | | - Joris T Ten Holder
- Department of Pulmonary Medicine, Haaglanden Medical Center, Den Haag, the Netherlands
| | - Peter M Huisman
- Department of Radiology, Tergooi Hospitals, Hilversum, the Netherlands
| | - Geert Kazemier
- Department of Surgery, Cancer Center Amsterdam UMC, VU University Amsterdam, Amsterdam, the Netherlands
| | - Floortje van Kesteren
- Department of Radiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Kammy Keywani
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Sara Z Kuiper
- Department of Surgery, Maastricht UMC+, Maastricht, the Netherlands
| | - Maurits D J Lange
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Mark E Lobatto
- Department of Radiology, Spaarne Gasthuis, Haarlem and Hoofddorp, the Netherlands
| | | | - Martijn Poeze
- Department of Surgery, Maastricht UMC+, Maastricht, the Netherlands
| | - Elise M van Praag
- Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jorit van Rossen
- Department of Radiology, Hospital Group Twente, Almelo, the Netherlands
| | - Hjalmar C van Santvoort
- Department of Surgery, Sint Antonius Hospital, Nieuwegein, the Netherlands
- Department of Surgery, UMC Utrecht Cancer Center, UMC Utrecht, Utrecht, the Netherlands
| | - Wouter J A Sedee
- Department of Emergency Medicine, St Jansdal Hospital, Harderwijk, the Netherlands
| | - Leonard W F Seelen
- Department of Surgery, Sint Antonius Hospital, Nieuwegein, the Netherlands
| | - Sarah Sharabiany
- Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Nico L Sosef
- Department of Surgery, Spaarne Gasthuis, Haarlem and Hoofddorp, the Netherlands
| | - Marian J R Quanjel
- Department of Pulmonary Medicine, Sint Antonius Hospital, Nieuwegein, the Netherlands
| | - Jeroen Veltman
- Department of Radiology, Hospital Group Twente, Almelo, the Netherlands
| | - Tim Verhagen
- Department of Surgery, Hospital Group Twente, Almelo, the Netherlands
| | | | - Pepijn D Weeder
- Department of Surgery, Spaarne Gasthuis, Haarlem and Hoofddorp, the Netherlands
| | | | - Nina J Wesdorp
- Department of Surgery, Cancer Center Amsterdam UMC, VU University Amsterdam, Amsterdam, the Netherlands
| | - Susan van Dieren
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Alvin X Han
- Laboratory of Applied Evolutionary Biology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Colin A Russell
- Laboratory of Applied Evolutionary Biology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Menno D de Jong
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Patrick M M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | | | | | - Suzanne S Gisbertz
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jan M Prins
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity (AI&II), Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Marc G Besselink
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Marja A Boermeester
- Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Hester A Gietema
- Department of Radiology, Maastricht UMC+, Maastricht, the Netherlands
| | - Jaap Stoker
- Department of Radiology and Nuclear Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| |
Collapse
|
33
|
Cloutier M, Nandi M, Ihsan AU, Chamard HA, Ilangumaran S, Ramanathan S. ADE and hyperinflammation in SARS-CoV2 infection- comparison with dengue hemorrhagic fever and feline infectious peritonitis. Cytokine 2020; 136:155256. [PMID: 32866898 PMCID: PMC7439999 DOI: 10.1016/j.cyto.2020.155256] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/05/2020] [Accepted: 08/12/2020] [Indexed: 12/13/2022]
Abstract
The COVID-19 pandemic has rapidly spread around the world with significant morbidity and mortality in a subset of patients including the elderly. The poorer outcomes are associated with 'cytokine storm-like' immune responses, otherwise referred to as 'hyperinflammation'. While most of the infected individuals show minimal or no symptoms and recover spontaneously, a small proportion of the patients exhibit severe symptoms characterized by extreme dyspnea and low tissue oxygen levels, with extensive damage to the lungs referred to as acute respiratory distress symptom (ARDS). The consensus is that the hyperinflammatory response of the host is akin to the cytokine storm observed during sepsis and is the major cause of death. Uncertainties remain on the factors that lead to hyperinflammatory response in some but not all individuals. Hyperinflammation is a common feature in different viral infections such as dengue where existing low-titer antibodies to the virus enhances the infection in immune cells through a process called antibody-dependent enhancement or ADE. ADE has been reported following vaccination or secondary infections with other corona, Ebola and dengue virus. Detailed analysis has shown that antibodies to any viral epitope can induce ADE when present in sub-optimal titers or is of low affinity. In this review we will discuss ADE in the context of dengue and coronavirus infections including Covid-19.
Collapse
Affiliation(s)
- Maryse Cloutier
- Department of Immunology and Cell Biology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Madhuparna Nandi
- Department of Immunology and Cell Biology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Awais Ullah Ihsan
- Department of Immunology and Cell Biology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Hugues Allard Chamard
- Division of Rheumatology, Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada; Centre de Recherche Clinique, Centre Hospitalier d'Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Subburaj Ilangumaran
- Department of Immunology and Cell Biology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada; Centre de Recherche Clinique, Centre Hospitalier d'Université de Sherbrooke, Sherbrooke, QC, Canada.
| | - Sheela Ramanathan
- Department of Immunology and Cell Biology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada; Centre de Recherche Clinique, Centre Hospitalier d'Université de Sherbrooke, Sherbrooke, QC, Canada.
| |
Collapse
|
34
|
Shields A, Faustini SE, Perez-Toledo M, Jossi S, Aldera E, Allen JD, Al-Taei S, Backhouse C, Bosworth A, Dunbar LA, Ebanks D, Emmanuel B, Garvey M, Gray J, Kidd IM, McGinnell G, McLoughlin DE, Morley G, O'Neill J, Papakonstantinou D, Pickles O, Poxon C, Richter M, Walker EM, Wanigasooriya K, Watanabe Y, Whalley C, Zielinska AE, Crispin M, Wraith DC, Beggs AD, Cunningham AF, Drayson MT, Richter AG. SARS-CoV-2 seroprevalence and asymptomatic viral carriage in healthcare workers: a cross-sectional study. Thorax 2020; 75:1089-1094. [PMID: 32917840 PMCID: PMC7462045 DOI: 10.1136/thoraxjnl-2020-215414] [Citation(s) in RCA: 183] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/03/2020] [Accepted: 08/11/2020] [Indexed: 02/06/2023]
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.
Collapse
Affiliation(s)
- Adrian Shields
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Sian E Faustini
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Marisol Perez-Toledo
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Sian Jossi
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Erin Aldera
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK
| | - Joel D Allen
- School of Biological Sciences, University of Southampton, Southampton, UK
| | - Saly Al-Taei
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Claire Backhouse
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Andrew Bosworth
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Lyndsey A Dunbar
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Daniel Ebanks
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Beena Emmanuel
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Mark Garvey
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK
| | - Joanna Gray
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - I Michael Kidd
- Public Health England Midlands and East Region, Birmingham, UK
| | - Golaleh McGinnell
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Dee E McLoughlin
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Gabriella Morley
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Joanna O'Neill
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Oliver Pickles
- Surgical Research Laboratory, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Charlotte Poxon
- Surgical Research Laboratory, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Megan Richter
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Eloise M Walker
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK
| | - Kasun Wanigasooriya
- Surgical Research Laboratory, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Yasunori Watanabe
- School of Biological Sciences, University of Southampton, Southampton, UK
- Oxford Glycobiology Institute, Department of Biochemistry, University of Oxford, Oxford, UK
| | - Celina Whalley
- Surgical Research Laboratory, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | | | - Max Crispin
- School of Biological Sciences, University of Southampton, Southampton, UK
| | - David C Wraith
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, NIHR Biomedical Research Centre, Birmingham, UK
| | - Andrew D Beggs
- Surgical Research Laboratory, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Adam F Cunningham
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Mark T Drayson
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, NIHR Biomedical Research Centre, Birmingham, UK
| | - Alex G Richter
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| |
Collapse
|
35
|
Alserehi HA, Alqunaibet AM, Al-Tawfiq JA, Alharbi NK, Alshukairi AN, Alanazi KH, Bin Saleh GM, Alshehri AM, Almasoud A, Hashem AM, Alruwaily AR, Alaswad RH, Al-Mutlaq HM, Almudaiheem AA, Othman FM, Aldakeel SA, Abu Ghararah MR, Jokhdar HA, Algwizani AR, Almudarra SS, Albarrag AM. Seroprevalence of SARS-CoV-2 (COVID-19) among healthcare workers in Saudi Arabia: comparing case and control hospitals. Diagn Microbiol Infect Dis 2020; 99:115273. [PMID: 33296851 PMCID: PMC7677039 DOI: 10.1016/j.diagmicrobio.2020.115273] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 11/08/2020] [Accepted: 11/15/2020] [Indexed: 01/27/2023]
Abstract
Healthcare workers (HCWs) stand at the frontline for fighting coronavirus disease 2019 (COVID-19) pandemic. This puts them at higher risk of acquiring the infection than other individuals in the community. Defining immunity status among health care workers is therefore of interest since it helps to mitigate the exposure risk. This study was conducted between May 20th and 30th, 2020. Eighty-five hospitals across Kingdom of Saudi Arabia were divided into 2 groups: COVID-19 referral hospitals are those to which RT-PCR-confirmed COVID-19 patients were admitted or referred for management (Case-hospitals). COVID-19 nonaffected hospitals where no COVID-19 patients had been admitted or managed and no HCW outbreak (Control hospitals). Next, seroprevalence of severe acute respiratory syndrome coronavirus 2 among HCWs was evaluated; there were 12,621 HCWs from the 85 hospitals. There were 61 case-hospitals with 9379 (74.3%) observations, and 24 control-hospitals with 3242 (25.7%) observations. The overall positivity rate by the immunoassay was 299 (2.36%) with a significant difference between the case-hospital (2.9%) and the control-group (0.8%) (P value <0.001). There was a wide variation in the positivity rate between regions and/or cities in Saudi Arabia, ranging from 0% to 6.31%. Of the serology positive samples, 100 samples were further tested using the SAS2pp neutralization assay; 92 (92%) samples showed neutralization activity. The seropositivity rate in Kingdom of Saudi Arabia is low and varies across different regions with higher positivity in case-hospitals than control-hospitals. The lack of neutralizing antibodies (NAb) in 8% of the tested samples could mean that assay is a more sensitive assay or that neutralization assay has a lower detection limits; or possibly that some samples had cross-reaction to spike protein of other coronaviruses in the assay, but these were not specific to neutralize severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Collapse
Affiliation(s)
- Haleema Ali Alserehi
- Executive Department of Global Health, Epidemiology, surveillance and preparedness affairs, Executive Department of Research, Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia.
| | - Ada Mohammed Alqunaibet
- Executive Department of Global Health, Epidemiology, surveillance and preparedness affairs, Executive Department of Research, Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, and Quality and Patient Safety Departement, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Naif Khalaf Alharbi
- Vaccine Development Unit, Department of Infectious Disease Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abeer Nizar Alshukairi
- Department of medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | | | | | - Amer Mohammed Alshehri
- Public Health Lab, Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Abdulrahman Almasoud
- Vaccine Development Unit, Department of Infectious Disease Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Anwar M Hashem
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amaal Rabie Alruwaily
- Executive Department of Global Health, Epidemiology, surveillance and preparedness affairs, Executive Department of Research, Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Rehab Habeeb Alaswad
- Executive Department of Global Health, Epidemiology, surveillance and preparedness affairs, Executive Department of Research, Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Hind Mohammed Al-Mutlaq
- Executive Department of Global Health, Epidemiology, surveillance and preparedness affairs, Executive Department of Research, Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Abdulllah Ali Almudaiheem
- Executive Department of Global Health, Epidemiology, surveillance and preparedness affairs, Executive Department of Research, Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Fatmah Mahmoud Othman
- Research department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | | | | | | | - Sami Saeed Almudarra
- Executive Department of Global Health, Epidemiology, surveillance and preparedness affairs, Executive Department of Research, Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Ahmed Mohammed Albarrag
- Public Health Lab, Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia; Department of Pathology, School of Medicine, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
36
|
Weis S, Scherag A, Baier M, Kiehntopf M, Kamradt T, Kolanos S, Ankert J, Glöckner S, Makarewicz O, Hagel S, Bahrs C, Kimmig A, Proquitté H, Guerra J, Rimek D, Löffler B, Pletz MW. Antibody response using six different serological assays in a completely PCR-tested community after a coronavirus disease 2019 outbreak-the CoNAN study. Clin Microbiol Infect 2020; 27:470.e1-470.e9. [PMID: 33221432 PMCID: PMC7677041 DOI: 10.1016/j.cmi.2020.11.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 12/20/2022]
Abstract
Objectives Due to a substantial proportion of asymptomatic and mild courses, many severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections remain unreported. Therefore, assessment of seroprevalence may detect the real burden of disease. We aimed to determine and characterize the rate of SARS-CoV-2 infections and the resulting seroprevalence in a defined population. The primary objective of the study was to assess SARS-CoV-2 antibody seroprevalence using six different IgG-detecting immunoassays. Secondary objectives of the study were: (a) to determine potential risk factors for symptomatic versus asymptomatic coronavirus disease 2019 courses, and (b) to investigate the rate of virus RNA-persistence. Methods CoNAN is a population-based cohort study performed in the community Neustadt am Rennsteig, Germany, which was quarantined from 22 March to 5 April after six SARS-CoV-2 cases were detected in the village's population. The SARS-CoV-2 outbreak comprised 51 cases and 3 deaths. The CoNAN study was performed from 13 May to 22 May 2020, 6 weeks after a SARS-CoV-2 outbreak. Results We enrolled a total of 626 participants (71% of the community population) for PCR and antibody testing in the study. All actual SARS-CoV-2 PCR tests were negative. Fifty-two out of 620 (8.4%) participants had antibodies against SARS-CoV-2 in at least two different assays. There were 38 participants with previously PCR-confirmed SARS-CoV-2 infection. Of those, only 19 (50%) displayed anti-SARS-CoV-2 antibodies. We also show that antibody-positive participants with symptoms compatible with a respiratory tract infection had significantly higher antibody levels then asymptomatic participants (EU-assay: median 2.9 versus 7.2 IgG-index, p 0.002; DS-assay: median 45.2 versus 143 AU/mL, p 0.002). Persisting viral replication was not detected. Conclusions Our data question the relevance and reliability of IgG antibody testing to detect past SARS-CoV-2 infections 6 weeks after an outbreak. We conclude that assessing immunity for SARS-CoV-2 infection should not rely on antibody tests alone.
Collapse
Affiliation(s)
- Sebastian Weis
- Institute for Infectious Diseases and Infection Control, Jena University Hospital - Friedrich Schiller University, Jena, Germany; Centre for Sepsis Control and Care (CSCC), Jena University Hospital - Friedrich Schiller University, Jena, Germany; Department of Anaesthesiology and Intensive Care, Jena University Hospital - Friedrich Schiller University, Jena, Germany.
| | - André Scherag
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital - Friedrich Schiller University, Jena, Germany
| | - Michael Baier
- Institute of Medical Microbiology, Jena University Hospital - Friedrich Schiller University, Jena, Germany
| | - Michael Kiehntopf
- Institute of Clinical Chemistry and Laboratory Diagnostics and Integrated Biobank Jena (IBBJ), Jena University Hospital - Friedrich Schiller University, Jena, Germany
| | - Thomas Kamradt
- Institute of Immunology, Jena University Hospital - Friedrich Schiller University, Jena, Germany
| | - Steffi Kolanos
- Institute for Infectious Diseases and Infection Control, Jena University Hospital - Friedrich Schiller University, Jena, Germany
| | - Juliane Ankert
- Institute for Infectious Diseases and Infection Control, Jena University Hospital - Friedrich Schiller University, Jena, Germany
| | - Stefan Glöckner
- Institute of Medical Microbiology, Jena University Hospital - Friedrich Schiller University, Jena, Germany
| | - Oliwia Makarewicz
- Institute for Infectious Diseases and Infection Control, Jena University Hospital - Friedrich Schiller University, Jena, Germany
| | - Stefan Hagel
- Institute for Infectious Diseases and Infection Control, Jena University Hospital - Friedrich Schiller University, Jena, Germany
| | - Christina Bahrs
- Institute for Infectious Diseases and Infection Control, Jena University Hospital - Friedrich Schiller University, Jena, Germany; Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Aurelia Kimmig
- Institute for Infectious Diseases and Infection Control, Jena University Hospital - Friedrich Schiller University, Jena, Germany
| | - Hans Proquitté
- Children's Hospital, Jena University Hospital-Friedrich Schiller University, Jena, Germany
| | - Joel Guerra
- Institute for Infectious Diseases and Infection Control, Jena University Hospital - Friedrich Schiller University, Jena, Germany; Centre for Sepsis Control and Care (CSCC), Jena University Hospital - Friedrich Schiller University, Jena, Germany
| | - Dagmar Rimek
- Thuringian State Office for Consumer Protection, Bad Langensalza, Germany
| | - Bettina Löffler
- Institute of Medical Microbiology, Jena University Hospital - Friedrich Schiller University, Jena, Germany
| | - Mathias W Pletz
- Institute for Infectious Diseases and Infection Control, Jena University Hospital - Friedrich Schiller University, Jena, Germany
| |
Collapse
|
37
|
Trullàs JC, Vilardell I, Blasco M, Heredia J. COVID-19 in healthcare workers at the Olot Regional Hospital (Girona). Rev Clin Esp 2020. [PMID: 32739026 PMCID: PMC7550089 DOI: 10.1016/j.rceng.2020.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- J C Trullàs
- Servicio de Medicina Interna, Hospital d'Olot i Comarcal de la Garrotxa, Olot, Girona, España; Laboratori de Reparació i Regeneració Tissular (TR2Lab), Facultat de Medicina, Universitat de Vic - Universitat Central de Catalunya, Vic, Barcelona, España.
| | - I Vilardell
- Salud Laboral, Hospital d'Olot i Comarcal de la Garrotxa, Olot, Girona, España
| | - M Blasco
- Seguridad del paciente, Hospital d'Olot i Comarcal de la Garrotxa, Olot, Girona, España
| | - J Heredia
- Dirección médica, Hospital d'Olot i Comarcal de la Garrotxa, Olot, Girona, España
| |
Collapse
|
38
|
Rawson A, Wilson AC, Schwaderer AL, Spiwak E, Johnston B, Anderson S, Nailescu C, Gupta S, Christenson JC, Hains DS, Starr MC. Coronavirus disease 2019 (COVID-19) in two pediatric patients with kidney disease on chronic immunosuppression: A case series. Hemodial Int 2020; 25:E1-E5. [PMID: 33015942 PMCID: PMC7675317 DOI: 10.1111/hdi.12876] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/11/2020] [Accepted: 09/12/2020] [Indexed: 12/31/2022]
Abstract
Coronavirus disease 2019 (COVID‐19) is a highly infectious disease caused by the severe acute respiratory syndrome coronavirus 2 virus (SARS‐CoV‐2). While children appear to experience less severe disease than adults, those with underlying conditions such as kidney disease may be more susceptible to infection. Limited data are present for children with kidney disease, and there are limited prior reports of pediatric hemodialysis patients with COVID‐19. This report describes the mild clinical disease course of COVID‐19 in two pediatric patients with chronic kidney disease, one on hemodialysis and both on chronic immunosuppression. We review treatment in these patients, as well as our measures to reduce transmission among our hemodialysis patients and staff.
Collapse
Affiliation(s)
- Ashley Rawson
- Division of Nephrology, Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - Amy C Wilson
- Division of Nephrology, Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - Andrew L Schwaderer
- Division of Nephrology, Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - Elizabeth Spiwak
- Division of Nephrology, Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - Bethanne Johnston
- Division of Nephrology, Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - Shannon Anderson
- Division of Nephrology, Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - Corina Nailescu
- Division of Nephrology, Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - Sushil Gupta
- Division of Nephrology, Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - John C Christenson
- Division of Infectious Diseases, Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - David S Hains
- Division of Nephrology, Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| | - Michelle C Starr
- Division of Nephrology, Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA
| |
Collapse
|
39
|
Gandhi M, Beyrer C, Goosby E. Masks Do More Than Protect Others During COVID-19: Reducing the Inoculum of SARS-CoV-2 to Protect the Wearer. J Gen Intern Med 2020; 35:3063-3066. [PMID: 32737790 PMCID: PMC7393808 DOI: 10.1007/s11606-020-06067-8] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 07/15/2020] [Indexed: 12/17/2022]
Abstract
Although the benefit of population-level public facial masking to protect others during the COVID-19 pandemic has received a great deal of attention, we discuss for one of the first times the hypothesis that universal masking reduces the "inoculum" or dose of the virus for the mask-wearer, leading to more mild and asymptomatic infection manifestations. Masks, depending on type, filter out the majority of viral particles, but not all. We first discuss the near-century-old literature around the viral inoculum and severity of disease (conceptualized as the LD50 or lethal dose of the virus). We include examples of rising rates of asymptomatic infection with population-level masking, including in closed settings (e.g., cruise ships) with and without universal masking. Asymptomatic infections may be harmful for spread but could actually be beneficial if they lead to higher rates of exposure. Exposing society to SARS-CoV-2 without the unacceptable consequences of severe illness with public masking could lead to greater community-level immunity and slower spread as we await a vaccine. This theory of viral inoculum and mild or asymptomatic disease with SARS-CoV-2 in light of population-level masking has received little attention so this is one of the first perspectives to discuss the evidence supporting this theory.
Collapse
Affiliation(s)
- Monica Gandhi
- Department of Medicine, Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco (UCSF) , San Francisco, CA, USA.
| | - Chris Beyrer
- Desmond M. Tutu Professor of Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD, USA
| | - Eric Goosby
- Department of Medicine, Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco (UCSF) , San Francisco, CA, USA
| |
Collapse
|
40
|
Riggioni C, Comberiati P, Giovannini M, Agache I, Akdis M, Alves‐Correia M, Antó JM, Arcolaci A, Azkur AK, Azkur D, Beken B, Boccabella C, Bousquet J, Breiteneder H, Carvalho D, De las Vecillas L, Diamant Z, Eguiluz‐Gracia I, Eiwegger T, Eyerich S, Fokkens W, Gao Y, Hannachi F, Johnston SL, Jutel M, Karavelia A, Klimek L, Moya B, Nadeau KC, O'Hehir R, O'Mahony L, Pfaar O, Sanak M, Schwarze J, Sokolowska M, Torres MJ, Veen W, Zelm MC, Wang DY, Zhang L, Jiménez‐Saiz R, Akdis CA. A compendium answering 150 questions on COVID-19 and SARS-CoV-2. Allergy 2020; 75:2503-2541. [PMID: 32535955 PMCID: PMC7323196 DOI: 10.1111/all.14449] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/05/2020] [Accepted: 06/07/2020] [Indexed: 02/06/2023]
Abstract
In December 2019, China reported the first cases of the coronavirus disease 2019 (COVID‐19). This disease, caused by the severe acute respiratory syndrome–related coronavirus 2 (SARS‐CoV‐2), has developed into a pandemic. To date, it has resulted in ~9 million confirmed cases and caused almost 500 000 related deaths worldwide. Unequivocally, the COVID‐19 pandemic is the gravest health and socioeconomic crisis of our time. In this context, numerous questions have emerged in demand of basic scientific information and evidence‐based medical advice on SARS‐CoV‐2 and COVID‐19. Although the majority of the patients show a very mild, self‐limiting viral respiratory disease, many clinical manifestations in severe patients are unique to COVID‐19, such as severe lymphopenia and eosinopenia, extensive pneumonia, a “cytokine storm” leading to acute respiratory distress syndrome, endothelitis, thromboembolic complications, and multiorgan failure. The epidemiologic features of COVID‐19 are distinctive and have changed throughout the pandemic. Vaccine and drug development studies and clinical trials are rapidly growing at an unprecedented speed. However, basic and clinical research on COVID‐19–related topics should be based on more coordinated high‐quality studies. This paper answers pressing questions, formulated by young clinicians and scientists, on SARS‐CoV‐2, COVID‐19, and allergy, focusing on the following topics: virology, immunology, diagnosis, management of patients with allergic disease and asthma, treatment, clinical trials, drug discovery, vaccine development, and epidemiology. A total of 150 questions were answered by experts in the field providing a comprehensive and practical overview of COVID‐19 and allergic disease.
Collapse
|
41
|
The possibility of SARS-CoV-2 transmission in a haemodialysis unit - report from a large in-hospital centre. Epidemiol Infect 2020; 148:e226. [PMID: 32981558 PMCID: PMC7542315 DOI: 10.1017/s0950268820002277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Data on the possibility of transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) during the provision of chronic haemodialysis, which often entails many person-to-person contacts, are lacking. We report a follow-up of the in-centre contacts of three positive chronic haemodialysis patients. Under strict preventive measures, only one patient out of 21 patient-contacts and 29 personnel-contacts tested positive within 2 weeks after the last contact. This patient, case #3, most likely became infected during unprotected, organised group transportation to the dialysis centre.
Collapse
|
42
|
McAndrews KM, Dowlatshahi DP, Dai J, Becker LM, Hensel J, Snowden LM, Leveille JM, Brunner MR, Holden KW, Hopkins NS, Harris AM, Kumpati J, Whitt MA, Lee JJ, Ostrosky-Zeichner LL, Papanna R, LeBleu VS, Allison JP, Kalluri R. Heterogeneous antibodies against SARS-CoV-2 spike receptor binding domain and nucleocapsid with implications for COVID-19 immunity. JCI Insight 2020; 5:142386. [PMID: 32796155 PMCID: PMC7526535 DOI: 10.1172/jci.insight.142386] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/13/2020] [Indexed: 01/07/2023] Open
Abstract
Evaluation of potential immunity against the novel severe acute respiratory syndrome (SARS) coronavirus that emerged in 2019 (SARS-CoV-2) is essential for health, as well as social and economic recovery. Generation of antibody response to SARS-CoV-2 (seroconversion) may inform on acquired immunity from prior exposure, and antibodies against the SARS-CoV-2 spike protein receptor binding domain (S-RBD) are speculated to neutralize virus infection. Some serology assays rely solely on SARS-CoV-2 nucleocapsid protein (N-protein) as the antibody detection antigen; however, whether such immune responses correlate with S-RBD response and COVID-19 immunity remains unknown. Here, we generated a quantitative serological ELISA using recombinant S-RBD and N-protein for the detection of circulating antibodies in 138 serial serum samples from 30 reverse transcription PCR–confirmed, SARS-CoV-2–hospitalized patients, as well as 464 healthy and non–COVID-19 serum samples that were collected between June 2017 and June 2020. Quantitative detection of IgG antibodies against the 2 different viral proteins showed a moderate correlation. Antibodies against N-protein were detected at a rate of 3.6% in healthy and non–COVID-19 sera collected during the pandemic in 2020, whereas 1.9% of these sera were positive for S-RBD. Approximately 86% of individuals positive for S-RBD–binding antibodies exhibited neutralizing capacity, but only 74% of N-protein–positive individuals exhibited neutralizing capacity. Collectively, our studies show that detection of N-protein–binding antibodies does not always correlate with presence of S-RBD–neutralizing antibodies and caution against the extensive use of N-protein–based serology testing for determination of potential COVID-19 immunity. Detection of SARS-CoV-2 nucleocapsid protein binding antibodies does not always correlate with the presence of spike protein receptor binding domain neutralizing antibodies.
Collapse
Affiliation(s)
- Kathleen M McAndrews
- Metastasis Research Center, Department of Cancer Biology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Dara P Dowlatshahi
- Metastasis Research Center, Department of Cancer Biology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jianli Dai
- Metastasis Research Center, Department of Cancer Biology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lisa M Becker
- Metastasis Research Center, Department of Cancer Biology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Janine Hensel
- Metastasis Research Center, Department of Cancer Biology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Laura M Snowden
- Metastasis Research Center, Department of Cancer Biology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jennifer M Leveille
- Metastasis Research Center, Department of Cancer Biology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michael R Brunner
- Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA
| | - Kylie W Holden
- Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA
| | - Nikolas S Hopkins
- Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA
| | - Alexandria M Harris
- Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA
| | - Jerusha Kumpati
- Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA
| | - Michael A Whitt
- Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA
| | - J Jack Lee
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Ramesha Papanna
- The Fetal Center, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas McGovern Medical School at Houston, Houston, Texas, USA
| | - Valerie S LeBleu
- Metastasis Research Center, Department of Cancer Biology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - James P Allison
- Department of Immunology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Raghu Kalluri
- Metastasis Research Center, Department of Cancer Biology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Department of Bioengineering, Rice University, Houston, Texas, USA.,Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, USA
| |
Collapse
|
43
|
McDade TW, McNally EM, Zelikovich AS, D’Aquila R, Mustanski B, Miller A, Vaught LA, Reiser NL, Bogdanovic E, Fallon KS, Demonbreun AR. High seroprevalence for SARS-CoV-2 among household members of essential workers detected using a dried blood spot assay. PLoS One 2020; 15:e0237833. [PMID: 32797108 PMCID: PMC7428174 DOI: 10.1371/journal.pone.0237833] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/04/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Serological testing is needed to investigate the extent of transmission of SARS-CoV-2 from front-line essential workers to their household members. However, the requirement for serum/plasma limits serological testing to clinical settings where it is feasible to collect and process venous blood. To address this problem we developed a serological test for SARS-CoV-2 IgG antibodies that requires only a single drop of finger stick capillary whole blood, collected in the home and dried on filter paper (dried blood spot, DBS). We describe assay performance and demonstrate its utility for remote sampling with results from a community-based study. METHODS An ELISA to the receptor binding domain of the SARS-CoV-2 spike protein was optimized to quantify IgG antibodies in DBS. Samples were self-collected from a community sample of 232 participants enriched with health care workers, including 30 known COVID-19 cases and their household members. RESULTS Among 30 individuals sharing a household with a virus-confirmed case of COVID-19, 80% were seropositive. Of 202 community individuals without prior confirmed acute COVID-19 diagnoses, 36% were seropositive. Of documented convalescent COVID-19 cases from the community, 29 of 30 (97%) were seropositive for IgG antibodies to the receptor binding domain. CONCLUSION DBS ELISA provides a minimally-invasive alternative to venous blood collection. Early analysis suggests a high rate of transmission among household members. High rates of seroconversion were also noted following recovery from infection. Serological testing for SARS-CoV-2 IgG antibodies in DBS samples can facilitate seroprevalence assessment in community settings to address epidemiological questions, monitor duration of antibody responses, and assess if antibodies against the spike protein correlate with protection from reinfection.
Collapse
Affiliation(s)
- Thomas W. McDade
- Department of Anthropology and Institute for Policy Research, Northwestern University, Evanston, Illinois, United States of America
- Canadian Institute for Advanced Research, Child and Brain Development Program, Toronto, Canada
- * E-mail:
| | - Elizabeth M. McNally
- Center for Genetic Medicine, Northwestern University, Evanston, Illinois, United States of America
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
- Department of Biochemistry and Molecular Genetics, Northwestern University, Evanston, Illinois, United States of America
| | - Aaron S. Zelikovich
- Center for Genetic Medicine, Northwestern University, Evanston, Illinois, United States of America
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Richard D’Aquila
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing and Department of Medical Social Sciences, Northwestern University, Chicago, Illinois, United States of America
| | - Aaron Miller
- Department of Anthropology and Institute for Policy Research, Northwestern University, Evanston, Illinois, United States of America
| | - Lauren A. Vaught
- Center for Genetic Medicine, Northwestern University, Evanston, Illinois, United States of America
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Nina L. Reiser
- Center for Genetic Medicine, Northwestern University, Evanston, Illinois, United States of America
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Elena Bogdanovic
- Center for Genetic Medicine, Northwestern University, Evanston, Illinois, United States of America
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Katherine S. Fallon
- Center for Genetic Medicine, Northwestern University, Evanston, Illinois, United States of America
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Alexis R. Demonbreun
- Center for Genetic Medicine, Northwestern University, Evanston, Illinois, United States of America
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| |
Collapse
|
44
|
Trullàs JC, Vilardell I, Blasco M, Heredia J. [COVID-19 in health workers from the Olot Regional Hospital (Girona)]. Rev Clin Esp 2020; 220:529-531. [PMID: 33994576 PMCID: PMC7366981 DOI: 10.1016/j.rce.2020.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/29/2020] [Accepted: 07/12/2020] [Indexed: 12/28/2022]
Affiliation(s)
- J C Trullàs
- Servicio de Medicina Interna, Hospital d'Olot i Comarcal de la Garrotxa, Olot, Girona, España.,Laboratori de Reparació i Regeneració Tissular (TR2Lab), Facultat de Medicina, Universitat de Vic - Universitat Central de Catalunya, Vic, Barcelona, España
| | - I Vilardell
- Salud Laboral, Hospital d'Olot i Comarcal de la Garrotxa, Olot, Girona, España
| | - M Blasco
- Seguridad del paciente, Hospital d'Olot i Comarcal de la Garrotxa, Olot, Girona, España
| | - J Heredia
- Dirección médica, Hospital d'Olot i Comarcal de la Garrotxa, Olot, Girona, España
| |
Collapse
|
45
|
El-Boghdadly K, Wong DJN, Owen R, Neuman MD, Pocock S, Carlisle JB, Johnstone C, Andruszkiewicz P, Baker PA, Biccard BM, Bryson GL, Chan MTV, Cheng MH, Chin KJ, Coburn M, Jonsson Fagerlund M, Myatra SN, Myles PS, O'Sullivan E, Pasin L, Shamim F, van Klei WA, Ahmad I. Risks to healthcare workers following tracheal intubation of patients with COVID-19: a prospective international multicentre cohort study. Anaesthesia 2020; 75:1437-1447. [PMID: 32516833 PMCID: PMC7300828 DOI: 10.1111/anae.15170] [Citation(s) in RCA: 182] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2020] [Indexed: 01/25/2023]
Abstract
Healthcare workers involved in aerosol‐generating procedures, such as tracheal intubation, may be at elevated risk of acquiring COVID‐19. However, the magnitude of this risk is unknown. We conducted a prospective international multicentre cohort study recruiting healthcare workers participating in tracheal intubation of patients with suspected or confirmed COVID‐19. Information on tracheal intubation episodes, personal protective equipment use and subsequent provider health status was collected via self‐reporting. The primary endpoint was the incidence of laboratory‐confirmed COVID‐19 diagnosis or new symptoms requiring self‐isolation or hospitalisation after a tracheal intubation episode. Cox regression analysis examined associations between the primary endpoint and healthcare worker characteristics, procedure‐related factors and personal protective equipment use. Between 23 March and 2 June 2020, 1718 healthcare workers from 503 hospitals in 17 countries reported 5148 tracheal intubation episodes. The overall incidence of the primary endpoint was 10.7% over a median (IQR [range]) follow‐up of 32 (18–48 [0–116]) days. The cumulative incidence within 7, 14 and 21 days of the first tracheal intubation episode was 3.6%, 6.1% and 8.5%, respectively. The risk of the primary endpoint varied by country and was higher in women, but was not associated with other factors. Around 1 in 10 healthcare workers involved in tracheal intubation of patients with suspected or confirmed COVID‐19 subsequently reported a COVID‐19 outcome. This has human resource implications for institutional capacity to deliver essential healthcare services, and wider societal implications for COVID‐19 transmission.
Collapse
Affiliation(s)
- K El-Boghdadly
- Department of Anaesthesia and Perioperative Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London, UK
| | - D J N Wong
- Department of Anaesthesia and Perioperative Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - R Owen
- Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - M D Neuman
- Penn Centre for Peri-operative Outcomes Research and Transformation, University of Pennsylvania, USA
| | - S Pocock
- Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - J B Carlisle
- Department of Anaesthesia, Peri-operative Medicine and Intensive Care, Torbay Hospital, UK
| | - C Johnstone
- Department of Anaesthesia and Perioperative Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - P Andruszkiewicz
- Department of Anaesthesiology and Intensive Care, Institute of Tuberculosis and Lung Diseases, Poland
| | | | - B M Biccard
- Department of Anaesthesia and Perioperative Medicine, University of Cape Town, South Africa
| | - G L Bryson
- Department of Anaesthesia and Pain Medicine, University of Ottawa, Canada
| | - M T V Chan
- The Chinese University of Hong Kong, Hong Kong
| | - M H Cheng
- Division of Anaesthesiology, Singapore General Hospital, Singapore
| | - K J Chin
- Department of Anaesthesia and Pain Medicine, University of Toronto, Canada
| | - M Coburn
- Department of Anaesthesia, University Hospital RWTH, Aachen, Germany
| | - M Jonsson Fagerlund
- Perioperative Medicine and Intensive Care, Karolinska University Hospital, Sweden
| | - S N Myatra
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, India
| | - P S Myles
- Department of Anaesthesiology and Perioperative Medicine, Monash University, Australia
| | | | - L Pasin
- Department of Anaesthesia and Intensive Care, Azienda Ospedale-Università di Padova, Italy
| | - F Shamim
- Department of Anaesthesiology, Aga Khan University Hospital, Pakistan
| | - W A van Klei
- Division Anaesthesia, Intensive Care and Emergency Medicine, University Medical Center Utrecht, Netherlands
| | - I Ahmad
- Department of Anaesthesia and Perioperative Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London, UK
| |
Collapse
|
46
|
Plebani M, Padoan A, Sciacovelli L, Basso D. Towards the rational utilization of SARS-CoV-2 serological tests in clinical practice. ACTA ACUST UNITED AC 2020; 58:e189-e191. [DOI: 10.1515/cclm-2020-0880] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/15/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Mario Plebani
- Department of Medicine-DIMED, Medical School , University of Padova , Padova , Italy
- Department of Laboratory Medicine , University-Hospital of Padova , Padova , Italy
| | - Andrea Padoan
- Department of Medicine-DIMED, Medical School , University of Padova , Padova , Italy
- Department of Laboratory Medicine , University-Hospital of Padova , Padova , Italy
| | - Laura Sciacovelli
- Department of Laboratory Medicine , University-Hospital of Padova , Padova , Italy
| | - Daniela Basso
- Department of Medicine-DIMED, Medical School , University of Padova , Padova , Italy
- Department of Laboratory Medicine , University-Hospital of Padova , Padova , Italy
| |
Collapse
|
47
|
Mayanskiy NA. Immunity to COVID-19 and issues of screening for SARS-Cov-2 antibodies. BULLETIN OF RUSSIAN STATE MEDICAL UNIVERSITY 2020. [DOI: 10.24075/brsmu.2020.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This paper briefly presents the known data on the immune response to SARS-CoV-2, and also analyzes the possibilities and limitations of serological testing for antibodies that should be accounted for when planning population studies and interpreting their results.
Collapse
Affiliation(s)
- NA Mayanskiy
- Pirogov Russian National Research Medical University, Moscow, Russia
| |
Collapse
|
48
|
Acuti Martellucci C, Flacco ME, Cappadona R, Bravi F, Mantovani L, Manzoli L. SARS-CoV-2 pandemic: An overview. Adv Biol Regul 2020; 77:100736. [PMID: 32773099 PMCID: PMC7832554 DOI: 10.1016/j.jbior.2020.100736] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/04/2020] [Indexed: 02/07/2023]
Abstract
By the end of May 2020, SARS-CoV-2 pandemic caused more than 350,000 deaths worldwide. In the first months, there have been uncertainties on almost any area: infection transmission route, virus origin and persistence in the environment, diagnostic tests, therapeutic approach, high-risk subjects, lethality, and containment policies. We provide an updated summary of the current knowledge on the pandemic, discussing the available evidence on the effectiveness of the adopted mitigation strategies.
Collapse
Affiliation(s)
- Cecilia Acuti Martellucci
- Section of Hygiene and Preventive Medicine, Department of Biomedical Sciences and Public Health, University of the Marche Region, Via Conca, 60126, Ancona, Italy
| | - Maria Elena Flacco
- Department of Medical Sciences, University of Ferrara, Via Fossato di Mortara 64/B, 44121, Ferrara, Italy
| | - Rosaria Cappadona
- Department of Medical Sciences, University of Ferrara, Via Fossato di Mortara 64/B, 44121, Ferrara, Italy
| | - Francesca Bravi
- "Sant'Anna" University Hospital of Ferrara, Via Aldo Moro 8, 44124, Cona (Fe), Italy
| | - Lorenzo Mantovani
- University Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy; IRCCS Multimedica, Sesto San Giovanni, Italy
| | - Lamberto Manzoli
- Department of Medical Sciences, University of Ferrara, Via Fossato di Mortara 64/B, 44121, Ferrara, Italy.
| |
Collapse
|
49
|
Liow MHL, Tay KXK, Yeo NEM, Tay DKJ, Goh SK, Koh JSB, Howe TS, Tan AHC. From "business continuity" to "back to business" for orthopaedic surgeons during the COVID-19 pandemic. Bone Jt Open 2020; 1:222-228. [PMID: 33225293 PMCID: PMC7677721 DOI: 10.1302/2633-1462.16.bjo-2020-0036.r1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented challenges to healthcare systems worldwide. Orthopaedic departments have adopted business continuity models and guidelines for essential and non-essential surgeries to preserve hospital resources as well as protect patients and staff. These guidelines broadly encompass reduction of ambulatory care with a move towards telemedicine, redeployment of orthopaedic surgeons/residents to the frontline battle against COVID-19, continuation of education and research through web-based means, and cancellation of non-essential elective procedures. However, if containment of COVID-19 community spread is achieved, resumption of elective orthopaedic procedures and transition plans to return to normalcy must be considered for orthopaedic departments. The COVID-19 pandemic also presents a moral dilemma to the orthopaedic surgeon considering elective procedures. What is the best treatment for our patients and how does the fear of COVID-19 influence the risk-benefit discussion during a pandemic? Surgeons must deliberate the fine balance between elective surgery for a patient’s wellbeing versus risks to the operating team and utilization of precious hospital resources. Attrition of healthcare workers or Orthopaedic surgeons from restarting elective procedures prematurely or in an unsafe manner may render us ill-equipped to handle the second wave of infections. This highlights the need to develop effective screening protocols or preoperative COVID-19 testing before elective procedures in high-risk, elderly individuals with comorbidities. Alternatively, high-risk individuals should be postponed until the risk of nosocomial COVID-19 infection is minimal. In addition, given the higher mortality and perioperative morbidity of patients with COVID-19 undergoing surgery, the decision to operate must be carefully deliberated. As we ramp-up elective services and get “back to business” as orthopaedic surgeons, we have to be constantly mindful to proceed in a cautious and calibrated fashion, delivering the best care, while maintaining utmost vigilance to prevent the resurgence of COVID-19 during this critical transition period. Cite this article: Bone Joint Open 2020;1-6:222–228.
Collapse
Affiliation(s)
| | - Kenny Xian Khing Tay
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | | | - Darren Keng Jin Tay
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Seo Kiat Goh
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Joyce Suang Bee Koh
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Tet Sen Howe
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Andrew Hwee Chye Tan
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| |
Collapse
|
50
|
Nailescu C, Khalid M, Wilson AC, Amanat F, Arregui S, Canas J, Hooks J, Krammer F, Schwaderer AL, Hains DS. Assessment of Seroconversion to SARS-CoV-2 in a Cohort of Pediatric Kidney Transplant Recipients. Front Pediatr 2020; 8:601327. [PMID: 33194930 PMCID: PMC7661782 DOI: 10.3389/fped.2020.601327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/05/2020] [Indexed: 12/18/2022] Open
Abstract
Background: The occurrence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated coronavirus disease 2019 (COVID-19) have profoundly affected adult kidney disease patients. In contrast, pediatric solid organ transplant recipients, including pediatric kidney transplant (KT) recipients, do not seem to be at particularly higher risk for SARS-CoV-2 infection or for severe COVID-19 disease. This patient population might be protected by certain mechanisms, such as the immunosuppressive medications with their anti-inflammatory properties or simply being well-versed in self-protection techniques. Assessing SARS-CoV-2 antibody serologies could potentially help understand why this patient population is apparently spared from severe SARS-CoV-2 clinical courses. Objective: To examine SARS-CoV-2 serologic status in a cohort of pediatric KT recipients. Methods: SARS-CoV-2 anti-spike IgG and IgM antibodies were measured by three different methods in pediatric KT recipients coming for routine clinic visits immediately post-confinement in May-June of 2020. The patients were considered seroconverted if SARS-CoV-2 antibodies were positive by 2/3 methods and weak positive/indeterminate if positive by 1/3. Results: Thirty-one patients were evaluated (about 1/3 of our institution's pediatric KT population). One patient seroconverted, while three were considered weak positive/indeterminate. None were symptomatic and none had nasopharyngeal PCR confirmed SARS-CoV-2 disease. Conclusions: Seroconversion to SARS-CoV-2 was rare in this population and likely reflects the social distancing practiced by these patients. The results will serve as a foundation for a future longitudinal study to evaluate the long-term emergence and persistence of antibodies in this population and may inform studies of response to a future vaccine.
Collapse
Affiliation(s)
- Corina Nailescu
- Department of Pediatrics, Indiana University, Indianapolis, IN, United States
| | - Myda Khalid
- Department of Pediatrics, Indiana University, Indianapolis, IN, United States
| | - Amy C Wilson
- Department of Pediatrics, Indiana University, Indianapolis, IN, United States
| | - Fatima Amanat
- Department of Microbiology, Icahn School of Medicine at Mount Sinai Medical Center, New York, NY, United States
| | - Samuel Arregui
- Department of Pediatrics, Indiana University, Indianapolis, IN, United States
| | - Jorge Canas
- Department of Pediatrics, Indiana University, Indianapolis, IN, United States
| | - Jenaya Hooks
- Department of Pediatrics, Indiana University, Indianapolis, IN, United States
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai Medical Center, New York, NY, United States
| | - Andrew L Schwaderer
- Department of Pediatrics, Indiana University, Indianapolis, IN, United States
| | - David S Hains
- Department of Pediatrics, Indiana University, Indianapolis, IN, United States
| |
Collapse
|