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Captur G, Moon JC, Topriceanu CC, Joy G, Swadling L, Hallqvist J, Doykov I, Patel N, Spiewak J, Baldwin T, Hamblin M, Menacho K, Fontana M, Treibel TA, Manisty C, O'Brien B, Gibbons JM, Pade C, Brooks T, Altmann DM, Boyton RJ, McKnight Á, Maini MK, Noursadeghi M, Mills K, Heywood WE. Plasma proteomic signature predicts who will get persistent symptoms following SARS-CoV-2 infection. EBioMedicine 2022; 85:104293. [PMID: 36182629 PMCID: PMC9515404 DOI: 10.1016/j.ebiom.2022.104293] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/27/2022] [Accepted: 09/16/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The majority of those infected by ancestral Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) during the UK first wave (starting March 2020) did not require hospitalisation. Most had a short-lived mild or asymptomatic infection, while others had symptoms that persisted for weeks or months. We hypothesized that the plasma proteome at the time of first infection would reflect differences in the inflammatory response that linked to symptom severity and duration. METHODS We performed a nested longitudinal case-control study and targeted analysis of the plasma proteome of 156 healthcare workers (HCW) with and without lab confirmed SARS-CoV-2 infection. Targeted proteomic multiple-reaction monitoring analysis of 91 pre-selected proteins was undertaken in uninfected healthcare workers at baseline, and in infected healthcare workers serially, from 1 week prior to 6 weeks after their first confirmed SARS-CoV-2 infection. Symptom severity and antibody responses were also tracked. Questionnaires at 6 and 12 months collected data on persistent symptoms. FINDINGS Within this cohort (median age 39 years, interquartile range 30-47 years), 54 healthcare workers (44% male) had PCR or antibody confirmed infection, with the remaining 102 (38% male) serving as uninfected controls. Following the first confirmed SARS-CoV-2 infection, perturbation of the plasma proteome persisted for up to 6 weeks, tracking symptom severity and antibody responses. Differentially abundant proteins were mostly coordinated around lipid, atherosclerosis and cholesterol metabolism pathways, complement and coagulation cascades, autophagy, and lysosomal function. The proteomic profile at the time of seroconversion associated with persistent symptoms out to 12 months. Data are available via ProteomeXchange with identifier PXD036590. INTERPRETATION Our findings show that non-severe SARS-CoV-2 infection perturbs the plasma proteome for at least 6 weeks. The plasma proteomic signature at the time of seroconversion has the potential to identify which individuals are more likely to suffer from persistent symptoms related to SARS-CoV-2 infection. FUNDING INFORMATION The COVIDsortium is supported by funding donated by individuals, charitable Trusts, and corporations including Goldman Sachs, Citadel and Citadel Securities, The Guy Foundation, GW Pharmaceuticals, Kusuma Trust, and Jagclif Charitable Trust, and enabled by Barts Charity with support from University College London Hospitals (UCLH) Charity. This work was additionally supported by the Translational Mass Spectrometry Research Group and the Biomedical Research Center (BRC) at Great Ormond Street Hospital.
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Affiliation(s)
- Gabriella Captur
- UCL MRC Unit for Lifelong Health and Ageing, 33 Bedford Place, London WC1B 5JU, UK; Institute of Cardiovascular Science, University College London, Gower Street, London WC1E 6BT, UK; The Royal Free Hospital, Center for Inherited Heart Muscle Conditions, Cardiology Department, Pond Street, Hampstead, London NW3 2QG, UK
| | - James C Moon
- Institute of Cardiovascular Science, University College London, Gower Street, London WC1E 6BT, UK; Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit and The Inherited Cardiovascular Diseases Unit, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK
| | - Constantin-Cristian Topriceanu
- UCL MRC Unit for Lifelong Health and Ageing, 33 Bedford Place, London WC1B 5JU, UK; Institute of Cardiovascular Science, University College London, Gower Street, London WC1E 6BT, UK
| | - George Joy
- Institute of Cardiovascular Science, University College London, Gower Street, London WC1E 6BT, UK; Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit and The Inherited Cardiovascular Diseases Unit, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK
| | - Leo Swadling
- Division of Infection and Immunity, University College London, London WC1E 6JF, UK
| | - Jenny Hallqvist
- Translational Mass Spectrometry Research Group, UCL Institute of Child Health and Great Ormond Street Hospital, 30 Guilford Street, London WC1N 1EH, UK
| | - Ivan Doykov
- Translational Mass Spectrometry Research Group, UCL Institute of Child Health and Great Ormond Street Hospital, 30 Guilford Street, London WC1N 1EH, UK
| | - Nina Patel
- Translational Mass Spectrometry Research Group, UCL Institute of Child Health and Great Ormond Street Hospital, 30 Guilford Street, London WC1N 1EH, UK
| | - Justyna Spiewak
- Translational Mass Spectrometry Research Group, UCL Institute of Child Health and Great Ormond Street Hospital, 30 Guilford Street, London WC1N 1EH, UK
| | - Tomas Baldwin
- Translational Mass Spectrometry Research Group, UCL Institute of Child Health and Great Ormond Street Hospital, 30 Guilford Street, London WC1N 1EH, UK
| | - Matt Hamblin
- Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit and The Inherited Cardiovascular Diseases Unit, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK
| | - Katia Menacho
- Institute of Cardiovascular Science, University College London, Gower Street, London WC1E 6BT, UK; Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit and The Inherited Cardiovascular Diseases Unit, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK
| | - Marianna Fontana
- Institute of Cardiovascular Science, University College London, Gower Street, London WC1E 6BT, UK; The Royal Free Hospital, Cardiac MRI Unit, Pond Street, Hampstead, London NW3 2QG, UK
| | - Thomas A Treibel
- Institute of Cardiovascular Science, University College London, Gower Street, London WC1E 6BT, UK; Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit and The Inherited Cardiovascular Diseases Unit, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK
| | - Charlotte Manisty
- Institute of Cardiovascular Science, University College London, Gower Street, London WC1E 6BT, UK; Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit and The Inherited Cardiovascular Diseases Unit, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK
| | - Ben O'Brien
- Department of Perioperative Medicine, St. Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK; Department of Cardiac Anesthesiology and Intensive Care Medicine, German Heart Center, Augustenburger Platz 1, 13353 Berlin, Germany; Department of Cardiac Anesthesiology and Intensive Care Medicine, Charité Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; Outcomes Research Consortium, Department of Outcomes Research, The Cleveland Clinic, 9500 Euclid Ave P77, Cleveland, OH 44195, USA
| | - Joseph M Gibbons
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
| | - Corrina Pade
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
| | - Tim Brooks
- National Infection Service, Public Health England, Porton Down, UK
| | - Daniel M Altmann
- Department of Immunology and Inflammation, Imperial College London, London W12 0NN, UK
| | - Rosemary J Boyton
- Department of Infectious Disease, Imperial College London, London SW7 2AZ, UK; Lung Division, Royal Brompton Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London SW3 6NP, UK
| | - Áine McKnight
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
| | - Mala K Maini
- Division of Infection and Immunity, University College London, London WC1E 6JF, UK
| | - Mahdad Noursadeghi
- Division of Infection and Immunity, University College London, London WC1E 6JF, UK
| | - Kevin Mills
- Translational Mass Spectrometry Research Group, UCL Institute of Child Health and Great Ormond Street Hospital, 30 Guilford Street, London WC1N 1EH, UK
| | - Wendy E Heywood
- Translational Mass Spectrometry Research Group, UCL Institute of Child Health and Great Ormond Street Hospital, 30 Guilford Street, London WC1N 1EH, UK.
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Mei Y, Guo X, Chen Z, Chen Y. An Effective Mechanism for the Early Detection and Containment of Healthcare Worker Infections in the Setting of the COVID-19 Pandemic: A Systematic Review and Meta-Synthesis. Int J Environ Res Public Health 2022; 19:ijerph19105943. [PMID: 35627479 PMCID: PMC9141359 DOI: 10.3390/ijerph19105943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 05/09/2022] [Indexed: 02/04/2023]
Abstract
The COVID-19 pandemic has exposed healthcare workers (HCWs) to serious infection risks. In this context, the proactive monitoring of HCWs is the first step toward reducing intrahospital transmissions and safeguarding the HCW population, as well as reflecting the preparedness and response of the healthcare system. As such, this study systematically reviewed the literature on evidence-based effective monitoring measures for HCWs during the COVID-19 pandemic. This was followed by a meta-synthesis to compile the key findings, thus, providing a clearer overall understanding of the subject. Effective monitoring measures of syndromic surveillance, testing, contact tracing, and exposure management are distilled and further integrated to create a whole-process monitoring workflow framework. Taken together, a mechanism for the early detection and containment of HCW infections is, thus, constituted, providing a composite set of practical recommendations to healthcare facility leadership and policy makers to reduce nosocomial transmission rates while maintaining adequate staff for medical services. In this regard, our study paves the way for future studies aimed at strengthening surveillance capacities and upgrading public health system resilience, in order to respond more efficiently to future pandemic threats.
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Affiliation(s)
- Yueli Mei
- School of Political Science and Public Administration, East China University of Political Science and Law, Shanghai 201620, China; (Y.M.); (X.G.); (Z.C.)
- Shanghai Jiao Tong University-Yale University Joint Center for Health Policy, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Xiuyun Guo
- School of Political Science and Public Administration, East China University of Political Science and Law, Shanghai 201620, China; (Y.M.); (X.G.); (Z.C.)
| | - Zhihao Chen
- School of Political Science and Public Administration, East China University of Political Science and Law, Shanghai 201620, China; (Y.M.); (X.G.); (Z.C.)
| | - Yingzhi Chen
- School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China
- Correspondence: ; Tel.: +86-135-649-90786
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Chandran A, Rosenheim J, Nageswaran G, Swadling L, Pollara G, Gupta RK, Burton AR, Guerra-Assunção JA, Woolston A, Ronel T, Pade C, Gibbons JM, Sanz-Magallon Duque De Estrada B, Robert de Massy M, Whelan M, Semper A, Brooks T, Altmann DM, Boyton RJ, McKnight Á, Captur G, Manisty C, Treibel TA, Moon JC, Tomlinson GS, Maini MK, Chain BM, Noursadeghi M. Rapid synchronous type 1 IFN and virus-specific T cell responses characterize first wave non-severe SARS-CoV-2 infections. Cell Rep Med 2022; 3:100557. [PMID: 35474751 PMCID: PMC8895494 DOI: 10.1016/j.xcrm.2022.100557] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 11/22/2021] [Accepted: 02/09/2022] [Indexed: 12/15/2022]
Abstract
Effective control of SARS-CoV-2 infection on primary exposure may reveal correlates of protective immunity to future variants, but we lack insights into immune responses before or at the time virus is first detected. We use blood transcriptomics, multiparameter flow cytometry, and T cell receptor (TCR) sequencing spanning the time of incident non-severe infection in unvaccinated virus-naive individuals to identify rapid type 1 interferon (IFN) responses common to other acute respiratory viruses and cell proliferation responses that discriminate SARS-CoV-2 from other viruses. These peak by the time the virus is first detected and sometimes precede virus detection. Cell proliferation is most evident in CD8 T cells and associated with specific expansion of SARS-CoV-2-reactive TCRs, in contrast to virus-specific antibodies, which lag by 1-2 weeks. Our data support a protective role for early type 1 IFN and CD8 T cell responses, with implications for development of universal T cell vaccines.
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Affiliation(s)
- Aneesh Chandran
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
| | - Joshua Rosenheim
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
| | - Gayathri Nageswaran
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
| | - Leo Swadling
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
| | - Gabriele Pollara
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
| | - Rishi K. Gupta
- Institute for Global Health, University College London, London WC1E 6BT, UK
| | - Alice R. Burton
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
| | | | - Annemarie Woolston
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
| | - Tahel Ronel
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
| | - Corinna Pade
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 4NS, UK
| | - Joseph M. Gibbons
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 4NS, UK
| | | | - Marc Robert de Massy
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
| | - Matthew Whelan
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
| | - Amanda Semper
- National Infection Service, Public Health England, Porton Down, Salisbury SP4 0JQ, UK
| | - Tim Brooks
- National Infection Service, Public Health England, Porton Down, Salisbury SP4 0JQ, UK
| | - Daniel M. Altmann
- Department of Immunology and Inflammation, Imperial College London, London SW7 2BX, UK
| | - Rosemary J. Boyton
- Department of Infectious Disease, Imperial College London, London SW7 2BX, UK
- Lung Division, Royal Brompton and Harefield Hospitals, Guy’s and St Thomas' NHS Foundation Trust, London, UK
| | - Áine McKnight
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 4NS, UK
| | - Gabriella Captur
- Institute of Cardiovascular Sciences, University College London, London WC1E 6BT, UK
- MRC Unit for Lifelong Health and Ageing, University College London, London WC1E 6BT, UK
| | - Charlotte Manisty
- Institute of Cardiovascular Sciences, University College London, London WC1E 6BT, UK
| | | | - James C. Moon
- Institute of Cardiovascular Sciences, University College London, London WC1E 6BT, UK
| | - Gillian S. Tomlinson
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
| | - Mala K. Maini
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
| | - Benjamin M. Chain
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
| | - Mahdad Noursadeghi
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
| | - COVIDsortium Investigators
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
- Institute for Global Health, University College London, London WC1E 6BT, UK
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 4NS, UK
- National Infection Service, Public Health England, Porton Down, Salisbury SP4 0JQ, UK
- Department of Immunology and Inflammation, Imperial College London, London SW7 2BX, UK
- Department of Infectious Disease, Imperial College London, London SW7 2BX, UK
- Lung Division, Royal Brompton and Harefield Hospitals, Guy’s and St Thomas' NHS Foundation Trust, London, UK
- Institute of Cardiovascular Sciences, University College London, London WC1E 6BT, UK
- MRC Unit for Lifelong Health and Ageing, University College London, London WC1E 6BT, UK
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4
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Trivedi A, Fontelera M, Lai A. SARS-COV-2 Screening of Health Care Workers in Brunei Darussalam. Workplace Health Saf 2022; 70:452-458. [PMID: 35112612 DOI: 10.1177/21650799211062802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Health care workers (HCWs) are at high risk of COVID-19 infection; therefore, screening is recommended for early detection and management to break the chain of transmission. Globally, multiple strategies have been utilized for the screening of HCWs. This article reports and evaluates an active surveillance and screening strategy for severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) among HCWs following work or nonwork exposures in Brunei Darussalam to prevent health care-associated COVID-19 transmission. METHODS In March 2020, the Ministry of Health through the Occupational Health Division adopted an active screening strategy for symptomatic and asymptomatic HCWs, which involved symptom screening, risk assessment, SARS-COV-2 testing, and management following work/nonwork exposure and recent overseas travel, and those with influenza-like illness (ILI) symptoms. Screening frequency was based on the HCWs' symptoms and exposure, with the intent to evaluate all possible sources of exposure. FINDINGS As of December 31, 2020, 821 HCWs were screened, of which 632 (77%) had ILI symptoms and 14 (1.7%) had high-risk occupational exposure. Reverse transcription polymerase chain reaction (RT-PCR) swab testing was carried out on 577 (70.3%) HCWs, with the highest proportion of swabs done on doctors (85.1%; p < .01) due to their workplace exposure (34.3%) and overseas travel (38.7%). CONCLUSION By July 2021, Brunei Darussalam had recorded zero cases of COVID-19 among HCWs from occupational exposure. Our strategy of active screening for SARS-COV-2 RT-PCR testing since early in the outbreak has proven to be successful, in combination with infection control practices and public health measures, in the prevention of occupational transmission, thereby facilitating early return to work for HCWs with low-risk exposure and without symptoms.
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Affiliation(s)
- Ashish Trivedi
- Occupational Health Division, Ministry of Health, Brunei Darussalam
| | - Maria Fontelera
- Occupational Health Division, Ministry of Health, Brunei Darussalam
| | - Alice Lai
- Occupational Health Division, Ministry of Health, Brunei Darussalam.,Universiti Brunei Darussalam
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Shamshirgaran SM, Aminisani N, Abasi H, Mollanoroozy E, Mohammad Malekzadeh M, Fazel H, Ghasemi A, khorashadizade F, Moshar-Movahed G, Alimardani AS, Gholami A. Risk assessment of coronavirus disease 2019 among healthcare workers in Neyshabur, 2020. Proceedings of Singapore Healthcare 2021. [DOI: 10.1177/20101058211028854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Since the onset of coronavirus disease 2019 (COVID-19) in the world, healthcare workers have been exposed to this virus due to their important roles and responsibilities in the care and treatment of patients with COVID-19. In this regard, doing risk assessments in healthcare centres helps significantly to control and reduce COVID-19. Therefore, this study aimed to assess COVID-19 risk and its association with clinical symptoms among healthcare workers in Neyshabur. Methods: This cross-sectional study was conducted among 483 healthcare workers of Neyshabur medical centres in 2020. In order to collect the data, a checklist consisting of three sections of demographic variables, risk assessment and clinical symptoms was used. Statistical analyses were performed by using the STATA software version 14. The significance level was set at P<0.05. Results: The mean ± standard deviation age of the study population was 34.2 ± 8.4 years. Out of 483 participants, 55 (11.4%) were identified as high-risk exposure category, 52 (10.8%) as medium-risk category and 77 (15.9%) as low-risk category. According to multiple logistic regression models, it was observed that cough (odds ratio (OR)=2.2; P=0.001), running nose (OR=3.3; P<0.001), suffocation (OR=3.2; P<0.001), shivering (OR=3.4; P=0.001), nausea (OR=3.3; P=0.001), vomiting (OR=7.2; P=0.025), diarrhoea (OR=3.0; P=0.001), muscular pain (OR=2.1; P=0.005), joint pain (OR=2.2; P=0.005) and fatigue (OR=2.1; P=0.003) were significantly associated with risk assessment. Conclusions: The findings showed that more than one-fifth of studied healthcare workers were at high or medium-risk exposure of COVID-19. Cough and fatigue had the most frequencies in healthcare workers with high or medium-risk exposure, and also, vomiting and shivering had a stronger association with risk assessment status.
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Affiliation(s)
| | - Nayyereh Aminisani
- Healthy Ageing Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Hamid Abasi
- Public Health Department, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Ensiyeh Mollanoroozy
- Non-communicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | | | - Hadi Fazel
- Basic Sciences Department, Neyshabur University of Medical Sciences, Tehran, Iran
| | - Ahmad Ghasemi
- Healthy Ageing Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Fatemeh khorashadizade
- Epidemiology and Biostatistics Department, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Ghasem Moshar-Movahed
- 22 Bahman Teaching Hospital, Neyshabur University of Medical Sciences, Neyshabur, Neyshabur, Iran
| | - Amir Sadegh Alimardani
- 22 Bahman Teaching Hospital, Neyshabur University of Medical Sciences, Neyshabur, Neyshabur, Iran
| | - Ali Gholami
- Non-communicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
- Epidemiology and Biostatistics Department, Neyshabur University of Medical Sciences, Neyshabur, Iran
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Allen N, Riain UN, Conlon N, Ferenczi A, Carrion Martin AI, Domegan L, Walsh C, Doherty L, O'Farrelly C, Higgins E, Kerr C, McGrath J, Fleming C, Bergin C; PRECISE Study Steering Group. Prevalence of antibodies to SARS-CoV-2 in Irish hospital healthcare workers. Epidemiol Infect 2021; 149:e157. [PMID: 33902786 DOI: 10.1017/S0950268821000984] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Hospital healthcare workers (HCWs) are at increased risk of contracting COVID-19 infection. We aimed to determine the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in HCWs in Ireland. Two tertiary referral hospitals in Irish cities with diverging community incidence and seroprevalence were identified; COVID-19 had been diagnosed in 10.2% and 1.8% of staff respectively by the time of the study (October 2020). All staff of both hospitals (N = 9038) were invited to participate in an online questionnaire and blood sampling for SARS-CoV-2 antibody testing. Frequencies and percentages for positive SARS-CoV-2 antibody were calculated and adjusted relative risks (aRR) for participant characteristics were calculated using multivariable regression analysis. In total, 5788 HCWs participated (64% response rate). Seroprevalence of antibodies to SARS-CoV-2 was 15% and 4.1% in hospitals 1 and 2, respectively. Thirty-nine percent of infections were previously undiagnosed. Risk for seropositivity was higher for healthcare assistants (aRR 2.0, 95% confidence interval (CI) 1.4–3.0), nurses (aRR: 1.6, 95% CI 1.1–2.2), daily exposure to patients with COVID-19 (aRR: 1.6, 95% CI 1.2–2.1), age 18–29 years (aRR: 1.4, 95% CI 1.1–1.9), living with other HCWs (aRR: 1.3, 95% CI 1.1–1.5), Asian background (aRR: 1.3, 95% CI 1.0–1.6) and male sex (aRR: 1.2, 95% CI 1.0–1.4). The HCW seroprevalence was six times higher than community seroprevalence. Risk was higher for those with close patient contact. The proportion of undiagnosed infections call for robust infection control guidance, easy access to testing and consideration of screening in asymptomatic HCWs. With emerging evidence of reduction in transmission from vaccinated individuals, the authors strongly endorse rapid vaccination of all HCWs.
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