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Ebinger JE, Lan R, Sun N, Wu M, Joung S, Botwin GJ, Botting P, Al-Amili D, Aronow H, Beekley J, Coleman B, Contreras S, Cozen W, Davis J, Debbas P, Diaz J, Driver M, Fert-Bober J, Gu Q, Heath M, Herrera E, Hoang A, Hussain SK, Huynh C, Kim L, Kittleson M, Liu Y, Lloyd J, Luong E, Malladi B, Merchant A, Merin N, Mujukian A, Nguyen N, Nguyen TT, Pozdnyakova V, Rashid M, Raedschelders K, Reckamp KL, Rhoades K, Sternbach S, Vallejo R, White S, Tompkins R, Wong M, Arditi M, Figueiredo JC, Van Eyk JE, Miles PB, Chavira C, Shane R, Sobhani K, Melmed GY, McGovern DPB, Braun JG, Cheng S, Minissian MB. Symptomology following mRNA vaccination against SARS-CoV-2. Prev Med 2021;153:106860. [PMID: 34687733 PMCID: PMC8527734 DOI: 10.1016/j.ypmed.2021.106860] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/06/2021] [Accepted: 10/14/2021] [Indexed: 01/08/2023]

Affiliation(s)

Joseph E Ebinger Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Roy Lan College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
Nancy Sun Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Min Wu Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Sandy Joung Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Gregory J Botwin F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars Sinai, USA
Patrick Botting Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Daniah Al-Amili Biomedical Imaging Research Institute, Cedars-Sinai Medical Centre, Los Angeles, CA, USA
Harriet Aronow Brawerman Nursing Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
James Beekley Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Bernice Coleman Brawerman Nursing Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Sandra Contreras Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Wendy Cozen Division of Hematology/Oncology, Department of Medicine, School of Medicine at UCI, Irvine, CA, USA; Department of Pathology, School of Medicine at UCI, Irvine, CA, USA; Chao Family Comprehensive Cancer Center, University of California, Irvine, CA, USA
Jennifer Davis F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars Sinai, USA
Philip Debbas F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars Sinai, USA
Jacqueline Diaz Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Matthew Driver Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Justyna Fert-Bober Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Advanced Clinical Biosystems Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Quanquan Gu Department of Computer Science, University of California, Los Angeles, CA, USA
Mallory Heath Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Ergueen Herrera Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Amy Hoang Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Shehnaz K Hussain Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Carissa Huynh Biobank & Translational Research Core Laboratory, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Linda Kim Brawerman Nursing Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Michelle Kittleson Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Yunxian Liu Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
John Lloyd Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Eric Luong Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Bhavya Malladi Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Akil Merchant Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Noah Merin Department of Internal Medicine, Division of Hematology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Angela Mujukian F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars Sinai, USA
Nathalie Nguyen Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Trevor-Trung Nguyen Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Valeriya Pozdnyakova F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars Sinai, USA
Mohamad Rashid Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Koen Raedschelders Advanced Clinical Biosystems Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Karen L Reckamp Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Kylie Rhoades Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Sarah Sternbach Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Rocío Vallejo Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Shane White F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars Sinai, USA
Rose Tompkins Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Melissa Wong Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Moshe Arditi Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Departments of Pediatrics, Division of Infectious Diseases and Immunology, and Infectious, Immunologic Diseases Research Center (IIDRC), Los Angeles, CA, USA; Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Jane C Figueiredo Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Jennifer E Van Eyk Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Advanced Clinical Biosystems Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Peggy B Miles Employee Health Services, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Cynthia Chavira Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Rita Shane Department of Pharmacy, Cedar-Sinai Medical Center, Los Angeles, CA, USA
Kimia Sobhani Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Gil Y Melmed F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars Sinai, USA
Dermot P B McGovern F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars Sinai, USA
Jonathan G Braun F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars Sinai, USA; Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA..
Susan Cheng Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Margo B Minissian Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Brawerman Nursing Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

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Ebinger JE, Botwin GJ, Albert CM, Alotaibi M, Arditi M, Berg AH, Binek A, Botting P, Fert-Bober J, Figueiredo JC, Grein JD, Hasan W, Henglin M, Hussain SK, Jain M, Joung S, Karin M, Kim EH, Li D, Liu Y, Luong E, McGovern DPB, Merchant A, Merin N, Miles PB, Minissian M, Nguyen TT, Raedschelders K, Rashid MA, Riera CE, Riggs RV, Sharma S, Sternbach S, Sun N, Tourtellotte WG, Van Eyk JE, Sobhani K, Braun JG, Cheng S. Seroprevalence of antibodies to SARS-CoV-2 in healthcare workers: a cross-sectional study. BMJ Open 2021;11:e043584. [PMID: 33579769 PMCID: PMC7883610 DOI: 10.1136/bmjopen-2020-043584] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/30/2020] [Accepted: 01/20/2021] [Indexed: 12/12/2022] Open

Abstract

OBJECTIVE

We sought to determine the extent of SARS-CoV-2 seroprevalence and the factors associated with seroprevalence across a diverse cohort of healthcare workers.

DESIGN

Observational cohort study of healthcare workers, including SARS-CoV-2 serology testing and participant questionnaires.

SETTINGS

A multisite healthcare delivery system located in Los Angeles County.

PARTICIPANTS

A diverse and unselected population of adults (n=6062) employed in a multisite healthcare delivery system located in Los Angeles County, including individuals with direct patient contact and others with non-patient-oriented work functions.

MAIN OUTCOMES

Using Bayesian and multivariate analyses, we estimated seroprevalence and factors associated with seropositivity and antibody levels, including pre-existing demographic and clinical characteristics; potential COVID-19 illness-related exposures; and symptoms consistent with COVID-19 infection.

RESULTS

We observed a seroprevalence rate of 4.1%, with anosmia as the most prominently associated self-reported symptom (OR 11.04, p<0.001) in addition to fever (OR 2.02, p=0.002) and myalgias (OR 1.65, p=0.035). After adjusting for potential confounders, seroprevalence was also associated with Hispanic ethnicity (OR 1.98, p=0.001) and African-American race (OR 2.02, p=0.027) as well as contact with a COVID-19-diagnosed individual in the household (OR 5.73, p<0.001) or clinical work setting (OR 1.76, p=0.002). Importantly, African-American race and Hispanic ethnicity were associated with antibody positivity even after adjusting for personal COVID-19 diagnosis status, suggesting the contribution of unmeasured structural or societal factors.

CONCLUSION AND RELEVANCE

The demographic factors associated with SARS-CoV-2 seroprevalence among our healthcare workers underscore the importance of exposure sources beyond the workplace. The size and diversity of our study population, combined with robust survey and modelling techniques, provide a vibrant picture of the demographic factors, exposures and symptoms that can identify individuals with susceptibility as well as potential to mount an immune response to COVID-19.

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Affiliation(s)

Joseph E Ebinger Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Gregory J Botwin F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Christine M Albert Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Mona Alotaibi Division of Pulmonary and Critical Care Medicine, University of California, San Diego, La Jolla, California, USA
Moshe Arditi Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA Departments of Pediatrics, Division of Infectious Diseases and Immunology, and Infectious and Immunologic Diseases Research Center (IIDRC), Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
Anders H Berg Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
Aleksandra Binek Advanced Clinical Biosystems Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
Patrick Botting Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Justyna Fert-Bober Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Jane C Figueiredo Cedars-Sinai Cancer and Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
Jonathan D Grein Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA Department of Epidemiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
Wohaib Hasan Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA Biobank & Translational Research Core Laboratory, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Mir Henglin Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Shehnaz K Hussain Department of Public Health Sciences and Comprehensive Cancer Center, University of California, Davis, Davis, California, USA
Mohit Jain Department of Medicine and Pharmacology, University of California, San Diego, La Jolla, California, USA
Sandy Joung Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Michael Karin Department of Pharmacology, University of California San Diego School of Medicine, La Jolla, California, USA
Elizabeth H Kim Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Dalin Li F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Yunxian Liu Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Eric Luong Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Dermot P B McGovern F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Akil Merchant Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
Noah Merin Department of Internal Medicine, Division of Hematology, Cedars-Sinai Medical Center, Los Angeles, California, USA
Peggy B Miles Employee Health Services, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
Margo Minissian Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA Brawerman Nursing Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Trevor Trung Nguyen Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Koen Raedschelders Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA Advanced Clinical Biosystems Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
Mohamad A Rashid Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Celine E Riera Center for Neural Science and Medicine, Department of Biomedical Sciences, Board of Governors Regenerative Medicine Institute, Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
Richard V Riggs Chief Medical Officer, Cedars-Sinai Medical Center, Los Angeles, California, USA
Sonia Sharma La Jolla Institute for Allergy and Immunology, La Jolla, California, USA
Sarah Sternbach Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Nancy Sun Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Warren G Tourtellotte Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA Biobank & Translational Research Core Laboratory, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Jennifer E Van Eyk Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA Advanced Clinical Biosystems Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA Barbra Streisand Women's Heart Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
Kimia Sobhani Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
Jonathan G Braun Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
Susan Cheng Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA Barbra Streisand Women's Heart Center, Cedars-Sinai Medical Center, Los Angeles, California, USA

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Miles PB. Practical issues in administering welfare benefit programs for two career families. Empl Benefits J 1991;16:17-9. [PMID: 10111171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]