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Tracing asymptomatic SARS-CoV-2 carriers among 3674 hospital staff:a cross-sectional survey.

ABSTRACT: Background:Asymptomatic carriers were positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) without developing symptoms, which might be a potential source of infection outbreak. Here, we aim to clarify the epidemiologic and influencing factors of asymptomatic carriers in the general population. Methods:In our hospital, all hospital staff have received throat swab RT-PCR test, plasma COVID-19 IgM/IgG antibodies test and chest CT examination. We analyzed the correlation between infection rates and gender, age, job position, work place and COVID-19 knowledge training of the staff. After that, all asymptomatic staff were re-examined weekly for 3 weeks. Findings:A total of 3764 hospital staff were included in this single-center cross-sectional study. Among them, 126 hospital staff had abnormal findings, and the proportion of asymptomatic infection accounted for 0.76% (28/3674). There were 26 staff with IgM+, 73 with IgG+, and 40 with ground glass shadow of chest CT. Of all staff with abnormal findings, the older they are, the more likely they are to be the staff with abnormal results, regardless of their gender. Of 3674 hospital staff, the positive rate of labor staff is obviously higher than that of health care workers (HCWs) and administrative staff (P<0.05). In the course of participating in the treatment of COVID-19, there was no statistically significant difference in positive rates between high-risk departments and low-risk departments (P>0.05). The positive rate of HCWs who participated in the COVID-19 knowledge training was lower than those did not participate in early training (P <0.01). Importantly, it was found that there was no statistical difference between the titers of IgM antibody of asymptomatic infections and confirmed patients with COVID-19 in recovery period (P>0.05). During 3 weeks follow-up, all asymptomatic patients did not present the development of clinical symptoms or radiographic abnormalities after active intervention in isolation point. Interpretation:To ensure the safety of resumption of work, institutions should conduct COVID-19 prevention training for staff and screening for asymptomatic patients, and take quarantine measures as soon as possible in areas with high density of population. Funding:The Key Project for Anti-2019 novel Coronavirus Pneumonia from the Ministry of Science and Technology, China; Wuhan Emergency Technology Project of COVID-19 epidemic, China.

SUBMITTER: Zhou F

PROVIDER: S-EPMC7490283 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Tracing asymptomatic SARS-CoV-2 carriers among 3674 hospital staff:a cross-sectional survey.

Zhou Fuling F Li Jingfeng J Lu Mengxin M Ma Linlu L Pan Yunbao Y Liu Xiaoyan X Zhu Xiaobin X Hu Chao C Wu Sanyun S Chen Liangjun L Wang Yi Y Wei Yongchang Y Li Yirong Y Xu Haibo H Wang Xinghuan X Cai Lin L

EClinicalMedicine 20200915

<h4>Background</h4>Asymptomatic carriers were positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) without developing symptoms, which might be a potential source of infection outbreak. Here, we aim to clarify the epidemiologic and influencing factors of asymptomatic carriers in the general population.<h4>Methods</h4>In our hospital, all hospital staff have received throat swab RT-PCR test, plasma COVID-19 IgM/IgG antibodies test and chest CT examination. We analyzed the corr ...[more]

PMID: 32954232

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Project description:ObjectivesCardiovascular disease is a major cause of morbidity and mortality worldwide. Cardiovascular disease was responsible for over 17.9 million deaths in 2016, accounting for 31% of deaths globally and 37% of deaths in Saudi Arabia. With a lifetime risk exceeding 60% for the general population, healthcare professionals are continuously monitoring the health of others but often do not find time to care for themselves. This study aimed to assess the prevalence of cardiovascular risk factors; medical conditions, such as, hypertension and diabetes mellitus; stress; and attitudes and barriers against healthy lifestyle choices among healthcare professionals at King Abdulaziz University Hospital.MethodsA cross-sectional study based on a self-administered questionnaire was conducted among the staff at King Abdulaziz University Hospital over a period of 12 weeks. A validated questionnaire was adopted from a study that had previously been conducted in the United Kingdom.ResultsThe study included 400 healthcare workers, of whom, 78% were clinical staff and 22% were non-clinical staff. Approximately, two-thirds of the clinical staff were aged ⩽25 years, whereas 43.2% of the non-clinical staff were aged 26-35 years. Most of the clinical staff (70.5%) were female, compared to 56.8% of the non-clinical staff. Significantly higher rates of hypertension and smoking were observed among the non-clinical staff than among the clinical staff. However, no other significant differences were observed in the prevalence of diseases between the groups. Overall, poor lifestyle, in terms of low compliance with the recommended dietary and physical activity guidelines, was observed in both groups.ConclusionThe prevalence of cardiovascular risk factors among the clinical staff at King Abdulaziz University Hospital was not markedly different from that among the non-clinical staff, except the prevalence of hypertension and smoking, which was significantly higher among the non-clinical staff. Further studies that include staff from other institutions are recommended.

Project description:ObjectivesAn initial report of findings from 1.14 million SARS CoV-2 serology tests in National Health Service (NHS) staff to compare NHS staff seroconversion with community seroconversion rates at a regional level.DesignA national cross-sectional survey.SettingA SARS-CoV-2 antibody testing programme offered across all NHS Trusts.Participants1.14 million NHS staff.InterventionSARS-CoV-2 antibody testing.Primary and secondary outcome measuresSARS-CoV-2 antibody testing was used to estimate the seroprevalence of SARS-CoV-2 in NHS staff by region, compared with community seroprevalence as determined by the COVID-19 Infection Survey (Office for National Statistics). We also explored seroprevalence trends by regional COVID-19 activity, using regional death rates as a proxy for COVID-19 'activity'.Results1 146 310 tests were undertaken on NHS staff between 26 May and 31 August 2020. 186 897 NHS tests were positive giving a seroconversion rate of 16.3% (95% CI 16.2% to 16.4%), in contrast to the national community seroconversion rate of 5.9% (95% CI 5.3% to 6.6%). There was significant geographical regional variation, which mirrored the trends seen in community prevalence rates. NHS staff were infected at a higher rate than the general population (OR 3.1, 95% CI 2.8 to 3.5). NHS seroconversion by regional death rate suggested a trend towards higher seroconversion rates in the areas with higher COVID-19 'activity'.ConclusionsThis is the first cross-sectional survey assessing the risk of COVID-19 disease in healthcare workers at a national level. It is the largest study of its kind. It suggests that NHS staff have a significantly higher rate of COVID-19 seroconversion compared with the general population in England, with regional variation across the country which matches the background population prevalence trends. There was also a trend towards higher seroconversion rates in areas which had experienced high COVID-19 clinical activity. This work has global significance in terms of the value of such a testing programme and contributing to the understanding of healthcare worker seroconversion at a national level.

Project description:Information regarding the infectivity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in asymptomatic carriers is scarce. In order to determine the duration of infectivity and its correlation with reverse transcription-PCR (RT-PCR) results and time since initial positive PCR test in this population, we evaluated SARS-CoV-2 cell infectivity in nasopharyngeal samples longitudinally obtained from asymptomatic carriers who disembarked from a cruise ship during a COVID-19 outbreak. Of 166 nasopharyngeal samples collected from 39 asymptomatic carriers every 48 h until two consecutive negative PCR test results were obtained, SARS-CoV-2 was successfully isolated from 9 PCR-positive samples which were obtained from 7 persons (18%; 7/39). Viable viruses were isolated predominantly within 7 days after the initial positive PCR test, except for one person who shed viable virus until day 15. The median crossing point (Cp) value of RT-PCR of culture-positive samples was 24.6 (interquartile range [IQR], 20.4 to 25.8; range, 17.9 to 30.3), and Cp values were significantly associated with isolation of viable virus (odds ratio, 0.496; 95% confidence interval [CI], 0.329 to 0.747; P value, 0.001), which was consistent with existing data for symptomatic patients. Genome sequence analysis of SARS-CoV-2 samples consecutively obtained from a person who shed viable virus for 15 days identified the emergence of two novel single nucleotide variants (C8626T transition and C18452T transition) in the sample collected on day 15, with the latter corresponding to an amino acid substitution in nonstructural protein 14. The impact of these mutations on prolonged viable-virus shedding is unclear. These findings underscore the potential role of asymptomatic carriers in transmission.IMPORTANCE A growing number of studies suggest the potential role of asymptomatic SARS-CoV-2 carriers as a major driver of the COVID-19 pandemic; however, virological assessment of asymptomatic infection has largely been limited to reverse transcription-PCR (RT-PCR), which can be persistently positive without necessarily indicating the presence of viable virus (e.g., replication-competent virus). Here, we evaluated the infectivity of asymptomatic SARS-CoV-2 carriers by detecting SARS-CoV-2-induced cytopathic effects on Vero cells using longitudinally obtained nasopharyngeal samples from asymptomatic carriers. We show that asymptomatic carriers can shed viable virus until 7 days after the initial positive PCR test, with one outlier shedding until day 15. The crossing point (Cp) value of RT-PCR was the leading predictive factor for virus viability. These findings provide additional insights into the role of asymptomatic carriers as a source of transmission and highlight the importance of universal source control measures, along with isolation policy for asymptomatic carriers.

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Tracing asymptomatic SARS-CoV-2 carriers among 3674 hospital staff:a cross-sectional survey.

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Tracing asymptomatic SARS-CoV-2 carriers among 3674 hospital staff:a cross-sectional survey.

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