Dataset Information

Seroprevalence of SARS-CoV-2 antibodies and associated factors in health care workers: a systematic review and meta-analysis.

ABSTRACT:

Background

Health care workers (HCWs) represent a high risk population for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Aim

To determine the seroprevalence of SARS-CoV-2 antibodies among HCWs, and to find out the factors that are 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 pre-print services (medR?iv and bioR?iv) were searched from inception up to August 24, 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% CI: 6.7-10.9%). Seroprevalence was higher in studies that were conducted in North America (12.7%) compared to those in Europe (8.5%), Africa (8.2), and Asia (4%). Meta-regression showed that increased sensitivity of antibodies test 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, frontline health care workers, health care assistants, personal protective equipment shortage, self-reported belief for previous SARS-CoV-2 infection, previous positive polymerase chain reaction test, and household contact with suspected or confirmed COVID-19 patients.

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 that are infected with SARS-CoV-2 are imperative to decrease the risk of SARS-CoV-2 infection.

SUBMITTER: Galanis P

PROVIDER: S-EPMC7668234 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Publications

Seroprevalence of SARS-CoV-2 antibodies and associated factors in healthcare workers: a systematic review and meta-analysis.

Galanis P P Vraka I I Fragkou D D Bilali A A Kaitelidou D D

The Journal of hospital infection 20201116

<h4>Background</h4>Healthcare workers (HCWs) represent a high-risk population for infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).<h4>Aim</h4>To determine the seroprevalence of SARS-CoV-2 antibodies among HCWs, and identify the factors associated with this seroprevalence.<h4>Methods</h4>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 prep ...[more]

PMID: 33212126

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Project description:BackgroundIdentifying factors associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care workers (HCWs) may help health systems optimize SARS-CoV-2 infection control strategies.MethodsWe conducted a cross-sectional analysis of baseline data from the Northwestern HCW SARS-CoV-2 Serology Cohort Study. We used the Abbott Architect Nucleocapsid IgG assay to determine seropositivity. Logistic regression models (adjusted for demographics and self-reported community exposure to coronavirus disease 2019 [COVID-19]) were fit to quantify the associations between occupation group, health care delivery tasks, and community exposure and seropositive status.ResultsA total of 6510 HCWs, including 1794 nurses and 904 non-patient-facing administrators, participated. The majority were women (79.6%), 74.9% were White, 9.7% were Asian, 7.3% were Hispanic, and 3.1% were non-Hispanic Black. The crude prevalence of seropositivity was 4.8% (95% CI, 4.6%-5.2%). Seropositivity varied by race/ethnicity as well as age, ranging from 4.2% to 9.6%. Out-of-hospital exposure to COVID-19 occurred in 9.3% of HCWs, 15.0% (95% CI, 12.2%-18.1%) of whom were seropositive; those with family members diagnosed with COVID-19 had a seropositivity rate of 54% (95% CI, 44.2%-65.2%). Support service workers (10.4%; 95% CI, 4.6%-19.4%), medical assistants (10.1%; 95% CI, 5.5%-16.6%), and nurses (7.6%; 95% CI, 6.4%-9.0%) had significantly higher seropositivity rates than administrators (referent; 3.3%; 95% CI, 2.3%-4.4%). However, after adjustment, nursing was the only occupation group with a significantly higher odds (odds ratio, 1.9; 95% CI, 1.3-2.9) of seropositivity. Exposure to patients receiving high-flow oxygen therapy and hemodialysis was significantly associated with 45% and 57% higher odds for seropositive status, respectively.ConclusionsHCWs are at risk for SARS-CoV-2 infection from longer-duration exposures to people infected with SARS-CoV-2 within health care settings and their communities of residence.

Project description:BackgroundKnowing the seroprevalence of SARS-CoV-2 IgG antibodies across geographic regions before vaccine administration is one key piece of knowledge to achieve herd immunity. While people of all ages, occupations, and communities are at risk of getting infected with SARS-CoV-2, the health care workers (HCWs) are possibly at the highest risk. Most seroprevalence surveys with HCWs conducted worldwide have been limited to Europe, North America, and East Asia. We aimed to understand how the seroprevalence of SARS-CoV-2 IgG antibodies varied across these geographic regions among HCWs based on the available evidences.MethodsBy searching through PubMed, ScienceDirect, and Google Scholar databases, eligible studies published from January 1, 2020 to January 15, 2021 were included for the systematic review and meta-analysis. The random-effects model was used to estimate the pooled proportion of IgG seropositive HCWs. Publication bias was assessed by funnel plot and confirmed by Egger's test. Heterogeneity was quantified using I2 statistics. We performed sensitivity analyses based on sample size, diagnostic method and publication status. The study protocol was registered with PROSPERO (CRD42020219086).FindingsA total of 53 peer-reviewed articles were selected, including 173,353 HCWs (32.7% male) from the United States, ten European, and three East Asian countries. The overall seropositive prevalence rate of IgG antibodies was 8.6% in these regions (95% CI= 7.2-9.9%). Pooled seroprevalence of IgG antibodies was higher in studies conducted in the USA (12.4%, 95% CI= 7.8-17%) than in Europe (7.7%, 95% CI=6.3-9.2%) and East Asia (4.8%, 95% CI=2.9-6.7%). The subgroup study also estimated that male HCWs had 9.4% (95% CI= 7.2-11.6%) IgG seroconversion, and female HCWs had 7.8% (95% CI=5.9-9.7%). The study exhibits a high prevalence of IgG antibodies among HCWs under 40 years in the USA, conversely, it was high in older HCWs (≥40 years of age) in Europe and East Asia. In the months February-April 2020, the estimated pooled seroprevalence was 5.7% (4.0-7.4%) that increased to 8·2% (6.2-10%) in April-May and further to 9.9% (6.9-12.9%) in the May-September time-period.InterpretationIn the view of all evidence to date, a significant variation in the prevalence of SARS-CoV-2 antibodies in HCWs is observed in regions of Europe, the United States, and East Asia. The patterns of IgG antibodies by time, age, and gender suggest noticeable regional differences in transmission of the virus. Based on the insights driven from the analysis, priority is required for effective vaccination for older HCWs from Europe and East Asia. A considerable high seroprevalence of IgG among HCWs from the USA suggests a high rate of past infection that indicates the need to take adequate measures to prevent hospital spread. Moreover, the seroprevalence trend was not substantially changed after May 2020, suggesting a slow progression of long-term SARS-CoV-2 immunity. Routine testing of HCWs for SARS-CoV-2 should be considered even after the rollout of vaccination to identify the areas of increased transmission.FundingNone.