A prospective study of risk factors associated with seroprevalence of SARS-CoV-2 antibodies in healthcare workers at a large UK teaching hospital

Daniel J Cooper; Sara Lear; Laura Watson; Ashley Shaw; Mark Ferris; Rainer Doffinger; Rachel Bousfield; Katherine Sharrocks; Michael P Weekes; Ben Warne; Dominic Sparkes; Nick K Jones; Lucy Rivett; Matthew Routledge; Afzal Chaudhry; Katherine Dempsey; Montgomery Matson; Adil Lakha; George Gathercole; Olivia O'Connor; Emily Wilson; Orthi Shahzad; Kieran Toms; Rachel Thompson; Ian Halsall; David Halsall; Sally Houghton; Sofia Papadia; Nathalie Kingston; Kathleen E Stirrups; Barbara Graves; Paul Townsend; Neil Walker; Hannah Stark; CITIID-NIHR BioResource COVID-19 Collaboration; Daniela De Angelis; Shaun Seaman; Gordon Dougan; John R Bradley; M Estée Török; Ian Goodfellow; Stephen Baker

doi:10.1016/j.jinf.2022.08.030

A prospective study of risk factors associated with seroprevalence of SARS-CoV-2 antibodies in healthcare workers at a large UK teaching hospital

J Infect. 2022 Nov;85(5):557-564. doi: 10.1016/j.jinf.2022.08.030. Epub 2022 Sep 2.

Authors

Daniel J Cooper¹, Sara Lear², Laura Watson³, Ashley Shaw², Mark Ferris², Rainer Doffinger², Rachel Bousfield², Katherine Sharrocks², Michael P Weekes², Ben Warne², Dominic Sparkes⁴, Nick K Jones⁴, Lucy Rivett⁴, Matthew Routledge⁴, Afzal Chaudhry², Katherine Dempsey³, Montgomery Matson⁵, Adil Lakha⁵, George Gathercole⁵, Olivia O'Connor⁵, Emily Wilson⁵, Orthi Shahzad⁵, Kieran Toms⁵, Rachel Thompson⁵, Ian Halsall², David Halsall², Sally Houghton², Sofia Papadia⁶, Nathalie Kingston⁷, Kathleen E Stirrups⁷, Barbara Graves⁶, Paul Townsend⁸, Neil Walker⁷, Hannah Stark⁶; CITIID-NIHR BioResource COVID-19 Collaboration; Daniela De Angelis⁹, Shaun Seaman⁹, Gordon Dougan¹⁰, John R Bradley¹¹, M Estée Török¹², Ian Goodfellow¹³, Stephen Baker¹⁰

Affiliations

¹ Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Global and Tropical Health Division, Menzies School of Heath Research and Charles Darwin University, Darwin, Northern Territory, Australia; Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK. Electronic address: Daniel.cooper@addenbrookes.nhs.uk.
² Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
³ NIHR Cambridge Clinical Research Facility.
⁴ Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Clinical Microbiology and Public Health Laboratory, Public Health England, United Kingdom.
⁵ University of Cambridge School of Clinical Medicine, Cambridge, UK.
⁶ NIHR BioResource, NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK; Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
⁷ NIHR BioResource, NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK; Department of Haematology, School of Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
⁸ NIHR BioResource, NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK.
⁹ MRC Biostatistics Unit, University of Cambridge, Cambridge, UK.
¹⁰ Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK; Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.
¹¹ Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; NIHR BioResource, NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK.
¹² Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.
¹³ Department of pathology, Division of virology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.

Abstract

Objectives: To describe the risk factors for SARS-CoV-2 infection in UK healthcare workers (HCWs).

Methods: We conducted a prospective sero-epidemiological study of HCWs at a major UK teaching hospital using a SARS-CoV-2 immunoassay. Risk factors for seropositivity were analysed using multivariate logistic regression.

Results: 410/5,698 (7·2%) staff tested positive for SARS-CoV-2 antibodies. Seroprevalence was higher in those working in designated COVID-19 areas compared with other areas (9·47% versus 6·16%) Healthcare assistants (aOR 2·06 [95%CI 1·14-3·71]; p=0·016) and domestic and portering staff (aOR 3·45 [95% CI 1·07-11·42]; p=0·039) had significantly higher seroprevalence than other staff groups after adjusting for age, sex, ethnicity and COVID-19 working location. Staff working in acute medicine and medical sub-specialities were also at higher risk (aOR 2·07 [95% CI 1·31-3·25]; p<0·002). Staff from Black, Asian and minority ethnic (BAME) backgrounds had an aOR of 1·65 (95% CI 1·32 - 2·07; p<0·001) compared to white staff; this increased risk was independent of COVID-19 area working. The only symptoms significantly associated with seropositivity in a multivariable model were loss of sense of taste or smell, fever, and myalgia; 31% of staff testing positive reported no prior symptoms.

Conclusions: Risk of SARS-CoV-2 infection amongst HCWs is highly heterogeneous and influenced by COVID-19 working location, role, age and ethnicity. Increased risk amongst BAME staff cannot be accounted for solely by occupational factors.

Keywords: COVID-19; SARS-CoV-2; healthcare workers; risk factor analysis; sero-epidemiology.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antibodies, Viral
COVID-19* / epidemiology
Health Personnel
Hospitals, Teaching
Humans
Prospective Studies
Risk Factors
SARS-CoV-2*
Seroepidemiologic Studies
United Kingdom / epidemiology

Substances

Antibodies, Viral

Abstract

Publication types

MeSH terms

Substances

Grants and funding