BACKGROUND AND PURPOSE:

• Moscola et al. (JAMA, 2020) investigated the prevalence of SARS-CoV-2 antibodies among healthcare personnel (HCP) in NYC and the association with demographics, primary work location and type, and suspicion of virus exposure

METHODS:

• Cohort study (April 20, 2020, to June 23, 2020)
• Setting
  • 52 sites in large healthcare system in NYC
• Participants
  • All HCP in system
• Study design
  • RT-PCR testing was available (March 7, 2020) to any HCP who had COVID-19 symptoms or suspected exposure
  • During the study period, all HCP were offered free, voluntary antibody testing, regardless of symptoms
  • There were 7 different validated assays used
  • HCP reported demographics, primary work location, job function, direct patient care, work on a COVID or non-COVID unit, and their level of suspicion of virus exposure
  • Associations between seroprevalence and these variables was assessed using Poisson logistic regression
• Primary outcome
  • Seroprevalence

RESULTS:

• 46,117 HCPs were tested (65.1% of personnel)
  • Median age 42 (IQR 31.5 to 54.5) years | 73.7% women
  • 16.0% Black | 0.8% multiracial | 14.0% Hispanic HCP
  • 28.4% nurses | 9.3% physicians
• Seroprevalence
  • 13.7% of the tested population were seropositive
• Prior RT-PCR test
  • Seroprevalence in those with prior positive RT-PCR test: 93.5%
  • Seroprevalence in those with a prior negative RT-PCR test: 89.7%
• No prior RT-PCR test
  • Seropositive: 9.0%
• Working in COVID-19 units or in ICU
  • Association with seroprevalence present in bivariate analyses but not in multivariable analyses
• In a fully adjusted model, the following were associated with seroprevalence
  • Previous positive PCR test result
    • Relative risk (RR) 1.52 (95% CI, 1.44 to 1.60; P < 0.001)
  • Reported high suspicion of virus exposure
    • Relative risk 1.23 (95% CI, 1.18 to 1.28; P < 0.001)

CONCLUSION:

• In this study of HCP in a large health system NYC, seroprevalence was 13.7%
  • Similar to approximately 14% seroprevalence reported for the general population in New York State
• Seropositivity was most associated with high suspicion of exposure and a prior positive RT-PCR test
• Limitations
  • Different tests were used with different sensitivities and specificities
  • The time between RT-PCR and antibody testing was unknown and possibly too short to detect an antibody response
  • Only responses for ‘suspicion for exposure’ were collected | Source (e.g. community, hospital, home etc.) not obtained
• The authors conclude

Providing HCP with data about their SARS-CoV-2 virus exposure is important so they can protect themselves, their patients, their colleagues, and their families

High levels of HCP-reported suspicion of virus exposure may be useful as an indication for SARS-CoV-2 testing 

Learn More – Primary Sources:

Prevalence of SARS-CoV-2 Antibodies in Health Care Personnel in the New York City Area

Related ObG Topics:

CDC Update: COVID-19 Infection Rate Among Healthcare Workers

COVID-19 Infection Rates in Healthcare Personnel: Data from Washington State

How Long Does It Take for COVID-19 Patients to Develop Antibodies?