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Evolution of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) seroprevalence among employees of a US academic children’s hospital during coronavirus disease 2019 (COVID-19) pandemic

Published online by Cambridge University Press:  02 December 2021

Brian T. Fisher*
Affiliation:
Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Anna Sharova
Affiliation:
Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
Craig L. K. Boge
Affiliation:
Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
Sigrid Gouma
Affiliation:
Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Audrey Kamrin
Affiliation:
Center for Human Phenomic Science, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
Jesse Blumenstock
Affiliation:
Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
Sydney Shuster
Affiliation:
Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
Lauren Gianchetti
Affiliation:
Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
Danielle Collins
Affiliation:
Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
Elikplim Akaho
Affiliation:
Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
Madison E. Weirick
Affiliation:
Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Christopher M. McAllister
Affiliation:
Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Marcus J. Bolton
Affiliation:
Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Claudia P. Arevalo
Affiliation:
Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Eileen C. Goodwin
Affiliation:
Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Elizabeth M. Anderson
Affiliation:
Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Shannon R. Christensen
Affiliation:
Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Fran Balamuth
Affiliation:
Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Audrey R. Odom John
Affiliation:
Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Yun Li
Affiliation:
Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Susan Coffin
Affiliation:
Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Jeffrey S. Gerber
Affiliation:
Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Scott E. Hensley
Affiliation:
Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
*
Author for correspondence: Brian T. Fisher, E-mail: fisherbria@chop.edu

Abstract

Objective:

To describe the cumulative seroprevalence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) antibodies during the coronavirus disease 2019 (COVID-19) pandemic among employees of a large pediatric healthcare system.

Design, setting, and participants:

Prospective observational cohort study open to adult employees at the Children’s Hospital of Philadelphia, conducted April 20–December 17, 2020.

Methods:

Employees were recruited starting with high-risk exposure groups, utilizing e-mails, flyers, and announcements at virtual town hall meetings. At baseline, 1 month, 2 months, and 6 months, participants reported occupational and community exposures and gave a blood sample for SARS-CoV-2 antibody measurement by enzyme-linked immunosorbent assays (ELISAs). A post hoc Cox proportional hazards regression model was performed to identify factors associated with increased risk for seropositivity.

Results:

In total, 1,740 employees were enrolled. At 6 months, the cumulative seroprevalence was 5.3%, which was below estimated community point seroprevalence. Seroprevalence was 5.8% among employees who provided direct care and was 3.4% among employees who did not perform direct patient care. Most participants who were seropositive at baseline remained positive at follow-up assessments. In a post hoc analysis, direct patient care (hazard ratio [HR], 1.95; 95% confidence interval [CI], 1.03–3.68), Black race (HR, 2.70; 95% CI, 1.24–5.87), and exposure to a confirmed case in a nonhealthcare setting (HR, 4.32; 95% CI, 2.71–6.88) were associated with statistically significant increased risk for seropositivity.

Conclusions:

Employee SARS-CoV-2 seroprevalence rates remained below the point-prevalence rates of the surrounding community. Provision of direct patient care, Black race, and exposure to a confirmed case in a nonhealthcare setting conferred increased risk. These data can inform occupational protection measures to maximize protection of employees within the workplace during future COVID-19 waves or other epidemics.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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