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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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References

Sikkema, RS, Pas, SD, Nieuwenhuijse, DF, et al. COVID-19 in healthcare workers in three hospitals in the south of the Netherlands: a cross-sectional study. Lancet Infect Dis 2020;20:12731280.CrossRefGoogle ScholarPubMed
Moscola, J, Sembajwe, G, Jarrett, M, et al. Prevalence of SARS-CoV-2 antibodies in healthcare personnel in the New York City area. JAMA 2020;324:893895.CrossRefGoogle Scholar
Behrens, GMN, Cossmann, A, Stankov, MV, et al. Perceived versus proven SARS-CoV-2-specific immune responses in healthcare professionals. Infection 2020;48:631634.CrossRefGoogle Scholar
Dacosta-Urbieta, A, Rivero-Calle, I, Pardo-Seco, J, et al. Seroprevalence of SARS-CoV-2 among pediatric healthcare workers in Spain. Front Pediatr 2020;8:547.CrossRefGoogle ScholarPubMed
Goldblatt, D, Johnson, M, Falup-Pecurariu, O, et al. Cross-sectional prevalence of SARS-CoV-2 antibodies in healthcare workers in paediatric facilities in eight countries. J Hosp Infect 2021;110:6066.CrossRefGoogle ScholarPubMed
Harris, PA, Taylor, R, Thielke, R, Payne, J, Gonzalez, N, Conde, JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009;42:377381.CrossRefGoogle ScholarPubMed
Harris, PA, Taylor, R, Minor, BL, et al. The REDCap consortium: building an international community of software platform partners. J Biomed Inform 2019;95:103208.CrossRefGoogle ScholarPubMed
Sikkens, JJ, Buis, DTP, Peters, EJG, et al. Serologic surveillance and phylogenetic analysis of SARS-CoV-2 infection among hospital healthcare workers. JAMA Netw Open 2021;4:e2118554.CrossRefGoogle Scholar
Flannery, DD, Gouma, S, Dhudasia, MB, et al. SARS-CoV-2 seroprevalence among parturient women in Philadelphia. Sci Immunol 2020;5.Google ScholarPubMed
Stokes, EK, Zambrano, LD, Anderson, KN, et al. Coronavirus disease 2019 case surveillance—United States, January 22–May 30, 2020. Morb Mortal Wkly Rep 2020;69:759765.CrossRefGoogle ScholarPubMed
Otto, WR, Geoghegan, S, Posch, LC, et al. The epidemiology of severe acute respiratory syndrome coronavirus 2 in a pediatric healthcare network in the United States. J Pediatric Infect Dis Soc 2020;9:523529.CrossRefGoogle Scholar
Akinbami, LJ, Vuong, N, Petersen, LR, et al. SARS-CoV-2 seroprevalence among healthcare, first response, and public safety personnel, Detroit metropolitan area, Michigan, USA, May–June 2020. Emerg Infect Dis 2020;26:28632871.CrossRefGoogle Scholar
Lopez, L, Hart, LH, Katz, MH. Racial and ethnic health disparities related to COVID-19. JAMA 2021;325:719720.CrossRefGoogle ScholarPubMed
Seow, J, Graham, C, Merrick, B, et al. Longitudinal observation and decline of neutralizing antibody responses in the three months following SARS-CoV-2 infection in humans. Nat Microbiol 2020;5:15981607.CrossRefGoogle ScholarPubMed
Wajnberg, A, Amanat, F, Firpo, A, et al. Robust neutralizing antibodies to SARS-CoV-2 infection persist for months. Science 2020;370:12271230.Google ScholarPubMed
Dan, JM, Mateus, J, Kato, Y, et al. Immunological memory to SARS-CoV-2 assessed for up to 8 months after infection. Science 2021;371.Google ScholarPubMed