Skip to main content Accessibility help
×
Home
Hostname: page-component-544b6db54f-prt4h Total loading time: 0.464 Render date: 2021-10-22T01:26:47.689Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

High severe acute respiratory coronavirus virus 2 (SARS-CoV-2) seroconversion rate among geriatric staff from Strasbourg University Hospitals

Published online by Cambridge University Press:  06 September 2021

Baptiste Panaget
Affiliation:
Laboratoire de Virologie, CHU de Strasbourg, Strasbourg, France
Aurélie Velay
Affiliation:
Laboratoire de Virologie, CHU de Strasbourg, Strasbourg, France INSERM, Strasbourg University, Strasbourg, France
Louise Gontard
Affiliation:
Laboratoire de Virologie, CHU de Strasbourg, Strasbourg, France
François Severac
Affiliation:
Service de Santé Publique, CHU de Strasbourg, Strasbourg, France
Maxence Meyer
Affiliation:
Service de Gériatrie, CHU de Strasbourg, Strasbourg, France
Elisabeth Antoni
Affiliation:
Pôle de Biologie, CHU de Strasbourg, Strasbourg, France
Georges Kaltenbach
Affiliation:
Service de Gériatrie, CHU de Strasbourg, Strasbourg, France
Laurence Kling-Pillitteri
Affiliation:
Service de santé au travail du personnel hospitalier, CHU de Strasbourg, Strasbourg, France
Yasmine Sammour
Affiliation:
Direction, CHU de Strasbourg, Strasbourg, France
Yves Hansmann
Affiliation:
Service des maladies infectieuses et tropicales, CHU de Strasbourg, Strasbourg, France
Céline Hernandez
Affiliation:
Service d’hygiène hospitalière, CHU de Strasbourg, Strasbourg, France
Thierry Lavigne
Affiliation:
Service d’hygiène hospitalière, CHU de Strasbourg, Strasbourg, France
Jean-Marc Lessinger
Affiliation:
Laboratoire de Biochimie Clinique et Biologie Moléculaire, CHU de Strasbourg, Strasbourg, France
Maria Gonzalez
Affiliation:
Service de santé au travail du personnel hospitalier, CHU de Strasbourg, Strasbourg, France Service de Pathologies Professionnelles, CHU de Strasbourg, Strasbourg, France
Marie-Josée Wendling
Affiliation:
Laboratoire de Virologie, CHU de Strasbourg, Strasbourg, France
Floriane Gallais
Affiliation:
Laboratoire de Virologie, CHU de Strasbourg, Strasbourg, France INSERM, Strasbourg University, Strasbourg, France
Sabrina Garnier Kepka
Affiliation:
Service d’Urgences Medico-Chirurgicales Adultes, CHU de Strasbourg, Strasbourg, France
Samira Fafi-Kremer*
Affiliation:
Laboratoire de Virologie, CHU de Strasbourg, Strasbourg, France INSERM, Strasbourg University, Strasbourg, France
*
Author for correspondence: Samira Fafi-Kremer, E-mail samira.fafi-kremer@chru-strasbourg.fr
Rights & Permissions[Opens in a new window]

Abstract

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

To the Editor—The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China at the end of 2019 and spread worldwide, leading to the current pandemic. During the first pandemic wave in France, the northeastern region was one of the first and most affected areas. Thus, healthcare workers (HCWs) in the Strasbourg University Hospitals (SUH) were early and intensively exposed to SARS-CoV-2. This exposure varied between hospital departments, notably at the beginning of the pandemic. Some departments were rapidly dedicated to the care of SARS-CoV-2 patients, with earlier implementation and use of personal protective equipment (PPE). In this study, we evaluated SARS-CoV-2 seroprevalence in hospital staff according to department in SUH.

From June 22, 2020, to November 1, 2020, SARS-CoV-2 serology was offered to all hospital staff at SUH. Each participant completed a questionnaire collecting data about their occupational department and the onset of symptoms (ie, type of symptoms and delay expressed in weeks between onset and serum sampling time). Serum samples were tested using an immunochromatographic lateral flow assay (Biosynex COVID-19 BSS, Switzerland, Fribourg) detecting IgM and IgG directed against the receptor binding domain of SARS-CoV-2 spike protein (Supplementary Fig. 1 online). This assay was reported to have overall estimated sensitivity of 93% and clinical specificity of 99%. Reference Velay, Gallais and Benotmane1

Univariable and multivariable analyses were performed using R version 4.0.4 software (R Foundation for Statistical Computing, Vienna, Austria). Statistical significance was set at P < .05. Hospital departments were grouped together according to staff exposure risk for multivariable analysis (see Supplementary Material online for statistical analysis detail). This study was approved by the local ethics review committee (record CE-2021-79).

In total, 5,694 HCWs participated in this study. Participant characteristics and serological results of the cohort are presented in Supplementary Table 1 (online). The mean age was 40.4 years (SD, ±11.7). In total, 482 participants had positive serology (8.5%) and among them, 422 participants answered about the onset of symptoms, including 48% of asymptomatic subjects (Supplementary Fig. 2 and Supplementary Table 1 online). The seropositive and symptomatic subjects predominantly reported anosmia (29.2 %) and agueusia (27.2%).

The departments in the “geriatric group” showed the highest seroprevalence rate (27.7%) (Supplementary Table 2 online) and a strong association with seropositive status (OR, 5.3; 95% CI, 3.5–8.2; P < .05) (Supplementary Table 3 online and Fig. 1). Seroprevalence rates in the frontline departments were all lower than in the geriatric group: internal medicine department (which contains the infectious disease department, 15%), department of thoracic pathology (11.6%), anesthesia and reanimation department (7.9%), and emergency departments (8.1%).

Fig. 1. Odds ratio of SARS-CoV-2 seroprevalence according to a history of anosmia and/or agueusia and the type of hospital department. Data are depicted as odds ratios (black or grey symbols) and 95% confidence intervals (bars on either side), and P values are mentioned for each criterion.

However, the seroprevalence rate of 8.5% was concordant with those reported in the literature in Europe, Reference Galanis, Vraka, Fragkou, Bilali and Kaitelidou2 and we found a high rate of asymptomatic infections (48%). Remarkably, working in a geriatric department was associated with positive serology. The high rate of seroconversion among staff in the geriatric department contrasted with low seroconversion rates among staff in departments on the frontline from the start of the pandemic.

Many contributing factors could explain this high seroprevalence. First, the onset of 2 clusters of contamination in geriatric departments, from the beginning of March 2020, led to contamination of caregivers. At the onset of the pandemic, no guidelines were in place for systematically wearing a surgical mask (ie, this obligation was implemented on March 23, 2020). Second, even when the wearing a mask became compulsory for caregivers and patients, implementation was laborious, especially among patients with cognitive disorders. Some of these fragile patients do not stay in their rooms but walk in the corridors, thus favoring virus circulation. Moreover, patients in geriatric departments often complain of discomfort when wearing a mask. Third, elderly COVID-19 patients were frequently admitted to geriatric departments (up to 50% of beds during the first wave in SUH). Cases of nosocomial transmission were reported probably related to the type of patient care (eg, repeated nursing and grooming). Another difficulty was the asymptomatic or atypical forms of the disease, Reference Gan, Kho and Akhunbay-Fudge3 which were not well known at the beginning of the pandemic, possibly leading to underdiagnosis. The advanced age of the patients also led to prolonged shedding of the virus. Reference Meyer, Meyer and Calabrese4

Despite the implementation of protective measures for caregivers, the number of clusters remains high in geriatric units, in nursing homes, as well as in long-term care facilities, Reference Martinot, Carnein, Kempf, Gantner, Gallais and Fafi-Kremer5,Reference Zollner-Schwetz, König, Krause, Pux, Laubreiter and Schippinger6 leading to substantial mortality rates. Reference Meyer, Calabrese and Meyer7 The recurrence of these clusters paralleled the arrival of new variants of SARS-CoV-2. Considering the higher risk of being exposed to SARS-CoV-2 when working in a geriatric department, vaccination of staff working in these services is a priority.

Supplementary material

To view supplementary material for this article, please visit https://doi.org/10.1017/ice.2021.402

Acknowledgments

Financial support

Strasbourg University Hospital supported this study. This sponsor had no role on the design, methods, subject recruitment, data collections, analysis or preparation of this report.

Conflicts of interest

All authors have no conflicts of interest to declare.

References

Velay, A, Gallais, F, Benotmane, I, et al. Evaluation of the performance of SARS-CoV-2 serological tools and their positioning in COVID-19 diagnostic strategies. Diagn Microbiol Infect Dis 2020;98:115181.CrossRefGoogle ScholarPubMed
Galanis, P, Vraka, I, Fragkou, D, Bilali, A, Kaitelidou, D. Seroprevalence of SARS-CoV-2 antibodies and associated factors in healthcare workers: a systematic review and meta-analysis. J Hosp Infect 2021;108:120134.CrossRefGoogle ScholarPubMed
Gan, JM, Kho, J, Akhunbay-Fudge, M, et al. Atypical presentation of COVID-19 in hospitalised older adults. Ir J Med Sci 2021;190:469474.CrossRefGoogle ScholarPubMed
Meyer, M, Meyer, A, Calabrese, L, et al. Quantitative description of SARS-CoV-2 RT-PCR, a cohort of 76 COVID-19 older hospitalized adults. J Am Geriatr Soc 2021;69:11701174.CrossRefGoogle ScholarPubMed
Martinot, M, Carnein, S, Kempf, C, Gantner, P, Gallais, F, Fafi-Kremer, S. Outbreak of SARS-CoV-2 infection in a long-term care facility after COVID-19 BNT162b2 mRNA vaccination. Clin Microbiol Infect 2021;S1198-743X(21)00369-4.CrossRefGoogle Scholar
Zollner-Schwetz, I, König, E, Krause, R, Pux, C, Laubreiter, L, Schippinger, W. Analysis of COVID-19 outbreaks in three long-term care facilities in Graz, Austria. Am J Infect Control 2021;S0196-6553(21)00522-8.CrossRefGoogle Scholar
Meyer, M, Calabrese, L, Meyer, A, et al. Clinical and virological follow-up of a cohort of 76 COVID-19 older hospitalized adults. J Am Geriatr Soc 2021;69:11671170.CrossRefGoogle ScholarPubMed
Figure 0

Fig. 1. Odds ratio of SARS-CoV-2 seroprevalence according to a history of anosmia and/or agueusia and the type of hospital department. Data are depicted as odds ratios (black or grey symbols) and 95% confidence intervals (bars on either side), and P values are mentioned for each criterion.

Supplementary material: File

Panaget et al. supplementary material

Panaget et al. supplementary material

Download Panaget et al. supplementary material(File)
File 280 KB
You have Access

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

High severe acute respiratory coronavirus virus 2 (SARS-CoV-2) seroconversion rate among geriatric staff from Strasbourg University Hospitals
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

High severe acute respiratory coronavirus virus 2 (SARS-CoV-2) seroconversion rate among geriatric staff from Strasbourg University Hospitals
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

High severe acute respiratory coronavirus virus 2 (SARS-CoV-2) seroconversion rate among geriatric staff from Strasbourg University Hospitals
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *