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Serologic Status and SARS-CoV-2 Infection over 6 Months of Follow Up in Healthcare Workers in Chicago: A Cohort Study

Part of: SARS-CoV-2/COVID-19

Published online by Cambridge University Press:  09 August 2021

John T. Wilkins Open the ORCID record for John T. Wilkins [Opens in a new window] ,
Lisa R. Hirschhorn ,
Elizabeth L. Gray ,
Amisha Wallia ,
Mercedes Carnethon ,
Teresa R. Zembower ,
Joyce Ho ,
Benjamin J. DeYoung ,
Alex Zhu  and
Laura J. Rasmussen-Torvik
...Show all authors
John T. Wilkins*
Affiliation:
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois Division of Cardiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Lisa R. Hirschhorn
Affiliation:
Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois Institute for Global Health, Center for Global Cardiovascular Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Elizabeth L. Gray
Affiliation:
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Amisha Wallia
Affiliation:
Division of Endocrinology, Metabolism, and Molecular Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, Institute for Public Health and Medicine, Center for Health Services and Outcomes Research. Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Mercedes Carnethon
Affiliation:
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Teresa R. Zembower
Affiliation:
Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Joyce Ho
Affiliation:
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Benjamin J. DeYoung
Affiliation:
Program in Public Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Alex Zhu
Affiliation:
Weinberg College of Arts and Sciences, Northwestern University, Evanston, Illinois
Laura J. Rasmussen-Torvik
Affiliation:
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Babafemi Taiwo
Affiliation:
Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Charlesnika T. Evans
Affiliation:
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois Institute for Public Health and Medicine, Center for Health Services and Outcomes Research. Feinberg School of Medicine, Northwestern University, Chicago, Illinois Department of Veterans’ Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr VA Hospital, Hines, Illinois
*
Author for correspondence: John T. Wilkins, E-mail: j-wilkins@northwestern.edu
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Abstract

Objective:

To determine the changes in severe acute respiratory coronavirus virus 2 (SARS-CoV-2) serologic status and SARS-CoV-2 infection rates in healthcare workers (HCWs) over 6-months of follow-up.

Design:

Prospective cohort study.

Setting and participants:

HCWs in the Chicago area.

Methods:

Cohort participants were recruited in May and June 2020 for baseline serology testing (Abbott anti-nucleocapsid IgG) and were then invited for follow-up serology testing 6 months later. Participants completed monthly online surveys that assessed demographics, medical history, coronavirus disease 2019 (COVID-19), and exposures to SARS-CoV-2. The electronic medical record was used to identify SARS-CoV-2 polymerase chain reaction (PCR) positivity during follow-up. Serologic conversion and SARS-CoV-2 infection or possible reinfection rates (cases per 10,000 person days) by antibody status at baseline and follow-up were assessed.

Results:

In total, 6,510 HCWs were followed for a total of 1,285,395 person days (median follow-up, 216 days). For participants who had baseline and follow-up serology checked, 285 (6.1%) of the 4,681 seronegative participants at baseline seroconverted to positive at follow-up; 138 (48%) of the 263 who were seropositive at baseline were seronegative at follow-up. When analyzed by baseline serostatus alone, 519 (8.4%) of 6,194 baseline seronegative participants had a positive PCR after baseline serology testing (4.25 per 10,000 person days). Of 316 participants who were seropositive at baseline, 8 (2.5%) met criteria for possible SARS-CoV-2 reinfection (ie, PCR positive >90 days after baseline serology) during follow-up, a rate of 1.27 per 10,000 days at risk. The adjusted rate ratio for possible reinfection in baseline seropositive compared to infection in baseline seronegative participants was 0.26 (95% confidence interval, 0.13–0.53).

Conclusions:

Seropositivity in HCWs is associated with moderate protection from future SARS-CoV-2 infection.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 9 , September 2022 , pp. 1207 - 1215
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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