Section of Infectious Diseases and International Medicine, Department of Internal Medicine, Beaumont Royal Oak, Royal Oak, MI, USA.
Department of Internal Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
Clin Infect Dis. 2021 Jul 30;73(Suppl 2):S154-S162. doi: 10.1093/cid/ciaa1684.
Although the risk of exposure to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is higher for frontline healthcare workers, not all personnel have similar risks. Determining infection rate is difficult due to the limits on testing and the high rate of asymptomatic individuals. Detection of antibodies against SARS-CoV-2 may be useful for determining prior exposure to the virus and assessing mitigation strategies, such as isolation, masks, and other protective equipment.
An online assessment that included demographic, clinical, and exposure information and a blood sample was collected from 20 614 participants out of ~43 000 total employees at Beaumont Health, which includes 8 hospitals distributed across the Detroit metropolitan area in southeast Michigan. The presence of anti-SARS-CoV-2 IgG was determined using the EUROIMMUN assay.
A total of 1818 (8.8%) participants were seropositive between April 13 and May 28, 2020. Among the seropositive individuals, 44% reported that they were asymptomatic during the month prior to blood collection. Healthcare roles such as phlebotomy, respiratory therapy, and nursing/nursing support exhibited significantly higher seropositivity. Among participants reporting direct exposure to a Coronavirus Disease 2019 (COVID-19) positive individual, those wearing an N95/PAPR mask had a significantly lower seropositivity rate (10.2%) compared to surgical/other masks (13.1%) or no mask (17.5%).
Direct contact with COVID-19 patients increased the likelihood of seropositivity among employees but study participants who wore a mask during COVID-19 exposures were less likely to be seropositive. Additionally, a large proportion of seropositive employees self-reported as asymptomatic. (Funded by Beaumont Health and by major donors through the Beaumont Health Foundation).
CLINICALTRIALS.GOV NUMBER: NCT04349202.
虽然一线医护人员接触严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的风险更高，但并非所有人员的风险都相同。由于检测的限制和大量无症状个体的存在，确定感染率较为困难。检测针对 SARS-CoV-2 的抗体可能有助于确定之前对该病毒的暴露情况，并评估缓解策略，如隔离、口罩和其他防护设备。
从 2020 年 4 月 13 日至 5 月 28 日，在 Beaumont Health 收集了来自约 43000 名员工中的 20614 名员工的在线评估，其中包括人口统计学、临床和暴露信息以及血液样本。使用 EUROIMMUN 检测法确定抗 SARS-CoV-2 IgG 的存在。
共有 1818 名（8.8%）参与者在 2020 年 4 月 13 日至 5 月 28 日之间呈血清阳性。在血清阳性个体中，44%的人报告在采血前一个月无症状。抽血、呼吸治疗和护理/护理支持等医疗角色的血清阳性率明显更高。在报告直接接触 COVID-19 阳性个体的参与者中，与戴外科/其他口罩（13.1%）或不戴口罩（17.5%）相比，戴 N95/PAPR 口罩的参与者血清阳性率（10.2%）显著降低。
与 COVID-19 患者的直接接触增加了员工血清阳性的可能性，但在 COVID-19 暴露期间戴口罩的研究参与者血清阳性的可能性较低。此外，很大一部分血清阳性的员工自述无症状。（由 Beaumont Health 和 Beaumont Health 基金会的主要捐赠者提供资金）。
临床试验.gov 编号：NCT04349202。
