Hoag Center for Research and Education, Hoag Memorial Hospital Presbyterian, Newport Beach, California, United States of America.
Infection Prevention, Hoag Memorial Hospital Presbyterian, Newport Beach, California, United States of America.
PLoS One. 2020 Nov 12;15(11):e0240006. doi: 10.1371/journal.pone.0240006. eCollection 2020.
Serological surveys have been conducted to establish prevalence for COVID-19 antibodies in various cohorts and communities, reporting a wide range of outcomes. The prevalence of such antibodies among healthcare workers, presumed at higher risk for infection, has been increasingly investigated, more studies are needed to better understand the risks and infection transmission in different healthcare settings. The present study reports on initial sero-surveillance conducted on healthcare workers at a regional hospital system in Orange County, California, during May and June, 2020. Study subjects were recruited from the entire hospital employee workforce and the independent medical staff. Data were collected for job duties and locations, COVID-19 symptoms, a PCR test history, travel record since January 2020, and existence of household contacts with COVID-19. A blood sample was collected from each subject for serum analysis for IgG antibodies to SARS-CoV-2. Of 2,992 tested individuals, a total 2,924 with complete data were included in the analysis. Observed prevalence of 1.06% (31 antibody positive cases), adjusted prevalence of 1.13% for test sensitivity and specificity were identified. Significant group differences between positive vs. negative were observed for age (z = 2.65, p = .008), race (p = .037), presence of fever (p < .001), and loss of smell (p < .001), but not for occupations (p = .710). Possible explanation for this low prevalence includes a relatively low local geographic community prevalence (~4.4%) at the time of testing, the hospital's timely procurement of personal protective equipment, rigorous employee education, patient triage, and treatment protocol development and implementation. In addition, cross-reactive adaptive T cell mediated immunity, as recently described, may possibly play a greater role in healthcare workers than in the general population.
已进行血清学调查,以确定 COVID-19 抗体在不同队列和社区中的流行率,报告了广泛的结果。在感染风险较高的医护人员中,此类抗体的流行率已得到越来越多的研究,需要更多的研究来更好地了解不同医疗环境中的风险和感染传播。本研究报告了 2020 年 5 月至 6 月在加利福尼亚州奥兰治县的一个区域医院系统中对医护人员进行的初步血清监测。研究对象从整个医院员工队伍和独立医务人员中招募。收集的数据包括工作职责和地点、COVID-19 症状、PCR 检测史、自 2020 年 1 月以来的旅行记录以及与 COVID-19 有家庭接触的情况。从每个受试者采集血样,用于分析针对 SARS-CoV-2 的 IgG 抗体。在接受检测的 2992 人中,共有 2924 人完成了完整的数据纳入分析。观察到的流行率为 1.06%(31 例抗体阳性病例),根据测试灵敏度和特异性调整后的流行率为 1.13%。阳性与阴性之间观察到显著的组间差异,包括年龄(z = 2.65,p =.008)、种族(p =.037)、发热(p <.001)和嗅觉丧失(p <.001),但职业无差异(p =.710)。这种低流行率的可能解释包括在检测时当地社区流行率相对较低(约 4.4%),医院及时采购个人防护设备、严格的员工教育、患者分诊以及治疗方案的制定和实施。此外,最近描述的交叉反应性适应性 T 细胞介导免疫可能在医护人员中的作用大于在普通人群中的作用。