Occupational Health Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
Infectious Diseases and Research Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
Enferm Infecc Microbiol Clin (Engl Ed). 2022 Jun-Jul;40(6):302-309. doi: 10.1016/j.eimce.2020.11.025.
Hospital-wide SARS-CoV-2 seroprevalence is rarely explored and can identify areas of unexpected risk. We determined the seroprevalence against SARS-CoV-2 in all health care workers (HCW) at a hospital.
Cross-sectional study (14-27/04/2020). We determined SARS-CoV-2 IgG by ELISA in all HCW including external workers of a teaching hospital in Madrid. They were classified by professional category, working area, and risk for SARS-CoV-2 exposure.
Among 2919 HCW, 2590 (88,7%) were evaluated. The mean age was 43.8 years (SD 11.1), and 73.9% were females. Globally, 818 (31.6%) workers were IgG positive with no differences for age, sex or previous diseases. Of these, 48.5% did not report previous symptoms. Seropositivity was more frequent in high- (33.1%) and medium- (33.8%) than in low-risk areas (25.8%, p=0.007), but not for hospitalization areas attending COVID-19 and non-COVID-19 patients (35.5 vs 38.3% p>0.05). HWC with a previous SARS-CoV2 PCR-positive test were IgG seropositive in 90.8%. By multivariate logistic regression analysis seropositivity was significantly associated with being physicians (OR 2.37, CI95% 1.61-3.49), nurses (OR 1.67, CI95% 1.14-2.46), nurse assistants (OR 1.84, CI95% 1.24-2.73), HCW working at COVID-19 hospitalization areas (OR 1.71, CI95% 1.22-2.40), non-COVID-19 hospitalization areas (OR 1.88, CI95% 1.30-2.73), and at the Emergency Room (OR 1.51, CI95% 1.01-2.27).
Seroprevalence uncovered a high rate of infection previously unnoticed among HCW. Patients not suspected of having COVID-19 as well as asymptomatic HCW may be a relevant source for nosocomial SARS-CoV-2 transmission.
医院范围内的 SARS-CoV-2 血清流行率很少被研究,它可以确定意想不到的风险区域。我们确定了一家马德里教学医院所有医护人员(HCW)的 SARS-CoV-2 血清流行率。
横断面研究(2020 年 4 月 14 日至 27 日)。我们通过酶联免疫吸附试验(ELISA)测定了所有 HCW 的 SARS-CoV-2 IgG,包括马德里一所教学医院的外部工作人员。根据职业类别、工作区域和 SARS-CoV-2 暴露风险对他们进行了分类。
在 2919 名 HCW 中,评估了 2590 名(88.7%)。平均年龄为 43.8 岁(标准差 11.1),73.9%为女性。总体而言,818 名(31.6%)工人 IgG 呈阳性,年龄、性别或既往疾病无差异。其中,48.5%未报告有既往症状。高(33.1%)和中(33.8%)风险区域的血清阳性率高于低(25.8%,p=0.007),但 COVID-19 和非 COVID-19 患者就诊的住院区域则无差异(35.5% vs 38.3%,p>0.05)。以前 SARS-CoV2 PCR 阳性检测结果的 HCW 的 IgG 血清阳性率为 90.8%。通过多变量逻辑回归分析,血清阳性与医生(OR 2.37,95%CI95%1.61-3.49)、护士(OR 1.67,95%CI95%1.14-2.46)、护士助理(OR 1.84,95%CI95%1.24-2.73)、COVID-19 住院区(OR 1.71,95%CI95%1.22-2.40)、非 COVID-19 住院区(OR 1.88,95%CI95%1.30-2.73)和急诊科(OR 1.51,95%CI95%1.01-2.27)的 HCW 显著相关。
血清流行率揭示了 HCW 中先前未被发现的高感染率。未被怀疑患有 COVID-19 的患者以及无症状的 HCW 可能是医院内 SARS-CoV-2 传播的一个相关来源。