尼日利亚医护人员严重急性呼吸综合征冠状病毒2血清学研究：一项前瞻性纵向队列研究的结果

Nigeria healthcare worker SARS-CoV-2 serology study: Results from a prospective, longitudinal cohort.

作者信息

Ojji Dike B, Sancilio Amelia, Shedul Gabriel L, Orji Ikechukwu A, Chopra Aashima, Abu Joel, Akor Blessing, Ripiye Nana, Akinlade Funmi, Okoye Douglas, Okpetu Emmanuel, Eze Helen, Odoh Emmanuel, Baldridge Abigail S, Tripathi Priya, Abubakar Haruna, Jamda Abubakar M, Hirschhorn Lisa R, McDade Thomas, Huffman Mark D

机构信息

Department of Internal Medicine, Faculty of Clinical Sciences, Federal Capital Territory, University of Abuja, Abuja, Nigeria.

Cardiovascular Research Unit, University of Abuja and University of Abuja Teaching Hospital, Federal Capital Territory, Abuja, Nigeria.

出版信息

PLOS Glob Public Health. 2023 Jan 17;3(1):e0000549. doi: 10.1371/journal.pgph.0000549. eCollection 2023.

DOI:10.1371/journal.pgph.0000549

PMID:36962953

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10022168/

Abstract

Healthcare workers, both globally and in Nigeria, have an increased risk for SARS-CoV-2 infection compared with the general population due to higher risk contacts, including occupational exposures. In addition, primary healthcare workers represent an important group for estimating prior infection to SARS-CoV-2 because they work at the first point-of-contact for most patients yet have not been included in prior COVID-19 seroepidemiology research in Nigeria. We sought to evaluate baseline seroprevalence, rates of seroconversion (IgG- to IgG+) and seroreversion (IgG+ to IgG-), change in IgG concentration at 3- and 6-month follow-up, and factors associated with seropositivity. From June 2020 to December 2020, we conducted a longitudinal seroepidemiology study among frontline health care workers in Nigeria using a validated dried blood spot assay. Among 525 participants, mean (SD) age was 39.1 (9.7) years, 61.0% were female, and 45.1% were community health workers. The six-month follow-up rate was 93.5%. Seropositivity rates increased from 31% (95% CI: 27%, 35%) at baseline to 45% (95% CI: 40%, 49%) at 3-month follow-up, and 70% (95% CI: 66%, 74%) at 6-month follow-up. There was a corresponding increase in IgG levels from baseline (median = 0.18 ug/mL) to 3-month (median = 0.35 ug/mL) and 6-month follow-up (median = 0.59 ug/mL, Ptrend < .0001). A minority of participants reported symptoms from February 2020 until baseline (12.2%) or during 3-month (6.6%) or 6-month (7.5%) follow-up. only 1 participant was hospitalized. This study demonstrated high baseline, 3-month and 6-month follow-up prevalence of IgG antibodies to SARS-CoV-2 during the first two waves of the COVID-19 pandemic in Nigeria among a cohort of unvaccinated frontline healthcare workers, including primary healthcare workers despite low symptomatology. These results may have implications in state- and national-level disease pandemic modeling. Trial registration: NCT04158154.

摘要

与普通人群相比，全球及尼日利亚的医护人员感染新型冠状病毒2（SARS-CoV-2）的风险更高，这是因为他们有更高的风险接触，包括职业暴露。此外，初级医护人员是评估SARS-CoV-2既往感染情况的重要群体，因为他们是大多数患者的首个接触点，但尚未被纳入尼日利亚先前的新冠病毒血清流行病学研究。我们试图评估基线血清阳性率、血清转化（IgG-到IgG+）和血清逆转（IgG+到IgG-）率、3个月和6个月随访时IgG浓度的变化以及与血清阳性相关的因素。从2020年6月到2020年12月，我们使用经过验证的干血斑检测法，在尼日利亚的一线医护人员中进行了一项纵向血清流行病学研究。在525名参与者中，平均（标准差）年龄为39.1（9.7）岁，61.0%为女性，45.1%为社区卫生工作者。六个月的随访率为93.5%。血清阳性率从基线时的31%（95%置信区间：27%，35%）增加到3个月随访时的45%（95%置信区间：40%，49%），以及6个月随访时的70%（95%置信区间：66%，74%）。从基线（中位数 = 0.18微克/毫升）到3个月（中位数 = 0.35微克/毫升）和6个月随访（中位数 = 0.59微克/毫升，Ptrend < .0001），IgG水平相应增加。少数参与者报告在2020年2月至基线期间（12.2%）或3个月（6.6%）或6个月（7.5%）随访期间出现症状。只有1名参与者住院。这项研究表明，在尼日利亚新冠疫情的前两波期间，在一组未接种疫苗的一线医护人员（包括初级医护人员）中，SARS-CoV-2 IgG抗体的基线、3个月和6个月随访患病率很高，尽管症状较轻。这些结果可能对州和国家层面的疾病大流行建模有影响。试验注册：NCT04158154。