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Meta-Analysis
. 2021 Feb:108:120-134.
doi: 10.1016/j.jhin.2020.11.008. Epub 2020 Nov 16.

Seroprevalence of SARS-CoV-2 antibodies and associated factors in healthcare workers: a systematic review and meta-analysis

P Galanis  1 , I Vraka  2 , D Fragkou  3 , A Bilali  4 , D Kaitelidou  3
Affiliations
Meta-Analysis

Seroprevalence of SARS-CoV-2 antibodies and associated factors in healthcare workers: a systematic review and meta-analysis

P Galanis et al. J Hosp Infect. 2021 Feb.

Abstract

Background: Healthcare workers (HCWs) represent a high-risk population for infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).

Aim: To determine the seroprevalence of SARS-CoV-2 antibodies among HCWs, and identify the factors associated with this seroprevalence.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were applied for this systematic review and meta-analysis. Databases including PubMed/MEDLINE and preprint services (medRχiv and bioRχiv) were searched from inception to 24th August 2020.

Findings: Forty-nine studies including 127,480 HCWs met the inclusion criteria. The estimated overall seroprevalence of SARS-CoV-2 antibodies among HCWs was 8.7% (95% confidence interval 6.7-10.9%). Seroprevalence was higher in studies conducted in North America (12.7%) compared with those conducted in Europe (8.5%), Africa (8.2) and Asia (4%). Meta-regression showed that increased sensitivity of antibody tests was associated with increased seroprevalence. The following factors were associated with seropositivity: male gender; Black, Asian and Hispanic HCWs; work in a coronavirus disease 2019 (COVID-19) unit; patient-related work; front-line HCWs; healthcare assistants; shortage of personal protective equipment; self-reported belief of previous SARS-CoV-2 infection; previous positive polymerase chain reaction test; and household contact with suspected or confirmed cases of COVID-19.

Conclusion: The seroprevalence of SARS-CoV-2 antibodies among HCWs is high. Excellent adherence to infection prevention and control measures; sufficient and adequate personal protective equipment; and early recognition, identification and isolation of HCWs infected with SARS-CoV-2 are imperative to decrease the risk of SARS-CoV-2 infection.

Keywords: Antibodies; COVID-19; Healthcare workers; SARS-CoV-2; Seroprevalence.

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Figures

Figure 1
Figure 1
Flowchart of the literature search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.
Figure 2
Figure 2
Forest plot of the seroprevalence of severe acute respiratory syndrome coronavirus-2 antibodies with corresponding 95% confidence intervals. The size of the black boxes is positively proportional to the weight assigned to studies, and horizontal lines represent the 95% confidence intervals according to random effects analysis.
Figure S1
Figure S1
Leave-one-out sensitivity analysis of the seroprevalence of severe acute respiratory syndrome coronavirus-2 antibodies with corresponding 95% confidence intervals.
Figure S2
Figure S2
Funnel plot of the meta-analysis.
See this image and copyright information in PMC

Comment in

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