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. 2021 Apr:34:100835.
doi: 10.1016/j.eclinm.2021.100835. Epub 2021 Apr 15.

Longitudinal assessment of symptoms and risk of SARS-CoV-2 infection in healthcare workers across 5 hospitals to understand ethnic differences in infection risk

Ana M Valdes  1 , James C Moon  2   3 , Amrita Vijay  1 , Nish Chaturvedi  4 , Alan Norrish  1 , Adeel Ikram  1 , Simon Craxford  1 , Lola M L Cusin  5 , Jessica Nightingale  1 , Amanda Semper  6 , Timothy Brooks  6 , Aine McKnight  7 , Hibba Kurdi  2 , Cristina Menni  8 , Patrick Tighe  5 , Mahdad Noursadeghi  9 , Guruprasad Aithal  10 , Thomas A Treibel  2   3 , Benjamin J Ollivere  1 , Charlotte Manisty  2   3
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Longitudinal assessment of symptoms and risk of SARS-CoV-2 infection in healthcare workers across 5 hospitals to understand ethnic differences in infection risk

Ana M Valdes et al. EClinicalMedicine. 2021 Apr.

Abstract

Background: : Healthcare workers (HCWs) have increased rates of SARS-CoV-2 infection compared with the general population. We aimed to understand ethnic differences in SARS-CoV-2 seropositivity among hospital healthcare workers depending on their hospital role, socioeconomic status, Covid-19 symptoms and basic demographics.

Methods: A prospective longitudinal observational cohort study. 1364 HCWs at five UK hospitals were studied with up to 16 weeks of symptom questionnaires and antibody testing (to both nucleocapsid and spike protein) during the first UK wave in five NHS hospitals between March 20 and July 10 2020. The main outcome measures were SARS-CoV-2 infection (seropositivity at any time-point) and symptoms. Registration number: NCT04318314.

Findings: 272 of 1364 HCWs (mean age 40.7 years, 72% female, 74% White, ≥6 samples per participant) seroconverted, reporting predominantly mild or no symptoms. Seropositivity was lower in Intensive Therapy Unit (ITU) workers (OR=0.44 95%CI 0.24, 0.77; p=0.0035). Seropositivity was higher in Black (compared to White) participants, independent of age, sex, role and index of multiple deprivation (OR=2.61 95%CI 1.47-4.62 p=0.0009). No association was seen between White HCWs and other minority ethnic groups.

Interpretation: In the UK first wave, Black ethnicity (but not other ethnicities) more than doubled HCWs likelihood of seropositivity, independent of age, sex, measured socio-economic factors and hospital role.

Keywords: Covid-19; Healthcare workers; ethnicity; seropositivity.

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Conflict of interest statement

Dr. Norrish reports grants from Medical Research Council, COVID-19 Rapid Response Rolling Call, during the conduct of the study; personal fees from AOTrauma, personal fees from LINK Orthopaedics, outside the submitted work. Dr. Chaturvedi reports grants from Medical Research Council, grants from UKRI, personal fees from AstraZeneca, outside the submitted work. All other authors have nothing to declare.

Figures

Figure 1
Figure 1
Association between SARS-COV-2 seropositivity over a 10-13 week period and demographic, hospital role and ethnicity in 1365 healthcare workers from London and Nottingham. All analyses are adjusted for age (per year), sex (male vs female), body mass index, index of multiple deprivation (IMD, per decile), hospital role (ITU vs non ITU, doctors vs other roles), presence of symptoms and ethnicity (vs Whites). Where the heterogeneity variance (τ2) is equal to 0 the fixed effect meta-analysis estimates are the same as random effects . Where τ2 >0 Dersimonian-Laird random effects estimates (indicated as Summary RE) are presented; .p-values shown for results that are statistically significant with p<0.05.
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