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 Valdes¹, James C Moon^{2

3}, Amrita Vijay¹, Nish Chaturvedi⁴, Alan Norrish¹, Adeel Ikram¹, Simon Craxford¹, Lola M L Cusin⁵, Jessica Nightingale¹, Amanda Semper⁶, Timothy Brooks⁶, Aine McKnight⁷, Hibba Kurdi², Cristina Menni⁸, Patrick Tighe⁵, Mahdad Noursadeghi⁹, Guruprasad Aithal¹⁰, Thomas A Treibel^{2

3}, Benjamin J Ollivere¹, Charlotte Manisty^{2

3}

Affiliations

¹ Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, NG5 1PB, UK.
² Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom.
³ Institute of Cardiovascular Sciences, University College London, London, United Kingdom.
⁴ MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, United Kingdom.
⁵ School of Life Sciences, University of Nottingham, NG7 2RB.
⁶ National Infection Service, Public Health England, Porton Down, UK.
⁷ Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
⁸ Department of Twin Research and Genetic Epidemiology, King's College London, London SE1 7EH, UK.
⁹ Division of Infection and Immunity, University College London, London, UK.
¹⁰ Nottingham Digestive Disease Centre, University of Nottingham School of Medicine, Nottingham, UK.

PMID: 33880438
PMCID: PMC8049191
DOI: 10.1016/j.eclinm.2021.100835

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.

. 2021 Apr:34:100835.

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

Authors

Affiliations

¹ Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, NG5 1PB, UK.
² Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom.
³ Institute of Cardiovascular Sciences, University College London, London, United Kingdom.
⁴ MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, United Kingdom.
⁵ School of Life Sciences, University of Nottingham, NG7 2RB.
⁶ National Infection Service, Public Health England, Porton Down, UK.
⁷ Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
⁸ Department of Twin Research and Genetic Epidemiology, King's College London, London SE1 7EH, UK.
⁹ Division of Infection and Immunity, University College London, London, UK.
¹⁰ Nottingham Digestive Disease Centre, University of Nottingham School of Medicine, Nottingham, UK.

PMID: 33880438
PMCID: PMC8049191
DOI: 10.1016/j.eclinm.2021.100835

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.

PubMed Disclaimer

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**
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.

See this image and copyright information in PMC

References

1. Price-Haywood EG, Burton J, Fort D, Seoane L. Hospitalization and Mortality among Black Patients and White Patients with Covid-19. N Engl J Med. 2020;382:2534–2543. - PMC - PubMed
1. Harrison EM, Docherty AB, Barr B, et al. Ethnicity and Outcomes from COVID-19: The ISARIC CCP-UK Prospective Observational Cohort Study of Hospitalised Patients. 2020; published online May 31. DOI:10.2139/ssrn.3618215.
1. Rimmer A. Covid-19: Disproportionate impact on ethnic minority healthcare workers will be explored by government. BMJ. 2020;369:m1562. - PubMed
1. Ward H, Atchison CJ, Whitaker M. Antibody prevalence for SARS-CoV-2 in England following first peak of the pandemic: REACT2 study in 100,000 adults. Infectious Diseases (except HIV/AIDS) 2020 doi: 10.37473/dac/10.1101/2020.08.12.20173690. published online Aug 14. - DOI
1. de Lusignan S, Dorward J, Correa A. Risk factors for SARS-CoV-2 among patients in the Oxford Royal College of General Practitioners Research and Surveillance Centre primary care network: a cross-sectional study. Lancet Infect Dis. 2020;20:1034–1042. - PMC - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Associated data

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Miscellaneous