A prospective study of risk factors associated with seroprevalence of SARS-CoV-2 antibodies in healthcare workers at a large UK teaching hospital

doi:10.1016/j.jinf.2022.08.030

. 2022 Nov;85(5):557-564.

doi: 10.1016/j.jinf.2022.08.030. Epub 2022 Sep 2.

A prospective study of risk factors associated with seroprevalence of SARS-CoV-2 antibodies in healthcare workers at a large UK teaching hospital

Daniel J Cooper¹, Sara Lear², Laura Watson³, Ashley Shaw², Mark Ferris², Rainer Doffinger², Rachel Bousfield², Katherine Sharrocks², Michael P Weekes², Ben Warne², Dominic Sparkes⁴, Nick K Jones⁴, Lucy Rivett⁴, Matthew Routledge⁴, Afzal Chaudhry², Katherine Dempsey³, Montgomery Matson⁵, Adil Lakha⁵, George Gathercole⁵, Olivia O'Connor⁵, Emily Wilson⁵, Orthi Shahzad⁵, Kieran Toms⁵, Rachel Thompson⁵, Ian Halsall², David Halsall², Sally Houghton², Sofia Papadia⁶, Nathalie Kingston⁷, Kathleen E Stirrups⁷, Barbara Graves⁶, Paul Townsend⁸, Neil Walker⁷, Hannah Stark⁶; CITIID-NIHR BioResource COVID-19 Collaboration; Daniela De Angelis⁹, Shaun Seaman⁹, Gordon Dougan¹⁰, John R Bradley¹¹, M Estée Török¹², Ian Goodfellow¹³, Stephen Baker¹⁰

Affiliations

¹ Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Global and Tropical Health Division, Menzies School of Heath Research and Charles Darwin University, Darwin, Northern Territory, Australia; Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK. Electronic address: Daniel.cooper@addenbrookes.nhs.uk.
² Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
³ NIHR Cambridge Clinical Research Facility.
⁴ Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Clinical Microbiology and Public Health Laboratory, Public Health England, United Kingdom.
⁵ University of Cambridge School of Clinical Medicine, Cambridge, UK.
⁶ NIHR BioResource, NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK; Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
⁷ NIHR BioResource, NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK; Department of Haematology, School of Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
⁸ NIHR BioResource, NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK.
⁹ MRC Biostatistics Unit, University of Cambridge, Cambridge, UK.
¹⁰ Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK; Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.
¹¹ Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; NIHR BioResource, NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK.
¹² Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.
¹³ Department of pathology, Division of virology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.

PMID: 36058413
PMCID: PMC9436870
DOI: 10.1016/j.jinf.2022.08.030

A prospective study of risk factors associated with seroprevalence of SARS-CoV-2 antibodies in healthcare workers at a large UK teaching hospital

Daniel J Cooper et al. J Infect. 2022 Nov.

. 2022 Nov;85(5):557-564.

doi: 10.1016/j.jinf.2022.08.030. Epub 2022 Sep 2.

Authors

Affiliations

¹ Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Global and Tropical Health Division, Menzies School of Heath Research and Charles Darwin University, Darwin, Northern Territory, Australia; Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK. Electronic address: Daniel.cooper@addenbrookes.nhs.uk.
² Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
³ NIHR Cambridge Clinical Research Facility.
⁴ Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Clinical Microbiology and Public Health Laboratory, Public Health England, United Kingdom.
⁵ University of Cambridge School of Clinical Medicine, Cambridge, UK.
⁶ NIHR BioResource, NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK; Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
⁷ NIHR BioResource, NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK; Department of Haematology, School of Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
⁸ NIHR BioResource, NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK.
⁹ MRC Biostatistics Unit, University of Cambridge, Cambridge, UK.
¹⁰ Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK; Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.
¹¹ Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; NIHR BioResource, NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK.
¹² Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.
¹³ Department of pathology, Division of virology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.

PMID: 36058413
PMCID: PMC9436870
DOI: 10.1016/j.jinf.2022.08.030

Abstract

Objectives: To describe the risk factors for SARS-CoV-2 infection in UK healthcare workers (HCWs).

Methods: We conducted a prospective sero-epidemiological study of HCWs at a major UK teaching hospital using a SARS-CoV-2 immunoassay. Risk factors for seropositivity were analysed using multivariate logistic regression.

Results: 410/5,698 (7·2%) staff tested positive for SARS-CoV-2 antibodies. Seroprevalence was higher in those working in designated COVID-19 areas compared with other areas (9·47% versus 6·16%) Healthcare assistants (aOR 2·06 [95%CI 1·14-3·71]; p=0·016) and domestic and portering staff (aOR 3·45 [95% CI 1·07-11·42]; p=0·039) had significantly higher seroprevalence than other staff groups after adjusting for age, sex, ethnicity and COVID-19 working location. Staff working in acute medicine and medical sub-specialities were also at higher risk (aOR 2·07 [95% CI 1·31-3·25]; p<0·002). Staff from Black, Asian and minority ethnic (BAME) backgrounds had an aOR of 1·65 (95% CI 1·32 - 2·07; p<0·001) compared to white staff; this increased risk was independent of COVID-19 area working. The only symptoms significantly associated with seropositivity in a multivariable model were loss of sense of taste or smell, fever, and myalgia; 31% of staff testing positive reported no prior symptoms.

Conclusions: Risk of SARS-CoV-2 infection amongst HCWs is highly heterogeneous and influenced by COVID-19 working location, role, age and ethnicity. Increased risk amongst BAME staff cannot be accounted for solely by occupational factors.

Keywords: COVID-19; SARS-CoV-2; healthcare workers; risk factor analysis; sero-epidemiology.

PubMed Disclaimer

Conflict of interest statement

Competing interests The authors declare that they have no competing interests

Figures

Figure 1: — **Figure 1**
Epidemic curve of COVID-19 admissions at Cambridge University Hospitals NHS Foundation Trust

Figure 2: — **Figure 2**
Study flowchart

Figure 3: — **Figure 3**
Adjusted odds ratio for SARS-CoV-2 seropositivity according to job role

Figure 4: — **Figure 4**
Adjusted odds ratio for SARS-CoV-2 seropositivity according to ethnic group

See this image and copyright information in PMC

Cited by

Single-dose BNT162b2 vaccine protects against asymptomatic SARS-CoV-2 infection.
Jones NK, Rivett L, Seaman S, Samworth RJ, Warne B, Workman C, Ferris M, Wright J, Quinnell N, Shaw A; Cambridge COVID-19 Collaboration; Goodfellow IG, Lehner PJ, Howes R, Wright G, Matheson NJ, Weekes MP. Jones NK, et al. Elife. 2021 Apr 8;10:e68808. doi: 10.7554/eLife.68808. Elife. 2021. PMID: 33830018 Free PMC article.
SARS-CoV-2 seroprevalence in health care workers from 10 hospitals in Quebec, Canada: a cross-sectional study.
Brousseau N, Morin L, Ouakki M, Savard P, Quach C, Longtin Y, Cheng MP, Carignan A, Dufresne SF, Leduc JM, Lavallée C, Gauthier N, Bestman-Smith J, Arrieta MJ, Ishak M, Lévesque S, Martin P, De Serres G. Brousseau N, et al. CMAJ. 2021 Dec 13;193(49):E1868-E1877. doi: 10.1503/cmaj.202783. CMAJ. 2021. PMID: 34903591 Free PMC article.
Risk factors for SARS-CoV-2 seroprevalence following the first pandemic wave in UK healthcare workers in a large NHS Foundation Trust.
Hodgson D, Colton H, Hornsby H, Brown R, Mckenzie J, Bradley KL, James C, Lindsey BB, Birch S, Marsh L, Wood S, Bayley M, Dickson G, James DC, Nicklin MJH, Sayers JR, Zafred D, Rowland-Jones SL, Kudesia G, Kucharski A; CMMID COVID-19 Working Group; Darton TC, de Silva TI, Collini PJ. Hodgson D, et al. medRxiv [Preprint]. 2021 Jul 8:2021.07.07.21260151. doi: 10.1101/2021.07.07.21260151. medRxiv. 2021. Update in: Wellcome Open Res. 2021 Sep 3;6:220. doi: 10.12688/wellcomeopenres.17143.1. PMID: 34268521 Free PMC article. Updated. Preprint.
Superspreaders drive the largest outbreaks of hospital onset COVID-19 infections.
Illingworth CJ, Hamilton WL, Warne B, Routledge M, Popay A, Jackson C, Fieldman T, Meredith LW, Houldcroft CJ, Hosmillo M, Jahun AS, Caller LG, Caddy SL, Yakovleva A, Hall G, Khokhar FA, Feltwell T, Pinckert ML, Georgana I, Chaudhry Y, Curran MD, Parmar S, Sparkes D, Rivett L, Jones NK, Sridhar S, Forrest S, Dymond T, Grainger K, Workman C, Ferris M, Gkrania-Klotsas E, Brown NM, Weekes MP, Baker S, Peacock SJ, Goodfellow IG, Gouliouris T, de Angelis D, Török ME. Illingworth CJ, et al. Elife. 2021 Aug 24;10:e67308. doi: 10.7554/eLife.67308. Elife. 2021. PMID: 34425938 Free PMC article.
Risk factors for recognized and unrecognized SARS-CoV-2 infection: a seroepidemiologic analysis of the Prospective Urban Rural Epidemiology (PURE) study.
Leong DP, Loeb M, Mony PK, Rangarajan S, Mushtaha M, Miller MS, Dias M, Yegorov S, V M, Telci Caklili O, Temizhan A, Szuba A, Abat MEM, Mat-Nasir N, Diaz ML, Khansaheb H, Lopez-Jaramillo P, Duong M, Teo KK, Poirier P, Oliveira G, Avezum Á, Yusuf S. Leong DP, et al. Microbiol Spectr. 2024 Feb 6;12(2):e0149223. doi: 10.1128/spectrum.01492-23. Epub 2024 Jan 12. Microbiol Spectr. 2024. PMID: 38214526 Free PMC article.

See all "Cited by" articles

References

1. World Health Organisation. Coronavirus Disease (COVID-2019) Situation Reports. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situatio.... Accessed September 23rd 2020.
1. Anderson RM, Hollingsworth TD, Baggaley RF, Maddren R, Vegvari C. COVID-19 spread in the UK: the end of the beginning? Lancet. 2020;396(10251):587–590. - PMC - PubMed
1. UK Health Security Agency. COVID-19 Variants: Genomically Conformed Case Numbers [Available from: https://www.gov.uk/government/publications/covid-19-variants-genomically....
1. Office for national statistics. COVID-19 Latest Insights. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/.... Accessed August 2022.
1. Lin L, Zhao Y, Chen B, He D. Multiple COVID-19 waves and vaccination effectiveness in the United States. Int J Environ Res Public Health. 2022;19(4) - PMC - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Substances

Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information
Miscellaneous
- NCI CPTAC Assay Portal

[1] World Health Organisation. Coronavirus Disease (COVID-2019) Situation Reports. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situatio.... Accessed September 23rd 2020.

[2] World Health Organisation. Coronavirus Disease (COVID-2019) Situation Reports. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situatio.... Accessed September 23rd 2020.

[3] Anderson RM, Hollingsworth TD, Baggaley RF, Maddren R, Vegvari C. COVID-19 spread in the UK: the end of the beginning? Lancet. 2020;396(10251):587–590. - PMC - PubMed

[4] Anderson RM, Hollingsworth TD, Baggaley RF, Maddren R, Vegvari C. COVID-19 spread in the UK: the end of the beginning? Lancet. 2020;396(10251):587–590. - PMC - PubMed

[5] UK Health Security Agency. COVID-19 Variants: Genomically Conformed Case Numbers [Available from: https://www.gov.uk/government/publications/covid-19-variants-genomically....

[6] UK Health Security Agency. COVID-19 Variants: Genomically Conformed Case Numbers [Available from: https://www.gov.uk/government/publications/covid-19-variants-genomically....

[7] Office for national statistics. COVID-19 Latest Insights. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/.... Accessed August 2022.

[8] Office for national statistics. COVID-19 Latest Insights. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/.... Accessed August 2022.

[9] Lin L, Zhao Y, Chen B, He D. Multiple COVID-19 waves and vaccination effectiveness in the United States. Int J Environ Res Public Health. 2022;19(4) - PMC - PubMed

[10] Lin L, Zhao Y, Chen B, He D. Multiple COVID-19 waves and vaccination effectiveness in the United States. Int J Environ Res Public Health. 2022;19(4) - 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

A prospective study of risk factors associated with seroprevalence of SARS-CoV-2 antibodies in healthcare workers at a large UK teaching hospital

Affiliations

A prospective study of risk factors associated with seroprevalence of SARS-CoV-2 antibodies in healthcare workers at a large UK teaching hospital

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Substances

Related information

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous