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.

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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

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

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

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

Authors

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Conflict of interest statement

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