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Open Access 01-12-2021 | SARS-CoV-2 | Research

Longitudinal assessment of SARS-CoV-2 IgG seroconversionamong front-line healthcare workers during the first wave of the Covid-19 pandemic at a tertiary-care hospital in Chile

Authors: Mirentxu Iruretagoyena, Macarena R. Vial, Maria Spencer-Sandino, Pablo Gaete, Anne Peters, Iris Delgado, Inia Perez, Claudia Calderon, Lorena Porte, Paulette Legarraga, Alicia Anderson, Ximena Aguilera, Pablo Vial, Thomas Weitzel, Jose M. Munita

Published in: BMC Infectious Diseases | Issue 1/2021

Abstract

Background

Healthcare workers (HCWs) are at high risk of exposure to SARS-CoV-2. Cross-sectional studies have provided variable rates of seroprevalence in HCWs. Longitudinal assessments of the serological response to Covid-19 among HCWs are crucial to understanding the risk of infection and changes in antibody titers over time. We aimed to investigate seroprevalence and risk factors associated with seroconversion in a prospective cohort of HCWs during the peak of the first wave of the Covid-19 pandemic.

Methods

We conducted a longitudinal study among 446 front-line HCWsin a tertiary-care hospital in Chile from April to July 2020. IgG was determined monthly using two different ELISAs in serum samples of HCWs, during the three-month period. In each visit, demographic data, symptoms, risk factors, and exposure risks were also assessed.

Results

The overall seroprevalence at the end of the study period was 24% (95% CI20.2–28.3), with 43% of seropositive HCWs reporting no prior symptoms. Seroconversion rates significantly differed over the study period, from 2.1% to as high as 8.8% at the peak of the epidemic. There were no statistically significant differences observed between HCWs in direct clinical care of patients with Covid-19 and those working in low risk areas. Antibody titers appeared to wane over time.

Conclusions

HCWs were severely affected with a high rate of seroconversion that appeared to mirror the local epidemiological situation. A significant amount of participants underwent an asymptomatic infection, highlighting the need for improved surveillance policies. Antibody titers appear to wane over time; further studies to understand this finding’s impact on the risk of reinfection are warranted.

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covid19.who.int. 2021. https://covid19.who.int/region/amro/country/cl.

Treibel TA, Manisty C, Burton M, McKnight Á, Lambourne J, Augusto JB, et al. COVID-19: PCR screening of asymptomatic health-care workers at London hospital. Lancet. 2020;395(10237):1608–10. https://doi.org/10.1016/S0140-6736(20)31100-4.CrossRefPubMedPubMedCentral

Pan A, Liu L, Wang C, Guo H, Hao X, Wang Q, et al. Association of Public Health Interventions with the epidemiology of the COVID-19 outbreak in Wuhan, China. JAMA. 2020;323(19):1915–23. https://doi.org/10.1001/jama.2020.6130.CrossRefPubMed

Ran L, Chen X, Wang Y, Wu W, Zhang L, Tan X. Risk factors of healthcare workers with coronavirus disease 2019: a retrospective cohort study in a designated Hospital of Wuhan in China. Clin Infect Dis. 2020;71(16):2218–21. https://doi.org/10.1093/cid/ciaa287.CrossRefPubMed

Lombardi A, et al. Characteristics of 1573 healthcare workers who underwent nasopharyngeal swab testing for SARS-CoV-2 in Milan, Lombardy, Italy. Clin Microbiol Infect. 2020;26(10):1413.e9–1413.e13.CrossRef

Nguyen LH, Drew DA, Graham MS, Joshi AD, Guo CG, Ma W, et al. Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. Lancet Public Health. 2020;5(9):e475–83. https://doi.org/10.1016/S2468-2667(20)30164-X.CrossRefPubMedPubMedCentral

Venugopal U, et al. SARS-CoV-2 seroprevalence among health care workers in a new York City hospital: a cross-sectional analysis during the COVID-19 pandemic. Int J Infect Dis. 2020;102:63–9.CrossRefPubMedPubMedCentral

Sood N, Simon P, Ebner P, Eichner D, Reynolds J, Bendavid E, et al. Seroprevalence of SARS-CoV-2-specific antibodies among adults in Los Angeles County, California, on April 10-11, 2020. JAMA. 2020;323(23):2425–7. https://doi.org/10.1001/jama.2020.8279.CrossRefPubMedPubMedCentral

Self WH, Tenforde MW, Stubblefield WB, Feldstein LR, Steingrub JS, Shapiro NI, et al. Seroprevalence of SARS-CoV-2 among frontline health care personnel in a multistate hospital network - 13 academic medical centers, April-June 2020. MMWR Morb Mortal Wkly Rep. 2020;69(35):1221–6. https://doi.org/10.15585/mmwr.mm6935e2.CrossRefPubMedPubMedCentral

10.

Moncunill G, et al. SARS-CoV-2 seroprevalence and antibody kinetics among health care workers in a Spanish hospital after three months of follow-up. J Infect Dis. 2021;223(1):62–71. https://doi.org/10.1093/infdis/jiaa696.

11.

Weinberger, T., et al., Prospective longitudinal Serosurvey of health Care Workers in the First Wave of the SARS-CoV-2 pandemic in a quaternary Care Hospital in Munich, Germany. Clin Infect Dis, 2021.

12.

Ciccone EJ, et al. SARS-CoV-2 infection in healthcare personnel and their household contacts at a tertiary Academic Medical Center: protocol for a longitudinal cohort study. JMIR Res Protoc. 2021;10(4):e25410.CrossRefPubMedPubMedCentral

13.

Milazzo L, et al. Dynamics of the seroprevalence of SARS-CoV-2 antibodies among healthcare workers at a COVID-19 referral hospital in Milan, Italy. Occup Environ Med. 2021;oemed-2020-107060. https://doi.org/10.1136/oemed-2020-107060.

14.

https://www.gob.cl/coronavirus/cifrasoficiales/. 2021. Accessed 31 Aug 2020.

15.

Vial MR, et al. Covid-19 in South America: clinical and epidemiological characteristics among 381 patients during the early phase of the pandemic in Santiago, Chile. BMC Infect Dis. 2020;20(1):955. https://doi.org/10.1186/s12879-020-05665-5.CrossRefPubMedPubMedCentral

16.

Kohmer N, Westhaus S, Rühl C, Ciesek S, Rabenau HF. Brief clinical evaluation of six high-throughput SARS-CoV-2 IgG antibody assays. J Clin Virol. 2020;129:104480. https://doi.org/10.1016/j.jcv.2020.104480.CrossRefPubMedPubMedCentral

17.

Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81. https://doi.org/10.1016/j.jbi.2008.08.010.CrossRefPubMed

18.

Bielicki JA, Duval X, Gobat N, Goossens H, Koopmans M, Tacconelli E, et al. Monitoring approaches for health-care workers during the COVID-19 pandemic. Lancet Infect Dis. 2020;20(10):e261–7. https://doi.org/10.1016/S1473-3099(20)30458-8.CrossRefPubMedPubMedCentral

19.

Moscola J, Sembajwe G, Jarrett M, Farber B, Chang T, McGinn T, et al. Prevalence of SARS-CoV-2 antibodies in health care personnel in the new York City area. JAMA. 2020;324(9):893–5. https://doi.org/10.1001/jama.2020.14765.CrossRefPubMedPubMedCentral

20.

Garcia-Basteiro AL, Moncunill G, Tortajada M, Vidal M, Guinovart C, Jiménez A, et al. Seroprevalence of antibodies against SARS-CoV-2 among health care workers in a large Spanish reference hospital. Nat Commun. 2020;11(1):3500. https://doi.org/10.1038/s41467-020-17318-x.CrossRefPubMedPubMedCentral

21.

Iversen K, Bundgaard H, Hasselbalch RB, Kristensen JH, Nielsen PB, Pries-Heje M, et al. Risk of COVID-19 in health-care workers in Denmark: an observational cohort study. Lancet Infect Dis. 2020;20(12):1401–8. https://doi.org/10.1016/S1473-3099(20)30589-2.CrossRefPubMedPubMedCentral

22.

Shields A, Faustini SE, Perez-Toledo M, Jossi S, Aldera E, Allen JD, et al. SARS-CoV-2 seroprevalence and asymptomatic viral carriage in healthcare workers: a cross-sectional study. Thorax. 2020;75(12):1089–94. https://doi.org/10.1136/thoraxjnl-2020-215414.CrossRefPubMed

23.

Houlihan CF, Vora N, Byrne T, Lewer D, Kelly G, Heaney J, et al. Pandemic peak SARS-CoV-2 infection and seroconversion rates in London frontline health-care workers. Lancet. 2020;396(10246):e6–7. https://doi.org/10.1016/S0140-6736(20)31484-7.CrossRefPubMedPubMedCentral

24.

Galanis P, et al. Seroprevalence of SARS-CoV-2 antibodies and associated factors in health care workers: a systematic review and meta-analysis. J Hosp Infect. 2021;108:120–34. https://doi.org/10.1016/j.jhin.2020.11.008.

25.

Mani NS, et al. Prevalence of COVID-19 infection and outcomes among symptomatic healthcare Workers in Seattle, Washington. Clin Infect Dis. 2020;71(10):2702–7.CrossRefPubMedPubMedCentral

26.

Kluytmans-van den Bergh MFQ, et al. Prevalence and Clinical Presentation of Health Care Workers With Symptoms of Coronavirus Disease 2019 in 2 Dutch Hospitals During an Early Phase of the Pandemic. JAMA Netw Open. 2020;3(5):e209673.CrossRefPubMedPubMedCentral

27.

Fukuda H, Seyama K, Ito K, Ai T, Nojiri S, Hori S, et al. SARS-CoV-2 seroprevalence in healthcare workers at a frontline hospital in Tokyo. Sci Rep. 2021;11(1):8380. https://doi.org/10.1038/s41598-021-87688-9.CrossRefPubMedPubMedCentral

28.

Steensels D, Oris E, Coninx L, Nuyens D, Delforge ML, Vermeersch P, et al. Hospital-wide SARS-CoV-2 antibody screening in 3056 staff in a tertiary Center in Belgium. JAMA. 2020;324(2):195–7. https://doi.org/10.1001/jama.2020.11160.CrossRefPubMedPubMedCentral

29.

Sikkema RS, Pas SD, Nieuwenhuijse DF, O'Toole Á, Verweij J, van der Linden A, et al. COVID-19 in health-care workers in three hospitals in the south of the Netherlands: a cross-sectional study. Lancet Infect Dis. 2020;20(11):1273–80. https://doi.org/10.1016/S1473-3099(20)30527-2.CrossRefPubMedPubMedCentral

30.

de Lusignan S, Liyanage H, McGagh D, Jani BD, Bauwens J, Byford R, et al. COVID-19 surveillance in a primary care sentinel network: in-pandemic development of an application ontology. JMIR Public Health Surveill. 2020;6(4):e21434. https://doi.org/10.2196/21434.CrossRefPubMedPubMedCentral

31.

Simons D, et al. The association of smoking status with SARS-CoV-2 infection, hospitalization and mortality from COVID-19: a living rapid evidence review with Bayesian meta-analyses (version 7). Addiction. 2021;116(6):1319–68. https://doi.org/10.1111/add.15276.

32.

Kantele A, et al. SARS-CoV-2 infections among healthcare workers at Helsinki University Hospital, Finland, spring 2020: Serosurvey, symptoms and risk factors. Travel Med Infect Dis. 2020;39:101949.CrossRefPubMedPubMedCentral

33.

Farsalinos K, Barbouni A, Niaura R. Systematic review of the prevalence of current smoking among hospitalized COVID-19 patients in China: could nicotine be a therapeutic option? Intern Emerg Med. 2020;15(5):845–52. https://doi.org/10.1007/s11739-020-02355-7.CrossRefPubMedPubMedCentral

34.

Çelebi G, Pişkin N, Çelik Bekleviç A, Altunay Y, Salcı Keleş A, Tüz MA, et al. Specific risk factors for SARS-CoV-2 transmission among health care workers in a university hospital. Am J Infect Control. 2020;48(10):1225–30. https://doi.org/10.1016/j.ajic.2020.07.039.CrossRefPubMedPubMedCentral

35.

Hoxha A, et al. Asymptomatic SARS-CoV-2 infection in Belgian long-term care facilities. Lancet Infect Dis. 2021;21(4):e67. https://doi.org/10.1016/S1473-3099(20)30560-0.

36.

Oran DP, Topol EJ. Prevalence of asymptomatic SARS-CoV-2 infection : a narrative review. Ann Intern Med. 2020;173(5):362–7. https://doi.org/10.7326/M20-3012.CrossRefPubMed

37.

Lumley SF, Wei J, O’Donnell D, Stoesser NE, Matthews PC, Howarth A, et al. The duration, dynamics and determinants of SARS-CoV-2 antibody responses in individual healthcare workers. Clin Infect Dis. 2021. https://doi.org/10.1093/cid/ciab004.

38.

Lumley SF, et al. Antibody status and incidence of SARS-CoV-2 infection in health care workers. N Engl J Med. 2021;384(6):533–40. https://doi.org/10.1056/NEJMoa2034545.

39.

Tang F, Quan Y, Xin ZT, Wrammert J, Ma MJ, Lv H, et al. Lack of peripheral memory B cell responses in recovered patients with severe acute respiratory syndrome: a six-year follow-up study. J Immunol. 2011;186(12):7264–8. https://doi.org/10.4049/jimmunol.0903490.CrossRefPubMed

40.

Harrington WE, Trakhimets O, Andrade DV, Dambrauskas N, Raappana A, Jiang Y, et al. Rapid decline of neutralizing antibodies is associated with decay of IgM in adults recovered from mild COVID-19 disease. Cell Rep Med. 2021;2(4):100253. https://doi.org/10.1016/j.xcrm.2021.100253.CrossRefPubMedPubMedCentral

Title: Longitudinal assessment of SARS-CoV-2 IgG seroconversionamong front-line healthcare workers during the first wave of the Covid-19 pandemic at a tertiary-care hospital in Chile
Authors: Mirentxu Iruretagoyena
Macarena R. Vial
Maria Spencer-Sandino
Pablo Gaete
Anne Peters
Iris Delgado
Inia Perez
Claudia Calderon
Lorena Porte
Paulette Legarraga
Alicia Anderson
Ximena Aguilera
Pablo Vial
Thomas Weitzel
Jose M. Munita
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: SARS-CoV-2
Care
COVID-19
Published in: BMC Infectious Diseases / Issue 1/2021
Electronic ISSN: 1471-2334
DOI: https://doi.org/10.1186/s12879-021-06208-2

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Longitudinal assessment of SARS-CoV-2 IgG seroconversionamong front-line healthcare workers during the first wave of the Covid-19 pandemic at a tertiary-care hospital in Chile

Abstract

Background

Methods

Results

Conclusions

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