Risk factors for SARS-CoV-2 seroprevalence following the first pandemic wave in UK healthcare workers in a large NHS Foundation Trust.
Risk factors for SARS-CoV-2 seroprevalence following the first pandemic wave in UK healthcare workers in a large NHS Foundation Trust.
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DOI：
10.12688/wellcomeopenres.17143.1
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发表时间：
2021-01-01
影响因子：
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通讯作者：
Collini, Paul J
中科院分区：
文献类型：
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作者：
Colton, Hayley;Hodgson, David;Collini, Paul J
背景资料：我们的目的是在英国第一波COVID-19大流行期间测量医护人员（HCW）队列中的SARS-CoV-2血清阳性率，探索与感染相关的风险因素，并调查抗体滴度对检测灵敏度的影响。方法：前瞻性招募谢菲尔德教学医院NHS基金会信托的HCW，并在两个时间点进行抽样。SARS-CoV-2抗体使用针对刺突和核蛋白的IgG和伊加反应性的内部测定进行测试（灵敏度99.47%，特异性99.56%）。使用三种统计模型分析数据：血清阳性率模型、抗体动力学模型和异质性敏感性模型。结果：截至2020年6月12日，24.4%（n=311/1275）的HCW为血清阳性。其中，39.2%（n=122/311）无症状。调整后的血清阳性率最高的是在急症室的医务工作者（41.1%，95%CrI 30.0 - 52.9）和物理治疗师和职业治疗师（39.2%，95%CrI 24.4 - 56.5）。进一步建模表明，对于总体灵敏度为80%的血清学检测，抗体滴度可能受到年龄差异的显著影响，60岁以上人群的灵敏度估计值为89%，而≤30岁人群的灵敏度估计值为61%。结论：与COVID-19患者密切合作的急性医疗单位的医务人员感染风险最高，但这些感染是否来自患者或其他工作人员尚不清楚。如果使用老年人和/或症状更严重的个体的血清进行验证，目前的血清学检测可能会低估较年轻年龄组的血清阳性率。
Background: We aimed to measure SARS-CoV-2 seroprevalence in a cohort of healthcare workers (HCWs) during the first UK wave of the COVID-19 pandemic, explore risk factors associated with infection, and investigate the impact of antibody titres on assay sensitivity. Methods: HCWs at Sheffield Teaching Hospitals NHS Foundation Trust were prospectively enrolled and sampled at two time points. SARS-CoV-2 antibodies were tested using an in-house assay for IgG and IgA reactivity against Spike and Nucleoprotein (sensitivity 99·47%, specificity 99·56%). Data were analysed using three statistical models: a seroprevalence model, an antibody kinetics model, and a heterogeneous sensitivity model. Results: As of 12th June 2020, 24·4% (n=311/1275) of HCWs were seropositive. Of these, 39·2% (n=122/311) were asymptomatic. The highest adjusted seroprevalence was measured in HCWs on the Acute Medical Unit (41·1%, 95% CrI 30·0-52·9) and in Physiotherapists and Occupational Therapists (39·2%, 95% CrI 24·4-56·5).Older age groups showed overall higher median antibody titres. Further modelling suggests that, for a serological assay with an overall sensitivity of 80%, antibody titres may be markedly affected by differences in age, with sensitivity estimates of 89% in those over 60 years but 61% in those ≤30 years. Conclusions: HCWs in acute medical units working closely with COVID-19 patients were at highest risk of infection, though whether these are infections acquired from patients or other staff is unknown. Current serological assays may underestimate seroprevalence in younger age groups if validated using sera from older and/or more symptomatic individuals.