Seroprevalence of antibodies to SARS-CoV-2 in healthcare workers: a cross-sectional study
Sonia Sharma,
Jane C Figueiredo,
Michael Karin,
Margo Minissian,
Nancy Sun,
Susan Cheng,
Patrick Botting,
Joseph E Ebinger,
Eric Luong,
Elizabeth H Kim,
Trevor Trung Nguyen,
Dalin Li,
Dermot P B McGovern,
Christine M Albert,
Anders H Berg,
Kimia Sobhani,
Mohit Jain,
Sandy Joung,
Yunxian Liu,
Mona Alotaibi,
Justyna Fert-Bober,
Jennifer E Van Eyk,
Moshe Arditi,
Jonathan G Braun,
Gregory J Botwin,
Akil Merchant,
Aleksandra Binek,
Jonathan D Grein,
Wohaib Hasan,
Mir Henglin,
Shehnaz K Hussain,
Noah Merin,
Peggy B Miles,
Koen Raedschelders,
Mohamad A Rashid,
Celine E Riera,
Richard V Riggs,
Sarah Sternbach,
Warren G Tourtellotte
Affiliations
Sonia Sharma
8 La Jolla Institute for Allergy and Immunology, La Jolla, California, USA
Jane C Figueiredo
1 Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
Michael Karin
34 Department of Pharmacology and Pathology, University of California at San Diego (UCSD) School of Medicine, La Jolla, California, USA
Margo Minissian
Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Nancy Sun
1 Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Susan Cheng
1 Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Patrick Botting
1 Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
Joseph E Ebinger
3 Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Eric Luong
6 Department of Cardiology, Schmidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Elizabeth H Kim
1 Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
Trevor Trung Nguyen
1 Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
Dalin Li
F. Widjaja Inflammatory Bowel Disease Institute, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
Dermot P B McGovern
F. Widjaja Inflammatory Bowel Disease Institute, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
Christine M Albert
8Department of Medicine, Division of Cardiology, Brigham and Women`s Hospital, Boston, Massachusetts, USA
Anders H Berg
Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, California, USA
Kimia Sobhani
13 Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
Mohit Jain
7 Department of Medicine, School of Medicine, University of California, San Diego, San Diego, California, USA
Sandy Joung
Smidt Heart Institute, Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
Yunxian Liu
1 Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Mona Alotaibi
3 Division of Pulmonary and Critical Care Medicine, University of California San Diego, San Diego, California, USA
Justyna Fert-Bober
1 Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Jennifer E Van Eyk
1 Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Moshe Arditi
11 Smidt Heart Institute; Department of Pediatrics, Division of Infectious Diseases and Immunology; Infectious and Immunologic Diseases Research Center (IIDRC); Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
Jonathan G Braun
12 F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Gregory J Botwin
F. Widjaja Inflammatory Bowel Disease Institute, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
Akil Merchant
3Cedars-Sinai Medical Center, Los Angeles, CA, USA
Aleksandra Binek
Advanced Clinical Biosystems Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
Jonathan D Grein
Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
Wohaib Hasan
Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
Mir Henglin
Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
Shehnaz K Hussain
Department of Public Health Sciences and Comprehensive Cancer Center, University of California, Davis, Davis, California, USA
Noah Merin
Department of Internal Medicine, Division of Hematology, Cedars-Sinai Medical Center, Los Angeles, California, USA
Peggy B Miles
Employee Health Services, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
Koen Raedschelders
Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
Mohamad A Rashid
Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
Celine E Riera
Center for Neural Science and Medicine, Department of Biomedical Sciences, Board of Governors Regenerative Medicine Institute, Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
Richard V Riggs
Chief Medical Officer, Cedars-Sinai Medical Center, Los Angeles, California, USA
Sarah Sternbach
Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
Warren G Tourtellotte
Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
Objective We sought to determine the extent of SARS-CoV-2 seroprevalence and the factors associated with seroprevalence across a diverse cohort of healthcare workers.Design Observational cohort study of healthcare workers, including SARS-CoV-2 serology testing and participant questionnaires.Settings A multisite healthcare delivery system located in Los Angeles County.Participants A diverse and unselected population of adults (n=6062) employed in a multisite healthcare delivery system located in Los Angeles County, including individuals with direct patient contact and others with non-patient-oriented work functions.Main outcomes Using Bayesian and multivariate analyses, we estimated seroprevalence and factors associated with seropositivity and antibody levels, including pre-existing demographic and clinical characteristics; potential COVID-19 illness-related exposures; and symptoms consistent with COVID-19 infection.Results We observed a seroprevalence rate of 4.1%, with anosmia as the most prominently associated self-reported symptom (OR 11.04, p<0.001) in addition to fever (OR 2.02, p=0.002) and myalgias (OR 1.65, p=0.035). After adjusting for potential confounders, seroprevalence was also associated with Hispanic ethnicity (OR 1.98, p=0.001) and African-American race (OR 2.02, p=0.027) as well as contact with a COVID-19-diagnosed individual in the household (OR 5.73, p<0.001) or clinical work setting (OR 1.76, p=0.002). Importantly, African-American race and Hispanic ethnicity were associated with antibody positivity even after adjusting for personal COVID-19 diagnosis status, suggesting the contribution of unmeasured structural or societal factors.Conclusion and relevance The demographic factors associated with SARS-CoV-2 seroprevalence among our healthcare workers underscore the importance of exposure sources beyond the workplace. The size and diversity of our study population, combined with robust survey and modelling techniques, provide a vibrant picture of the demographic factors, exposures and symptoms that can identify individuals with susceptibility as well as potential to mount an immune response to COVID-19.
