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

doi:10.1136/bmjopen-2020-043584

BMJ Open (Feb 2021)

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

DOI: https://doi.org/10.1136/bmjopen-2020-043584
Journal volume & issue: Vol. 11, no. 2

Abstract

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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.

Published in BMJ Open

ISSN: 2044-6055 (Online)
Publisher: BMJ Publishing Group
Country of publisher: United Kingdom
LCC subjects: Medicine
Website: https://bmjopen.bmj.com

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