Abstract
BackgroundHealthcare 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.MethodsWe 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.ResultsThe 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.ConclusionsHCWs 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.
Highlights
Healthcare workers (HCWs) are at high risk of exposure to SARS-CoV-2
Seroconversion rates significantly differed over the study period, with a lower rate in the first month (2.1, 95% CI 0.97–4.52) as compared to the second (8.8, 95% CI 6.28–12.12) and third months, respectively (7.6, 95% CI 5.24–10.9) (Figs. 1 and 2A)
Several studies have examined SARS-CoV-2 IgG seroprevalence among HCWs, to our knowledge, the present study provides the first data on Covid-19 exposure of HCWs in South America
Summary
Healthcare workers (HCWs) are at high risk of exposure to SARS-CoV-2. Cross-sectional studies have provided variable rates of seroprevalence in HCWs. Most of these efforts are cross-sectional evaluations (seroprevalence), and longitudinal assessments of the seroconversion rate of HCWs are limited to European centers [10,11,12,13] Such longitudinal assessments are crucial to better understand the dynamics of Covid-19 among exposed hospital personnel and help optimize local policies regarding infection surveillance, as exposure and employee behavior may change as the pandemic progresses. Understanding the kinetics of antibody titers may help design preventive measures and vaccination strategies for front-line HCWs. Here, we present a three-month longitudinal follow-up study of the SARS-CoV-2 IgG seropositivity and epidemiological features of front-line HCWs in a tertiary-care hospital during the peak of the first wave of the Covid-19 outbreak in Santiago, Chile
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