Abstract
BackgroundSARS-CoV-2 cases in Germany increased in early March 2020. By April 2020, cases among health care workers (HCW) were detected across departments at a tertiary care hospital in Berlin, prompting a longitudinal investigation to assess HCW SARS-CoV-2 serostatus with an improved testing strategy and associated risk factors.MethodsIn May/June and December 2020, HCWs voluntarily provided blood for serology and nasopharyngeal/oropharyngeal (NP/OP) samples for real-time polymerase chain reaction (PCR) and completed a questionnaire. A four-tiered SARS-CoV-2 serological testing strategy including two different enzyme-linked immunosorbent assays (ELISA) and biological neutralization test (NT) was used. ELISA-NT correlation was assessed using Pearson’s correlation coefficient. Sociodemographic and occupational factors associated with seropositivity were assessed with multivariate logistic regression.ResultsIn May/June, 18/1477 (1.2%) HCWs were SARS-CoV-2 seropositive, followed by 56/1223 (4.6%) in December. Among those tested in both, all seropositive in May/June remained seropositive by ELISA and positive by NT after 6 months. ELISA ratios correlated well with NT titres in May/June (R = 0.79) but less so in December (R = 0.41). Those seropositive reporting a past SARS-CoV-2 positive PCR result increased from 44.4% in May/June to 85.7% in December. HCWs with higher occupational risk (based on profession and working site), nurses, males, and those self-reporting COVID-19-like symptoms had significantly higher odds of seropositivity.ConclusionsThis investigation provides insight into the burden of HCW infection in this local outbreak context and the antibody dynamics over time with an improved robust testing strategy. It also highlights the continued need for effective infection control measures particularly among HCWs with higher occupational risk.
Highlights
SARS-CoV-2 cases in Germany increased in early March 2020
A total of 1944 health care workers (HCWs) participated in the May–June and/ or December 2020 cross-sectional surveys
The final estimates of seropositivity using the four-tiered testing strategy were not substantially different compared to the results of the Euroimmun enzyme-linked immunosorbent assays (ELISA) ratios adjusted for test performance in the second survey (Additional file 1: section 3)
Summary
SARS-CoV-2 cases in Germany increased in early March 2020. By April 2020, cases among health care workers (HCW) were detected across departments at a tertiary care hospital in Berlin, prompting a longitudinal inves‐ tigation to assess HCW SARS-CoV-2 serostatus with an improved testing strategy and associated risk factors. Cases of SARS-CoV-2 in Germany started to significantly increase in early March 2020 (‘first wave’), with a peak of approximately 35,000 reported cases in calendar week 14, leading to wide-reaching impacts on the German health system. The burden of the COVID-19 pandemic has stressed the capacity of hospitals and ICUs. In Berlin, Germany, a standardised approach was developed to distribute COVID-19 patients requiring invasive ventilation across hospitals in order to optimize the flow and care of these at-risk patients (“SAVE-Model”) [3]. In Berlin, Germany, a standardised approach was developed to distribute COVID-19 patients requiring invasive ventilation across hospitals in order to optimize the flow and care of these at-risk patients (“SAVE-Model”) [3] This includes a ‘first-level’ coordinating hospital and 16 ‘second-level’ specialised hospitals with the capacity to treat critically-ill COVID-19 patients. The remaining 60 ‘thirdlevel’ hospitals with emergency services are designated to provide intensive care for non-COVID-19 patients
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