Prevalence of SARS-CoV-2 infection in previously undiagnosed health care workers in New Jersey, at the onset of the U.S. COVID-19 pandemic

Emily S Barrett,Andrew Brooks,Daniel B Horton,Maria Laura Gennaro,Sugeet Jagpal,Jason Roy,Reynold A Panettieri,Patricia Greenberg,Jay Tischfield,Tracy Andrews,Martin J Blaser,Jeffrey L Carson,Nancy Reilly

doi:10.1186/s12879-020-05587-2

Abstract

BackgroundHealthcare workers (HCW) are presumed to be at increased risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection due to occupational exposure to infected patients. However, there has been little epidemiological research to assess these risks.MethodsWe conducted a prospective cohort study of HCW (n = 546) and non-healthcare workers (NHCW; n = 283) with no known prior SARS-CoV-2 infection who were recruited from a large U.S. university and two affiliated university hospitals. In this cross-sectional analysis of data collected at baseline, we examined SARS-CoV-2 infection status (as determined by presence of SARS-CoV-2 RNA in oropharyngeal swabs) by healthcare worker status and role.ResultsAt baseline, 41 (5.0%) of the participants tested positive for SARS-CoV-2 infection, of whom 14 (34.2%) reported symptoms. The prevalence of SARS-CoV-2 infection was higher among HCW (7.3%) than in NHCW (0.4%), representing a 7.0% greater absolute risk (95% confidence interval for risk difference 4.7, 9.3%). The majority of infected HCW (62.5%) were nurses. Positive tests increased across the two weeks of cohort recruitment in line with rising confirmed cases in the hospitals and surrounding counties.ConclusionsOverall, our results demonstrate that HCW had a higher prevalence of SARS-CoV-2 infection than NHCW. Continued follow-up of this cohort will enable us to monitor infection rates and examine risk factors for transmission.

Highlights

Healthcare workers (HCW) are presumed to be at increased risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection due to occupational exposure to infected patients
We report on the baseline prevalence of SARS-CoV-2 infection in previously undiagnosed HCW and NHCW recruited into a prospective observational study conducted within a major university located in New Jersey (NJ), one of the early U.S epicenters of the pandemic [8]
Despite the large number of responses, in light of our recruitment goals as well as timing and funding considerations, recruitment was curtailed after 829 subjects (546 HCW and 283 NHCW) had completed baseline visits (Fig. 1)

Summary

Introduction

Healthcare workers (HCW) are presumed to be at increased risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection due to occupational exposure to infected patients. There is clear underreporting of infection in this critical population as CDC data indicate that 84% of all reported U.S COVID-19 cases had no information on HCW status [9]. Among both HCW and non-HCW (NHCW), access to testing has been inconsistent in the U.S, and a large proportion of cases that are asymptomatic or have only mild symptoms are likely to have gone untested [10, 11]. These data are vitally important to understand potential sources of exposure as well as to inform clinical decision-making about staffing and protections for HCW and their patients

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