Seroprevalence of SARS-CoV-2 differed among different types of healthcare workers in Italy in the early stages of the COVID-19 pandemic

1. Health care assistants and nurses were at the highest risk of contracting SARS-CoV-2 among healthcare professionals early in the COVID-19 pandemic in Italy.

2. Healthcare workers employed in operational units that may result in prolonged exposure to SARS-CoV-2 patients, such as internal medicine and related subspecialties, were at higher risk of infection compared to those less exposed to patients.

Evidence Rating Level: 4 (Below Average)

Study Rundown: The COVID-19 pandemic provided insight into which healthcare workers (HCWs) and healthcare settings were at higher risk of contracting SARS-CoV-2 infection. This cross-sectional study examined the seroprevalence of SARS-CoV-2 and odds of infection among different healthcare fields in Italy early in the COVID-19 pandemic. The primary outcome was the proportion of HCWs (in various professional categories and operational units) with a positive Liaison SARS-CoV-2 test (detects SARS-CoV-2 IgG antibodies). Among 82 961 HCWs tested from April 1 through May 26, 2020, 10 115 (12.2% [95% CI: 12.0-12.4] tested positive for SARS-CoV-2 antibodies. Seroprevalence differed among professional categories when compared to administrative personnel as the control group (seroprevalence: 11.6% [95% CI:10.9-12.3]). Healthcare assistants (adjusted odds ratio [aOR]: 1.48 [95% CI: 1.33-1.65]) and nurses (aOR: 1.28 [95% CI: 1.17-1.41]) had the highest odds of infection; laboratory personnel (aOR: 0.7 [95% CI: 0.46-1.1]) and radiologists (aOR: 0.63 [95% CI: 0.39-1.0]) had the lowest odds of infection, however, these odds were not significantly different from control. Physicians did not have a significantly higher risk of infection compared to control. Seroprevalence differed among operational units when comparing to telephone operators as the control group (seroprevalence: 11.7% [95% CI: 10.3-13.3]). HCWs employed in internal medicine (aOR: 2.24 [95% CI: 1.87-2.68]) and rheumatology (aOR: 2.30 [95% CI: 1.37-3.86]) had the highest risk of infection; those employed in forensic medicine (aOR: 0.40 [95% CI: 0.19-0.88]), histologic and anatomical pathology (aOR: 0.71 [95% CI: 0.52-0.97]), and medical device sterilization (aOR: 0.54 [95% CI: 0.35-0.84]) had the lowest odds of infection. Overall, it appears that certain healthcare professionals and fields had a higher risk of contracting SARS-CoV-2 infection than others. Notably, one major limitation of this study, however, is that it was unknown which participants contracted SARS-CoV-2 infection from their workplace versus elsewhere.

Click to read the study in JAMA Network Open

Relevant Reading: Seroprevalence of SARS-CoV-2 antibodies and associated factors in healthcare workers: a systematic review and meta-analysis

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