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Serologic Status and SARS-CoV-2 Infection over 6 Months of Follow Up in Healthcare Workers in Chicago: A Cohort Study

Published online by Cambridge University Press:  09 August 2021

John T. Wilkins*
Affiliation:
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois Division of Cardiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Lisa R. Hirschhorn
Affiliation:
Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois Institute for Global Health, Center for Global Cardiovascular Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Elizabeth L. Gray
Affiliation:
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Amisha Wallia
Affiliation:
Division of Endocrinology, Metabolism, and Molecular Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, Institute for Public Health and Medicine, Center for Health Services and Outcomes Research. Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Mercedes Carnethon
Affiliation:
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Teresa R. Zembower
Affiliation:
Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Joyce Ho
Affiliation:
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Benjamin J. DeYoung
Affiliation:
Program in Public Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Alex Zhu
Affiliation:
Weinberg College of Arts and Sciences, Northwestern University, Evanston, Illinois
Laura J. Rasmussen-Torvik
Affiliation:
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Babafemi Taiwo
Affiliation:
Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Charlesnika T. Evans
Affiliation:
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois Institute for Public Health and Medicine, Center for Health Services and Outcomes Research. Feinberg School of Medicine, Northwestern University, Chicago, Illinois Department of Veterans’ Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr VA Hospital, Hines, Illinois
*
Author for correspondence: John T. Wilkins, E-mail: [email protected]

Abstract

Objective:

To determine the changes in severe acute respiratory coronavirus virus 2 (SARS-CoV-2) serologic status and SARS-CoV-2 infection rates in healthcare workers (HCWs) over 6-months of follow-up.

Design:

Prospective cohort study.

Setting and participants:

HCWs in the Chicago area.

Methods:

Cohort participants were recruited in May and June 2020 for baseline serology testing (Abbott anti-nucleocapsid IgG) and were then invited for follow-up serology testing 6 months later. Participants completed monthly online surveys that assessed demographics, medical history, coronavirus disease 2019 (COVID-19), and exposures to SARS-CoV-2. The electronic medical record was used to identify SARS-CoV-2 polymerase chain reaction (PCR) positivity during follow-up. Serologic conversion and SARS-CoV-2 infection or possible reinfection rates (cases per 10,000 person days) by antibody status at baseline and follow-up were assessed.

Results:

In total, 6,510 HCWs were followed for a total of 1,285,395 person days (median follow-up, 216 days). For participants who had baseline and follow-up serology checked, 285 (6.1%) of the 4,681 seronegative participants at baseline seroconverted to positive at follow-up; 138 (48%) of the 263 who were seropositive at baseline were seronegative at follow-up. When analyzed by baseline serostatus alone, 519 (8.4%) of 6,194 baseline seronegative participants had a positive PCR after baseline serology testing (4.25 per 10,000 person days). Of 316 participants who were seropositive at baseline, 8 (2.5%) met criteria for possible SARS-CoV-2 reinfection (ie, PCR positive >90 days after baseline serology) during follow-up, a rate of 1.27 per 10,000 days at risk. The adjusted rate ratio for possible reinfection in baseline seropositive compared to infection in baseline seronegative participants was 0.26 (95% confidence interval, 0.13–0.53).

Conclusions:

Seropositivity in HCWs is associated with moderate protection from future SARS-CoV-2 infection.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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References

Lumley, SF, O’Donnell, D, Stoesser, NE, et al. Antibody status and incidence of SARS-CoV-2 infection in healthcare workers. N Engl J Med 2021;384:533540.CrossRefGoogle Scholar
Lumley, SF, Rodger, G, Constantinides, B, et al. An observational cohort study on the incidence of SARS-CoV-2 infection and B.1.1.7 variant infection in healthcare workers by antibody and vaccination status. medRxiv 2021. doi: 10.1101/2021.03.09.21253218.CrossRefGoogle Scholar
COVID-19 cases and deaths in the US. Centers for Disease Control and Prevention website. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html. Updated September 8, 2020. Accessed September 8, 2020.Google Scholar
Wilkins, JT, Gray, EL, Wallia, A, et al. Seroprevalence and correlates of SARS-CoV-2 antibodies in healthcare workers in Chicago. Open Forum Infect Dis 2020. doi: 10.1093/ofid/ofaa582.Google ScholarPubMed
Jacob, JT, Baker, JM, Fridkin, SK, et al. Risk factors associated with SARS-CoV-2 seropositivity among US healthcare personnel. JAMA Netw Open 2021;4:e211283.CrossRefGoogle Scholar
Meyer, MN, Gjorgjieva, T, Rosica, D. Trends in healthcare worker intentions to receive a COVID-19 vaccine and reasons for hesitancy. JAMA Netw Open 2021;4:e215344.CrossRefGoogle ScholarPubMed
Bryan, A, Pepper, G, Wener, MH, et al. Performance characteristics of the Abbott Architect SARS-CoV-2 IgG assay and seroprevalence in Boise, Idaho. J Clin Microbiol 2020;58:e0094120.CrossRefGoogle ScholarPubMed
Duration of isolation and precautions for adults with COVID-19. Centers for Disease Control website. https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html. Accessed January 22, 2021.Google Scholar
Zhou, B, She, J, Wang, Y, Ma, X. Duration of viral shedding of discharged patients with severe COVID-19. Clin Infect Dis 2020;71:22402242.CrossRefGoogle ScholarPubMed
Yahav, D, Yelin, D, Eckerle, I, et al. Definitions for coronavirus disease 2019 reinfection, relapse and PCR re-positivity. Clin Microbiol Infect 2020. doi: 10.1016/j.cmi.2020.11.028.Google ScholarPubMed
Investigative criteria for suspected cases of SARS-CoV-2 reinfection. Centers for Disease Control and Prevention website. https://www.cdc.gov/coronavirus/2019-ncov/php/invest-criteria.html. Accessed April 22, 2021.Google Scholar
Chicago COVID-19 update. Chicago Department of Public Health website. https://www.chicago.gov/content/dam/city/sites/covid/reports/2020-08-11/Chicago_COVID-19_Update_V8_8.11.2020.pdf. Updated August 11, 2020.Google Scholar
Hall, V, Foulkes, S, Charlett, A, et al. Do antibody positive healthcare workers have lower SARS-CoV-2 infection rates than antibody negative healthcare workers? Large multi-centre prospective cohort study (the SIREN study)—England, June to November 2020. medRxiv 2021. doi: 10.1101/2021.01.13.21249642.CrossRefGoogle Scholar
Harvey, RA, Rassen, JA, Kabelac, CA, et al. Association of SARS-CoV-2 seropositive antibody test with risk of future infection. JAMA Intern Med 2021;181:672679.CrossRefGoogle ScholarPubMed
Recalde-Zamacona, B, Tomas-Velazquez, A, Campo, A, et al. Chronic rhinosinusitis is associated with prolonged SARS-CoV2 RNA shedding in upper respiratory tract samples: a case–control study. J Intern Med 2021;289:921925.CrossRefGoogle Scholar
Bongiovanni, M, Bini, F, Giuliani, G, Gianturco, L. Insight into the reason of prolonged viral RNA shedding in patients with COVID-19 infection. J Infect 2021;82(4):e13e14.CrossRefGoogle ScholarPubMed
Vena, A, Taramasso, L, Di Biagio, A, et al. Prevalence and clinical significance of persistent viral shedding in hospitalized adult patients with SARS-CoV-2 infection: a prospective observational study. Infect Dis Ther 2021;10:387398.CrossRefGoogle ScholarPubMed
Nakajima, Y, Ogai, A, Furukawa, K, et al. Prolonged viral shedding of SARS-CoV-2 in an immunocompromised patient. J Infect Chemother 2021;27:387389.CrossRefGoogle Scholar
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