Non-occupational and occupational factors associated with specific SARS-CoV-2 antibodies among hospital workers - A multicentre cross-sectional study.

Kahlert, Christian R; Persi, Raphael; Güsewell, Sabine; Egger, Thomas; Leal-Neto, Onicio B; Sumer, Johannes; Flury, Domenica; Brucher, Angela; Lemmenmeier, Eva; Möller, J Carsten; Rieder, Philip; Stocker, Reto; Vuichard-Gysin, Danielle; Wiggli, Benedikt; Albrich, Werner C; Babouee Flury, Baharak; Besold, Ulrike; Fehr, Jan; Kuster, Stefan P; McGeer, Allison; ... (2021). Non-occupational and occupational factors associated with specific SARS-CoV-2 antibodies among hospital workers - A multicentre cross-sectional study. Clinical microbiology and infection, 27(9), pp. 1336-1344. Elsevier 10.1016/j.cmi.2021.05.014

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OBJECTIVES

Protecting healthcare workers (HCWs) from coronavirus disease-19 (COVID-19) is critical to preserve the functioning of healthcare systems. We therefore assessed seroprevalence and identified risk factors for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) seropositivity in this population.

METHODS

Between 22 June 22 and 15 August 2020, HCWs from institutions in northern/eastern Switzerland were screened for SARS-CoV-2 antibodies. We recorded baseline characteristics, non-occupational and occupational risk factors. We used pairwise tests of associations and multivariable logistic regression to identify factors associated with seropositivity.

RESULTS

Among 4664 HCWs from 23 healthcare facilities, 139 (3%) were seropositive. Non-occupational exposures independently associated with seropositivity were contact with a COVID-19-positive household (adjusted OR 59, 95% CI 33-106), stay in a COVID-19 hotspot (aOR 2.3, 95% CI 1.2-4.2) and male sex (aOR 1.9, 95% CI 1.1-3.1). Blood group 0 vs. non-0 (aOR 0.5, 95% CI 0.3-0.8), active smoking (aOR 0.4, 95% CI 0.2-0.7), living with children <12 years (aOR 0.3, 95% CI 0.2-0.6) and being a physician (aOR 0.2, 95% CI 0.1-0.5) were associated with decreased risk. Other occupational risk factors were close contact to COVID-19 patients (aOR 2.7, 95% CI 1.4-5.4), exposure to COVID-19-positive co-workers (aOR 1.9, 95% CI 1.1-2.9), poor knowledge of standard hygiene precautions (aOR 1.9, 95% CI 1.2-2.9) and frequent visits to the hospital canteen (aOR 2.3, 95% CI 1.4-3.8).

DISCUSSION

Living with COVID-19-positive households showed the strongest association with SARS-CoV-2 seropositivity. We identified several potentially modifiable work-related risk factors, which might allow mitigation of the COVID-19 risk among HCWs. The lower risk among those living with children, even after correction for multiple confounders, is remarkable and merits further study.

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