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. 2021 Apr;42(4):392-398.
doi: 10.1017/ice.2020.1220. Epub 2020 Sep 23.

Seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection among Veterans Affairs healthcare system employees suggests higher risk of infection when exposed to SARS-CoV-2 outside the work environment

Derek E Dimcheff  1   2 , Richard J Schildhouse  1   2 , Mark S Hausman  3   4 , Brenda M Vincent  5 , Erica Markovitz  6   7 , Stephen W Chensue  8   9 , Jane Deng  10   11 , Melissa McLeod  12 , Danielle Hagan  12 , Jon Russell  12 , Suzanne F Bradley  13   14
Affiliations

Seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection among Veterans Affairs healthcare system employees suggests higher risk of infection when exposed to SARS-CoV-2 outside the work environment

Derek E Dimcheff et al. Infect Control Hosp Epidemiol. 2021 Apr.

Abstract

Objective: The seroprevalence of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) IgG antibody was evaluated among employees of a Veterans Affairs healthcare system to assess potential risk factors for transmission and infection.

Methods: All employees were invited to participate in a questionnaire and serological survey to detect antibodies to SARS-CoV-2 as part of a facility-wide quality improvement and infection prevention initiative regardless of clinical or nonclinical duties. The initiative was conducted from June 8 to July 8, 2020.

Results: Of the 2,900 employees, 51% participated in the study, revealing a positive SARS-CoV-2 seroprevalence of 4.9% (72 of 1,476; 95% CI, 3.8%-6.1%). There were no statistically significant differences in the presence of antibody based on gender, age, frontline worker status, job title, performance of aerosol-generating procedures, or exposure to known patients with coronavirus infectious disease 2019 (COVID-19) within the hospital. Employees who reported exposure to a known COVID-19 case outside work had a significantly higher seroprevalence at 14.8% (23 of 155) compared to those who did not 3.7% (48 of 1,296; OR, 4.53; 95% CI, 2.67-7.68; P < .0001). Notably, 29% of seropositive employees reported no history of symptoms for SARS-CoV-2 infection.

Conclusions: The seroprevalence of SARS-CoV-2 among employees was not significantly different among those who provided direct patient care and those who did not, suggesting that facility-wide infection control measures were effective. Employees who reported direct personal contact with COVID-19-positive persons outside work were more likely to have SARS-CoV-2 antibodies. Employee exposure to SARS-CoV-2 outside work may introduce infection into hospitals.

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Conflict of interest statement

All authors report no conflicts of interest relevant to this article.

Figures

Fig. 1.
Fig. 1.
Inpatient daily census and institutional infection control measures for coronavirus infectious disease 2019 (COVID-19). We indicate 3 outbreaks in staff members: 2 identified between March 20 and April 7, 2020, and another between April 4 and April 14, 2020. These known clusters occurred before masking for all persons entering the facility on April 15, 2020.
Fig. 2.
Fig. 2.
Forest plot showing results of multiple variable logistic regression model of symptoms associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) seropositivity. For presence and absence of symptoms, we indicate the number of seropositive employees and the number of seronegative employees for each symptom category.
See this image and copyright information in PMC

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