SARS-CoV-2 Seroprevalence Among All Workers in a Teaching Hospital in Spain: Unmasking The Risk

Abstract

ABSTRACT Background Health-care workers (HCW) are at increased risk for SARS-CoV-2 infection, but few studies have evaluated prevalence of antibodies against SARS-CoV-2 among them. Objective To determine the seroprevalence against SARS-CoV-2 in all HCW. Methods Cross-sectional study (April 14 th - 27 th , 2020) of all HCW at Hospital Universitario Fundación Alcorcón, a second level teaching hospital in Madrid, Spain. SARS-CoV-2 IgG was measured by ELISA. HCW were classified by professional category, working area, and risk for SARS-CoV-2 exposure. Results Among 2919 HCW, 2590 (90.5%) were evaluated. Mean age was 43.8 years (SD 11.1) and 73.9% were females. Globally, 818 (31.6%) workers were IgG positive, with no differences for age, sex or previous diseases. Among them, 48.5% did not report previous symptoms. Seropositivity was more frequent in high (33.1%) and medium (33.8%) than in low-risk areas (25.8%, p = 0.007), but no difference was found for hospitalization areas attending COVID-19 and non-COVID-19 patients (35.5 vs 38.3% p = NS). HCW with a previous SARS-CoV2 PCR positive test were IgG seropositive in 90.8%. By multivariate logistic regression analysis, seropositivity was associated with being physicians (OR 2.37, CI95% 1.61–3.49), nurses (OR 1.67, CI95% 1.14–2.46), or nurse- assistants (OR 1.84, CI95% 1.24–2.73), HCW working at COVID-19 hospitalization areas (OR 1.71, CI95% 1.22–2.40), non-COVID-19 hospitalization areas (OR 1.88, CI95% 1.30–2.73), and at the Emergency Room (OR 1.51, CI95% 1.01–2.27) Conclusions Seroprevalence uncovered a high rate of infection previously unnoticed among HCW. Patients not suspected of having COVID-19 as well as asymptomatic HCW may be a relevant source for nosocomial SARS-CoV-2 transmission.