Among health care workers, COVID-19 risk starts at home, not work

  • Steensels D & al.
  • JAMA
  • 15 Jun 2020

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • Despite ongoing, consistent clinical exposure, SARS-CoV-2 seroprevalence is low among Belgian health care professionals except among those living with someone with suspected COVID-19. 

Why this matters

  • Personal protective equipment, high infection control standards, and regular screening in hospital staff, together with contact tracing and quarantine, were associated with low seroprevalence.

Key results

  • 74% (3056/4125) of staff participated. 
  • Overall, 6.4% (197; 95% CI, 5.5%-7.3%) had SARS-CoV-2 antibodies.
  • Age did not affect antibody status:
    • With antibodies, mean age was 39.5 (standard deviation, 13.1) years.
    • Without antibodies, it was 41.3 (12.4) years.
  • Sex also did not affect antibody status. 
  • ORs (95% CIs) for seropositivity:
    • With suspected COVID-19+ household contact: 3.15 (P<.001>
    • Any patient contact: 0.91 (0.67-1.25).
    • Working during lockdown: 1.14 (0.59-2.57). 
    • Contact with patient who had COVID-19: 1.08 (0.80-1.45).
    • Contact with colleague who had COVID-19: 1.03 (0.77-1.38).
  • 75% (2294/3052) of staff reported 1 prior symptom.
  • 15% (30/197) of staff with antibodies reported no symptoms.
  • Antibodies were associated (ORs; 95% CIs) with prior:
    • Anosmia: 7.78 (5.22-11.53).
    • Fever: 2.23 (1.49-3.31). 
    • Cough: 1.44 (1.00-2.07).

Study design

  • Prospective case screening analysis of prevalence of antibodies against SARS-CoV-2 among Belgian hospital staff, April 22-30, 2020.
  • Funding: None disclosed.

Limitations

  • Single-center.
  • ~26% of staff untested.