Risk of COVID-19 in health-care workers in Denmark: an observational cohort study
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Title
Risk of COVID-19 in health-care workers in Denmark: an observational cohort study
Subject
Description
Health-care workers are thought to be highly exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We aimed to investigate the prevalence of antibodies against SARS-CoV-2 in health-care workers and the proportion of seroconverted health-care workers with previous symptoms of COVID-19.
Responses to this article were published:
Responses to this article were published:
- Kucharski, Adam J., and Eric J. Nilles. 2020. "Using serological data to understand unobserved SARS-CoV-2 risk in health-care settings." The Lancet Infectious Diseases.
- Choy, Kay Weng. 2020. "Specificity and cross-reactivity of a test for anti-SARS-CoV-2 antibodies." The Lancet Infectious Diseases.
- Iversen, Kasper, Henning Bundgaard, Lene Harritshøj, and Henrik Ullum. 2020. "Specificity and cross-reactivity of a test for anti-SARS-CoV-2 antibodies - Authors' reply." The Lancet Infectious Diseases.
Date
2020-08-03
Type
Citation
Iversen, Kasper, Henning Bundgaard, Rasmus B. Hasselbalch, Jonas H. Kristensen, Pernille B. Nielsen, Mia Pries-Heje, Andreas D. Knudsen, Casper E. Christensen, Kamille Fogh, Jakob B. Norsk, Ove Andersen, Thea K. Fischer, Claus Antonio Juul Jensen, Margit Larsen, Christian Torp-Pedersen, Jørgen Rungby, Sisse B. Ditlev, Ida Hageman, Rasmus Møgelvang, Christoffer E. Hother, Mikkel Gybel-Brask, Erik Sørensen, Lene Harritshøj, Fredrik Folke, Curt Sten, Thomas Benfield, Susanne Dam Nielsen, and Henrik Ullum. 2020. "Risk of COVID-19 in health-care workers in Denmark: an observational cohort study." The Lancet Infectious Diseases.
Abstract
Background
Health-care workers are thought to be highly exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We aimed to investigate the prevalence of antibodies against SARS-CoV-2 in health-care workers and the proportion of seroconverted health-care workers with previous symptoms of COVID-19.
Methods
In this observational cohort study, screening was offered to health-care workers in the Capital Region of Denmark, including medical, nursing, and other students who were associated with hospitals in the region. Screening included point-of-care tests for IgM and IgG antibodies against SARS-CoV-2. Test results and participant characteristics were recorded. Results were compared with findings in blood donors in the Capital Region in the study period.
Findings
Between April 15 and April 23, 2020, we screened 29 295 health-care workers, of whom 28 792 (98·28%) provided their test results. We identified 1163 (4·04% [95% CI 3·82–4·27]) seropositive health-care workers. Seroprevalence was higher in health-care workers than in blood donors (142 [3·04%] of 4672; risk ratio [RR] 1·33 [95% CI 1·12–1·58]; p<0·001). Seroprevalence was higher in male health-care workers (331 [5·45%] of 6077) than in female health-care workers (832 [3·66%] of 22 715; RR 1·49 [1·31–1·68]; p<0·001). Frontline health-care workers working in hospitals had a significantly higher seroprevalence (779 [4·55%] of 16 356) than health-care workers in other settings (384 [3·29%] of 11 657; RR 1·38 [1·22–1·56]; p<0·001). Health-care workers working on dedicated COVID-19 wards (95 [7·19%] of 1321) had a significantly higher seroprevalence than other frontline health-care workers working in hospitals (696 [4·35%] of 15 983; RR 1·65 [1·34–2·03]; p<0·001). 622 [53·5%] of 1163 seropositive participants reported symptoms attributable to SARS-CoV-2. Loss of taste or smell was the symptom that was most strongly associated with seropositivity (377 [32·39%] of 1164 participants with this symptom were seropositive vs 786 [2·84%] of 27 628 without this symptom; RR 11·38 [10·22–12·68]). The study is registered at ClinicalTrials.gov, NCT04356560.
Interpretation
The prevalence of health-care workers with antibodies against SARS-CoV-2 was low but higher than in blood donors. The risk of SARS-CoV-2 infection in health-care workers was related to exposure to infected patients. More than half of seropositive health-care workers reported symptoms attributable to COVID-19.
Funding
Lundbeck Foundation.
Accessibility
Free online on Lancet site.
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