SARS-CoV-2 antibody screening in healthcare workers: lessons learned from the first months of COVID-19 outbreak in Europe
DOI:
https://doi.org/10.2478/pjph-2022-0001Keywords:
SARS-CoV-2, COVID-19, serologic test, health personel, seroprevalence , IgG antibodyAbstract
Introduction. Detected in 2019 in Wuhan, China, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing a coronavirus disease 2019 (COVID-19), has changed almost all aspects of human lives. It has had an enormous impact on societies, economies and politics across the world. Nevertheless, first and foremost, it has led to a global health crisis on an unprecedented scale. Since the pandemic’s beginning, one of the greatest global challenges has been to stop the spread of infection among healthcare workers (HCWs). As a front-line fighters, they are at higher risk of contracting SARS-CoV-2 than other professions.
Aim. The study aimed to determine the role of serological testing among HCWs by analyzing screening results for the presence of SARS-CoV-2 antibodies in this group in 12 European countries during the first wave of the pandemic.
Material and methods. Pubmed, MEDLINE, Web of Science, Google Scholar, and WHO COVID-19 databases were searched for studies on screening among HCWs using immunoassays or chemiluminescence assays for preventive purposes and determining the percentage of HCWs with acquired immunity to SARS-CoV-2. The number of 30 papers were selected. Immunoglobulin G (IgG) percentage was analyzed, and determination of immunoglobulin A (IgA) and immunoglobulin M (IgM) antibodies and their diagnostic usefulness.
Results. The screening results of HCWs were juxtaposed with epidemic situation of that time and public health measures in given country.
Conclusion. Introduction of routine serological testing of HCWs could be a valuable strategy to monitor the occupational risk in this group and effectiveness of local epidemic management strategies.
References
1. Cheng S-C, Chang Y-C, Fan Chiang Y-L, et al. First case of Coronavirus Disease 2019 (COVID-19) pneumonia in Taiwan. J Formos Med Assoc Taiwan Yi Zhi. 2020;119(3):747-51.
2. Lai C-C, Shih T-P, Ko W-C, et al. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020;55(3):105924.
3. WHO Director-General’s opening remarks at the media briefing on COVID- 19 – 11 March 2020.. [https://www.who.int/director-general/speeches/ detail/who-director-general-s-opening-remarks-at-the-media-briefing-oncovid- 19] (accessed: 1.06.2021)
4. Download COVID-19 datasets. European Centre for Disease Prevention and Control. [https://www.ecdc.europa.eu/en/covid-19/data] (accessed: 1.06.2021)
5. Rudberg A-S, Havervall S, Månberg A, et al. SARS-CoV-2 exposure, symptoms and seroprevalence in healthcare workers in Sweden. Nat Com- mun. 2020;11(1):5064.
6. He J, Guo Y, Mao R, Zhang J. Proportion of asymptomatic coronavirus disease 2019: A systematic review and meta-analysis. J Med Virol. 2021;93(2):820-30.
7. Garcia-Basteiro AL, Moncunill G, Tortajada M, et al. Seroprevalence of antibodies against SARS-CoV-2 among health care workers in a large Spanish reference hospital. Nat Commun. 2020;11(1):3500.
8. European Centre for Disease Prevention and Control. [https://www.ecdc. europa.eu/en] (accessed: 1.06.2021)
9. Parikh R, Mathai A, Parikh S, Chandra Sekhar G, Thomas R. Understanding and using sensitivity, specificity and predictive values. Indian J Ophthalmol. 2008;56(1):45-50.
10. Guglielmi G. Fast coronavirus tests: what they can and can’t do. Nature. 2020;585(7826):496-8.
11. Zhao J, Yuan Q, Wang H, et al. Antibody responses to SARS-CoV-2 in patients with Novel Coronavirus Disease 2019. Clin Infect Dis Off Publ Infect Dis Soc Am. 2020;71(16):2027-34.
12. Bułdak RJ, Woźniak-Grygiel E, Wąsik M, et al. SARS-CoV-2 Antibody screening in healthcare workers in non-infectious hospitals in two different regions of Southern Poland (Upper Silesia and Opole Voivodeships): AProspective cohort study. Int J Environ Res Public Health. 2021;18(8):4376.
13. Yu H-Q, Sun B-Q, Fang Z-F, et al. Distinct features of SARS-CoV-2-specific IgAresponse in COVID-19 patients. Eur Respir J. 2020;56(2):2001526.
14. Huang Z, Chen H, Xue M, et al. Characteristics and roles of severe acute respiratory syndrome coronavirus 2-specific antibodies in patients with different severities of coronavirus 19. Clin Exp Immunol. 2020;202(2):210-9.
15. Guo L, Ren L, Yang S, et al. Profiling early humoral response to diagnose Novel Coronavirus Disease (COVID-19). Clin Infect Dis Off Publ Infect Dis Soc Am. 2020;71(15):778-85.
16. Laboratory diagnostics SARS-CoV-2. [http://www.aotm.gov.pl/media/2021/ 04/Diagnostya-laboratoryjna-SARS-CoV-2-%E2%80%93-aktualizacja -Zalecen-wersja-2.0-7-kwietnia-2021-r.pdf] (accessed: 1.06.2021)
17. Kavaliunas A, Ocaya P, Mumper J, et al. Swedish policy analysis for Covid- 19. Health Policy Technol. 2020;9(4):598-612.
18. Lidström A-K, Sund F, Albinsson B, et al. Work at inpatient care units is associated with an increased risk of SARS-CoV-2 infection; a crosssectional study of 8679 healthcare workers in Sweden. Ups J Med Sci. 2020;125(4):305-10.
19. Rashid-Abdi M, Krifors A, Sälléber A, et al. Low rate of COVID-19 seroconversion in health-care workers at a Department of Infectious Diseases in Sweden during the later phase of the first wave; a prospective longitudinal seroepidemiological study. Infect Dis Lond Engl. 2021;53(3):169-75.
20. He R, Zhang J, Mao Y, et al. Preparedness and responses faced during the COVID-19 pandemic in Belgium: An observational study and using the national open data. Int J Environ Res Public Health. 2020;17(21):7985.
21. Silvia K. States of emergency in response to the coronavirus crisis: Situation in certain Member States; 2020. [https://www.europarl.europa.eu/RegData/etudes/STUD/2020/659385/EPRS_STU(2020)659385_EN.pdf]
22. [https://www.gov.pl/web/belgia/informacja-w-zwiazku-z-rozprzestrzenianiem- sie-koronawirusa-w-belgii] (accessed 1.06.2021)
23. Martin C, Montesinos I, Dauby N, et al. Dynamics of SARS-CoV-2 RT PCR positivity and seroprevalence among high-risk healthcare workers and hospital staff. J Hosp Infect. 2020;106(1):102-6.
24. Spain against COVID-19. [http://pism.pl/publikacje/Hiszpania_wobec_ pandemii_COVID19] (accessed 1.06.2021)
25. Gras-Valentí P, Chico-Sánchez P, Algado-Sellés N, et al. Sero-epidemiological study of SARS-CoV-2 infection among healthcare personnel in a healthcare department. Enferm Infecc Microbiol Clin. 2021;39(7):31925.
26. Moncunill G, Mayor A, Santano R, et al. SARS-CoV-2 seroprevalence and antibody kinetics among health care workers in a Spanish Hospital after 3 months of follow-up. J Infect Dis. 2021;223(1):62-71.
27. Plümper T, Neumayer E. Lockdown policies and the dynamics of the first wave of the Sars-CoV-2 pandemic in Europe. J Eur Public Policy. 2020;0(0):1-21.
28. Shields A, Faustini SE, Perez-Toledo M, et al. SARS-CoV-2 seroprevalence and asymptomatic viral carriage in healthcare workers: a cross-sectional study. Thorax. 2020;75(12):1089-94.
29. Shields AM, Faustini SE, Perez-Toledo M, et al. Serological responses to SARS-CoV-2 following non-hospitalised infection: clinical and ethnodemographic features associated with the magnitude of the antibody response. MedRxiv Prepr Serv Health Sci. 2020. doi:10.1101/2020.11.12.20230763
30. Razvi S, Oliver R, Moore J, Beeby A. Exposure of hospital healthcare workers to the novel coronavirus (SARS-CoV-2). Clin Med Lond Engl. 2020;20(6):e238-e40.
31. Martin CA, Patel P, Goss C, et al. Demographic and occupational determinants of anti-SARS-CoV-2 IgG seropositivity in hospital staff. J Public Health. 2020:1-12.
32. Bampoe S, Lucas DN, Neall G, et al. A cross-sectional study of immune seroconversion to SARS-CoV-2 in frontline maternity health profession als. Anaesthesia. 2020;75(12):1614-9.
33. Poulikakos D, Sinha S, Kalra PA. SARS-CoV-2 antibody screening in healthcare workers in a tertiary centre in North West England. J Clin Virol. 2020;129:104545.
34. Di Lorenzo G, Di Trolio R. Coronavirus Disease (COVID-19) in Italy: Analysis of risk factors and proposed remedial measures. Front Med. 2020;7. doi:10.3389/fmed.2020.00140
35. Colombo AD, Impicciatore R. Analisi di 1.084 comuni italiani. In: Analisi dell’Istituto Cattaneo. Bologna: Fondazione di Ricerca istituto Carlo Cattaneo; 2020.
36. Conticini E, Frediani B, Caro D. Can atmospheric pollution be considered a co-factor in extremely high level of SARS-CoV-2 lethality in Northern Italy? Environ Pollut. 2020;261:114465.
37. Murgante B, Borruso G, Balletto G, Castiglia P, Dettori M. Why Italy first? Health, geographical and planning aspects of the COVID-19 outbreak. Sustainability. 2020;12(12):5064.
38. Lahner E, Dilaghi E, Prestigiacomo C, et al. Prevalence of Sars-Cov-2 infection in Health Workers (HWs) and diagnostic test performance: The experience of a Teaching Hospital in Central Italy. Int J Environ Res Public Health. 2020;17(12):4417.
39. Plebani M, Padoan A, Fedeli U, et al. SARS-CoV-2 serosurvey in health care workers of the Veneto Region. Clin Chem Lab Med. 2020;58(12):2107-11.
40. Calcagno A, Ghisetti V, Emanuele T, et al. Risk for SARS-CoV-2 Infection in Healthcare Workers, Turin, Italy. Emerg Infect Dis. 2021;27(1):303-5.
41. Swiss Economy – Facts and Figures. [https://www.eda.admin.ch/aboutswitzerland/en/home/wirtschaft/uebersicht/wirtschaft---fakten-und-zahlen.html] (accessed: 1.06.2021)
42. Giachino M, Valera CBG, Rodriguez Velásquez S, et al. Understanding the dynamics of the COVID-19 pandemic: A real-time analysis of Switzerland’s first wave. Int J Environ Res Public Health. 2020;17(23):8825.
43. Kohler PP, Kahlert CR, Sumer J, et al. Prevalence of SARS-CoV-2 antibodies among Swiss hospital workers: Results of a prospective cohort study. Infect Control Hosp Epidemiol. 2021;42(5):604-8.
44. France and COVID-19: Economic Priorities and the Risk of Recession. [http://pism.pl/publikacje/COVID19_we_Francji_priorytety_gospodarcze_wobec_widma_recesji] (accessed: 30.06.2021).
45. COVID-19 in France -democracy in isolation. [http://pism.pl/publikacje/COVID19_we_Francji_demokracja_w_izolacji] (accessed: 30.06.2021).
46. Delmas C, Plu-Bureau G, Canouï E, et al. Clinical characteristics and persistence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) IgG antibodies in 4,607 French healthcare workers: Comparison with European countries. Infect Control Hosp Epidemiol. 2020:42(11):1406-8.
47. Finkenzeller T, Faltlhauser A, Dietl K-H, et al. SARS-CoV-2 antibodies in ICU and clinic staff: From Germany’s region with the highest infection rate. Med Klin Intensivmed Notfallmedizin. 2020;115(Suppl 3):139-45.
48. Péré H, Wack M, Védie B, et al. Sequential SARS-CoV-2 IgG assays as confirmatory strategy to confirm equivocal results: Hospital-wide antibody screening in 3,569 staff health care workers in Paris. J Clin Virol. 2020;132:104617.
49. Mesnil M, Joubel K, Yavchitz A, et al. Seroprevalence of SARS-Cov-2 in 646 professionals at the Rothschild Foundation Hospital (ProSeCoV study). Anaesth Crit Care Pain Med. 2020;39(5):595-6.
50. Naumann E, Möhring K, Reifenscheid M, et al. COVID-19 policies in Germany and their social, political, and psychological consequences. Eur Policy Anal. 2020;6(2):191-202.
51. Korth J, Wilde B, Dolff S, et al. SARS-CoV-2-specific antibody detection in healthcare workers in Germany with direct contact to COVID-19 patients. J Clin Virol Off Publ Pan Am Soc Clin Virol. 2020;128:104437.
52. Schmidt SB, Grüter L, Boltzmann M, Rollnik JD. Prevalence of serum IgG antibodies against SARS-CoV-2 among clinic staff. PLoS ONE. 2020;15(6). doi:10.1371/journal.pone.0235417
53. Genomic epidemiology of superspreading events in Austria reveals mutational dynamics and transmission properties of SARS-CoV-2. Science Translational Medicine. [https://stm.sciencemag.org/content/12/573/ eabe2555] (accessed: 1.06.2021)
54. Amann J, Sleigh J, Vayena E. Digital contact-tracing during the Covid-19 pandemic: An analysis of newspaper coverage in Germany, Austria, and Switzerland. PLOS ONE. 2021;16(2):e0246524.
55. Desson Z, Lambertz L, Peters JW, et al. Europe’s Covid-19 outliers: German, Austrian and Swiss policy responses during the early stages of the 2020 pandemic. Health Policy Technol. 2020;9(4):405-18.
56. Pilz S, Chakeri A, Ioannidis JP, et al. SARS-CoV-2 re-infection risk in Austria. Eur J Clin Invest. 2021;51(4):e13520.
57. Orth-Höller D, Eigentler A, Weseslindtner L, Möst J. Antibody kinetics in primary- and secondary-care physicians with mild to moderate SARSCoV- 2 infection. Emerg Microbes Infect. 2020;9(1):1692-4.
58. Hackner K, Errhalt P, Willheim M, et al. Diagnostic accuracy of two commercially available rapid assays for detection of IgG and IgM antibodies to SARS-CoV-2 compared to ELISA in a low-prevalence population. GMS Hyg Infect Control. 2020;15. doi:10.3205/dgkh000363
59. Conyon MJ, He L, Thomsen S. Lockdowns and COVID-19 deaths in Scandinavia. Social Sci Res Network. 2020. doi:10.2139/ssrn.3616969
60. Trieu M-C, Bansal A, Madsen A, et al. SARS-CoV-2 – Specific neutralizing antibody responses in Norwegian health care workers after the first wave of COVID-19 pandemic: A prospective cohort study. J Infect Dis. 2021;223(4):589-99.
61. Basso T, Nordbø SA, Sundqvist E, et al. Transmission of infection from non-isolated patientswith COVID-19 to healthcare workers. J Hosp Infect. 2020;106(4):639-42.
62. Gujski M, Raciborski F, Jankowski M, et al. Epidemiological Analysis of the first 1389 cases of COVID-19 in Poland: APreliminary report. Med Sci Monit Int Med J Exp Clin Res. 2020;26:e924702.
63. Introducing an epidemic in Poland. Coronavirus: Information and Recommendations. [http://www.gov.pl/web/koronawirus/wprowadzamy-stanepidemii- w-polsce] (accessed: 1.06.2021).
64. The Impact of the COVID-19 Pandemic on Greek Policy. [https://pism.pl/ publications/The_Impact_of_the_COVID19_Pandemic_on_Greek_Policy] (accessed: 1.06.2021).
65. Moris D, Schizas D. Lockdown during COVID-19: The Greek success. In Vivo. 2020;34(3 suppl):1695-9.
66. Vlachoyiannopoulos P, Alexopoulos H, Apostolidi I, et al. Anti-SARSCoV- 2 antibody detection in healthcare workers of two tertiary hospitals in Athens, Greece. Clin Immunol Orlando Fla. 2020;221:108619.
67. Galanis P, Kaitelidou D, Prezerakos P, et al. Low seropositivity for SARSCoV- 2 antibodies among healthcare workers after the first COVID-19 pandemic wave in Greece. Public Health. 2021;198:223-9.
68. Goverment website: When to get vaccinated before traveling?Ministry of Health. Web Gov.pl. [http://www.gov.pl/web/zdrowie/kiedy-nalezy-zaszczepic- sie-przed-podroza] (accessed 1.06.2021).
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