ABSTRACT
BackgroundEstimating the prevalence of SARS-COV-2 antibody seropositivity among health care workers (HCWs) is crucial. In this study the seroprevalence of anti-SARS-COV-2 antibodies among HCWs of five hospitals of Tehran-Iran with high COVID-9 patient’s referrals was assessed.MethodsHCWs from public and private hospitals were included and were asked questions on their demographic characteristics, medical history, hospital role and usage of personal protective equipment (PPE). Seroprevalence was estimated on the basis of ELISA test results (IgG and IgM antibodies in blood samples) and adjusted for test performance.ResultsAmong the 2065 participants, 88.4% and 11.6% HCWs were recruited from the public and private hospitals, respectively. The overall test-performance adjusted seroprevalence estimate among HCWs was 22.6 (95% CI 20.2-25.1) and it was higher in private hospitals (37.0%; 95% CI 28.6-46.2) than public hospitals (20.7%; 95% CI 18.2-23.3). PPE usage was significantly higher among HCWs of public versus private hospitals (66.5% vs. 20.0%). Test-adjusted seroprevalence estimates were highest among assistant nurses and nurses, and lowest among janitor/superintendent categories. ConclusionsSeroprevalence of SARS-COV-2 among HCWs depends on hospital type, hospital department, and hospital role. The PPE usage was especially suboptimal among HCWs in private hospitals. Continued effort in access to adequate PPE is warranted.
ABSTRACT
Background: As the COVID-19 pandemic unfolded, rapid case increase was observed in multiple cities in Iran. However, in the absence of seroprevalence surveys, the true infection rate remains unknown. In this population-based study we assessed the seroprevalence of SARS-CoV-2 antibodies in eighteen cities of Iran.Methods: We randomly selected and invited study participants from the general population (N = 3,547) and occupations with high risk of COVID-19 exposure, defined as high-risk population (e.g., supermarket employees) (N = 5,391), in eighteen cities of Iran. SARS-CoV-2 ELISA kits were used to detect antibody against COVID-19. Crude, population weight adjusted, and test performance adjusted seroprevalence rates were estimated.Findings: The population weight adjusted and test performance adjusted prevalence rates of antibody seropositivity in general population were 13·1% (95% CI 11·6-14·8%) and 18·5% (95% CI 16·1-21·3%), respectively. The population-weighted seroprevalence estimate implies that 3,290,633 (95% CI 2,907185-3,709,167) individuals, from the eighteen included cities in this study, were infected by end of April 2020.The overall prevalence rate was higher among individuals aged ≥ 60 years (32·0%, 95% CI 23·9-40·8%) and with comorbidity condition (23·7%, 95% CI 18·5-28·8%). The estimated seroprevalence of SARS-CoV-2 antibodies varied greatly by city and the highest population test-adjusted prevalence rates were in Rasht 78·1% (95% CI 58·3-98·3%) and Qom (66·5%, 95% CI 39·9-95·4%) cities. The test-adjusted prevalence did not differ between low and high-risk populations and was about 20.0%.Interpretations: The findings of this study imply that prevalence of seropositivity is likely much higher than the reported prevalence rates based on confirmed COVID-19 cases in Iran. Despite the high seroprevalence rates in a few cities, the low overall prevalence estimates indicate that a large proportion of population is still susceptible to the virus. The similar seroprevalence estimates between low and high-risk occupations might be an indicator of inadequate or low adherence to infection control measures among general population.Funding Statement: Iranian Ministry of Health and Medical Education COVID-19 Grant (number 99-1-97-47964).Declaration of Interests: None to disclose.Ethics Approval Statement: Ethics approval for this study was granted by Vice-Chancellor in Research Affairs-Tehran University of Medical Sciences (IR. TUMS.VCR.REC.1399.308)
Subject(s)
COVID-19ABSTRACT
Background & aimsHepatic manifestations of coronavirus disease 2019 (COVID-19) are common among people infected with hepatitis B virus (HBV) and hepatitis C virus (HCV). This systematic review aimed to summarize the evidence on COVID-19 patients with HBV or HCV co-infections. MethodsWe searched multiple electronic databases and preprint servers from December 1, 2019 to August 9, 2020. Studies were included if they reported quantitative empirical data on COVID-19 patients with HBV or HCV co-infections. Descriptive analyses were reported and data were narratively synthesized. Quality assessments was completed using the Joanna Briggs Institute critical appraisal tools. ResultsOut of the 941 identified records, 28 studies were included. Of the eligible studies, 235 patients with COVID-19 were infected with HBV and 22 patients with HCV. Most patients were male and mean age was 49.8 and 62.8 in patients with HBV and HCV, respectively. Death proportion was 6% among COVID-19-HBV and 13% among COVID-19-HCV co-infected patients. Among COVID-19 patients, 34.1% and 76.2% reported at least one comorbidity besides HBV and HCV infections, mainly hypertension and diabetes mellites type 2. The most common COVID-19-related symptoms in both HBV and HCV groups were fever, cough and dyspnea. ICU admission was reported in 14.1% and 21.4% of individuals with HBV and HCV, respectively. ConclusionsOur findings suggest a considerable risk of morbidity and mortality among COVID-19 patients with HBV and HCV. Careful assessment of hepatic manifestations upon admission of patients could help improve health outcomes among COVID-19 patients with HBV or HCV co-infections. Key PointsO_LIHepatic manifestations of COVID-19 are common among people infected with HBV and HCV. C_LIO_LIAmong COVID-19 patients, 34.1% and 76.2% reported at least one comorbidity besides HBV and HCV infections. C_LIO_LIThe most common COVID-19-related symptoms in both HBV and HCV groups were fever, cough and dyspnea. C_LIO_LIThere is a considerable risk of mortality among COVID-19 patients with HBV and HCV. C_LI