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Risk Factors for Being Seronegative following SARS-CoV-2 Infection in a Large Cohort of Health Care Workers in Denmark.
Johannesen, Caroline Klint; Rezahosseini, Omid; Gybel-Brask, Mikkel; Kristensen, Jonas Henrik; Hasselbalch, Rasmus Bo; Pries-Heje, Mia Marie; Nielsen, Pernille Brok; Knudsen, Andreas Dehlbæk; Fogh, Kamille; Norsk, Jakob Boesgaard; Andersen, Ove; Jensen, Claus Antonio Juul; Torp-Pedersen, Christian; Rungby, Jørgen; Ditlev, Sisse Bolm; Hageman, Ida; Møgelvang, Rasmus; Dessau, Ram B; Sørensen, Erik; Harritshøj, Lene Holm; Folke, Fredrik; Sten, Curt; Møller, Maria Elizabeth Engel; Engsig, Frederik Neess; Ullum, Henrik; Jørgensen, Charlotte Sværke; Ostrowski, Sisse R; Bundgaard, Henning; Iversen, Kasper Karmark; Fischer, Thea Kølsen; Nielsen, Susanne Dam.
  • Johannesen CK; Department of Clinical Research, Nordsjaellands Hospital, Hilleroed, Denmark.
  • Rezahosseini O; Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
  • Gybel-Brask M; Department of Clinical Immunology, Rigshospitalet, Copenhagen, Denmark.
  • Kristensen JH; Department of Cardiology, Herlev og Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
  • Hasselbalch RB; Department of Emergency Medicine, Herlev og Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
  • Pries-Heje MM; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
  • Nielsen PB; Department of Cardiology, Herlev og Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
  • Knudsen AD; Department of Emergency Medicine, Herlev og Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
  • Fogh K; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
  • Norsk JB; Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
  • Andersen O; Department of Cardiology, Herlev og Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
  • Jensen CAJ; Department of Emergency Medicine, Herlev og Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
  • Torp-Pedersen C; Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
  • Rungby J; Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
  • Ditlev SB; Department of Cardiology, Herlev og Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
  • Hageman I; Department of Emergency Medicine, Herlev og Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
  • Møgelvang R; Department of Cardiology, Herlev og Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
  • Dessau RB; Department of Emergency Medicine, Herlev og Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
  • Sørensen E; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
  • Harritshøj LH; Department of Emergency, Copenhagen University Hospitalgrid.4973.9 - Amager og Hvidovre, Hvidovre, Denmark.
  • Folke F; Department of Clinical Research, Copenhagen University Hospitalgrid.4973.9 - Amager og Hvidovre, Hvidovre, Denmark.
  • Sten C; Department of Clinical Biochemistry, Copenhagen University Hospitalgrid.4973.9 - Nordsjællands Hospital, Hillerød, Denmark.
  • Møller MEE; Department of Cardiology and Clinical Research, Nordsjællands Hospital, Hillerød, Denmark.
  • Engsig FN; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
  • Ullum H; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
  • Jørgensen CS; Department of Endocrinology, Copenhagen University Hospitalgrid.4973.9 - Bispebjerg and Frederiksberg, Bispebjerg, Copenhagen, Denmark.
  • Ostrowski SR; Copenhagen Center for Translational Research, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Bispebjerg, Copenhagen, Denmark.
  • Bundgaard H; Copenhagen Center for Translational Research, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Bispebjerg, Copenhagen, Denmark.
  • Iversen KK; Department of Pulmonary Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Bispebjerg, Copenhagen, Denmark.
  • Fischer TK; Mental Health Services-The Capital Region of Denmark, Copenhagen, Denmark.
  • Nielsen SD; Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Microbiol Spectr ; 9(2): e0090421, 2021 10 31.
Article in English | MEDLINE | ID: covidwho-1476401
ABSTRACT
Most individuals seroconvert after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but being seronegative is observed in 1 to 9%. We aimed to investigate the risk factors associated with being seronegative following PCR-confirmed SARS-CoV-2 infection. In a prospective cohort study, we screened health care workers (HCW) in the Capital Region of Denmark for SARS-CoV-2 antibodies. We performed three rounds of screening from April to October 2020 using an enzyme-linked immunosorbent assay (ELISA) method targeting SARS-CoV-2 total antibodies. Data on all participants' PCR for SARS-CoV-2 RNA were captured from national registries. The Kaplan-Meier method and Cox proportional hazards models were applied to investigate the probability of being seronegative and the related risk factors, respectively. Of 36,583 HCW, 866 (2.4%) had a positive PCR before or during the study period. The median (interquartile range [IQR]) age of 866 HCW was 42 (31 to 53) years, and 666 (77%) were female. After a median of 132 (range, 35 to 180) days, 21 (2.4%) of 866 were seronegative. In a multivariable model, independent risk factors for being seronegative were self-reported asymptomatic or mild infection hazard ratio (HR) of 6.6 (95% confidence interval [CI], 2.6 to 17; P < 0.001) and body mass index (BMI) of ≥30, HR 3.1 (95% CI, 1.1 to 8.8; P = 0.039). Only a few (2.4%) HCW were not seropositive. Asymptomatic or mild infection as well as a BMI above 30 were associated with being seronegative. Since the presence of antibodies against SARS-CoV-2 reduces the risk of reinfection, efforts to protect HCW with risk factors for being seronegative may be needed in future COVID-19 surges. IMPORTANCE Most individuals seroconvert after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but negative serology is observed in 1 to 9%. We found that asymptomatic or mild infection as well as a BMI above 30 were associated with being seronegative. Since the presence of antibodies against SARS-CoV-2 reduces the risk of reinfection, efforts to protect HCW with risk factors for being seronegative may be needed in future COVID-19 surges.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Health Personnel / COVID-19 Serological Testing / SARS-CoV-2 / Antibodies, Viral Subject: Health Personnel / COVID-19 Serological Testing / SARS-CoV-2 / Antibodies, Viral Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Language: English Journal: Microbiol Spectr Clinical aspect: Etiology Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Health Personnel / COVID-19 Serological Testing / SARS-CoV-2 / Antibodies, Viral Subject: Health Personnel / COVID-19 Serological Testing / SARS-CoV-2 / Antibodies, Viral Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Language: English Journal: Microbiol Spectr Clinical aspect: Etiology Year: 2021
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