Non-occupational and occupational factors associated with specific SARS-CoV-2 antibodies among Hospital Workers - a multicentre cross-sectional study

ABSTRACT

ObjectivesProtecting healthcare workers (HCW) from Coronavirus Disease-19 (COVID-19) is critical to preserve the functioning of healthcare systems. We therefore assessed seroprevalence and identified risk factors for Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) seropositivity in this population. MethodsBetween June 22nd and August 15th 2020, HCW from institutions in Northern/Eastern Switzerland were screened for SARS-CoV-2 antibodies. We recorded baseline characteristics, non-occupational and occupational risk factors. We used pairwise tests of associations and multivariable logistic regression to identify factors associated with seropositivity. ResultsAmong 4664 HCW from 23 healthcare facilities, 139 (3%) were seropositive. Non-occupational exposures independently associated with seropositivity were contact with a COVID-19-positive household (adjusted OR=54, 95%-CI 31-97) and stay in a COVID-19 hotspot (aOR=2.2, 95%-CI 1.1-3.9). Blood group 0 vs. non-0 (aOR=0.4, 95%-CI 0.3-0.7), active smoking (aOR=0.5, 95%-CI 0.3-0.9) and living with children <12 years (aOR=0.3, 95%-CI 0.2-0.6) were associated with decreased risk. Occupational risk factors were close contact to COVID-19 patients (aOR=2.8, 95%-CI 1.5-5.5), exposure to COVID-19-positive co-workers (aOR=2.0, 95%-CI 1.2-3.1), poor knowledge of standard hygiene precautions (aOR=2.0, 95%-CI 1.3-3.2), and frequent visits to the hospital canteen (aOR=1.9, 95%-CI 1.2-3.1). ConclusionsLiving with COVID-19-positive households showed by far the strongest association with SARS-CoV-2 seropositivity. We identified several potentially modifiable risk factors, which might allow mitigation of the COVID-19 risk among HCW. The lower risk among those living with children, even after correction for multiple confounders, is remarkable and merits further study.