Seroepidemiology among Employees of New York City Health and Hospitals during the First Wave of the SARS-CoV-2 Epidemic

ABSTRACT

ObjectiveEstimate the seroprevalence of SARS-CoV-2 antibodies among New York City Health + Hospitals healthcare workers, and identify demographic and occupational factors associated with SARS-CoV-2 antibodies among healthcare workers. MethodsThis was an observational, cross-sectional study using data from SARS-CoV-2 serological tests accompanied by a demographic and occupational survey administered to healthcare workers. Participants were employed by New York City Health + Hospitals (NYC H+H) and either completed serologic testing at NYC H+H between April 30 and June 30, 2020, or completed SARS-CoV-2 antibody testing outside of NYC H+H and were able to self-report results. ResultsSeven hundred twenty-seven survey respondents were included in analysis. Participants had a mean age of 46 years (SD= 12.19) and 543 (75%) were women. Two hundred fourteen (29%) participants tested positive or reported testing positive for the presence of SARS-CoV-2 antibodies (IgG+). Characteristics associated with positive SARS-CoV-2 serostatus were Black race (25% IgG+ vs. 15% IgG-, p=0.001), having someone in the household with COVID symptoms (49% IgG+ vs. 21% IgG-, p<0.001), or having a confirmed COVID-19 case in the household (25% IgG+ vs 5% IgG-, p<0.001). Characteristics associated with negative SARS-CoV-2 serostatus included working on a COVID patient floor (27% IgG+ vs. 36% IgG-, p=0.02), working in the ICU (20% IgG+ vs. 28% IgG-, p=0.03), or having close contact with a patient with COVID-19 (51% IgG+ vs. 62% IgG-, p=0.03). ConclusionsResults underscore the significance of community factors and inequities might have on SARS-CoV-2 exposure for healthcare workers. What is already known about this subject?Healthcare workers are at risk of occupational transmission of SARS-CoV-2, and the risk of infection varies by demographic characteristics and work location. What are the new findings?Healthcare worker race and household contacts were significantly associated with SARS-CoV-2 seropositivity, while working on a COVID patient floor or ICU was associated with seronegativity. How might this impact on policy or clinical practice in the foreseeable future?Results underscore the significance of community factors and inequities on healthcare worker exposure to SARS-CoV-2, and the need to address these inequities at the community level where healthcare workers live.