Specific exposure of ICU staff to SARS-CoV-2 seropositivity: a wide seroprevalence study in a French city-center hospital

Emmanuel Vivier, Caroline Pariset, Stephane Rio, Sophie Armand, Fanny Doroszewski, Delphine Richard, Marc Chardon, Georges Romero, Pierre Metral, Matthieu Pecquet, Adrien Didelot, Emmanuel Vivier, Caroline Pariset, Stephane Rio, Sophie Armand, Fanny Doroszewski, Delphine Richard, Marc Chardon, Georges Romero, Pierre Metral, Matthieu Pecquet, Adrien Didelot

Abstract

Background: Most hospital organizations have had to face the burden of managing the ongoing COVID-19 outbreak. One of the challenges in overcoming the influx of COVID-19 patients is controlling patient-to-staff transmission. Measuring the specific extent of ICU caregiver exposure to the virus and identifying the associated risk factors are, therefore, critical issues. We prospectively studied SARS-CoV-2 seroprevalence in the staff of a hospital in Lyon, France, several weeks after a first epidemic wave. Risk factors for the presence of SARS-CoV-2 antibodies were identified using a questionnaire survey.

Results: The overall seroprevalence was 9% (87/971 subjects). Greater exposure was associated with higher seroprevalence, with a rate of 3.2% [95% CI 1.1-5.2%] among non-healthcare staff, 11.3% [8.9-13.7%] among all healthcare staff, and 16.3% [12.3-20.2%] among healthcare staff in COVID-19 units. The seroprevalence was dramatically lower (3.7% [1.0-6.7%]) in the COVID-19 ICU. Risk factors for seropositivity were contact with a COVID-19-confirmed household (odds ratio (OR), 3.7 [1.8-7.4]), working in a COVID-19 unit (OR, 3.5 [2.2-5.7], and contact with a confirmed COVID-19 coworker (OR, 1.9 [1.2-3.1]). Conversely, working in the COVID-19-ICU was negatively associated with seropositivity (OR, 0.33 [0.15-0.73]).

Conclusions: In this hospital, SARS-CoV-2 seroprevalence was higher among staff than in the general population. Seropositivity rates were particularly high for staff in contact with COVID-19 patients, especially those in the emergency department and in the COVID-19 unit, but were much lower in ICU staff. Clinical trial registration NCT04422977.

Keywords: COVID-19; Health personnel; SARS-CoV-2 seroepidemiologic studies.

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Timeline of daily COVID-19 hospitalizations and weekly numbers of staff members diagnosed with SARS-CoV-2 by RT-PCR in the studied hospital. The outbreak of the epidemic is highlighted by the daily evolution of COVID-19 hospitalizations (gray curve) and the weekly number of SARS-CoV-2-positive RT-PCR tests among staff (red bars). Key dates are shown at the bottom of the graph. The survey period ran from June 8 to June 30, 2020, 1 month after the end of the lockdown in France. COVID-19: coronavirus disease 2019; SARS-Cov-2: severe acute respiratory syndrome coronavirus 2; RT-PCR: reverse transcriptase polymerase chain reaction; ICU: intensive care unit
Fig. 2
Fig. 2
Risks of exposure to SARS-CoV-2 infection in different areas of the hospital. a Schematic illustration of the hospital's single-block architecture with administrative and support areas in gray, non-COVID treatment units in pink and COVID-19 treatment units in red. Surgical units include: plastic and reconstructive surgery, urology, vascular surgery, orthopedics, gynecology and digestive surgery (5th Floor). Non-COVID-19 treatment units include: nephrology, endocrinology, rheumatology, gastroenterology, neurology, infectious disease, internal medicine, cardiology (3rd Floor) and cardiologic intensive care unit (5th Floor). b, c Staff SARS-CoV-2 seroprevalence (b) in the different work areas (non-treatment areas, non-COVID-19 treatment areas, COVID-19 treatment areas) and c in the different COVID-19 units. COVID-19: coronavirus disease 2019; SARS-Cov-2: severe acute respiratory syndrome coronavirus 2; ICU: intensive care unit

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