Importance: Risks for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care personnel (HCP) are unclear. Objective: To evaluate the risk factors associated with SARS-CoV-2 seropositivity among HCP with the a priori hypothesis that community exposure but not health care exposure was associated with seropositivity. Design, Setting, and Participants: This cross-sectional study was conducted among volunteer HCP at 4 large health care systems in 3 US states. Sites shared deidentified data sets, including previously collected serology results, questionnaire results on community and workplace exposures at the time of serology, and 3-digit residential zip code prefix of HCP. Site-specific responses were mapped to a common metadata set. Residential weekly coronavirus disease 2019 (COVID-19) cumulative incidence was calculated from state-based COVID-19 case and census data. Exposures: Model variables included demographic (age, race, sex, ethnicity), community (known COVID-19 contact, COVID-19 cumulative incidence by 3-digit zip code prefix), and health care (workplace, job role, COVID-19 patient contact) factors. Main Outcome and Measures: The main outcome was SARS-CoV-2 seropositivity. Risk factors for seropositivity were estimated using a mixed-effects logistic regression model with a random intercept to account for clustering by site. Results: Among 24 749 HCP, most were younger than 50 years (17 233 [69.6%]), were women (19 361 [78.2%]), were White individuals (15 157 [61.2%]), and reported workplace contact with patients with COVID-19 (12 413 [50.2%]). Many HCP worked in the inpatient setting (8893 [35.9%]) and were nurses (7830 [31.6%]). Cumulative incidence of COVID-19 per 10 000 in the community up to 1 week prior to serology testing ranged from 8.2 to 275.6; 20 072 HCP (81.1%) reported no COVID-19 contact in the community. Seropositivity was 4.4% (95% CI, 4.1%-4.6%; 1080 HCP) overall. In multivariable analysis, community COVID-19 contact and community COVID-19 cumulative incidence were associated with seropositivity (community contact: adjusted odds ratio [aOR], 3.5; 95% CI, 2.9-4.1; community cumulative incidence: aOR, 1.8; 95% CI, 1.3-2.6). No assessed workplace factors were associated with seropositivity, including nurse job role (aOR, 1.1; 95% CI, 0.9-1.3), working in the emergency department (aOR, 1.0; 95% CI, 0.8-1.3), or workplace contact with patients with COVID-19 (aOR, 1.1; 95% CI, 0.9-1.3). Conclusions and Relevance: In this cross-sectional study of US HCP in 3 states, community exposures were associated with seropositivity to SARS-CoV-2, but workplace factors, including workplace role, environment, or contact with patients with known COVID-19, were not. These findings provide reassurance that current infection prevention practices in diverse health care settings are effective in preventing transmission of SARS-CoV-2 from patients to HCP.
Importance: Risks for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care personnel (HCP) are unclear. Objective: To evaluate the risk factors associated with SARS-CoV-2 seropositivity among HCP with the a priori hypothesis that community exposure but not health care exposure was associated with seropositivity. Design, Setting, and Participants: This cross-sectional study was conducted among volunteer HCP at 4 large health care systems in 3 US states. Sites shared deidentified data sets, including previously collected serology results, questionnaire results on community and workplace exposures at the time of serology, and 3-digit residential zip code prefix of HCP. Site-specific responses were mapped to a common metadata set. Residential weekly coronavirus disease 2019 (COVID-19) cumulative incidence was calculated from state-based COVID-19 case and census data. Exposures: Model variables included demographic (age, race, sex, ethnicity), community (known COVID-19 contact, COVID-19 cumulative incidence by 3-digit zip code prefix), and health care (workplace, job role, COVID-19patient contact) factors. Main Outcome and Measures: The main outcome was SARS-CoV-2 seropositivity. Risk factors for seropositivity were estimated using a mixed-effects logistic regression model with a random intercept to account for clustering by site. Results: Among 24 749 HCP, most were younger than 50 years (17 233 [69.6%]), were women (19 361 [78.2%]), were White individuals (15 157 [61.2%]), and reported workplace contact with patients with COVID-19 (12 413 [50.2%]). Many HCP worked in the inpatient setting (8893 [35.9%]) and were nurses (7830 [31.6%]). Cumulative incidence of COVID-19 per 10 000 in the community up to 1 week prior to serology testing ranged from 8.2 to 275.6; 20 072 HCP (81.1%) reported no COVID-19 contact in the community. Seropositivity was 4.4% (95% CI, 4.1%-4.6%; 1080 HCP) overall. In multivariable analysis, community COVID-19 contact and community COVID-19 cumulative incidence were associated with seropositivity (community contact: adjusted odds ratio [aOR], 3.5; 95% CI, 2.9-4.1; community cumulative incidence: aOR, 1.8; 95% CI, 1.3-2.6). No assessed workplace factors were associated with seropositivity, including nurse job role (aOR, 1.1; 95% CI, 0.9-1.3), working in the emergency department (aOR, 1.0; 95% CI, 0.8-1.3), or workplace contact with patients with COVID-19 (aOR, 1.1; 95% CI, 0.9-1.3). Conclusions and Relevance: In this cross-sectional study of US HCP in 3 states, community exposures were associated with seropositivity to SARS-CoV-2, but workplace factors, including workplace role, environment, or contact with patients with known COVID-19, were not. These findings provide reassurance that current infection prevention practices in diverse health care settings are effective in preventing transmission of SARS-CoV-2 from patients to HCP.
Authors: Joseph Moscola; Grace Sembajwe; Mark Jarrett; Bruce Farber; Tylis Chang; Thomas McGinn; Karina W Davidson Journal: JAMA Date: 2020-09-01 Impact factor: 56.272
Authors: Molly Scannell Bryan; Jiehuan Sun; Jyotsna Jagai; Daniel E Horton; Anastasia Montgomery; Robert Sargis; Maria Argos Journal: Ann Epidemiol Date: 2020-11-10 Impact factor: 3.797
Authors: Julia M Baker; Kristin N Nelson; Elizabeth Overton; Benjamin A Lopman; Timothy L Lash; Mark Photakis; Jesse T Jacob; John D Roback; Scott K Fridkin; James P Steinberg Journal: Ann Intern Med Date: 2021-01-29 Impact factor: 51.598
Authors: Kristina L Bajema; F Scott Dahlgren; Travis W Lim; Nicolette Bestul; Holly M Biggs; Jacqueline E Tate; Claudio Owusu; Christine M Szablewski; Cherie Drenzek; Jan Drobeniuc; Vera Semenova; Han Li; Peter Browning; Rita Desai; Monica Epperson; Lily T Jia; Natalie J Thornburg; Chris Edens; Alicia M Fry; Aron J Hall; Jarad Schiffer; Fiona P Havers Journal: Clin Infect Dis Date: 2020-12-10 Impact factor: 9.079
Authors: Mehul S Suthar; Matthew G Zimmerman; Robert C Kauffman; Grace Mantus; Susanne L Linderman; William H Hudson; Abigail Vanderheiden; Lindsay Nyhoff; Carl W Davis; Oluwaseyi Adekunle; Maurizio Affer; Melanie Sherman; Stacian Reynolds; Hans P Verkerke; David N Alter; Jeannette Guarner; Janetta Bryksin; Michael C Horwath; Connie M Arthur; Natia Saakadze; Geoffrey H Smith; Srilatha Edupuganti; Erin M Scherer; Kieffer Hellmeister; Andrew Cheng; Juliet A Morales; Andrew S Neish; Sean R Stowell; Filipp Frank; Eric Ortlund; Evan J Anderson; Vineet D Menachery; Nadine Rouphael; Aneesh K Mehta; David S Stephens; Rafi Ahmed; John D Roback; Jens Wrammert Journal: Cell Rep Med Date: 2020-06-08
Authors: Kasper Iversen; Henning Bundgaard; Rasmus B Hasselbalch; Jonas H Kristensen; Pernille B Nielsen; Mia Pries-Heje; Andreas D Knudsen; Casper E Christensen; Kamille Fogh; Jakob B Norsk; Ove Andersen; Thea K Fischer; Claus Antonio Juul Jensen; Margit Larsen; Christian Torp-Pedersen; Jørgen Rungby; Sisse B Ditlev; Ida Hageman; Rasmus Møgelvang; Christoffer E Hother; Mikkel Gybel-Brask; Erik Sørensen; Lene Harritshøj; Fredrik Folke; Curt Sten; Thomas Benfield; Susanne Dam Nielsen; Henrik Ullum Journal: Lancet Infect Dis Date: 2020-08-03 Impact factor: 25.071
Authors: Benton R Hunter; Lana Dbeibo; Christopher S Weaver; Cole Beeler; Michele Saysana; Michelle K Zimmerman; Lindsay Weaver Journal: Infect Control Hosp Epidemiol Date: 2020-08-03 Impact factor: 3.254
Authors: Tegan K Boehmer; Jourdan DeVies; Elise Caruso; Katharina L van Santen; Shichao Tang; Carla L Black; Kathleen P Hartnett; Aaron Kite-Powell; Stephanie Dietz; Matthew Lozier; Adi V Gundlapalli Journal: MMWR Morb Mortal Wkly Rep Date: 2020-10-02 Impact factor: 17.586
Authors: Wesley H Self; Mark W Tenforde; William B Stubblefield; Leora R Feldstein; Jay S Steingrub; Nathan I Shapiro; Adit A Ginde; Matthew E Prekker; Samuel M Brown; Ithan D Peltan; Michelle N Gong; Michael S Aboodi; Akram Khan; Matthew C Exline; D Clark Files; Kevin W Gibbs; Christopher J Lindsell; Todd W Rice; Ian D Jones; Natasha Halasa; H Keipp Talbot; Carlos G Grijalva; Jonathan D Casey; David N Hager; Nida Qadir; Daniel J Henning; Melissa M Coughlin; Jarad Schiffer; Vera Semenova; Han Li; Natalie J Thornburg; Manish M Patel Journal: MMWR Morb Mortal Wkly Rep Date: 2020-09-04 Impact factor: 17.586
Authors: Michelle M Hughes; Matthew R Groenewold; Sarah E Lessem; Kerui Xu; Emily N Ussery; Ryan E Wiegand; Xiaoting Qin; Tuyen Do; Deepam Thomas; Stella Tsai; Alexander Davidson; Julia Latash; Seth Eckel; Jim Collins; Mojisola Ojo; Lisa McHugh; Wenhui Li; Judy Chen; Jonathan Chan; Jonathan M Wortham; Sarah Reagan-Steiner; James T Lee; Sujan C Reddy; David T Kuhar; Sherry L Burrer; Matthew J Stuckey Journal: MMWR Morb Mortal Wkly Rep Date: 2020-09-25 Impact factor: 17.586
Authors: Christopher A Martin; Daniel Pan; Carl Melbourne; Lucy Teece; Avinash Aujayeb; Rebecca F Baggaley; Luke Bryant; Sue Carr; Bindu Gregary; Amit Gupta; Anna L Guyatt; Catherine John; I Chris McManus; Joshua Nazareth; Laura B Nellums; Rubina Reza; Sandra Simpson; Martin D Tobin; Katherine Woolf; Stephen Zingwe; Kamlesh Khunti; Keith R Abrams; Laura J Gray; Manish Pareek Journal: PLoS Med Date: 2022-05-26 Impact factor: 11.613
Authors: Andrés Mello López; Igor Carmo Borges; Alessandra Luna-Muschi; Carlos Henrique Mesquita Peres; Paolo Gripp Carreño; Arthur Magalhães de Oliveira; Humberto Bertola Siqueira de Almeida; Vivian Helena de Castro Marques; Felipe Corchs; Anna Sara Levin; Silvia Figueiredo Costa; Ana Marli Christovam Sartori Journal: Infect Control Hosp Epidemiol Date: 2022-05-26 Impact factor: 6.520
Authors: Nallely Bueno-Hernández; José Damian Carrillo-Ruíz; Lucía A Méndez-García; Salma A Rizo-Téllez; Rebeca Viurcos-Sanabria; Alisson Santoyo-Chávez; René Márquez-Franco; Alejandro Aguado-García; Neyla Baltazar-López; Yoshio Tomita-Cruz; Eira Valeria Barrón; Ana Laura Sánchez; Edna Márquez; Ruben Fossion; Ana Leonor Rivera; Luis Ruelas; Octavio A Lecona; Gustavo Martínez-Mekler; Markus Müller; América G Arroyo-Valerio; Galileo Escobedo Journal: Healthcare (Basel) Date: 2022-05-12
Authors: Sarah E Smith-Jeffcoat; Sadia Sleweon; Mitsuki Koh; George M Khalil; Marcos C Schechter; Paulina A Rebolledo; Vyjayanti Kasinathan; Adam Hoffman; Rebecca Rossetti; Talya Shragai; Kevin O'Laughlin; Catherine C Espinosa; Bettina Bankamp; Michael D Bowen; Ashley Paulick; Amy S Gargis; Jennifer M Folster; Juliana da Silva; Caitlin Biedron; Rebekah J Stewart; Yun F Wang; Hannah L Kirking; Jacqueline E Tate Journal: Front Public Health Date: 2022-03-24