Seroprevalence of anti-SARS-CoV-2 IgG among healthcare workers of a large university hospital in Milan, Lombardy, Italy: a cross-sectional study

BMJ Open. 2021 Feb 22;11(2):e047216. doi: 10.1136/bmjopen-2020-047216.

Abstract

Objectives: To assess the seroprevalence of anti-SARS-CoV-2 IgG among health careworkers (HCWs) in our university hospital and verify the risk of acquiring the infection according to work area.

Design: Cross-sectional study.

Setting: Monocentric, Italian, third-level university hospital.

Participants: All the employees of the hospital on a voluntary base, for a total of 4055 participants among 4572 HCWs (88.7%).

Primary and secondary outcome measures: Number of anti-SARS-CoV-2 positive serology according to working area. Association of anti-SARS-CoV-2 positive serology to selected variables (age, gender, country of origin, body mass index, smoking, symptoms and contact with confirmed cases).

Results: From 27 April 2020 to 12 June 2020, 4055 HCWs were tested and 309 (7.6%) had a serological positive test. No relevant difference was found between men and women (8.3% vs 7.3%, p=0.3), whereas a higher prevalence was observed among foreign-born workers (27/186, 14.5%, p<0.001), employees younger than 30 (64/668, 9.6%, p=0.02) or older than 60 years (38/383, 9.9%, p=0.02) and among healthcare assistants (40/320, 12.5%, p=0.06). Working as frontline HCWs was not associated with an increased frequency of positive serology (p=0.42). A positive association was found with presence and number of symptoms (p<0.001). The symptoms most frequently associated with a positive serology were taste and smell alterations (OR 4.62, 95% CI: 2.99 to 7.15) and fever (OR 4.37, 95% CI: 3.11 to 6.13). No symptoms were reported in 84/309 (27.2%) HCWs with positive IgG levels. Declared exposure to a suspected/confirmed case was more frequently associated (p<0.001) with positive serology when the contact was a family member (19/94, 20.2%) than a patient or colleague (78/888, 8.8%).

Conclusions: SARS-CoV-2 infection occurred undetected in a large fraction of HCWs and it was not associated with working in COVID-19 frontline areas. Beyond the hospital setting, exposure within the community represents an additional source of infection for HCWs.

Keywords: diagnostic microbiology; occupational & industrial medicine; public health; virology.

MeSH terms

  • Adult
  • Antibodies, Viral* / blood
  • COVID-19* / diagnosis
  • COVID-19* / epidemiology
  • Cross-Sectional Studies
  • Female
  • Hospitals, University
  • Humans
  • Immunoglobulin G* / blood
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Personnel, Hospital* / statistics & numerical data
  • SARS-CoV-2* / immunology
  • Seroepidemiologic Studies

Substances

  • Antibodies, Viral
  • Immunoglobulin G