Incidence of unknown COVID-19 infection in a cohort of emergency physicians and advance practice providers

Am J Emerg Med. 2023 Feb:64:155-160. doi: 10.1016/j.ajem.2022.12.012. Epub 2022 Dec 14.

Abstract

Introduction: In United States, health care workers have been immersed in the COVID-19 pandemic since February 2020. Since availability of COVID-19 vaccines, there is limited literature investigating the incidence of unknown COVID-19 infections in physicians and Advanced Practitioner Providers (APPs) working in emergency departments (EDs). The primary objective is to determine the incidence unknown COVID-19 infection within a cohort of emergency physicians (EPs) and APPs.

Methods: Prospective observational study at a tertiary academic center with emergency medicine residency and 64,000 annual ED visits. EPs/APPs providing care to ED patients over the prior 12 months were eligible. Serum samples were collected between May 1 and June 30, 2022. Analysis utilized Luminex xMAP® SARS-CoV-2 Multi-Antigen IgG Assay for antibodies to Nucleocapsid, Receptor-binding domain, and Spike subunit 1. Mean Fluorescent Intensity (MFI) ≥ 700 was considered positive. Subjects completed 12 question survey assessing demographics and previously confirmed COVID-19 infection. Fisher's exact test evaluated associations of demographics and clinical characteristics with confirmed COVID-19 status. Analyses performed using SAS, Version 9.4. P < 0.05 considered statistically significant.

Results: Sixty-nine of 81 eligible subjects (85.2%) participated, 58.0% were male, 97.1% white, with mean age of 37. Eighteen subjects had MFI ≥ 700 strongly suggestive of prior infection, with 17.7% unknown. No statistically significant difference between age, gender, race, children in home, or household member with previously COVID-19 infection.

Conclusion: Unknown previous COVID-19 infection was less then expected in this cohort of EPs/APPs, and no association with individual characteristics, previously infected household member, or children in the home.

Keywords: Antibodies; COVID-19; Emergency medicine; Infection; SARS-CoV-2.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Antibodies, Viral
  • COVID-19 Vaccines
  • COVID-19* / epidemiology
  • Child
  • Female
  • Humans
  • Immunoglobulin G
  • Incidence
  • Male
  • Pandemics / prevention & control
  • Physicians*
  • SARS-CoV-2
  • United States / epidemiology

Substances

  • COVID-19 Vaccines
  • Antibodies, Viral
  • Immunoglobulin G