Incidence of SARS-CoV-2 seropositivity in pediatric healthcare workers prior to widespread vaccination: A 5-month longitudinal cohort study

Mark Griffiths; Dunia Hatabah; Patrick Sullivan; Grace Mantus; Travis Sanchez; Maria Zlotorzynska; Stacy Heilman; Andres Camacho-Gonzalez; Deborah Leake; Rawan Korman; Mimi Le; Mehul Suthara; Jens Wrammert; Miriam B Vos; Claudia R Morris

doi:10.1016/j.ijid.2024.107064

Incidence of SARS-CoV-2 seropositivity in pediatric healthcare workers prior to widespread vaccination: A 5-month longitudinal cohort study

Int J Infect Dis. 2024 Apr 17:144:107064. doi: 10.1016/j.ijid.2024.107064. Online ahead of print.

Authors

Affiliations

¹ Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Children's Healthcare of Atlanta, Atlanta, GA, USA.
² Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
³ Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
⁴ Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Children's Healthcare of Atlanta, Atlanta, GA, USA; Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and Emory University, Atlanta, GA, USA.
⁵ Children's Healthcare of Atlanta, Atlanta, GA, USA.
⁶ Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Center for Clinical and Translational Research, Emory University and Children's Healthcare of Atlanta, Atlanta, GA, USA.
⁷ Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
⁸ Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and Emory University, Atlanta, GA, USA.
⁹ Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Children's Healthcare of Atlanta, Atlanta, GA, USA; Center for Clinical and Translational Research, Emory University and Children's Healthcare of Atlanta, Atlanta, GA, USA.
¹⁰ Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Children's Healthcare of Atlanta, Atlanta, GA, USA; Center for Clinical and Translational Research, Emory University and Children's Healthcare of Atlanta, Atlanta, GA, USA. Electronic address: claudia.r.morris@emory.edu.

PMID: 38641316
DOI: 10.1016/j.ijid.2024.107064

Abstract

Objectives: Determine SARS-CoV-2 IgG antibody incidence over time in unvaccinated pediatric healthcare workers (pHCWs).

Design: A prospective longitudinal cohort of unvaccinated pHCWs measuring the incidence of new infection after initial prevalence was established at 4.1% with seropositive predominance in emergency department (ED)-based pHCWs. Serum samples were collected at follow-up visits to detect new SARS-CoV-2 seropositivity. Univariate analysis was performed to estimate different incidence rates between participant demographics, job, employment location, and community risk factors. Anxiety levels about COVID-19 were collected. SARS-CoV-2 antibody decay postinfection and neutralization antibodies were evaluated. Log-linear Poisson regression models were used to estimate incidence.

Results: Of 642 initially enrolled, 390 pHCWs presented for at least one follow-up serology test after baseline analysis. The incidence of SARS-CoV-2 seropositivity was 8.2%. The seropositive cohort, like the negative one, consisted mainly of females in non-ED settings and nonphysician roles. There were no statistically significant differences in incidence across variables. Seropositive participants dropped antibody titers by 50% at 3 months. Neutralization antibodies correlated to SARS-CoV-2 binding antibodies (r = 0.43, P < 0.0001).

Conclusion: The incidence of seropositivity was 8.2%. Although seropositivity was higher among ED staff during the early stages of the pandemic, this difference declined over time, likely due to the universal adoption of personal protective equipment.

Keywords: COVID-19; Emergency department; Pediatric healthcare workers; Personal protective equipment; SARS-CoV-2; SARS-CoV-2 IgG antibodies.