Seroprevalence of SARS-CoV-2 antibodies and reduced risk of reinfection through 6 months: a Danish observational cohort study of 44 000 healthcare workers,Clinical Microbiology and Infection

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Seroprevalence of SARS-CoV-2 antibodies and reduced risk of reinfection through 6 months: a Danish observational cohort study of 44 000 healthcare workers
Clinical Microbiology and Infection ( IF 10.9 ) Pub Date : 2021-09-17 , DOI: 10.1016/j.cmi.2021.09.005
Kasper Iversen ₁ , Jonas Henrik Kristensen ₁ , Rasmus Bo Hasselbalch ₁ , Mia Pries-Heje ₂ , Pernille Brok Nielsen ₁ , Andreas Dehlbæk Knudsen ₃ , Kamille Fogh ₁ , Jakob Boesgaard Norsk ₁ , Ove Andersen ₄ , Thea Køhler Fischer ₅ , Claus Antonio Juul Jensen ₆ , Christian Torp-Pedersen ₅ , Jørgen Rungby ₇ , Sisse Bolm Ditlev ₈ , Ida Hageman ₉ , Rasmus Møgelvang ₂ , Mikkel Gybel-Brask ₁₀ , Ram B Dessau ₁₁ , Erik Sørensen ₁₀ , Lene Harritshøj ₁₀ , Fredrik Folke ₁₂ , Curt Sten ₁₃ , Maria Elizabeth Engel Møller ₁₄ , Thomas Benfield ₁₄ , Henrik Ullum ₁₅ , Charlotte Sværke Jørgensen ₁₅ , Christian Erikstrup ₁₆ , Sisse R Ostrowski ₁₀ , Susanne Dam Nielsen ₁₇ , Henning Bundgaard ₂

Affiliation

Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Emergency Medicine, Copenhagen University Hospital-Herlev and Gentofte, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark; Department of Infectious Disease, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Emergency and Department of Clinical Research, Copenhagen University Hospital-Amager og Hvidovre, Kettegård Alle 30, 2650, Hvidovre, Denmark.
Department of Clinical Research, Copenhagen University Hospital-Nordsjællands Hospital, Dyrehavevej 29, 3400, Hillerød, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Biochemistry, Copenhagen University Hospital-Nordsjællands Hospital, Dyrehavevej 29, 3400, Hillerød, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Endocrinology and Copenhagen Center for Translational Research, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400, København NV, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Pulmonary Medicine and Copenhagen Center for Translational Research, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Mental Health Services-The Capital Region of Denmark, Kristineberg 3, 2100, København Ø, Denmark.
Department of Clinical Immunology, Copenhagen University Hospital-Rigshospitalet, Inge Lehmans Vej 7, 2100, Copenhagen, Denmark.
Department of Clinical Microbiology, Zealand University Hospital-Slagelse, Ingemannsvej 46, 4200, Slagelse, Denmark; University of Southern Denmark, Odense, Denmark.
Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Copenhagen University Hospital-Copenhagen Emergency Medical Services, Copenhagen, Denmark; Copenhagen University Hospital-Copenhagen Emergency Medical Services, Telegrafvej 5A, Stairway 2, 2750, Ballerup, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Diagnostisk Enhed, Copenhagen University Hospital-Bornholm, Ullasvej 8, 3700, Rønne, Denmark.
Department of Infectious Disease, Copenhagen University Hospital-Amager and Hvidovre, Kettegaard Alle 30, 2650 Hvidovre, Denmark.
Statens Serum Institut, Artillerivej 5, 2300, København S, Copenhagen, Denmark.
Department of Clinical Immunology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Infectious Disease, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.

Objectives

Antibodies to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are a key factor in protecting against coronavirus disease 2019 (COVID-19). We examined longitudinal changes in seroprevalence in healthcare workers (HCWs) in Copenhagen and the protective effect of antibodies against SARS-CoV-2.

Methods

In this prospective study, screening for antibodies against SARS-CoV-2 (ELISA) was offered to HCWs three times over 6 months. HCW characteristics were obtained by questionnaires. The study was registered at ClinicalTrials.gov, NCT04346186.

Results

From April to October 2020 we screened 44 698 HCWs, of whom 2811 were seropositive at least once. The seroprevalence increased from 4.0% (1501/37 452) to 7.4% (2022/27 457) during the period (p < 0.001) and was significantly higher than in non-HCWs. Frontline HCWs had a significantly increased risk of seropositivity compared to non-frontline HCWs, with risk ratios (RRs) at the three rounds of 1.49 (95%CI 1.34–1.65, p < 0.001), 1.52 (1.39–1.68, p < 0.001) and 1.50 (1.38–1.64, p < 0.001). The seroprevalence was 1.42- to 2.25-fold higher (p < 0.001) in HCWs from dedicated COVID-19 wards than in other frontline HCWs. Seropositive HCWs had an RR of 0.35 (0.15–0.85, p 0.012) of reinfection during the following 6 months, and 2115 out of 2248 (95%) of those who were seropositive during rounds one or two remained seropositive after 4–6 months. The 133 of 2248 participants (5.0%) who seroreverted were slightly older and reported fewer symptoms than other seropositive participants.

Conclusions

HCWs remained at increased risk of infection with SARS-CoV-2 during the 6-month period. Seropositivity against SARS-CoV-2 persisted for at least 6 months in the vast majority of HCWs and was associated with a significantly lower risk of reinfection.

中文翻译：

SARS-CoV-2 抗体的血清阳性率和 6 个月内再感染风险降低：丹麦一项针对 44 000 名医护人员的观察性队列研究

目标

严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 的抗体是预防 2019 年冠状病毒病 (COVID-19) 的关键因素。我们检查了哥本哈根医护人员 (HCW) 血清阳性率的纵向变化以及抗体对 SARS-CoV-2 的保护作用。

方法

在这项前瞻性研究中，在 6 个月内向医护人员提供了 3 次针对 SARS-CoV-2 (ELISA) 的抗体筛查。HCW 特征是通过问卷调查获得的。该研究在 ClinicalTrials.gov 注册，NCT04346186。

结果

从 2020 年 4 月到 2020 年 10 月，我们筛查了 44698 名 HCW，其中 2811 名至少有一次血清反应呈阳性。在此期间，血清阳性率从 4.0% (1501/37 452) 增加到 7.4% (2022/27 457) (p < 0.001)，并且显着高于非 HCW。与非一线医护人员相比，一线医护人员的血清阳性风险显着增加，三轮风险比 (RR) 分别为 1.49 (95%CI 1.34–1.65, p < 0.001)、1.52 (1.39–1.68, p < 0.001) ) 和 1.50 (1.38–1.64, p < 0.001)。来自 COVID-19 专用病房的 HCW 的血清阳性率比其他一线 HCW 高 1.42 至 2.25 倍（p < 0.001）。在接下来的 6 个月中，血清阳性 HCW 的再感染 RR 为 0.35（0.15-0.85，p = 0.012），2248 人中有 2115 人（95%）在第一轮或第二轮中呈阳性，4-6 个月后仍然呈阳性。与其他血清反应阳性的参与者相比，2248 名参与者中有 133 名（5.0%）年龄稍大，报告的症状更少。