SCIENTIFIC
Pre-Vaccine COVID-19 Antibody Positivity in Healthcare Workers in West Virginia
AUTHORS : Ziad O . Dimachkie , MD 1 , 2
Danielle DeCicco , MD , PhD 1 Nathan M . Lerfald , MD , FACP 1 Arif R . Sarwari , MD , MSc , MBA 1 , 3 Rashida A . Khakoo , MD , MACP 1 , 3 Joy J . Juskowich , MD 1 , 2 , 3
1
West Virginia University Department of Medicine
2
West Virginia University Department of Medicine Section of Hospital Medicine
3
West Virginia University Department of Medicine Section of Infectious Diseases
INTRODUCTION
Severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2 ), a novel coronavirus , emerged in Wuhan , China , in December 2019 and resulted in coronavirus disease 2019 ( COVID-19 ), an acute respiratory disease that was declared a pandemic on March 11 , 2020 . 1 , 2 There have been several variants of SARS-CoV-2 ranging from the original ancestral variant to omicron and XBB . 1.5 subvariants being transmitted . 1 At least 12 different variants have been detected over the course of the pandemic as of the writing of this article . Globally , the alpha and delta variants were exceedingly transmissible with high symptom severity and case fatality . 1 The alpha variant was transmitted primarily from December 2020 onward , and the delta variant was named in May 2021 originating from India . 1 Omicron , detected in South Africa in November 2021 . was a variant with lower case-fatality rates . Several other variants ., including Beta , Mu , and Theta , all detected in 2020- 2021 , caused regional outbreaks . 1 Our study occurred during the period when the original virus and its alpha variant were the primary variants infecting the United States ( US ) population .
ABSTRACT
INTRODUCTION Preceding coronavirus disease 2019 ( COVID-19 ) vaccine availability , concern regarding the efficacy of personal protective equipment ( PPE ) was prevalent among healthcare workers ( HCW ). We measured COVID-19 seroprevalence among HCW in high-risk versus low-risk clinical settings to evaluate if implemented PPE policies were associated with seroconversion prevention . To our knowledge , our study is the largest seroprevalence study with randomly selected , risk stratified HCW conducted in Appalachia and the only such study in West Virginia .
MATERIALS AND METHODS
Several characteristics of this illness contributed to its pandemic status . Transmission during asymptomatic or pre-symptomatic infection , primarily through the respiratory route , caused many people to spread the virus without knowing they were infected . 2 Worldwide travel served as a catalyst for spreading a highly transmissible virus across continents quickly . 2 Importantly , the absence of prior SARS- CoV-2 exposure , established treatment , or vaccination contributed to early spread worldwide . 2 , 3 During the time this study was completed , personal protective equipment ( PPE ) was in short supply due to logistical challenges , and many workers were able to telecommute . 4 , 5 Healthcare workers ( HCW ), however , were required to be on the front lines caring for patients in need . As a result of the COVID-19 pandemic , many changes were made in healthcare institutions to promote HCW and patient safety , including canceling elective surgeries , limiting face-to-face
A multicenter , cross-sectional study was conducted across four West Virginia University ( WVU ) Medicine hospitals . Randomly selected HCW were tested for severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2 ) nucleocapsid immunoglobulin G ( IgG ) between May 26 , 2020 , and June 5 , 2020 . Medical personnel were characterized as being at high or low risk based on work location . Environmental services ( EVS ) workers were not risk stratified . Survey-based information on demographics , chronic medical conditions , symptoms , and exposures was analyzed .
RESULTS SARS-CoV-2 IgG was positive in 0.86 % of HCW . There was no significant difference in seroprevalence based on exposure risk of medical personnel . No EVS workers tested positive .
DISCUSSION Low seroprevalence among HCW in high-risk areas may be related to appropriate PPE in the workplace and other precautions taken outside of the healthcare setting .
CONCLUSION Our work supports the need for mandated PPE policies implemented in the clinical setting and further supports the use of basic PPE in the prevention of seroprevalence regardless of risk of exposure .
clinic visits , reducing inpatient transfers for conditions other than COVID-19 , and implementing visitor restrictions . 6 – 8
West Virginia University Hospital ( WVUH ) is the affiliated academic medical system of West Virginia University ( WVU ). At the time the study was completed , the system included over 20,000 employees ; consisted of 13 hospitals , including its tertiary care referral center J . W . Ruby Memorial Hospital ; and provided management services to six additional hospitals and five institutions . From the pandemic onset , appropriate PPE , including controlled air-purifying respirators ( CAPR ) for all HCW caring for persons with suspected or confirmed COVID-19 was provided at WVUH . Policies requiring masks for all HCW and patients at WVUH and across the system of WVU Medicine facilities were implemented on March 27 , 2020 , and April 29 , 2020 , respectively .
14 • www . wvsma . org