into patient rooms with known COVID-19 , an N-95 respirator or CAPR was made available for increased protection . This was to be worn in addition to eye protection if an N-95 was used , as well as a gown and gloves . The shields on the CAPRs are disposable ; however , due to ongoing supply chain issues , many HCW did keep their own shield for many shifts in a row . Additionally , those who used N-95 masks had the option of having those masks reprocessed for recurrent use , a procedure that had unclear impact on the efficacy of the PPE . These practices were highly unconventional as most of these PPE components were intended to be disposable , but they had to be reused given the superimposition of global inventory challenges . EVS workers were required to wear surgical masks and eye protection while cleaning rooms after patients were discharged .
Healthcare workers who otherwise met criteria for SARS-CoV-2 diagnostic testing as outlined in protocols by the Centers for Disease Control and Prevention ( CDC ) and WVU Medicine , including symptomatic HCW at time of enrollment , were excluded from the study and asked to undergo appropriate testing as well as isolation measures . As required by WV Department of Health and Human Resources , all positive and negative SARS-CoV-2 nucleocapsid IgG assay results were directly reported electronically to appropriate health authorities . HCW could view their own results electronically . In addition , designated employee health nurses or infection preventionists called HCW with notification of positive results .
Serum samples were obtained through venipuncture . All SARS-CoV-2 antibody testing was performed on serum samples using the Abbott Architect automated , two-step chemiluminescent microparticle immunoassay for qualitative detection of IgG against the SARS-CoV-2 nucleocapsid protein on the ARCHITECT i System . 12 Emergency use authorization for this assay was granted by the US Food and Drug Administration ( FDA ) on April 26 , 2020 . 13 All antibody testing was performed in a single centralized laboratory at J . W . Ruby Memorial Hospital between May 26 , 2020 , and June 5 , 2020 . Abbott ’ s SARS-CoV-2 IgG assay was assessed to have 99.9 %
TABLE 2 : Participant Demographics , Chronic Medical Conditions , Symptoms , and Exposures
specificity ( from 1,020 pre-COVID-19 serum specimens ) and 100 % sensitivity at 17 days after symptom onset and 13 days after SARS-CoV-2 positivity . 12 All HCW were required to wear PPE as outlined in protocols by the CDC and WVU Medicine summarized above during testing .
Results were expressed as numbers , percentages , odds ratios , and 95 % confidence intervals . Comparison between high-risk and low-risk groups were made using Pearson ’ s chi-square or Fisher ’ s exact test . Bivariate logistic regression analysis was conducted to estimate odds ratios ( OR ) and 95 % confidence intervals ( CI ) for riskgroup status of HCW and gender , chronic medical conditions , and exposures . Statistical analysis was conducted using IBM ® SPSS ® , version 26.0 .
High Risk Low Risk P-Value Responded to Survey 649 ( 77.72 %) 115 ( 65.34 %) < 0.001 Age in Years 0.055 < 30 205 ( 32.39 %) 25 ( 22.12 %) 30-39 185 ( 29.23 %) 30 ( 26.55 %) 40-49 135 ( 21.33 %) 29 ( 25.66 %) 50-59 69 ( 10.90 %) 15 ( 13.27 %) 60-69 36 ( 5.69 %) 13 ( 11.50 %) ≥70 3 ( 0.47 %) 1 ( 0.89 %) Gender 0.028 Male 178 ( 28.12 %) 20 ( 17.70 %) Female 455 ( 71.88 %) 93 ( 82.30 %) Chronic Disease Lung 28 ( 4.47 %) 14 ( 12.61 %) 0.002 Diabetes 19 ( 3.01 %) 6 ( 5.26 %) 0.248 Heart 11 ( 1.75 %) 0 ( 0.00 %) 0.385 Hypertension 86 ( 13.65 %) 22 ( 20.00 %) 0.106 Kidney 2 ( 0.32 %) 0 ( 0.00 %) 1.000 Liver 1 ( 0.16 %) 0 ( 0.00 %) 1.000 Other Immunosuppression 22 ( 3.51 %) 4 ( 3.54 %) 1.000 Fever / Cough / Dyspnea
Exposed to Person with COVID-19
200 ( 31.85 %) 37 ( 32.74 %) 0.913
280 ( 44.30 %) 11 ( 9.82 %) < 0.001
RESULTS
Of 2,400 HCW randomly selected to participate , 1,042 ( 43.4 %) underwent SARS- CoV-2 antibody testing ( Table 1 ). Of these , 764 HCW responded to the survey questionnaire : 649 ( 77.7 %) in the high-risk group and 115 ( 65.3 %) in the low-risk group . Overall , the median age was 30-39 years , 73.5 % identified themselves as female ( Table 2 ). Compared to those in the low-risk group , HCW in the high-risk group were 1.8 times as likely to be male ( OR 1.82 , 95 % CI 1.09-3.04 ). High-risk HCW were 3.2 times as likely not to have chronic lung disease ( OR 0.32 , 95 % CI 0.17-0.64 ) and 7.3 times as likely to have been exposed to a person with confirmed COVID-19 ( OR 7.30 , 95 % CI 3.84-13.88 ) ( Table 3 ). Chronic conditions , including diabetes , hypertension , and other immunosuppression , were
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