Our study found lower seroprevalence rate among many HCW at WVU Medicine before vaccine availability ( 0.86 % versus at least 1.75 % in the population at large ). 10 A majority of these HCW worked in locations that placed them at high-risk for exposure to patients with COVID-19 . Several similar seroprevalence studies support the efficacy of PPE for preventing COVID-19 in HCW pre-vaccination availability . A study from the Indiana University Health system showed a low overall seroprevalence of COVID-19 among HCW , with no significant difference based on high- and low-risk exposures . 3 Another multicenter study across 13 geographically diverse US academic medical centers resulted in 6 % seropositivity , with lower rates among those who wore PPE compared to those who did not . 15 One third of the cases were completely asymptomatic . 15 In New York City , SARS-CoV-2 IgG or total antibodies were detected in 13.7 % of HCW , with some association in high-risk exposures . 14 However , given the population density , it would be expected that these rates would be higher if PPE was ineffective . Furthermore , in two European studies , one in Germany and one in Belgium , seroprevalence rates in HCW ranged from 1.6 % to 6.4 %. 20 , 21 In the latter study , having a household contact with suspected or confirmed COVID-19 was associated with seroprevalence more than HCW-related duties . 21 Overall , HCW seroprevalence when using PPE during their duties was more highly associated with seroprevalence than healthcare duties .
Strengths of our study include random selection resulting in reduction of potential bias associated with voluntary participation , large total number of HCW who participated , and multicenter design across four large WVU Medicine hospitals . Our study has several limitations . Of HCW randomly selected to participate , fewer than half ( 43.4 %) enrolled . More high-risk versus low-risk individuals participated in the study . Healthcare workers from either group who chose to participate may have had preconceived notions of previous seropositivity . Given that data was obtained from one medical system in one state , the data may not be generalizable to other populations . In addition , our study was confined to HCW employed in a rural state with low cumulative percent positivity at time of study completion . To our knowledge , our study is the largest seroprevalence study with randomly selected , risk stratified HCW conducted in Appalachia and the only one in WV . Data may reflect the availability of and adherence to appropriate PPE at WVU Medicine . Further research will be needed to elucidate how vaccination may shape these numbers . This study is significant for new emerging infections . PPE can be the cornerstone in preventing spread of such highly transmissible diseases .
CONCLUSION
Overall SARS-CoV-2 IgG seroprevalence in a large sample of HCW across four WVU Medicine hospitals was low . Low seroprevalence among HCW in high-risk areas may be from appropriate PPE use . To the authors knowledge , this work is the largest Appalachian study , and the only study from WV of seroprevalence of HCW during the COVID-19 pandemic prior to the availability of vaccines . Seroprevalence in HCW not caring for patients with COVID-19 may be from community or other inadvertent exposure . Informing healthcare institutions and HCW about SARS-CoV-2 seroprevalence as hospital occupancies , surgical procedures , and face-to-face visits increase may provide a useful framework to help prepare for future pandemics or epidemics . In addition , sharing awareness of relatively low seroprevalence within the HCW may help mitigate fear associated with seeking medical care during the COVID-19 pandemic .
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18 • www . wvsma . org