Sanne Jespersen, Susan Mikkelsen, Thomas Greve, Kathrine Agergaard Kaspersen, Martin Tolstrup, Jens Kjaergaard Boldsen, Jacob Dvinge Redder, Kent Nielsen, Anders Moensted Abildgaard, Henrik Albert Kolstad, Lars Oestergaard, Marianne Kragh Thomsen, Holger Jon Moeller, Christian Erikstrup
The objective of this study was to perform a large seroprevalence survey on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among Danish healthcare workers to identify high risk groups.
All healthcare workers and administrative personnel at the seven hospitals, pre-hospital services and specialist practitioner clinics in the Central Denmark Region were invited by e-mail to be tested for antibodies against SARS-CoV-2 by a commercial SARS-CoV-2 total antibody enzyme-linked immunosorbent assay (ELISA, Wantai Biological Pharmacy Enterprise Co., Ltd., Beijing, China). Participants: A total of 25,950 participants were invited. Of these, 17,987 (69%) showed up for blood sampling, and 17,971 had samples available for SARS-CoV-2 antibody testing. Main outcome measures: 1) Prevalence of SARS-CoV-2 antibodies; 2) Risk factors for seropositivity; 3) Association of SARS-CoV-2 RNA and antibodies.
After adjustment for assay sensitivity and specificity, the overall seroprevalence was 3.4% (CI: 2.5%-3.8%). The seroprevalence was higher in the western part of the region than in the eastern part (11.9% vs 1.2%, difference: 10.7 percentage points, CI: 9.5-12.2). In the high prevalence area, the emergency departments had the highest seroprevalence (29.7%) while departments without patients or with limited patient contact had the lowest seroprevalence (2.2%). Multivariable logistic regression analysis with age, sex, and profession as the predictors showed that nursing staff, medical doctors, and biomedical laboratory scientists had a higher risk than medical secretaries, who served as reference (OR = 7.3, CI: 3.5-14.9; OR = 4., CI: 1.8-8.9; and OR = 5.0, CI: 2.1-11.6, respectively). Among the total 668 seropositive participants, 433 (64.8%) had previously been tested for SARS-CoV-2 RNA, and 50.0% had a positive RT-PCR result. A total of 98% of individuals who had a previous positive viral RNA test were also found to be seropositive.
We found large differences in the prevalence of SARS-CoV-2 antibodies in staff working in the healthcare sector within a small geographical area of Denmark and signs of in-hospital transmission. Half of all seropositive staff had been tested positive by PCR prior to this survey. This study raises awareness of precautions which should be taken to avoid in-hospital transmission. Additionally, regular testing of healthcare workers for SARS-CoV-2 should be considered to identify areas with increased transmission.
The study is approved by the Danish Data Protection Agency (1-16-02-207-20).