Risk Factors Associated With SARS-CoV-2 Seropositivity Among US Health Care Personnel

Area of Science:

• Epidemiology
• Infectious Diseases
• Public Health

Background:

• The risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care personnel (HCP) remains a critical public health concern.
• Understanding the specific risk factors for SARS-CoV-2 seropositivity in HCP is essential for refining occupational health and safety protocols.

Purpose of the Study:

• To investigate the association between community and healthcare-related exposures and SARS-CoV-2 seropositivity among a large cohort of US health care personnel.
• To test the hypothesis that community exposure, rather than healthcare workplace exposure, is the primary driver of SARS-CoV-2 seropositivity in HCP.

Main Methods:

• A cross-sectional study involving 24,749 volunteer HCP across 4 health care systems in 3 US states.
• Data collected included serology results, self-reported community and workplace exposures, and residential zip code data.
• SARS-CoV-2 seropositivity was assessed, and risk factors were analyzed using multivariable mixed-effects logistic regression, incorporating community COVID-19 incidence.

Main Results:

• Overall SARS-CoV-2 seropositivity was 4.4%.
• Higher community COVID-19 cumulative incidence and known community contact with COVID-19 were significantly associated with seropositivity (aOR 1.8 and 3.5, respectively).
• No significant association was found between seropositivity and workplace factors, including patient contact, job role, or work setting.

Conclusions:

• Community exposure is a significant risk factor for SARS-CoV-2 seropositivity among health care personnel.
• Current infection prevention strategies within healthcare settings appear effective in mitigating SARS-CoV-2 transmission from patients to HCP.
• Findings underscore the importance of community-level transmission dynamics in understanding occupational risk for infectious diseases.