Association between self-reported signs and symptoms and SARS-CoV-2 antibody detection in UK key workers

Ranya Mulchandani; Sian Taylor-Philips; Hayley E. Jones; A. E. Ades; Raymond Borrow; Ezra Linley; Peter Kirwan; Richard Stewart; Philippa Moore; John Boyes; Anil Hormis; Neil Todd; Antoanela Colda; Ian Reckless; Tim Brooks; Andre Charlett; Matthew Hickman; Isabel Oliver; David Wyllie

doi:10.1016/j.jinf.2021.03.019

Association between self-reported signs and symptoms and SARS-CoV-2 antibody detection in UK key workers

Ranya Mulchandani, Sian Taylor-Philips, Hayley E. Jones, A. E. Ades, Raymond Borrow, Ezra Linley, Peter Kirwan, Richard Stewart, Philippa Moore, John Boyes, Anil Hormis, Neil Todd, Antoanela Colda, Ian Reckless, Tim Brooks, Andre Charlett, Matthew Hickman, Isabel Oliver, David Wyllie^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: Screening for SARS-CoV-2 antibodies is under way in some key worker groups; how this adds to self-reported COVID-19 illness is unclear. In this study, we investigate the association between self-reported belief of COVID-19 illness and seropositivity.

Methods: Cross-sectional study of three key worker streams comprising (A) Police and Fire & Rescue (2 sites) (B) healthcare workers (1 site) and (C) healthcare workers with previously positive PCR result (5 sites). We collected self-reported signs and symptoms of COVID-19 and compared this with serology results from two SARS-CoV-2 immunoassays (Roche Elecsys® and EUROIMMUN).

Results: Between 01 and 26 June, we recruited 2847 individuals (Stream A: 1,247, Stream B: 1,546 and Stream C: 154). Amongst those without previous positive PCR tests, 687/2,579 (26%) reported belief they had COVID-19, having experienced compatible symptoms; however, only 208 (30.3%) of these were seropositive on both immunoassays. Both immunoassays had high sensitivities relative to previous PCR positivity (>93%); there was also limited decline in antibody titres up to 110 days post symptom onset. Symptomatic but seronegative individuals had differing symptom profiles and shorter illnesses than seropositive individuals.

Conclusion: Non-COVID-19 respiratory illness may have been mistaken for COVID-19 during the outbreak; laboratory testing is more specific than self-reported key worker beliefs in ascertaining past COVID-19 disease.

Original language	English
Pages (from-to)	151-161
Number of pages	11
Journal	Journal of Infection
Volume	82
Issue number	5
Early online date	26 Mar 2021
DOIs	https://doi.org/10.1016/j.jinf.2021.03.019
Publication status	Published - May 2021

Bibliographical note

Funding Information: The study was funded by Public Health England and supported by the NIHR Clinical Research Network (CRN) Portfolio.

Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Publisher Copyright: Crown Copyright © 2021 Published by Elsevier Ltd on behalf of The British Infection Association.

Citation: Mulchandani, Ranya, et al. "Association between self-reported signs and symptoms and SARS-CoV-2 antibody detection in UK key workers." Journal of Infection (2021).

DOI: https://doi.org/10.1016/j.jinf.2021.03.019

Keywords

Antibodies
Covid-19
Symptoms
United kingdom
serology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Mulchandani2021AssociationBetweenSelf-ReportedSignsAndSymptomsJInfectFinal published version, 2.54 MBLicence: CC BY-NC-ND

Cite this

Mulchandani, R., Taylor-Philips, S., Jones, H. E., Ades, A. E., Borrow, R., Linley, E., Kirwan, P., Stewart, R., Moore, P., Boyes, J., Hormis, A., Todd, N., Colda, A., Reckless, I., Brooks, T., Charlett, A., Hickman, M., Oliver, I., & Wyllie, D. (2021). Association between self-reported signs and symptoms and SARS-CoV-2 antibody detection in UK key workers. Journal of Infection, 82(5), 151-161. https://doi.org/10.1016/j.jinf.2021.03.019

@article{cb86c580d02a45daadb0f9c27ad7d15f,

title = "Association between self-reported signs and symptoms and SARS-CoV-2 antibody detection in UK key workers",

abstract = "Background: Screening for SARS-CoV-2 antibodies is under way in some key worker groups; how this adds to self-reported COVID-19 illness is unclear. In this study, we investigate the association between self-reported belief of COVID-19 illness and seropositivity. Methods: Cross-sectional study of three key worker streams comprising (A) Police and Fire \& Rescue (2 sites) (B) healthcare workers (1 site) and (C) healthcare workers with previously positive PCR result (5 sites). We collected self-reported signs and symptoms of COVID-19 and compared this with serology results from two SARS-CoV-2 immunoassays (Roche Elecsys{\textregistered} and EUROIMMUN). Results: Between 01 and 26 June, we recruited 2847 individuals (Stream A: 1,247, Stream B: 1,546 and Stream C: 154). Amongst those without previous positive PCR tests, 687/2,579 (26\%) reported belief they had COVID-19, having experienced compatible symptoms; however, only 208 (30.3\%) of these were seropositive on both immunoassays. Both immunoassays had high sensitivities relative to previous PCR positivity (>93\%); there was also limited decline in antibody titres up to 110 days post symptom onset. Symptomatic but seronegative individuals had differing symptom profiles and shorter illnesses than seropositive individuals. Conclusion: Non-COVID-19 respiratory illness may have been mistaken for COVID-19 during the outbreak; laboratory testing is more specific than self-reported key worker beliefs in ascertaining past COVID-19 disease.",

keywords = "Antibodies, Covid-19, Symptoms, United kingdom, serology",

author = "Ranya Mulchandani and Sian Taylor-Philips and Jones, \{Hayley E.\} and Ades, \{A. E.\} and Raymond Borrow and Ezra Linley and Peter Kirwan and Richard Stewart and Philippa Moore and John Boyes and Anil Hormis and Neil Todd and Antoanela Colda and Ian Reckless and Tim Brooks and Andre Charlett and Matthew Hickman and Isabel Oliver and David Wyllie",

note = "Funding Information: The study was funded by Public Health England and supported by the NIHR Clinical Research Network (CRN) Portfolio. Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) Publisher Copyright: Crown Copyright {\textcopyright} 2021 Published by Elsevier Ltd on behalf of The British Infection Association. Citation: Mulchandani, Ranya, et al. {"}Association between self-reported signs and symptoms and SARS-CoV-2 antibody detection in UK key workers.{"} Journal of Infection (2021). DOI: https://doi.org/10.1016/j.jinf.2021.03.019 ",

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doi = "10.1016/j.jinf.2021.03.019",

language = "English",

volume = "82",

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journal = "Journal of Infection",

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Mulchandani, R, Taylor-Philips, S, Jones, HE, Ades, AE, Borrow, R , Linley, E , Kirwan, P, Stewart, R, Moore, P, Boyes, J, Hormis, A, Todd, N, Colda, A, Reckless, I, Brooks, T, Charlett, A, Hickman, M, Oliver, I & Wyllie, D 2021, 'Association between self-reported signs and symptoms and SARS-CoV-2 antibody detection in UK key workers', Journal of Infection, vol. 82, no. 5, pp. 151-161. https://doi.org/10.1016/j.jinf.2021.03.019

TY - JOUR

T1 - Association between self-reported signs and symptoms and SARS-CoV-2 antibody detection in UK key workers

AU - Mulchandani, Ranya

AU - Taylor-Philips, Sian

AU - Jones, Hayley E.

AU - Ades, A. E.

AU - Borrow, Raymond

AU - Linley, Ezra

AU - Kirwan, Peter

AU - Stewart, Richard

AU - Moore, Philippa

AU - Boyes, John

AU - Hormis, Anil

AU - Todd, Neil

AU - Colda, Antoanela

AU - Reckless, Ian

AU - Brooks, Tim

AU - Charlett, Andre

AU - Hickman, Matthew

AU - Oliver, Isabel

AU - Wyllie, David

N1 - Funding Information: The study was funded by Public Health England and supported by the NIHR Clinical Research Network (CRN) Portfolio. Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) Publisher Copyright: Crown Copyright © 2021 Published by Elsevier Ltd on behalf of The British Infection Association. Citation: Mulchandani, Ranya, et al. "Association between self-reported signs and symptoms and SARS-CoV-2 antibody detection in UK key workers." Journal of Infection (2021). DOI: https://doi.org/10.1016/j.jinf.2021.03.019

PY - 2021/5

Y1 - 2021/5

N2 - Background: Screening for SARS-CoV-2 antibodies is under way in some key worker groups; how this adds to self-reported COVID-19 illness is unclear. In this study, we investigate the association between self-reported belief of COVID-19 illness and seropositivity. Methods: Cross-sectional study of three key worker streams comprising (A) Police and Fire & Rescue (2 sites) (B) healthcare workers (1 site) and (C) healthcare workers with previously positive PCR result (5 sites). We collected self-reported signs and symptoms of COVID-19 and compared this with serology results from two SARS-CoV-2 immunoassays (Roche Elecsys® and EUROIMMUN). Results: Between 01 and 26 June, we recruited 2847 individuals (Stream A: 1,247, Stream B: 1,546 and Stream C: 154). Amongst those without previous positive PCR tests, 687/2,579 (26%) reported belief they had COVID-19, having experienced compatible symptoms; however, only 208 (30.3%) of these were seropositive on both immunoassays. Both immunoassays had high sensitivities relative to previous PCR positivity (>93%); there was also limited decline in antibody titres up to 110 days post symptom onset. Symptomatic but seronegative individuals had differing symptom profiles and shorter illnesses than seropositive individuals. Conclusion: Non-COVID-19 respiratory illness may have been mistaken for COVID-19 during the outbreak; laboratory testing is more specific than self-reported key worker beliefs in ascertaining past COVID-19 disease.

AB - Background: Screening for SARS-CoV-2 antibodies is under way in some key worker groups; how this adds to self-reported COVID-19 illness is unclear. In this study, we investigate the association between self-reported belief of COVID-19 illness and seropositivity. Methods: Cross-sectional study of three key worker streams comprising (A) Police and Fire & Rescue (2 sites) (B) healthcare workers (1 site) and (C) healthcare workers with previously positive PCR result (5 sites). We collected self-reported signs and symptoms of COVID-19 and compared this with serology results from two SARS-CoV-2 immunoassays (Roche Elecsys® and EUROIMMUN). Results: Between 01 and 26 June, we recruited 2847 individuals (Stream A: 1,247, Stream B: 1,546 and Stream C: 154). Amongst those without previous positive PCR tests, 687/2,579 (26%) reported belief they had COVID-19, having experienced compatible symptoms; however, only 208 (30.3%) of these were seropositive on both immunoassays. Both immunoassays had high sensitivities relative to previous PCR positivity (>93%); there was also limited decline in antibody titres up to 110 days post symptom onset. Symptomatic but seronegative individuals had differing symptom profiles and shorter illnesses than seropositive individuals. Conclusion: Non-COVID-19 respiratory illness may have been mistaken for COVID-19 during the outbreak; laboratory testing is more specific than self-reported key worker beliefs in ascertaining past COVID-19 disease.

KW - Antibodies

KW - Covid-19

KW - Symptoms

KW - United kingdom

KW - serology

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U2 - 10.1016/j.jinf.2021.03.019

DO - 10.1016/j.jinf.2021.03.019

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C2 - 33775704

AN - SCOPUS:85103952091

SN - 0163-4453

VL - 82

SP - 151

EP - 161

JO - Journal of Infection

JF - Journal of Infection

IS - 5

ER -

Association between self-reported signs and symptoms and SARS-CoV-2 antibody detection in UK key workers

Abstract

Bibliographical note

Keywords

UN SDGs

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