Longitudinal assessment of symptoms and risk of SARS-CoV-2 infection in healthcare workers across 5 hospitals to understand ethnic differences in infection risk.

Ana M. Valdes; James C. Moon; Amrita Vijay; Nish Chaturvedi; Alan Norrish; Adeel Ikram; Simon Craxford; Lola M.L. Cusin; Jessica Nightingale; Amanda Semper; Timothy Brooks; Aine McKnight; Hibba Kurdi; Cristina Menni; Patrick Tighe; Mahdad Noursadeghi; Guruprasad Aithal; Thomas A. Treibel; Benjamin J. Ollivere; Charlotte Manisty

doi:10.1016/j.eclinm.2021.100835

Longitudinal assessment of symptoms and risk of SARS-CoV-2 infection in healthcare workers across 5 hospitals to understand ethnic differences in infection risk.

Ana M. Valdes^*, James C. Moon, Amrita Vijay, Nish Chaturvedi, Alan Norrish, Adeel Ikram, Simon Craxford, Lola M.L. Cusin, Jessica Nightingale, Amanda Semper, Timothy Brooks, Aine McKnight, Hibba Kurdi, Cristina Menni, Patrick Tighe, Mahdad Noursadeghi, Guruprasad Aithal, Thomas A. Treibel, Benjamin J. Ollivere, Charlotte Manisty

^*Corresponding author for this work

Porton Emerging Infections & Zoonosis

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

16 Citations (Scopus)

Abstract

Background: : Healthcare workers (HCWs) have increased rates of SARS-CoV-2 infection compared with the general population. We aimed to understand ethnic differences in SARS-CoV-2 seropositivity among hospital healthcare workers depending on their hospital role, socioeconomic status, Covid-19 symptoms and basic demographics.

Methods: A prospective longitudinal observational cohort study. 1364 HCWs at five UK hospitals were studied with up to 16 weeks of symptom questionnaires and antibody testing (to both nucleocapsid and spike protein) during the first UK wave in five NHS hospitals between March 20 and July 10 2020. The main outcome measures were SARS-CoV-2 infection (seropositivity at any time-point) and symptoms.

Findings: 272 of 1364 HCWs (mean age 40.7 years, 72% female, 74% White, >= 6 samples per participant) seroconverted, reporting predominantly mild or no symptoms. Seropositivity was lower in Intensive Therapy Unit (ITU) workers (OR=0.44 95%CI 0.24, 0.77; p=0.0035). Seropositivity was higher in Black (compared to White) participants, independent of age, sex, role and index of multiple deprivation (OR=2.61 95%CI 1.474.62 p=0.0009). No association was seen between White HCWs and other minority ethnic groups.

Interpretation: In the UK first wave, Black ethnicity (but not other ethnicities) more than doubled HCWs likelihood of seropositivity, independent of age, sex, measured socio-economic factors and hospital role. (C) 2021 Published by Elsevier Ltd.

Original language	English
Article number	100835
Number of pages	8
Journal	EClinicalMedicine
Volume	34
DOIs	https://doi.org/10.1016/j.eclinm.2021.100835
Publication status	Published - Apr 2021

Bibliographical note

Funding Information:
Funding for the PANTHER study was from the UKRI/MRC (Cov-0331 - MR/V027883/1), with additional institutional support from the Nottingham NIHR BRC. Funding for COVIDsortium was donated by individuals, charitable Trusts, and corporations including Goldman Sachs, Citadel and Citadel Securities, The Guy Foundation, GW Pharmaceuticals, Kusuma Trust, and Jagclif Charitable Trust, and enabled by Barts Charity with support from UCLH Charity. Wider support is acknowledged on the COVIDsortium website. Serology tests (anti-S1 and anti-NP) were funded by Public Health England. JCM, CMa and TAT are directly and indirectly supported by the University College London Hospitals (UCLH) and Barts NIHR Biomedical Research Centres and through the British Heart Foundation (BHF) Accelerator Award (AA/18/6/34223). TAT is funded by a BHF Intermediate Research Fellowship (FS/19/35/34374). MN is supported by the Wellcome Trust (207511/Z/17/Z) and by NIHR Biomedical Research Funding to UCL and UCLH. C Menni is supported by the Chronic Disease Research Foundation (CDRF).

Funding Information:
Funding: PANTHER study funded from the UKRI/MRC (Cov-0331 - MR/V027883/1), with additional institutional support from the Nottingham NIHR BRC. Funding for COVIDsortium was donated by individuals, charitable Trusts and corporations. Institutional support from Barts Health NHS Trust and Royal Free NHS Foundation Trust facilitated study processes, in partnership with University College London and Queen Mary University London.

Funding Information:
Dr. Norrish reports grants from Medical Research Council, COVID-19 Rapid Response Rolling Call, during the conduct of the study; personal fees from AOTrauma, personal fees from LINK Orthopaedics, outside the submitted work. Dr. Chaturvedi reports grants from Medical Research Council, grants from UKRI, personal fees from AstraZeneca, outside the submitted work. All other authors have nothing to declare.

Funding Information:
Funding: PANTHER study funded from the UKRI/MRC (Cov-0331 - MR/V027883/1), with additional institutional support from the Nottingham NIHR BRC. Funding for COVIDsortium was donated by individuals, charitable Trusts and corporations. Institutional support from Barts Health NHS Trust and Royal Free NHS Foundation Trust facilitated study processes, in partnership with University College London and Queen Mary University London.

Publisher Copyright:
© 2021

Keywords

Covid-19
Healthcare workers
ethnicity
seropositivity

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10.1016/j.eclinm.2021.100835

Cite this

Valdes, A. M., Moon, J. C., Vijay, A., Chaturvedi, N., Norrish, A., Ikram, A., Craxford, S., Cusin, L. M. L., Nightingale, J., Semper, A., Brooks, T., McKnight, A., Kurdi, H., Menni, C., Tighe, P., Noursadeghi, M., Aithal, G., Treibel, T. A., Ollivere, B. J., & Manisty, C. (2021). Longitudinal assessment of symptoms and risk of SARS-CoV-2 infection in healthcare workers across 5 hospitals to understand ethnic differences in infection risk. EClinicalMedicine, 34, Article 100835. https://doi.org/10.1016/j.eclinm.2021.100835

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title = "Longitudinal assessment of symptoms and risk of SARS-CoV-2 infection in healthcare workers across 5 hospitals to understand ethnic differences in infection risk.",

abstract = "Background: : Healthcare workers (HCWs) have increased rates of SARS-CoV-2 infection compared with the general population. We aimed to understand ethnic differences in SARS-CoV-2 seropositivity among hospital healthcare workers depending on their hospital role, socioeconomic status, Covid-19 symptoms and basic demographics.Methods: A prospective longitudinal observational cohort study. 1364 HCWs at five UK hospitals were studied with up to 16 weeks of symptom questionnaires and antibody testing (to both nucleocapsid and spike protein) during the first UK wave in five NHS hospitals between March 20 and July 10 2020. The main outcome measures were SARS-CoV-2 infection (seropositivity at any time-point) and symptoms.Findings: 272 of 1364 HCWs (mean age 40.7 years, 72% female, 74% White, >= 6 samples per participant) seroconverted, reporting predominantly mild or no symptoms. Seropositivity was lower in Intensive Therapy Unit (ITU) workers (OR=0.44 95%CI 0.24, 0.77; p=0.0035). Seropositivity was higher in Black (compared to White) participants, independent of age, sex, role and index of multiple deprivation (OR=2.61 95%CI 1.474.62 p=0.0009). No association was seen between White HCWs and other minority ethnic groups.Interpretation: In the UK first wave, Black ethnicity (but not other ethnicities) more than doubled HCWs likelihood of seropositivity, independent of age, sex, measured socio-economic factors and hospital role. (C) 2021 Published by Elsevier Ltd.",

keywords = "Covid-19, Healthcare workers, ethnicity, seropositivity",

author = "Valdes, {Ana M.} and Moon, {James C.} and Amrita Vijay and Nish Chaturvedi and Alan Norrish and Adeel Ikram and Simon Craxford and Cusin, {Lola M.L.} and Jessica Nightingale and Amanda Semper and Timothy Brooks and Aine McKnight and Hibba Kurdi and Cristina Menni and Patrick Tighe and Mahdad Noursadeghi and Guruprasad Aithal and Treibel, {Thomas A.} and Ollivere, {Benjamin J.} and Charlotte Manisty",

note = "Funding Information: Funding for the PANTHER study was from the UKRI/MRC (Cov-0331 - MR/V027883/1), with additional institutional support from the Nottingham NIHR BRC. Funding for COVIDsortium was donated by individuals, charitable Trusts, and corporations including Goldman Sachs, Citadel and Citadel Securities, The Guy Foundation, GW Pharmaceuticals, Kusuma Trust, and Jagclif Charitable Trust, and enabled by Barts Charity with support from UCLH Charity. Wider support is acknowledged on the COVIDsortium website. Serology tests (anti-S1 and anti-NP) were funded by Public Health England. JCM, CMa and TAT are directly and indirectly supported by the University College London Hospitals (UCLH) and Barts NIHR Biomedical Research Centres and through the British Heart Foundation (BHF) Accelerator Award (AA/18/6/34223). TAT is funded by a BHF Intermediate Research Fellowship (FS/19/35/34374). MN is supported by the Wellcome Trust (207511/Z/17/Z) and by NIHR Biomedical Research Funding to UCL and UCLH. C Menni is supported by the Chronic Disease Research Foundation (CDRF). Funding Information: Funding: PANTHER study funded from the UKRI/MRC (Cov-0331 - MR/V027883/1), with additional institutional support from the Nottingham NIHR BRC. Funding for COVIDsortium was donated by individuals, charitable Trusts and corporations. Institutional support from Barts Health NHS Trust and Royal Free NHS Foundation Trust facilitated study processes, in partnership with University College London and Queen Mary University London. Funding Information: Dr. Norrish reports grants from Medical Research Council, COVID-19 Rapid Response Rolling Call, during the conduct of the study; personal fees from AOTrauma, personal fees from LINK Orthopaedics, outside the submitted work. Dr. Chaturvedi reports grants from Medical Research Council, grants from UKRI, personal fees from AstraZeneca, outside the submitted work. All other authors have nothing to declare. Funding Information: Funding: PANTHER study funded from the UKRI/MRC (Cov-0331 - MR/V027883/1), with additional institutional support from the Nottingham NIHR BRC. Funding for COVIDsortium was donated by individuals, charitable Trusts and corporations. Institutional support from Barts Health NHS Trust and Royal Free NHS Foundation Trust facilitated study processes, in partnership with University College London and Queen Mary University London. Publisher Copyright: {\textcopyright} 2021",

year = "2021",

month = apr,

doi = "10.1016/j.eclinm.2021.100835",

language = "English",

volume = "34",

journal = "EClinicalMedicine",

issn = "2589-5370",

publisher = "Elsevier Ltd.",

}

Valdes, AM, Moon, JC, Vijay, A, Chaturvedi, N, Norrish, A, Ikram, A, Craxford, S, Cusin, LML, Nightingale, J, Semper, A , Brooks, T, McKnight, A, Kurdi, H, Menni, C, Tighe, P, Noursadeghi, M, Aithal, G, Treibel, TA, Ollivere, BJ & Manisty, C 2021, 'Longitudinal assessment of symptoms and risk of SARS-CoV-2 infection in healthcare workers across 5 hospitals to understand ethnic differences in infection risk.', EClinicalMedicine, vol. 34, 100835. https://doi.org/10.1016/j.eclinm.2021.100835

TY - JOUR

T1 - Longitudinal assessment of symptoms and risk of SARS-CoV-2 infection in healthcare workers across 5 hospitals to understand ethnic differences in infection risk.

AU - Valdes, Ana M.

AU - Moon, James C.

AU - Vijay, Amrita

AU - Chaturvedi, Nish

AU - Norrish, Alan

AU - Ikram, Adeel

AU - Craxford, Simon

AU - Cusin, Lola M.L.

AU - Nightingale, Jessica

AU - Semper, Amanda

AU - Brooks, Timothy

AU - McKnight, Aine

AU - Kurdi, Hibba

AU - Menni, Cristina

AU - Tighe, Patrick

AU - Noursadeghi, Mahdad

AU - Aithal, Guruprasad

AU - Treibel, Thomas A.

AU - Ollivere, Benjamin J.

AU - Manisty, Charlotte

N1 - Funding Information: Funding for the PANTHER study was from the UKRI/MRC (Cov-0331 - MR/V027883/1), with additional institutional support from the Nottingham NIHR BRC. Funding for COVIDsortium was donated by individuals, charitable Trusts, and corporations including Goldman Sachs, Citadel and Citadel Securities, The Guy Foundation, GW Pharmaceuticals, Kusuma Trust, and Jagclif Charitable Trust, and enabled by Barts Charity with support from UCLH Charity. Wider support is acknowledged on the COVIDsortium website. Serology tests (anti-S1 and anti-NP) were funded by Public Health England. JCM, CMa and TAT are directly and indirectly supported by the University College London Hospitals (UCLH) and Barts NIHR Biomedical Research Centres and through the British Heart Foundation (BHF) Accelerator Award (AA/18/6/34223). TAT is funded by a BHF Intermediate Research Fellowship (FS/19/35/34374). MN is supported by the Wellcome Trust (207511/Z/17/Z) and by NIHR Biomedical Research Funding to UCL and UCLH. C Menni is supported by the Chronic Disease Research Foundation (CDRF). Funding Information: Funding: PANTHER study funded from the UKRI/MRC (Cov-0331 - MR/V027883/1), with additional institutional support from the Nottingham NIHR BRC. Funding for COVIDsortium was donated by individuals, charitable Trusts and corporations. Institutional support from Barts Health NHS Trust and Royal Free NHS Foundation Trust facilitated study processes, in partnership with University College London and Queen Mary University London. Funding Information: Dr. Norrish reports grants from Medical Research Council, COVID-19 Rapid Response Rolling Call, during the conduct of the study; personal fees from AOTrauma, personal fees from LINK Orthopaedics, outside the submitted work. Dr. Chaturvedi reports grants from Medical Research Council, grants from UKRI, personal fees from AstraZeneca, outside the submitted work. All other authors have nothing to declare. Funding Information: Funding: PANTHER study funded from the UKRI/MRC (Cov-0331 - MR/V027883/1), with additional institutional support from the Nottingham NIHR BRC. Funding for COVIDsortium was donated by individuals, charitable Trusts and corporations. Institutional support from Barts Health NHS Trust and Royal Free NHS Foundation Trust facilitated study processes, in partnership with University College London and Queen Mary University London. Publisher Copyright: © 2021

PY - 2021/4

Y1 - 2021/4

N2 - Background: : Healthcare workers (HCWs) have increased rates of SARS-CoV-2 infection compared with the general population. We aimed to understand ethnic differences in SARS-CoV-2 seropositivity among hospital healthcare workers depending on their hospital role, socioeconomic status, Covid-19 symptoms and basic demographics.Methods: A prospective longitudinal observational cohort study. 1364 HCWs at five UK hospitals were studied with up to 16 weeks of symptom questionnaires and antibody testing (to both nucleocapsid and spike protein) during the first UK wave in five NHS hospitals between March 20 and July 10 2020. The main outcome measures were SARS-CoV-2 infection (seropositivity at any time-point) and symptoms.Findings: 272 of 1364 HCWs (mean age 40.7 years, 72% female, 74% White, >= 6 samples per participant) seroconverted, reporting predominantly mild or no symptoms. Seropositivity was lower in Intensive Therapy Unit (ITU) workers (OR=0.44 95%CI 0.24, 0.77; p=0.0035). Seropositivity was higher in Black (compared to White) participants, independent of age, sex, role and index of multiple deprivation (OR=2.61 95%CI 1.474.62 p=0.0009). No association was seen between White HCWs and other minority ethnic groups.Interpretation: In the UK first wave, Black ethnicity (but not other ethnicities) more than doubled HCWs likelihood of seropositivity, independent of age, sex, measured socio-economic factors and hospital role. (C) 2021 Published by Elsevier Ltd.

AB - Background: : Healthcare workers (HCWs) have increased rates of SARS-CoV-2 infection compared with the general population. We aimed to understand ethnic differences in SARS-CoV-2 seropositivity among hospital healthcare workers depending on their hospital role, socioeconomic status, Covid-19 symptoms and basic demographics.Methods: A prospective longitudinal observational cohort study. 1364 HCWs at five UK hospitals were studied with up to 16 weeks of symptom questionnaires and antibody testing (to both nucleocapsid and spike protein) during the first UK wave in five NHS hospitals between March 20 and July 10 2020. The main outcome measures were SARS-CoV-2 infection (seropositivity at any time-point) and symptoms.Findings: 272 of 1364 HCWs (mean age 40.7 years, 72% female, 74% White, >= 6 samples per participant) seroconverted, reporting predominantly mild or no symptoms. Seropositivity was lower in Intensive Therapy Unit (ITU) workers (OR=0.44 95%CI 0.24, 0.77; p=0.0035). Seropositivity was higher in Black (compared to White) participants, independent of age, sex, role and index of multiple deprivation (OR=2.61 95%CI 1.474.62 p=0.0009). No association was seen between White HCWs and other minority ethnic groups.Interpretation: In the UK first wave, Black ethnicity (but not other ethnicities) more than doubled HCWs likelihood of seropositivity, independent of age, sex, measured socio-economic factors and hospital role. (C) 2021 Published by Elsevier Ltd.

KW - Covid-19

KW - Healthcare workers

KW - ethnicity

KW - seropositivity

UR - http://www.scopus.com/inward/record.url?scp=85104364615&partnerID=8YFLogxK

U2 - 10.1016/j.eclinm.2021.100835

DO - 10.1016/j.eclinm.2021.100835

M3 - Article

AN - SCOPUS:85104364615

SN - 2589-5370

VL - 34

JO - EClinicalMedicine

JF - EClinicalMedicine

M1 - 100835

ER -

Longitudinal assessment of symptoms and risk of SARS-CoV-2 infection in healthcare workers across 5 hospitals to understand ethnic differences in infection risk.

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