Snapshot PCR surveillance for SARS-CoV-2 in hospital staff in England

Colin Brown*, Kathryn Clare, Meera Chand-Kumar, Julie Andrews, Cressida Auckland, Sarah Beshir, Saher Choudhry, Kerrie Davies, Jane Freeman, Andrew Gallini, Rachel Moores, Trupti Patel, Gosia Poznalska, Alison Rodger, Stella Roberts, Christopher Rooney, Mark Wilcox, Simon Warren, Joanna Ellis, Robin GopalWilliam Dunning, Maria Zambon, Susan Hopkins

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)

Abstract

Background: Significant nosocomial transmission of SARS-CoV-2 has been demonstrated. Understanding the prevalence of SARS-CoV-2 carriage amongst HCWs at work is necessary to inform the development of HCW screening programmes to control nosocomial spread. Methods: Cross-sectional ‘snapshot’ survey from April-May 2020; HCWs recruited from six UK hospitals. Participants self-completed a health questionnaire and underwent a combined viral nose and throat swab, tested by Polymerase Chain Reaction (PCR) for SARS-CoV-2 with viral culture on majority of positive samples. Findings: Point prevalence of SARS-CoV-2 carriage across the sites was 2.0% (23/1152 participants), median cycle threshold value 35.70 (IQR:32.42–37.57). 17 were previously symptomatic, two currently symptomatic (isolated anosmia and sore throat); the remainder declared no prior or current symptoms. Symptoms in the past month were associated with threefold increased odds of testing positive (aOR 3.46, 95%CI 1.38–8.67; p = 0.008). SARS-CoV-2 virus was isolated from only one (5%) of nineteen cultured samples. A large proportion (39%) of participants reported symptoms in the past month. Interpretation: The point-prevalence is similar to previous estimates for HCWs in April 2020, though a magnitude higher than in the general population. Based upon interpretation of symptom history and testing results including viral culture, the majority of those testing positive were unlikely to be infectious at time of sampling. Development of screening programmes must balance the potential to identify additional cases based upon likely prevalence, expanding the symptoms list to encourage HCW testing, with resource implications and risks of excluding those unlikely to be infectious with positive tests. Funding: Public Health England.

Original languageEnglish
Pages (from-to)427-434
Number of pages8
JournalJournal of Infection
Volume81
Issue number3
DOIs
Publication statusPublished - Sep 2020

Bibliographical note

Funding Information:
Public Health England (Mary Ramsay, Vanessa Saliba, Julie Robotham, Rifat Sofoo, Maria Kephalas, Mehdi Minaji, Joanna Connelly, Nandini Shetty, Steve Harbour, Lynne Foster, Gwyn Morris), Whittington Hospital (Helena Rochford, Joseph Grant, Matt Kinsella, Becky Lai, Neil Jones, Naina McCann), Leeds Teaching Hospital Trust (Phillip Wood), Royal Marsden Hospital (Pat Cattini), Royal National Orthopaedic Hospital (Iva Hauptmannova, Deidre Brooking, Andrew Symonds, Esther Hanison), Royal Devon & Exeter NHS Foundation Trust (Helen Quinn, Stephanie Estcourt, RDE Research & Development Team), Hospital of St John & St Elizabeth (Jozanne Bates, Giovanni D Stefano), Royal Free Hospital (Stephen Mepham, Clare Warrell, Aoife Malloy, Tehmi Bharucha, Nate Lee, Joe Jacobs). All of the staff across the sites who helped with logistics, planning, and operational running of the snapshot survey.

Publisher Copyright:
© 2020

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

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