Türkiye’de bir üçüncü basamak hastanede sağlık çalışanlarında SARS-CoV-2 seroprevalansı

Year 2022, Volume: 20 Issue: 1, 117 - 128, 01.04.2022

Erhan Eser , Sebnem Senol , Sinem Akçalı , Talat Ecemiş , Pınar Dündar , Kübra Çiçek , Damla Akman , Ecem Tüzün , Gülsüm Şanlı Erkekoğlu , Zeynep Buran , Zeynep Öztürk , Ferya Karadağ

https://doi.org/10.20518/tjph.981404

Abstract

Amaç: Bu çalışmanın amacı, salgının ilk dalgasında (Mart-Temmuz 2020) Türkiye’deki bir üniversite hastanesinde sağlık çalışanlarının SARS-CoV-2 enfeksiyon sıklığı ve seroprevalansını araştırmaktır. Yöntem: Bu çalışma, Türkiye’deki salgının ilk aşamasında (Mart-Temmuz 2020) üçüncü basamak bir hastanedeki çalışan sağlık çalışanlarında yapılan SARS-CoV-2 seroprevalans çalışmasıdır. Virüsün spike yapısına karşı IgM ve IgG antikorların varlığı Kemilüminesan enzim immünoassay (CLIA) yöntemi ile hazır ticari antikor kiti (COV2T, Siemens®, Tarrytown, NY, US), kullanılarak araştırılmıştır. Katılımcıların sosyodemografik özellikleri, sağlık durumu, yaşam tarzı, sosyal ve mesleki riskli davranışları, kişisel koruyucu ekipman (KKE) kullanımı çalışmanın bağımsız değişkenleridir. Tek değişkenli analizlerde Ki-kare ve Fisher’in kesin testi kullanılmış ve tip 1 hata değeri 0.05 olarak kabul edilmiştir. Analizler SPSS 23.0 paket programı kullanılarak yapılmıştır. Bulgular : Toplam 1702 sağlık çalışanından 1177’si çalışmaya katılmış, katılım oranı %69.1 olarak gerçekleştirilmiştir. Çalışma grubunun yaş ortalaması 35.3 ± 9.8 , %62.7’si kadındır. Nükleik asit amplifikasyon testi (NAAT-PCR) veya antikor testi (Elisa) ile tespit edilen SARS-CoV-2 enfeksiyon sıklığı (18/1177) %1.5; SARS-CoV-2’nin seroprevalansı %1.01’dir. Tüm SARS -CoV-2 vakalarının %17’si asemptomatiktir. En yüksek enfeksiyon prevalansı yardımcı sağlık çalışanlarında (%3.7) diğer gruplara göre anlamlı olarak daha yüksektir. Son 15 gün içinde sağlık çalışanları ve aile bireylerinde herhangi bir semptom olmaması, aşırı kilolu veya obez olması ve sürveyans birimine temaslı kişi olarak başvurmuş olması SARS-CoV-2 enfeksiyonu arasında anlamlı düzeyde ilişkilidir (p<0.05). Sonuç: Salgının ilk aşamasında enfeksiyon oranı ve seroprevalans düşüktür. Düşük eğitim seviyesi ve obez olmak, sağlık çalışanlarında SARS-CoV-2 ile enfekte olma olasılığını artmaktadır.

Keywords

SARS -CoV-2, sağlık çalışanları, seroprevalans çalışmaları, enfeksiyon, Türkiye

SARS-CoV-2 seroprevalence in health care workers in a third level hospital in Turkey

Abstract

Objective: The aim of this study is to investigate the previous four months (March-July 2020) SARS-CoV-2 infection rate, seroprevalence and the variables affecting these in HCWs in a university hospital. Methods: The present study is a SARS-CoV-2 seroprevalence study on HCWs working in a tertiary hospital during the first stage (March-July 2020) of the outbreak in Turkey. The presence of IgM and IgG antibodies against the spike structure of the virus was investigated by the chemiluminescent enzyme immunoassay (CLIA) method using the commercial antibody kit (COV2T, Siemens®, Tarrytown, NY, US). Participants’ socio-demographic characteristics, health status, lifestyle, risky occupational and social and personal protective equipment (PPE) usage were independent variables of the study. Chi-square test and Fisher’s exact test were used in univariate analyzes, and accepted type 1 error value was 0.05. The analyzes were made using the SPSS 23.0 package program. Results: 1177 out of a total of 1702 health workers participated in the study. Participation rate was 69.1% . The mean age of the study group was 35.3 ± 9.8 and 62.7% were females. SARS-CoV-2 infection rate detected by nucleic acid amplification test (NAAT-PCR) or antibody test (Elisa) was (18/1177) 1.5%; The seroprevalence of SARS-CoV-2 was 1.01%. 17% of the entire SARS-CoV-2 cases were asymptomatic. The highest infection prevalence was significantly higher in auxiliary health workers (3.7%) compared to other groups. The presence of symptoms HCW’s and their family members that did not exist before in the last 15 days, being overweight or obese and consulting as contacted person in survelliance unit were significantly related to having SARS-CoV-2 infection (p<0.05). Conclusion: The infection rate and seroprevalence was low in the first stage of the outbreak. Low level of education and being obese increase possibility of infected by SARS-CoV-2 in HCWs.

Keywords

SARS-CoV-2, health personnel, seroepidemiologic studies, infections, Turkey

References

• Marklund E, Leach S, Axelsson H, et al. Serum-IgG responses to SARS-CoV-2 after mild and severe COVID-19 infection and analysis of IgG non-responders. PLoS ONE 2020;15(10): e0241104.
• Wu F, Liu M, Wang A, et al. Evaluating the association of clinical characteristics with neutralizing antibody levels in patients who have recovered from mild COVID-19 in Shanghai, China. JAMA Internal Medicine 2020;180(10):1356-1362.
• Patel MM, Thornburg NJ, Stubblefield WB, et al. Change in antibodies to SARS-CoV-2 over 60 days among health care personnel in Nashville, Tennessee. JAMA 2020;324(17):1781-82.
• Ibarrondo FJ, Fulcher JA, Goodman-Meza D, et al. Rapid decay of Anti–SARS-CoV-2 antibodies in persons with mild Covid-19. New England Journal of Medicine 2020;383(11):1085-1087.
• Petersen LR, Sami S, Mat NV, et al. Lack of antibodies to SARS-CoV-2 in a large cohort of previously infected persons. Clinical Infectious Diseases 2020.
• Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Seroprevalence of SARS-CoV-2 antibodies and associated factors in health care workers: a systematic review and meta-analysis. The Journal of Hospital Infection 2021;108:120-134.
• Sahu AK, Amrithanand VT, Mathew R, Aggarwal P, Nayer J, Bhoi S. COVID-19 in health care workers – A systematic review and meta-analysis. The American Journal of Emergency Medicine 2020;38(9):1727-1731.
• Woon JL, Lee YL, Chong YM, et al. Serology surveillance of anti-SARS-CoV-2 antibodies among asymptomatic healthcare workers in Malaysian healthcare facilities designated for COVID-19 care. Research Square 2020;1
• Goenka MK, Afzalpurkar S, Goenka U, et al. Seroprevalence of COVID-19 amongst health care workers in a tertiary care hospital of a metropolitan city from India. LANGLH-D-20-03363, The Lancet Regional Health - Western Pacific 2020;3: 100041.
• Korth J, Wilde B, Dolff S, et al. SARS-CoV-2-specific antibody detection in healthcare workers in Germany with direct contact to COVID-19 patients. Journal of Clinical Virology 2020;128:104437
• Schmidt SB, Grüter L, Boltzmann M, Rollnik JD. Prevalence of serum IgG antibodies against SARS-CoV-2 among clinic staff. PLoS ONE 2020;15(6):e0235417
• Shields AM, Faustini SE, Perez-Toledo M, et al. Pericarditis and myocarditis long after SARS-CoV-2 infection: a cross-sectional descriptive study in health-care workers. MedRxiv 2020.
• Pallett JC, Rayment M, Patel A, et al. Point-of-care serological assays for delayed SARS-CoV-2 case identification among health-care workers in the UK: a prospective multicentre cohort study. The Lancet Respiratory Medicine 2020;8(9):885–894.
• Xueqiu L, Wenfeng C, Lifen H, et al. Comparison of epidemic characteristics between SARS in 2003 and COVID-19 in 2020 in Guangzhou. Zhonghua Liuxingbingxue Zazhi 2020;41(5):634–637.
• Zhang J, Dong X, Cao Y, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy 2020;75(7):1730–1741.
• Güldaval F, Anar C, Gayaf M, et al. Clinical presentation of health care workers with symptoms of coronavirus disease 2019 at the İzmir tertiary education hospital, during an early phase of the pandemic. Tuberkuloz ve Toraks 2020;68(3):218-226.
• Celebi G, Piskin N, Beklevic AC, et al. Specific risk factors for SARS-CoV-2 transmission among health care workers in a university hospital. American Journal of Infection Control 2020;48(10):1225−1230.
• Pala SÇ, Metintaş S. COVID-19 Pandemisinde Sağlık Çalışanları. ESTÜDAM Halk Sağlığı Dergisi 2020;5:156-68.
• Hunter E, Price DA, Murphy E, et al. First experience of COVID-19 screening of health-care workers in England. The Lancet 2020;395(10234):77-78.
• Folgueira MD, Munoz-Ruiperez C, Alonso-Lopez MA, Delgado R. SARS-CoV-2 infection in Health Care Workers in a large public hospital in Madrid, Spain, during March 2020. MedRxiv 2020.
• Kluytmans-van den Bergh MFQ, Buiting AGM, Pas SD et al. Prevalence and Clinical Presentation of Health Care Workers With Symptoms of Coronavirus Disease 2019 in 2 Dutch Hospitals During an Early Phase of the Pandemic. Jama Network Open 2020;3(5):e209673.
• Paderno A, Fior M, Berretti G, et al. SARS-CoV-2 infection in healthcare workers: cross-sectional analysis of an otolaryngology unit. Sage Journals- Otolaryngology Head and Neck Surgery 2020;163(4):671-672.
• Garcia-Basteiro AL, Moncunill G, Tortajada M, et al. Seroprevalence of antibodies against SARS-CoV-2 among health care workers in a large Spanish reference hospital. Nature Communications 2020;11:3500.
• Lumley SF, O’Donnell D, Stoesser NE, et al. Antibody Status and Incidence of SARS-CoV-2 Infection in Health Care Workers. New England Journal of Medicine 2020;384:533-540.
• Moscola J, Sembajwe G, Jarrett M et al. Prevalence of SARS-CoV-2 antibodies in health care personnel in the New York City area. JAMA 2020;324(9):893-895.
• Durmaz S, Küçük EF, Şimşek S, Durgun K, Karakaş EB, Durusoy R. Outcomes of COVID-19 contact tracing in hospital healthcare workers: a retrospective cohort study. Journal of the Pakistan Medical Association. 2021.
• Marimuthu K, Koh V, Pang J, et al. SARS-CoV-2 seroprevalence and transmission risk factors among high-risk close contacts: a retrospective cohort study. The Lancet Infectious Diseases 2020;21(3):333-343.
• Hamera M, Kivimäki M, Gale CR, Batty GD. Lifestyle risk factors, inflammatory mechanisms, and COVID-19 hospitalization: A community-based cohort study of 387,109 adults in UK. Brain, Behavior, and Immunity 2020;87:184-187.
• Devaux M, Sassi F, Church J, Cecchini M, Borgonovi F. Exploring the relationship between education and obesity OECD Journal: Economic Studies 2011;1.
• Figueiredo AM, Figueiredo DC, Gomes LB et al. Social determinants of health and COVID-19 infection in Brazil: an analysis of the pandemic. Revista Brasileira de Enfermagem 2020;73: e20200673