Seroprevalence of SARS-CoV-2 antibodies and associated factors in health care workers: a systematic review and meta-analysis

Abstract

SummaryBackgroundHealth care workers (HCWs) represent a high risk population for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.AimTo determine the seroprevalence of SARS-CoV-2 antibodies among HCWs, and to find out the factors that are associated with this seroprevalence.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were applied for this systematic review and meta-analysis. Databases including PubMed/MEDLINE and pre-print services (medRχiv and bioRχiv) were searched from inception up to August 24, 2020.FindingsForty-nine studies, including 127,480 HCWs met the inclusion criteria. The estimated overall seroprevalence of SARS-CoV-2 antibodies among HCWs was 8.7% (95% CI: 6.7-10.9%). Seroprevalence was higher in studies that were conducted in North America (12.7%) compared to those in Europe (8.5%), Africa (8.2), and Asia (4%). Meta-regression showed that increased sensitivity of antibodies test was associated with increased seroprevalence. The following factors were associated with seropositivity: male gender, Black, Asian, and Hispanic HCWs, work in a coronavirus disease 2019 (COVID-19) unit, patient-related work, frontline health care workers, health care assistants, personal protective equipment shortage, self-reported belief for previous SARS-CoV-2 infection, previous positive polymerase chain reaction test, and household contact with suspected or confirmed COVID-19 patients.ConclusionThe seroprevalence of SARS-CoV-2 antibodies among HCWs is high. Excellent adherence to infection prevention and control measures, sufficient and adequate personal protective equipment, and early recognition, identification and isolation of HCWs that are infected with SARS-CoV-2 are imperative to decrease the risk of SARS-CoV-2 infection.