Risk Factors for Being Seronegative following SARS-CoV-2 Infection in a Large Cohort of Health Care Workers in Denmark

Microbiology Spectrum

Sisse Bolm Ditlev¹  Christian Torp-Pedersen²  Rasmus Bo Hasselbalch³  Kasper Karmark Iversen³  Pernille Brok Nielsen³  Kamille Fogh³  Jonas Henrik Kristensen³  Fredrik Folke³  Jakob Boesgaard Norsk³  Mia Marie Pries-Heje⁴  Rasmus Møgelvang⁴  Claus Antonio Juul Jensen⁵  Erik Sørensen⁶  Mikkel Gybel-Brask⁶  Sisse R. Ostrowski⁶  Lene Holm Harritshøj⁶  Henning Bundgaard⁷  Ove Andersen⁷  Ram B. Dessau⁸  Thea Kølsen Fischer⁹  Caroline Klint Johannesen⁹  Jørgen Rungby^1,10  Frederik Neess Engsig^1,11  Maria Elizabeth Engel Møller^1,11  Curt Sten^1,12  Ida Hageman^1,13  Charlotte Sværke Jørgensen^1,14  Henrik Ullum^1,14  Andreas Dehlbæk Knudsen^1,15  Susanne Dam Nielsen^1,15  Omid Rezahosseini^1,15 

[1] Copenhagen Center for Translational Research, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Bispebjerg, Copenhagen, Denmark;Department of Cardiology and Clinical Research, Nordsjællands Hospital, Hillerød, Denmark;Department of Cardiology, Herlev og Gentofte Hospital, University of Copenhagen, Herlev, Denmark;Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark;Department of Clinical Biochemistry, Copenhagen University Hospital – Nordsjællands Hospital, Hillerød, Denmark;Department of Clinical Immunology, Rigshospitalet, Copenhagen, Denmark;Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark;Department of Clinical Microbiology, Zealand University Hospital–Slagelse, Slagelse, Denmark;Department of Clinical Research, Nordsjaellands Hospital, Hilleroed, Denmark;Department of Endocrinology, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Bispebjerg, Copenhagen, Denmark;Department of Infectious Disease, Copenhagen University Hospital–Amager and Hvidovre, Hvidovre, Denmark;Diagnostisk Enhed, Copenhagen University Hospital, Bornholm, Denmark;Mental Health Services-The Capital Region of Denmark, Copenhagen, Denmark;Statens Serum Institut, Copenhagen, Denmark;Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark;

关键词: asymptomatic infections;    body mass index;    health care workers;    risk factor;    SARS-CoV-2;    seroconversion;   

DOI  :  10.1128/Spectrum.00904-21

来源: DOAJ

【 摘 要 】

ABSTRACT Most individuals seroconvert after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but being seronegative is observed in 1 to 9%. We aimed to investigate the risk factors associated with being seronegative following PCR-confirmed SARS-CoV-2 infection. In a prospective cohort study, we screened health care workers (HCW) in the Capital Region of Denmark for SARS-CoV-2 antibodies. We performed three rounds of screening from April to October 2020 using an enzyme-linked immunosorbent assay (ELISA) method targeting SARS-CoV-2 total antibodies. Data on all participants’ PCR for SARS-CoV-2 RNA were captured from national registries. The Kaplan-Meier method and Cox proportional hazards models were applied to investigate the probability of being seronegative and the related risk factors, respectively. Of 36,583 HCW, 866 (2.4%) had a positive PCR before or during the study period. The median (interquartile range [IQR]) age of 866 HCW was 42 (31 to 53) years, and 666 (77%) were female. After a median of 132 (range, 35 to 180) days, 21 (2.4%) of 866 were seronegative. In a multivariable model, independent risk factors for being seronegative were self-reported asymptomatic or mild infection hazard ratio (HR) of 6.6 (95% confidence interval [CI], 2.6 to 17; P < 0.001) and body mass index (BMI) of ≥30, HR 3.1 (95% CI, 1.1 to 8.8; P = 0.039). Only a few (2.4%) HCW were not seropositive. Asymptomatic or mild infection as well as a BMI above 30 were associated with being seronegative. Since the presence of antibodies against SARS-CoV-2 reduces the risk of reinfection, efforts to protect HCW with risk factors for being seronegative may be needed in future COVID-19 surges. IMPORTANCE Most individuals seroconvert after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but negative serology is observed in 1 to 9%. We found that asymptomatic or mild infection as well as a BMI above 30 were associated with being seronegative. Since the presence of antibodies against SARS-CoV-2 reduces the risk of reinfection, efforts to protect HCW with risk factors for being seronegative may be needed in future COVID-19 surges.

【 授权许可】

Unknown