Prevalence of SARS-CoV-2 infection among health care workers in a reference hospital in Brazil

Almeida, Vanessa Neves; Cavalin, Roberta Figueiredo; Gallo, Juliana Failde; Guerra, Cleide Aparecida; Madureira, Karen Cristina Rolim; Rossi, Meire Bócoli; Sobreira, Rozania Soeli dos Santos; Santos, Ana Paula; Luna, Expedito; Lindoso, José Angelo Lauletta

doi:10.1590/S1678-9946202365052

Vanessa Neves Almeida

Instituto de Infectologia Emilio Ribas, São Paulo, São Paulo, Brazil

Roberta Figueiredo Cavalin

Instituto de Infectologia Emilio Ribas, São Paulo, São Paulo, Brazil

Juliana Failde Gallo

Instituto de Infectologia Emilio Ribas, São Paulo, São Paulo, Brazil

Cleide Aparecida Guerra

Instituto de Infectologia Emilio Ribas, São Paulo, São Paulo, Brazil

Karen Cristina Rolim Madureira

Instituto de Infectologia Emilio Ribas, São Paulo, São Paulo, Brazil

Meire Bócoli Rossi

Instituto de Infectologia Emilio Ribas, São Paulo, São Paulo, Brazil

Rozania Soeli dos Santos Sobreira

Instituto de Infectologia Emilio Ribas, São Paulo, São Paulo, Brazil

Ana Paula Santos

Instituto de Infectologia Emilio Ribas, São Paulo, São Paulo, Brazil

Expedito Luna

senior authorship

Universidade de São Paulo, Faculdade de Medicina, Departamento de Medicina Preventiva, São Paulo, São Paulo, Brazil

http://orcid.org/0000-0002-1145-9672

José Angelo Lauletta Lindoso

senior authorship

Instituto de Infectologia Emilio Ribas, São Paulo, São Paulo, Brazil

Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil

Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, Laboratório de Protozoologia (LIM-49), São Paulo, São Paulo, Brazil

http://orcid.org/0000-0002-4405-4401

Correspondence to: José Angelo Lauletta Lindoso Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, Av. Dr. Enéas de Carvalho Aguiar, 450, Cerqueira Cesar, CEP 05403-000, São Paulo, SP, Brazil Tel: +55 11 30617014, +55 11 995416749 E-mail:jlindoso@usp.br

Category	Number of HW included in the study	SARS-CoV-2 positive (n)	Seroprevalence % (95%CI)	p-value*
Resident physician	48	8	16.7 (8.1 – 29.2)	<0.0001
Health care workers from IIER*	940	115	12.2 (10.3 – 14.5)
Outsourced companies workers**	429	148	34.2 (30.1 – 39.1)
Total	1,417	271	20.6 (18.7 – 22.7)

Profession and health work activity	Total number of HCW	Number of Participants	SARS-CoV-2 positive (n)	SARS-CoV-2 negative (n)	Seroprevalence (95%CI)	Risk ratio (95%CI)	p-value**
Frontline COVID-19 workers from IIER*	1,633	945	123	822	13.0 (10.9-15.2)	–	–
Resident physicians	88	49	9	40	18.37 (7.53-29.21)	1.41 (0.76-2.60)	0.3895
Security workers	61	61	8	53	13.11 (4.64-21.59)	1.01 (0.52-1.96)	0.8618
Frontline COVID-19 workers from outsourced companies**	237	193	72	121	37.31 (30.48-44.13)	2.87 (2.24-3.67)	<0.0011
Cooks and kitchen assistants	50	38	13	25	34.21 (19.13-49.29)	2.63 (1.64-4.21)	0.0005
Hospital cleaning workers	103	99	33	66	33.33 (24.05-42.62)	2.56 (1.85-3.54)	<0.0011
Building maintenance workers	32	32	13	19	40.62 (23.61-57.64)	3.12 (1.99-4.89)	<0.0011
Total	2,204	1,417	271	1146	19.12 (17.14-21.24)	1.58 (1.38-1.80)	<0.0001

	Seroprevalence % (95%CI)		Serological Result				p-value*

			Positive (n=171)		Negative (n=490)

			n	%	n	%
Sex							0.758
Male	25.0	(18.8 – 32.1)	44	25.7	132	26.9
Female	26.2	(22.3 – 30.3)	127	74.3	358	73.1
Ethnicity							<0.001
White	19.6	(15.5 – 24.4)	64	37.4	262	53.5
Black or Mixed-race	33.3	(28.1 – 38.9)	104	60.8	208	42.4
Asian	13.0	(2.8 – 33.6)	3	1.8	20	4.1
Age							0.658
60 years or more	22.1	(12.9 – 33.8)	15	8.8	53	10.8
40 - 59 years	25.7	(21.5 – 30.2)	104	60.8	301	61.4
18 - 39 years	27.7	(21.4 – 34.6)	52	30.4	136	27.8
Municipality of residence							0.212
Sao Paulo	25.3	(21.5 – 29.3)	126	73.7	373	76.1
Cities in the metropolitan area of Sao Paulo	28.6	(21.4 -36.6)	42	24.6	105	21.4
Other	14.3	(1.8 – 42.8)	2	1.2	12	2.4
No information	100.0	(2.5 – 100.0)	1	0.6		0.0
Time spent commuting							0.108
Less than 30 minutes	18.5	(11.7 – 27.1)	20	11.7	88	18.0
30 to 59 minutes	24.2	(18.7 – 30.4)	53	31.0	166	33.9
60 to 119 minutes	28.5	(23.2 – 34.2)	78	45.6	196	40.0
120 minutes or more	33.3	(21.7 – 46.7)	20	11.7	40	8.2
Transportation used to commute							< 0.001
Individual transportation	14.0	(9.43 –19.7)	27	15.8	166	33.9
Public transportation	30.8	(26.6 – 35.2)	144	84.2	324	66.1
Schooling							< 0.001
Complete higher education or graduate studies	17.7	(13.8 – 22.3)	58	33.9	269	54.9
Complete secondary education or incomplete higher education	30.6	(24.9 – 36.7)	77	45.0	175	35.7
Complete primary education or incomplete secondary education	43.3	(30.6 – 56.8)	26	15.2	34	6.9
Incomplete primary education	45.5	(24.4 – 67.8)	10	5.8	12	2.4
Family income							< 0.001
> US$ 3,880.00	20.0	(7.7 – 38.6)	6	3.5	24	4.9
US$ 1,940.00 - U$ 3,880.00	15.5	(7.5 – 27.4)	9	5.3	49	10.0
US$ 1,164.00 - U$ 1,940.00	18.9	(10.8 – 29.7)	14	8.2	60	12.2
US$ 873.00 - U$ 1,164.00	22.6	(14.6 – 32.4)	21	12.3	72	14.7
US$ 582.00 - U$ 873.00	20.8	(14.2 – 28.8)	27	15.8	103	21.0
US$ 290.00 – U$ 582.00	30.8	(24.2 – 38.0)	56	32.7	126	25.7
< U$ 290.00	42.7	(32.6 – 53.6)	38	22.2	51	10.4
No information	0.0	(0 – 52.2)	0	0.0	5	1.0

	Unadjusted OR	(95%CI)	p-value*	Adjusted OR	(95%CI)	p-value*
Sex
Male	reference
Female	1.064	(0.716-1.582)	0.758
Ethnicity
White	reference			reference
Black or Mixed-race	2.047	(1.427-2.936)	<0.001	1.743	(1.172-2.594)	0.006
Asian	0.614	(0.177-2.130)	0.442	0.696	(0.195-2.486)	0.577
Age
60 years or more	reference
40 - 59 years	1.221	(0.660-2.258)	0.525
18 - 39 years	1.351	(0.701-2.604)	0.369
Municipality of residence
Sao Paulo	reference
Cities in the metropolitan area of Sao Paulo	1.184	(0.785-1.786)	0.420
Other	0.493	(0.109-2.235)	0.359
No information
Time spent commuting
Less than 30 minutes	reference
30 to 59 minutes	1.405	(0.790-2.498)	0.247
60 to 119 minutes	1.751	(1.008-3.041)	0.047
120 minutes or more	2.200	(1.067-4.537)	0.033
Transportation used to commute
Individual transportation	reference			reference
Public transportation	2.733	(1.740-4.292)	<0.001	2.134	(1.247-3.652)	0.006
Schooling
Complete higher education or graduate studies	reference			reference
Complete secondary education or incomplete higher education	2.041	(1.381-3.015)	<0.001	1.674	(1.033-2.714)	0.036
Complete primary education or incomplete secondary education	3.547	(1.978-6.361)	<0.001	2.662	(1.298-5.462)	0.008
Incomplete primary education	3.865	(1.594-9.373	0.003	2.719	(0.918-8.053)	0.071
Family income
> US$ 3,880.00	reference
US$ 1,940.00 - U$ 3,880.00	0.735	(0.234-2.303)	0.597
US$ 1,164.00 - U$ 1,940.00	0.933	(0.321-2.713)	0.899
US$ 873.00 - U$ 1,164.00	1.167	(0.421-3.229)	0.767
US$ 582.00 - U$ 873.00	1.049	(0.390-2.822)	0.925
US$ 290.00 – U$ 582.00	1.778	(0.689-4.589)	0.234
< US$ 290.00	2.980	(1.109-8.007)	0.030
No information
Loss of family income during pandemic	1.146	(0.808-1.624)	0.445
Any family member lost their job during pandemic	1.321	(0.919-1.899)	0.132
Obesity	1.566	(1.069-2.293)	0.021
Cardiovascular disease	1.349	(0.861-2.111)	0.191
Diabetes mellitus	0.679	(0.321-1.437)	0.311
Pulmonary disease	0.671	(0.249-1.809)	0.431
Workplace
Administrative	reference
Healthcare	0.932	(0.657-1.323)	0.694
Professional category
Administrative	reference			reference
Cleaning	2.665	(1.442-4.927)	0.002	1.392	(0.691-2.806)	0.355
Nursing	1.615	(0.962-2.712)	0.070	1.638	(0.958-2.801)	0.071
Maintenance	4.442	(1.704-11.578)	0.002	3.356	(1.248-9.026)	0.016
Physician	0.785	(0.384-1.606)	0.508	2.281	(0.975-5.336)	0.057
Other health professionals	1.112	(0.572-2.162)	0.754	1.871	(0.910-3.850)	0.089
Security	0.673	(0.215-2.109)	0.497	0.459	(0.142-1.477)	0.191

[1] Correspondence to: José Angelo Lauletta Lindoso Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, Av. Dr. Enéas de Carvalho Aguiar, 450, Cerqueira Cesar, CEP 05403-000, São Paulo, SP, Brazil Tel: +55 11 30617014, +55 11 995416749 E-mail:jlindoso@usp.br

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Prevalence of SARS-CoV-2 infection among health care workers in a reference hospital in Brazil

ABSTRACT