SARS-CoV-2 Infection in Mortuary and Cemetery Workers.

Alishaq, Moza; Jeremijenko, Andrew; Nafady-Hego, Hanaa; Al Ajmi, Jameela Ali; Elgendy, Mohamed; Fadel, Rayyan Abdulaziz Attya; Thomas, Anil George; Alahmed, Mohammed A A; Ammar, Adham; Bensaad, Meryem; Al-Barghouthi, Bayan; Coyle, Peter; Elgendy, Hamed; Abou-Samra, Abdul-Badi; Butt, Adeel A

BACKGROUND Mortuary and cemetery workers may be exposed to bodies of persons with SARS-CoV-2 infection. However, prevalence of infection among these groups is unknown. METHODS Nasopharyngeal swabs (NPS) for RT-PCR and serologic testing for SARS-CoV-2 was performed on mortuary and cemetery workers in Qatar. We gathered data on specific job duties, living conditions, contact history, and clinical course. Environmental sampling was carried out to explore any association with infection. We used logistic regression analysis to determine the factors associated with infection. RESULTS All 47 mortuary workers provided a NPS and 7(14.9%) were PCR-positive; 32 provided a blood sample and 8 (25%) were antibody positive, 6 (75%) of seropositive were also PCR-positive. Among the 81 cemetery workers, 76 provided a NPS and 5 (6.6%) were PCR-positive; 64 provided a blood sample and 22 (34.4%) were antibody positive, 3 (13.6%) of seropositive were also PCR-positive. Three (22.2 %) and 20 (83.3%) of infected mortuary and cemetery were asymptomatic. Age <30 years (OR 4.9, 95%CI 1.7-14.6), community exposure with a known case (OR 4.7, 95%CI 1.7-13.3), and presence of symptoms in the preceding 2 weeks (OR 9.0, 95%CI 1.9-42.0) were independently associated with an increased risk of infection (PCR or antibody positive). Of the 46 environmental and surface samples, all were negative or had a Ct value of >35. CONCLUSION A substantial proportion of mortuary and cemetery workers have evidence of SARS-CoV-2 infection, which is incidentally detected upon serologic testing. Our data are most consistent with community-acquisition rather than occupational-acquisition.