Risk factors for SARS-CoV-2 infection in hospital workers: results from a screening study in New Jersey, U.S. in Spring 2020

Barrett, Emily S; Horton, Daniel B; Roy, Jason; Xia, Weiyi; Greenberg, Patricia; Andrews, Tracy; Gennaro, Maria Laura; Parmar, Veenat; Russell, William D; Reilly, Nancy; Uprety, Priyanka; Gantner, John J; Stockman, Lydia; Trooskin, Stanley Z; Blaser, Martin J; Carson, Jeffrey L; Panettieri, Reynold A

BACKGROUND: SARS-CoV-2 infection is a critical concern among health care workers (HCW). Other studies have assessed SARS-CoV-2 virus and antibodies in HCW, with disparate findings regarding risk based on role and demographics. METHODS: We screened 3,904 employees and clinicians for SARS-CoV-2 virus positivity and serum IgG at a major New Jersey hospital from April 28-June 30, 2020. We assessed positive tests in relation to demographic and occupational characteristics and prior COVID-19 symptoms using multivariable logistic regression models. RESULTS: Thirteen participants (0.3%) tested positive for virus and 374 (9.6%) tested positive for IgG (total positive: 381 [9.8%]). Compared to participants with no patient care duties, the odds of positive testing (virus or antibodies) were higher for those with direct patient contact: below-median patient contact, adjusted OR (aOR): 1.71, 95% CI: 1.18, 2.48); above-median patient contact aOR: 1.98, 95% CI: 1.35, 2.91. The proportion of participants testing positive was highest for phlebotomists (23.9%), maintenance/housekeeping (17.3%), dining/food services (16.9%), and interpersonal/support roles (13.7%) despite lower levels of direct patient care duties. Positivity rates were lower among doctors (7.2%) and nurses (9.1%), roles with fewer under-represented minorities. After adjusting for job role and patient care responsibilities and other factors, Black and Latinx workers had two-fold increased odds of a positive test compared to White workers. Loss of smell, taste, and fever were associated with positive testing. CONCLUSIONS: The HCW categories at highest risk for SARS-CoV-2 infection include support staff and underrepresented minorities with and without patient care responsibilities. Future work is needed to examine potential sources of community and nosocomial exposure among these under-studied HCW.