Infectious Disease

SARS-CoV-2 antibodies are more common in African-American Hispanic HCW

March 17, 2021

3 min read

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The researchers reported that African-American and Hispanic healthcare workers were more likely to test positive for SARS-CoV-2 antibodies than non-Spanish white healthcare workers.

They also said community factors play an important role in SARS-CoV-2 exposure of healthcare workers and stressed the “importance of sources of exposure outside the workplace”.

Joseph E.. Ebinger, MD, The director of clinical analytics at Cedars-Sinai in Los Angeles and his colleagues based their findings on an analysis of data from a “diverse and unselected” group of 6,062 facility staff with direct and non-direct patient contact.

Joseph E. Ebinger

The researchers wrote that the overall seroprevalence among health care workers was 4.1% (95% CI, 3.1-5.7), “with higher estimates in younger versus older workers and in Hispanics versus non- Hispanics were recorded. “

According to the researchers, anosmia was the “most frequently associated” significant self-reported symptom (OR = 11.04), followed by fever (OR = 2.02) and myalgia (OR = 1.65). After adjusting to potential confounding factors, Ebinger and colleagues found that the seroprevalence was “significant” with contact with a person diagnosed with COVID-19 in the household (OR = 5.73) or the clinical work environment (OR = 1, 76) was associated with Afro-American race (OR = 2.02) or Hispanic ethnicity (OR = 1.98).

In addition, multivariate adjusted analyzes of pre-existing employee characteristics showed that “main factors” associated with a higher probability of seropositive status were African American (OR = 1.72; 95% CI, 1.03-2.89) or Hispanic American (OR = 1.8; 95%). CI, 1.31-2.46) compared to non-Hispanic whites.

“These differences underscore the continuing, pressing need to understand why certain populations and communities are at greater risk than others in the pandemic.” chemistry Sobhani, PhD, The medical director of the core clinical laboratories, associate professor of pathology and laboratory medicine at Cedars-Sinai and study co-author, said in a press release. “The reasons may well be structural and social factors that we could not capture.”

The researchers linked older age (OR = 0.81 per decade of age; 95% CI, 0.71-0.92) and a history of asthma (OR = 0.48; 95% CI, 0.28-0.83) a lower likelihood of a seropositive status. In all employees with a seropositive status, hypertension was associated with higher antibody levels (beta = 0.12 per 10 unit increment in the IgG index). A medical diagnosis of COVID-19 was also linked to higher levels of antibodies, the researchers wrote.

Multivariable adjusted analyzes of COVID-19-related exposures also showed that the traits associated with a higher likelihood of seropositive status were indicative of a medical diagnosis of COVID-19 (OR = 7.78; 95% CI, 5.73- 10.56) and a household member who was previously diagnosed with COVID-19 (OR = 9.42; 95% CI, 5.5-16.13), although a “similar trend” was only observed in those who worked where patients with COVID-19 were being treated (OR = 1.61; 95% CI, 1.18-2.18).

“In particular, domestic travel, apartment type, number of people at home and children or common pets were not associated with either seroprevalence or antibody level in the fully adapted multivariable models, which can at least partially explain the effects of unmeasured people Models are not recorded, ”wrote Ebinger and colleagues.

Multivariable fitted analyzes of COVID-19 responses also showed that the “strongest self-reported symptom” associated with a higher likelihood of seropositivity was anosmia (OR = 11.91; 95% CI, 7.77-18.24 ). Other symptoms related to the presence of antibodies included myalgia, dry cough, and loss of appetite.

“Symptoms associated with a lower chance of seropositive status include a sore throat and rhinorrhea,” the researchers wrote. “Dyspnoea was significantly associated with higher IgG index values ​​in seropositive subjects (beta = 0.13).”

According to the researchers, a multivariate analysis that consisted of all “significantly predictive preexisting features of the previous models” remained significantly associated with the presence of antibodies when analyzed together, with the exception of dry cough. Predictors that remained significantly associated with higher antibody levels were hypertension (beta = 0.1), previous COVID-19 diagnoses (beta = 0.1) that were in one COVID-19 unit (beta = 0.06), Nausea (= beta 0.06) and dyspnea (beta) worked = 0.08).

Ebinger and colleagues wrote that their results are in line with other studies suggesting that underrepresented populations, including Hispanics and African Americans, are “disproportionately affected” by COVID-19.

“Such differences exist even when all participants work for the same organization and not just in the same field,” they continued. “Such a finding could suggest that community and non-work-related environmental factors are likely to play a significant role in the spread of COVID-19 among certain minorities.”

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Shivaraj Nagalli, MD)

Shivaraj Nagalli, MD

There is growing evidence that Hispanics and African Americans are disproportionately affected by COVID-19 infection. Serological tests such as IgG antibody tests for the SARS-CoV2 virus provide valuable information on the extent of exposure.

This large, diverse study by Ebinger and colleagues estimated the seroprevalence in health care workers who are directly and indirectly exposed to COVID-19 infection and identified factors associated with seropositivity. The researchers also examined the effects of demographics, exposure, and clinical characteristics on serological status. They found that anosmia was the strongest self-reported symptom associated with seropositivity and that Hispanics and African Americans were more likely to be seropositive compared to non-Hispanic whites. It is important to note that the odds were greater in these populations despite the same work-related exposure. Therefore, non-work-related community and environmental factors contribute to this disproportionate spread of COVID-19 in these populations.

Discussions must be held between health care providers – especially general practitioners – and their patients in order to determine such environmental factors for SARS-CoV-2 and COVID-19. Medical community-wide training to contain such non-work-related risk factors can help minimize racial differences in COVID-19 infection rates. This study reiterated the importance of allocating more resources to these communities.

It is likely that results similar to those of Ebinger and colleagues will be achieved when studies are conducted nationwide. However, the seroprevalence rate may vary among non-healthcare workers. Studies like this one can also serve as a guide for reopening strategies and prioritizing communities at higher risk for vaccination. Future research is also needed to estimate seroprevalence between different healthcare professions and to further stratify the different types and lengths of exposures in caring for COVID-19 patients.

Shivaraj Nagalli, MD

Hospital Doctor, Shelby Baptist Medical Center, Alabaster, Ala.

Disclosure: Nagali does not report any relevant financial information.

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