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dc.contributor.authorJacob, Jesse T
dc.contributor.authorBaker, Julia M
dc.contributor.authorFridkin, Scott K
dc.contributor.authorLopman, Benjamin A
dc.contributor.authorSteinberg, James P
dc.contributor.authorChristenson, Robert H
dc.contributor.authorKing, Brent
dc.contributor.authorLeekha, Surbhi
dc.contributor.authorO'Hara, Lyndsay M
dc.contributor.authorRock, Peter
dc.contributor.authorSchrank, Gregory M
dc.contributor.authorHayden, Mary K
dc.contributor.authorHota, Bala
dc.contributor.authorLin, Michael Y
dc.contributor.authorStein, Brian D
dc.contributor.authorCaturegli, Patrizio
dc.contributor.authorMilstone, Aaron M
dc.contributor.authorRock, Clare
dc.contributor.authorVoskertchian, Annie
dc.contributor.authorReddy, Sujan C
dc.contributor.authorHarris, Anthony D
dc.date.accessioned2021-03-29T18:04:16Z
dc.date.available2021-03-29T18:04:16Z
dc.date.issued2021-03-10
dc.identifier.urihttp://hdl.handle.net/10713/15049
dc.description.abstractImportance: Risks for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care personnel (HCP) are unclear. Objective: To evaluate the risk factors associated with SARS-CoV-2 seropositivity among HCP with the a priori hypothesis that community exposure but not health care exposure was associated with seropositivity. Design, Setting, and Participants: This cross-sectional study was conducted among volunteer HCP at 4 large health care systems in 3 US states. Sites shared deidentified data sets, including previously collected serology results, questionnaire results on community and workplace exposures at the time of serology, and 3-digit residential zip code prefix of HCP. Site-specific responses were mapped to a common metadata set. Residential weekly coronavirus disease 2019 (COVID-19) cumulative incidence was calculated from state-based COVID-19 case and census data. Exposures: Model variables included demographic (age, race, sex, ethnicity), community (known COVID-19 contact, COVID-19 cumulative incidence by 3-digit zip code prefix), and health care (workplace, job role, COVID-19 patient contact) factors. Main Outcome and Measures: The main outcome was SARS-CoV-2 seropositivity. Risk factors for seropositivity were estimated using a mixed-effects logistic regression model with a random intercept to account for clustering by site. Results: Among 24 749 HCP, most were younger than 50 years (17 233 [69.6%]), were women (19 361 [78.2%]), were White individuals (15 157 [61.2%]), and reported workplace contact with patients with COVID-19 (12 413 [50.2%]). Many HCP worked in the inpatient setting (8893 [35.9%]) and were nurses (7830 [31.6%]). Cumulative incidence of COVID-19 per 10 000 in the community up to 1 week prior to serology testing ranged from 8.2 to 275.6; 20 072 HCP (81.1%) reported no COVID-19 contact in the community. Seropositivity was 4.4% (95% CI, 4.1%-4.6%; 1080 HCP) overall. In multivariable analysis, community COVID-19 contact and community COVID-19 cumulative incidence were associated with seropositivity (community contact: adjusted odds ratio [aOR], 3.5; 95% CI, 2.9-4.1; community cumulative incidence: aOR, 1.8; 95% CI, 1.3-2.6). No assessed workplace factors were associated with seropositivity, including nurse job role (aOR, 1.1; 95% CI, 0.9-1.3), working in the emergency department (aOR, 1.0; 95% CI, 0.8-1.3), or workplace contact with patients with COVID-19 (aOR, 1.1; 95% CI, 0.9-1.3). Conclusions and Relevance: In this cross-sectional study of US HCP in 3 states, community exposures were associated with seropositivity to SARS-CoV-2, but workplace factors, including workplace role, environment, or contact with patients with known COVID-19, were not. These findings provide reassurance that current infection prevention practices in diverse health care settings are effective in preventing transmission of SARS-CoV-2 from patients to HCP.en_US
dc.description.urihttps://doi.org/10.1001/jamanetworkopen.2021.1283en_US
dc.language.isoenen_US
dc.publisherAmerican Medical Associationen_US
dc.relation.ispartofJAMA Network Openen_US
dc.subjectseropositivityen_US
dc.subject.meshHealth Personnel
dc.subject.meshRisk Factorsen_US
dc.subject.meshSARS-CoV-2en_US
dc.titleRisk Factors Associated With SARS-CoV-2 Seropositivity Among US Health Care Personnelen_US
dc.typeArticleen_US
dc.identifier.doi10.1001/jamanetworkopen.2021.1283
dc.identifier.pmid33688967
dc.source.volume4
dc.source.issue3
dc.source.beginpagee211283
dc.source.endpage
dc.source.countryUnited States


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