Dr Manisha Madkaikar
doi:10.13140/RG.2.2.34411.77603
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has resulted in occupational exposure among health care workers (HCWs) and a high risk of nosocomial transmission. Asymptomatic infection and transmission of infection before the development of symptoms are well-recognised factors contributing to the spread of infection. The importance of understanding the dynamics of transmission in HCWs lies in planning strategies for the reduction of nosocomial spread.
Methods A cross-sectional sero-surveillance study was conducted among 500 HCWs in Dombivli and surrounding Mumbai Metropolitan area (MMR, Maharashtra, India). The vulnerability of the study participants to SARS-CoV-2 infection was ascertained through a history of (i) involvement in direct care of Novel Coronavirus Disease (COVID-19) patients, (ii) exposure to aerosol-generating procedures, (iii) presence of co-morbidities, (iv) use of Personal protective equipment(PPE), and (v) HCQ prophylaxis collected through a structured questionnaire. A systematic analysis of the correlation between the development of antibodies and factors affecting vulnerability to infection was performed.
Findings The overall SARS-CoV-2 seroprevalence in the study population was 11%. Only about two-fifths of the HCWs who had detectable anti-SARS-CoV-2 antibodies reported symptoms consistent with a prior viral illness. Direct care to COVID -19 patients for longer hours and irregular use of PPE were associated with an increased incidence of seropositivity. Prophylaxis with Hydroxychloroquine (HCQ) may have a role in reducing the vulnerability to infection as depicted by univariate and multivariate analysis. It was also noted that those not on HCQ prophylaxis were three-fold more prone to infection as confirmed by RT-PCR and had severe manifestations as compared to those on HCQ prophylaxis.
Interpretation HCQ may have a role in mitigating the incidence and severity of COVID-19 infection. A combined approach of optimised shift schedules, regular use of PPE, and HCQ prophylaxis may help safeguard our corona warriors.
Author Contribution: RMY analysed the data and wrote the manuscript. MM, AP and RMY designed and coordinated the study. RMY and UB designed the data collection tool. Data collection was done by AP, RMY, MP, MG, HP, MP, AS, SS. AS and SA performed the antibody testing. MM supervised the study, reviewed and approved the final version of the manuscript.
Conflict of Interest Statement: The authors declare no conflict of interest.
Source of funding: The study was funded by Indian Council of Medical Research (ICMR), an autonomous Government-funded medical research council. The corresponding author who is Director of an ICMR institute was responsible for the study design, data analysis, and writing of the report. The corresponding author had access to all the data and had final responsibility for the decision to submit for publication.
References
Banaji, What do the delhi and mumbai sero-survey results tell us about covid-19 in India? The Wire
Bhattacharya, Chowdhury, Mukherjee, Pre exposure Hydroxychloroquine use is associated with reduced COVID19 risk in healthcare workers -a Retrospective cohort, medRxiv,
doi:10.1101/2020.06.09.20116806Chatterjee, Anand, Singh, Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-19, Indian Journal of Medical Research
Dall, Antibody tests may hold clues to COVID-19 exposure, immunity-but it's complicated
Eckerle, Meyer, SARS-CoV-2 seroprevalence in COVID-19 hotspots, Lancet
Fusco, Pisaturo, Iodice, COVID-19 among healthcare workers in a specialist infectious diseases setting in Naples, Southern Italy: results of a cross-sectional surveillance study, J Hosp Infect
Galvis, Spinelli, Tello, Hydroxychloroquine as prophylaxis for coronavirus sars-cov-2 infection: review of the ongoing clinical trials, Arch Bronconeumol,
doi:10.1016/j.arbres.2020.05.008Huang, Zhang, Zhang, Rapid asymptomatic transmission of COVID-19 during the incubation period demonstrating strong infectivity in a cluster of youngsters aged 16-23 years outside Wuhan and characteristics of young patients with COVID-19: A prospective contact-tracing study, J Infect
Keeley, Evans, Colton, Roll-out of sars-cov-2 testing for healthcare workers at a large nhs foundation trust in the united kingdom, march 2020, Eurosurveillance
Koh, Occupational risks for COVID-19 infection, Occup Med (Lond)
Korth, Wilde, Dolff, SARS-CoV-2-specific antibody detection in healthcare workers in Germany with direct contact to COVID-19 patients, J Clin Virol
Livingston, Bucher, Coronavirus disease 2019 (COVID-19) in italy, JAMA
Mdaa, Targeting endosomal acidification by chloroquine analogs as a promising strategy for the treatment of emerging viral diseases, Pharmacol Res Perspect,
doi:10.1002/prp2.293Papoutsi, Giannakoulis, Ntella, Pappa, Katsaounou, Global burden of COVID-19 pandemic on healthcare workers, ERJ Open Research,
doi:10.1183/23120541.00195-2020Schlagenhauf, Grobusch, Maier, Gautret, Repurposing antimalarials and other drugs for COVID-19, Travel Med Infect Dis
Tostmann, Bradley, Bousema, Strong associations and moderate predictive value of early symptoms for SARS-CoV-2 test positivity among healthcare workers, the Netherlands, Eurosurveillance
Wang, Hu, Hu, Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirusinfected pneumonia in wuhan, china, JAMA
Xu, Sun, Nie, Seroprevalence of immunoglobulin m and g antibodies against sars-cov-2 in china, Nature Medicine
Zhou, Huang, Xiao, Huang, Fan, Protecting Chinese healthcare workers while combating the 2019 novel coronavirus, Infect Control Hosp Epidemiol
DOI record:
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"title": "Sero-survey for health-care workers provides corroborative evidence for the effectiveness of Hydroxychloroquine prophylaxis against COVID-19 infection",
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