Antibody Seropositivity And Potential Risk Factors For SARS-Cov-2 Among Healthcare Workers (HCW) In A Private Healthcare Group In Malaysia

Abstract

Background: Healthcare workers (HCW) are at increased risk of infection to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) due to occupational exposure to confirmed or suspected COVID-19 patient. Various potential risk factors for SARS-CoV-2 infection among HCWs as well as asymptomatic infections; are well documented.  This study was conducted to  investigate the antibody seropositivity and potential risk factors for SARS-CoV-2 infection among healthcare workers (HCW) in a private healthcare group in Malaysia. This study also sought to identify symptomatic and asymptomatic COVID-19 infection among the HCWs and to determine the relationship between effective prevention & control (IPC) measures and occupational risk with the SARS-CoV-2 antibody status.

Materials and Method: This is a cross-sectional study of all identified health care workers (HCW) working in a Malaysia-based private healthcare hospitals group, in which a patient with a confirmed/suspected COVID-19 infection was receiving care. The study had two components, the first is the filling up of a questionnaire (descriptive), the second is the blood test for SARS-CoV-2 antibody (investigative). Data were collected between the period of 1^st February 2020 until 1^st March 2021 and 1120 HWCs were recruited.

 Results: SARS-CoV-2 antibody results for all 1120 respondents was positive in 38 respondents (3.4%) and negative in 1082 respondents (96.6%). The study population comprised of 65% HCWs who had direct care to patient and 35% did not give direct care to patient. Low prevalence (3.4%) among the HCWs suggests that there was a low rate of undetected COVID-19 infection in this private healthcare group. 47.4% of the seropositive HCWs had never experienced any symptoms of COVID-19 while 52.6% were symptomatic. 60.7% respondents had their IPC training within the last 3-12 months with 60.3% acquiring more than 2 hours training. More than 95% of the respondents always and most of the time adhered to the WHO recommended hand hygiene practises.  According to the risk assessment, 94.6% always or most of the time wore personal protective equipment (PPE) 91.8% of the respondents agreed that PPE was available in sufficient quantity in the health care facility while 8.2% disagreed.

Conclusion: The overall low prevalence of SARS-CoV-2 antibody among the HCWs in this study may be due to effective IPC measures and COVID-19 management in the healthcare facilities. However, the higher prevalence seen among certain group of HCWs indicates the need of more stringent implementation and monitoring of IPC measures as well risk assessment among these groups. HCW’s health symptoms should not be used solely to rule out the COVID-19 infection in HCWs. If deemed necessary upon risk assessment, prompt screening or diagnostic testing should be conducted. The enforcement of routine screening testing programs for all HCW, regardless of the presence of symptoms, is highly recommended in healthcare settings to reduce the risk of hospital-acquired SARS-CoV-2 infections.