Occurrence of SARS-CoV-2 infection among healthcare personnel: results from an early systematic review and meta-analysis.
Keywords:
COVID-19, healthcare workers, epidemiology, SARS-CoV-2, coronavirusAbstract
Background. SARS-CoV-2 infection has become a global public health concern globally. Even though Healthcare Workers (HCWs) are supposedly at increased risk for SARS-CoV-2 infection, to date no pooled evidence has been collected.
Materials and Methods. We searched online electronic databases (PubMed, Embase, medRxiv.org for pre-prints) for all available contribution (up to May 20, 2019). Two Authors independently screened articles and extracted the data. The pooled prevalence of SARS-CoV-2 was analyzed using the random-effects model. The possible sources of heterogeneity were analyzed through subgroup analysis, and meta-regression.
Results. The overall pooled prevalence of SARS-CoV-2 was 3.5% (95%CI 1.8–6.6) for studies based on molecular assays, 5.5% (95%CI 2.1–14.1) for studies based on serological assays, and 6.5% (95%CI 2.5–15.6) for point-of-care capillary blood tests. Among subgroups, serological tests identified higher risk for SARS-CoV-2 seropositivity in physicians than in nurses (OR 1.436, 95%CI 1.026 to 2.008). Regression analysis indicated the possible presence of publication bias only for molecular tests (t -3.3526, p-value 0.002648).
Conclusions. The overall pooled prevalence of SARS-CoV-2 was lower than previously expected, but available studies were affected by significant heterogeneity, and the molecular studies by significant publication bias. Therefore, further high-quality research in the field is warranted.
References
1. Guan, W.; Liang, W.; Zhao, Y.; Liang, H.; Chen, Z.; Li, Y.; Liu, X.; Chen, R.; Tang, C.; Wang, T.; et al. Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis. Eur. Respir. J. 2020;55:2000547.doi: 10.1183/13993003.00547-2020
2. Huang, C.; Wang, Y.; Li, X.; Ren, L.; Zhao, J.; Hu, Y.; Zhang, L.; Fan, G.; Xu, J.; Gu, X. Clinical features of patients infected with 2019 novel coronavirus in Wuhan , China. Lancet 2020;395: 497-506 doi: 10.1016/S0140-6736(20)30183-5..
3. Li, Q.; Guan, X.; Wu, P.; Wang, X.; Zhou, L.; Tong, Y.; Ren, R.; Leung, K.S.M.; Lau, E.H.Y.; Wong, J.Y.; et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N. Engl. J. Med. 2020;382:1199-1207. doi: 10.1056/NEJMoa2001316
4. Wang, J.; Zhou, M.; Liu, F. Reasons for healthcare workers becoming infected with novel coronavirus disease 2019 (COVID-19) in China. J. Hosp. Infect. 2020;105:100-101. doi: 10.1016/j.jhin.2020.03.002
5. Rivett, L.; Routledge, M.; Sparkes, D.; Warne, B.; Bartholdson, J.; Cormie, C.; Forrest, S.; Gill, H. Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission. Elife 2020;e58728. doi: 10.7554/eLife.58728
6. Wang, D.; Hu, B.; Hu, C.; Zhu, F.; Liu, X.; Zhang, J.; Wang, B.; Xiang, H.; Cheng, Z.; Xiong, Y.; et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. Jama 2020;323:1061-1069. doi: 10.1001/jama.2020.1585
7. Zhou, M.; Tang, F.; Wang, Y.; Nie, H.; Zhang, L.; You, G.; Zhang, M. Knowledge, attitude and practice regarding COVID-19 among health care workers in Henan, China. J. Hosp. Infect. 2020;S0195-6701(20)30187-0. doi: 10.1016/j.jhin.2020.04.012.
8. Tang, Y.-W.; Schmitz, J.E.; Persing, D.H.; Stratton, C.W. The Laboratory Diagnosis of COVID-19 Infection: Current Issues and Challenges. J. Clin. Microbiol. 2020;58:e00512-20. doi: 10.1128/JCM.00512-20
9. Vashist, S.K. In Vitro Diagnostic Assays for COVID-19: Recent Advances and Emerging Trends. Diagnostics (Basel, Switzerland) 2020;10:202. doi: 10.3390/diagnostics10040202.
10. European Centre for Diseases Prevention and Control (ECDC) An overview of the rapid test situation for COVID-19 diagnosis in the EU / EEA; Stockholm, 2020;
11. Cassaniti, I.; Novazzi, F.; Giardina, F.; Salivaro, F.; Sachs, M.; Perlini, S.; Bruno, R.; Mojoli, F.; Baldanti, F.; San Matteo Pavia COVID-19 Task Force. Performance of VivaDiagTM COVID-19 IgM/IgG Rapid Test is inadequate for diagnosis of COVID-19 in acute patients referring to emergency room department. J. Med. Virol. 2020, epub ahead of print, 10.1002/jmv.25800. doi: 10.1002/jmv.25800
12. Lassaunière, R.; Frische, A.; Harboe, Z.B.; Nielsen, A.C.Y.; Fomsgaard, A.; Karen, A.; Jørgensen, C.S. Evaluation of nine commercial SARS-CoV-2 immunoassays. medRxiv 2020, 2020.04.09.20056325v1. doi: https://doi.org/10.1101/2020.04.09.20056325
13. Virgilio Paradiso, A.; Summa, S. De; Loconsole, D.; Procacci, V.; Sallustio, A.; Centrone, F.; Silvestris, N.; Cafagna, V.; Palma, G. De; Tufaro, A.; et al. Clinical meanings of rapid serological assay in patients tested for SARS-Co2 RT-PCR . medRxiv 2020, 2020.04.03.20052183v1, doi: 10.1101/2020.04.03.20052183
14. Pérez-Garcia, F.; Pérez-Tanoira, R.; Romanyk, J.; Arroyo, T.; Gómez-Herruz, P.; Cuadros-González, J. Rapid diagnosis of SARS-CoV-2 infection by detecting IgG and IgM antibodies with an immunochromatographic device: a prospective single-center study. medRxiv 2020. 2020.04.11.20062158v2 doi: 10.1101/2020.04.11.20062158
15. Liu, Y.; Liu, Y.; Diao, B.; Ren, F.; Wang, Y.; Ding, J.; Huang, Q. Diagnostic Indexes of a Rapid IgG/IgM Combined Antibody Test for SARS-CoV-2. medRxiv 2020, 2020.03.26.20044883 doi: 10.1101/2020.03.26.20044883
16. Loeffelholz, M.J.; Tang, Y.-W. Laboratory Diagnosis of Emerging Human Coronavirus Infections — The State of the Art. Emerg. Microbes Infect. 2020;9:747-756. doi: 10.1080/22221751.2020.1745095.
17. Riccò, M.; Ferraro, P.; Gualerzi, G.; Ranzieri, S.; Bragazzi, N.L.; Balzarini, F.; Signorelli, C. Point-of-Care diagnostic of SARS-CoV-2: knowledge, attitudes, and beliefs (KAP) of medical workforce in Italy. Acta Biomed 2020;91:57-67. doi: 10.23750/abm.v91i2.9573.
18. Riccò, M.; Ferraro, P.; Gualerzi, G.; Ranzieri, S.; Henry, B.M.; Said, Y. Ben; Pyatigorskaya, N.V.; Nevolina, E.; Wu, J.; Bragazzi, N.L.; et al. Point-of-Care Diagnostic Tests for Detecting SARS-CoV-2 Antibodies : A Systematic Review and Meta-Analysis of Real-World Data. J. Clin. Med. 2020;9:E1515. doi: 10.3390/jcm9051515.
19. Moher, D.; Liberati, A.; Tetzlaff, J.; Altman, D.G.; Altman, D.; Antes, G.; Atkins, D.; Barbour, V.; Barrowman, N.; Berlin, J.A.; et al. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med. 2009;6:e1000097. doi: 10.1371/journal.pmed.1000097
20. Bai, Y.; Wang, X.; Huang, Q.; Wang, H.; Gurarie, D.; Ndeffo-Mbah, M.; Fan, F.; Fu, P.; Horn, M.A.; Xu, S.; et al. SARS-CoV-2 infection in health care workers: a retrospective analysis and a model study. medRxiv 2020, 2020.03.29.20047159. doi: 10.1101/2020.03.29.20047159
21. Barrett, E.S.; Horton, D.B.; Roy, J.; Gennaro, M.L.; Brooks, A.; Tischfield, J.; Greenberg, P.; Andrews, T.; Jagpal, S.; Reilly, N.; et al. Prevalence of SARS-CoV-2 infection in previously undiagnosed health care workers at the onset of the U.S. COVID-19 epidemic. medRxiv 2020, 2020.04.20.20072470.
22. Kabesch, M.; Roth, S.; Brandstetter, S.; Häusler, S.; Juraschko, E.; Weigl, M.; Wellmann, S.; Lang, T.; Schmidt, B.; Salzberger, B.; et al. Successful containment of COVID‐19 outbreak in a large maternity and perinatal center while continuing clinical service. Pediatr. Allergy Immunol. 2020. epub ahead of print doi: 10.1111/pai.13265
23. Keeley, A.J.; Evans, C.; Colton, H.; Ankcorn, M.; Cope, A.; State, A.; Bennett, T.; Giri, P.; de Silva, T.I.; Raza, M. Roll-out of SARS-CoV-2 testing for healthcare workers at a large NHS Foundation Trust in the United Kingdom, March 2020. Euro Surveill. 2020;25:2000433. doi: 10.2807/1560-7917.ES.2020.25.14.2000433
24. Kluytmans-van den Bergh, M.; Buiting, A.; Pas, S.; Bentvelsen, R.; van den Bijllaardt, W.; van Oudheusden, A.; van Rijen MML; Verweij, J.; Koopmans, M.; Kluytmans, J. SARS- CoV- 2 infection in 86 healthcare workers in two Dutch hospitals in March. medRxiv 2020, 2020.03.23.20041913. doi: 10.1101/2020.03.23.20041913
25. Lombardi, A.; Consonni, D.; Carugno, M.; Bozzi, G.; Muscatello, A.; Castelli, V.; Palomba, E.; Cantù, A.P.; Ceriotti, F.; Tiso, B.; et al. Characteristics of 1,573 healthcare workers who underwent nasopharyngeal swab for SARS-CoV-2 in Milano, Lombardy, Italy. medRxiv 2020, 2020.05.07.20094276. doi: 10.1101/2020.03.23.20041913
26. Ran, L.; Chen, X.; Wang, Y.; Wu, W.; Zhang, L.; Tan, X. Risk Factors of Healthcare Workers with Corona Virus Disease 2019: A Retrospective Cohort Study in a Designated Hospital of Wuhan in China. Clin Infect Dis 2020;ciaa287. doi: 10.1093/cid/ciaa287.
27. Rivett, L.; Sridhar, S.; Sparkes, D.; Routledge, M.; Jones, N.K.; Forrest, S.; Young, J.; Pereira-Dias, J.; Hamilton, W.L.; Ferris, M.; et al. Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission. Elife 2020;9:e58728. doi: 10.7554/eLife.58728
28. Reusken, C.B.; Buiting, A.; Bleeker-Rovers, C.; Diederen, B.; Hooiveld, M.; Friesema, I.; Koopmans, M.; Kortbeek, T.; Lutgens, S.P.; Meijer, A.; et al. Rapid assessment of regional SARS-CoV-2 community transmission through a convenience sample of healthcare workers, the Netherlands, March 2020. Eurosurveillance 2017;25:2000334. doi: 10.2807/1560-7917.ES.2020.25.12.2000334.
29. Schwierzeck, V.; König, J.C.; Kühn, J.; Mellmann, A.; Correa-martínez, L.; Omran, H.; Konrad, M.; Kaiser, T. First reported nosocomial outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a pediatric dialysis unit. Clin Infect Dis 2020;ciaa491. doi: 10.1093/cid/ciaa491
30. Shields, A.M.; Faustini, S.E.; Perez-Toledo, M.; Jossi, S.; Aldera, E.; Allen, J.D.; Al-Taei, S.; Backhouse, C.; Bosworth, A.; Dunbar, L.; et al. SARS-CoV-2 seroconversion in health care workers. medRxiv 2020, 2020.05.18.20105197 doi: 10.1101/2020.05.18.20105197
31. Sikkema, R.S.; Pas, S.; Nieuwenhuijse, D.F. COVID-19 in healthcare workers in three hospitals in the South of the Netherlands , March 2020. medRxiv 2020, 2020.04.26.20079418. doi: 10.1101/2020.04.26.20079418
32. Comar, M.; Brumat, M.; Concas, M.P.; Argentini, G.; Bianco, A.; Bicego, L.; Bottega, R.; Carli, P.; Cassone, A.; Catamo, E.; et al. COVID-19 experience: first Italian survey on healthcare staff members from a Mother-Child Research hospital using combined molecular and rapid immunoassays test. medRxiv 2020, 2020.04.19.20071563. doi: 10.1101/2020.04.19.20071563
33. Tosato, F.; Pelloso, M.; Gallo, N.; Giraudo, C.; Llanaj, G.; Cosma, C.; Pozzato, C.; Padoan, A.; Donato D, Plebani, M. Severe Acute Respiratory Syndrome Coronaviru 2 Serology in Asymptomatic Healthcare Professionals: preliminary experience of a Tertiary Italian Academic Center. medRxiv 2020, 2020.04.27.20073858. doi: 10.1101/2020.04.27.20073858
34. Tostmann, A.; Bradley, J.; Bousema, T.; Yiek, W.-K.; Holwerda, M.; Bleeker-Rovers, C.; ten Oever, J.; Meijer, C.; Rahamat-Langendoen, J.; Hopman, J.; et al. Strong associations and moderate predictive value of early symptoms for SARS-CoV-2 test positivity among healthcare workers, the Netherlands, March 2020. Eurosurveillance 2020;25:2000508. doi: 10.2807/1560-7917.ES.2020.25.16.2000508
35. Treibel, T.; Manisty, C.; Burton, M.; McKnight, Á.; Lambourne, J.; Augusto, J.B.; Couto-Parada, X.; Cutino-Moguel, T.; Noursadeghi, M.; Moon, J.C. COVID-19: PCR screening of asymptomatic health- care workers at London hospital. Lancet 2020;395:1608-1610. doi: 10.1016/S0140-6736(20)31100-4.
36. Virgilio Paradiso, A.; De Summa, S.; Silvestris, N.; Tommasi, S.; Tufaro, A.; De Palma, G.; Maria Vittoria Larocca, A.; Raffaele, D.; Cafagna, V.; Garrisi, V.; et al. COVID-19 screening and monitoring of asymptomatic health workers with a rapid serological test. medRxiv 2020, 2020.05.05.20086017. doi: 10.1101/2020.05.05.20086017
37. Wang, Q.; Huang, X.; Bai, Y.; Wang, X.; Wang, H.; Hu, X.; Wang, F.; Wang, X.; Chen, J.; Chen, Q.; et al. Epidemiological characteristics of COVID-19 in medical staff members of neurosurgery departments in Hubei province: A multicentre descriptive study. medRxiv 2020, 2020.04.20.20064899. doi: 10.1101/2020.04.20.20064899
38. Olalla, J.; Correa, A.M.; Martín-Escalante, M.D.; Hortas, M.L.; Martín-Sendarrubias, M.J.; Fuentes, V.; Sena, G.; Garcia-Alegria, J. Search for asymptomatic carriers of SARS-CoV-2 in healthcare workers during the pandemic: a Spanish experience. medRxiv 2020, 2020.05.18.20103283. doi: 10.1101/2020.05.18.20103283
39. Durante-Mangoni, E.; Andini, R.; Bertolino, L.; Mele, F.; Bernardo, M.; Grimaldi, M.; Cuomo, N.; Tiberio, C.; Falco, E.; Di Spirito, A.; et al. Low rate of SARS-CoV-2 spread among health care personnel using ordinary personal protection equipment in a medium-incidence setting. Clin. Microbiol. Infect. 2020;S1198-743X(20)30270-6. doi: 10.1016/j.cmi.2020.04.042.
40. Folgueira, M.D.; Munoz-Ruiperez, C.; Alonso-Lopez, M.A.; Delgado, R. SARS-CoV-2 infection in Health Care Workers in a large public hospital in Madrid, Spain, during March 2020. medRxiv 2020, 2020.04.07.20055723. doi: 10.1101/2020.04.07.20055723
41. Garcia-Basteiro, A.L.; Moncunill, G.; Tortajada, M.; Vidal, M.; Santano, R.; Sanz, S.; Aguilar, R.; Alonso, S.; Barrios, D.; Carolis, C.; et al. Seroprevalence of antibodies against SARS-CoV-2 in a large Spanish reference hospital. medRxiv 2020, 2020.04.27.20082289. doi: 10.1101/2020.04.27.20082289
42. Heinzerling, A.; Stuckey, M.J.; Scheuer, T.; Xu, K.; Perkins, K.M.; Resseger, ; Heather; Magill, S.; Verani, J.R.; Jain, S.; Acosta, M.; et al. Transmission of COVID-19 to Health Care Personnel During Exposures to a Hospitalized Patient-Solano County, California, February 2020. Morb. Mortal. Wkly. Rep. 2020;69:472–476. doi: 10.15585/mmwr.mm6915e5
43. Hirotsu, Y.; Maejima, M.; Shibusawa, M.; Nagakubo, Y.; Hosaka, K.; Amemiya, K.; Sueki, H.; Hayakawa, M.; Mochizuki, H.; Omata, M. Pooling RT-PCR test of SARS-CoV-2 for large cohort of “healthy” and infection-suspected patients: A prospective and consecutive study on 1,000 individuals. medRxiv 2020, 2020.05.04.20088146. doi: 10.1101/2020.05.04.20088146.
44. Htet, L.H.; Wee Lim, D.; Mar Kyaw, W.; Janis Loh MCom, W.-N.; Tin Lee, L.; Ang, B.; Chow, A. Responding to the COVID-19 outbreak in Singapore: Staff Protection and Staff Temperature and Sickness Surveillance Systems. Clin Infect Dis 2020;ciaa468. doi: 10.1093/cid/ciaa468.
45. Hunter, E.; Price, D.A.; Murphy, E.; van der Loeff, I.S.; Baker, K.F.; Lendrem, D.; Lendrem, C.; Schmid, M.L.; Pareja-Cebrian, L.; Welch, A.; et al. First experience of COVID-19 screening of health-care workers in England. Lancet 2020;395:e77–e78. doi: 10.1016/S0140-6736(20)30970-3
46. Takita, M.; Mathsumura, T.; Yamamoto, K.; Yamashita, E.; Hosoda, K.; Hamaki, T.; Kusumi, E. Preliminary Results of Seroprevalence of SARS-CoV-2 at Community Clinics in Tokyo. medRxiv 2020, 2020.04.29.20085449. doi: 10.1101/2020.04.29.20085449
47. Sikora, K.; Barwick, I.; Hamilton, C. Serological prevalence of antibodies to SARS CoV-2 amongst cancer centre staff. medRxiv 2020, 2020.05.16.20099408. doi: 10.1101/2020.05.16.20099408
48. Behrens, G.M.N.; Cossmann, A.; Stankov, M. V; Witte, T.; Ernst, D.; Happle, C.; Jablonka, A.; Behrens, G.M.N. Perceived versus proven SARS-CoV-2 specific immune responses in health care professionals Corresponding author : Key words : Abbreviations : Abstract There have been concerns about high rates of thus far undiagnosed SARS-CoV-2 infections in the health car. medRxiv 2020, 2020.05.12.20094524. doi: 10.1101/2020.05.12.20094524
49. Fujita, K.; Kada, S.; Kanai, O.; Hata, H.; Odagaki, T.; Satoh-Asahara, N.; Tagami, T.; Yasoda, A. Experience of quantitative SARS-CoV-2 antibody screening of health-care workers in the southern part of Kyoto city during COVID-19 peri-pandemic period. medRxiv 2020, 2020.05.12.20098962. doi: 10.1101/2020.05.12.20098962
50. Korth, J.; Wilde, B.; Dol, S.; Anastasiou, O.E.; Krawczyk, A.; Jahn, M.; Cordes, S.; Ross, B.; Esser, S.; Lindemann, M.; et al. SARS-CoV-2-specific antibody detection in healthcare workers in Germany with direct contact to COVID-19 patients. J. Clin. Virol. 2020;128:104437. doi: 10.1016/j.jcv.2020.104437
51. Hains, D.S.; Schwaderer, A.L.; Carroll, A.E.; Starr, M.C.; Wilson, A.C.; Amanat, F.; Krammer, F. Asymptomatic Seroconversion of Immunoglobulins to SARS-CoV-2 in a Pediatric Dialysis Unit. JAMA 2020;e208438. doi: 10.1001/jama.2020.8438.
52. Nguyen, L.H.; Drew, D.A.; Ph, D.; Joshi, A.D.; Ph, D.; Guo, C. Risk of symptomatic Covid-19 among frontline healthcare workers. medRxiv 2020, 2020.04.29.20084111. doi: 10.1101/2020.04.29.20084111
53. Schiavone, M.; Forleo, G.B.; Mitacchione, G.; Gasperetti, A.; Viecca, M.; Tondo, C. Quis custodiet ipsos custodes: are we taking care of healthcare workers in the Italian Covid-19 outbreak? J. Hosp 2020;S0195-6701(20)30230-9. doi: 10.1016/j.jhin.2020.04.045.
54. Santé Publique France COVID-19 Point épidémiologique hebdomadaire du 21 mai 2020; Saint-Maurice, 2020; available from: https://www.santepubliquefrance.fr/maladies-et-traumatismes/maladies-et-infections-respiratoires/infection-a-coronavirus/documents/bulletin-national/covid-19-point-epidemiologique-du-21-mai-2020 Accessed on June 3rd, 2020
55. Long, Q.; Liu, B.; Deng, H.; Wu, G.; Deng, K.; Chen, Y.; Liao, P.; Qiu, J.; Lin, Y.; Cai, X.; et al. Antibody responses to SARS-CoV-2 in patients with COVID-19. Nat Med 2020, epub ahead of print. doi: 10.1038/s41591-020-0897-1.
56. Lippi, G.; Mattiuzzi, C.; Bovo, C.; Plebani, M.; Services, S. Current laboratory diagnostics of coronavirus disease 2019 ( COVID-19). Acta Biomed. 2019;91:137–145. doi: 10.23750/abm.v91i2.9548.
57. Odone, A.; Delmonte, D.; Scognamiglio, T.; Signorelli, C. COVID-19 deaths in Lombardy, Italy: data in context. Lancet Public Heal. 2020;S2468-2667(20)30099–2. doi: doi: 10.1016/S2468-2667(20)30099-2.
58. Signorelli, C.; Scognamiglio, T.; Odone, A. COVID-19 in Italy: impact of containment measures and prevalence estimates of infection in the general population. Acta Biomed. 2020;91: 175–179. doi: 10.23750/abm.v91i3-S.9511.
2. Huang, C.; Wang, Y.; Li, X.; Ren, L.; Zhao, J.; Hu, Y.; Zhang, L.; Fan, G.; Xu, J.; Gu, X. Clinical features of patients infected with 2019 novel coronavirus in Wuhan , China. Lancet 2020;395: 497-506 doi: 10.1016/S0140-6736(20)30183-5..
3. Li, Q.; Guan, X.; Wu, P.; Wang, X.; Zhou, L.; Tong, Y.; Ren, R.; Leung, K.S.M.; Lau, E.H.Y.; Wong, J.Y.; et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N. Engl. J. Med. 2020;382:1199-1207. doi: 10.1056/NEJMoa2001316
4. Wang, J.; Zhou, M.; Liu, F. Reasons for healthcare workers becoming infected with novel coronavirus disease 2019 (COVID-19) in China. J. Hosp. Infect. 2020;105:100-101. doi: 10.1016/j.jhin.2020.03.002
5. Rivett, L.; Routledge, M.; Sparkes, D.; Warne, B.; Bartholdson, J.; Cormie, C.; Forrest, S.; Gill, H. Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission. Elife 2020;e58728. doi: 10.7554/eLife.58728
6. Wang, D.; Hu, B.; Hu, C.; Zhu, F.; Liu, X.; Zhang, J.; Wang, B.; Xiang, H.; Cheng, Z.; Xiong, Y.; et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. Jama 2020;323:1061-1069. doi: 10.1001/jama.2020.1585
7. Zhou, M.; Tang, F.; Wang, Y.; Nie, H.; Zhang, L.; You, G.; Zhang, M. Knowledge, attitude and practice regarding COVID-19 among health care workers in Henan, China. J. Hosp. Infect. 2020;S0195-6701(20)30187-0. doi: 10.1016/j.jhin.2020.04.012.
8. Tang, Y.-W.; Schmitz, J.E.; Persing, D.H.; Stratton, C.W. The Laboratory Diagnosis of COVID-19 Infection: Current Issues and Challenges. J. Clin. Microbiol. 2020;58:e00512-20. doi: 10.1128/JCM.00512-20
9. Vashist, S.K. In Vitro Diagnostic Assays for COVID-19: Recent Advances and Emerging Trends. Diagnostics (Basel, Switzerland) 2020;10:202. doi: 10.3390/diagnostics10040202.
10. European Centre for Diseases Prevention and Control (ECDC) An overview of the rapid test situation for COVID-19 diagnosis in the EU / EEA; Stockholm, 2020;
11. Cassaniti, I.; Novazzi, F.; Giardina, F.; Salivaro, F.; Sachs, M.; Perlini, S.; Bruno, R.; Mojoli, F.; Baldanti, F.; San Matteo Pavia COVID-19 Task Force. Performance of VivaDiagTM COVID-19 IgM/IgG Rapid Test is inadequate for diagnosis of COVID-19 in acute patients referring to emergency room department. J. Med. Virol. 2020, epub ahead of print, 10.1002/jmv.25800. doi: 10.1002/jmv.25800
12. Lassaunière, R.; Frische, A.; Harboe, Z.B.; Nielsen, A.C.Y.; Fomsgaard, A.; Karen, A.; Jørgensen, C.S. Evaluation of nine commercial SARS-CoV-2 immunoassays. medRxiv 2020, 2020.04.09.20056325v1. doi: https://doi.org/10.1101/2020.04.09.20056325
13. Virgilio Paradiso, A.; Summa, S. De; Loconsole, D.; Procacci, V.; Sallustio, A.; Centrone, F.; Silvestris, N.; Cafagna, V.; Palma, G. De; Tufaro, A.; et al. Clinical meanings of rapid serological assay in patients tested for SARS-Co2 RT-PCR . medRxiv 2020, 2020.04.03.20052183v1, doi: 10.1101/2020.04.03.20052183
14. Pérez-Garcia, F.; Pérez-Tanoira, R.; Romanyk, J.; Arroyo, T.; Gómez-Herruz, P.; Cuadros-González, J. Rapid diagnosis of SARS-CoV-2 infection by detecting IgG and IgM antibodies with an immunochromatographic device: a prospective single-center study. medRxiv 2020. 2020.04.11.20062158v2 doi: 10.1101/2020.04.11.20062158
15. Liu, Y.; Liu, Y.; Diao, B.; Ren, F.; Wang, Y.; Ding, J.; Huang, Q. Diagnostic Indexes of a Rapid IgG/IgM Combined Antibody Test for SARS-CoV-2. medRxiv 2020, 2020.03.26.20044883 doi: 10.1101/2020.03.26.20044883
16. Loeffelholz, M.J.; Tang, Y.-W. Laboratory Diagnosis of Emerging Human Coronavirus Infections — The State of the Art. Emerg. Microbes Infect. 2020;9:747-756. doi: 10.1080/22221751.2020.1745095.
17. Riccò, M.; Ferraro, P.; Gualerzi, G.; Ranzieri, S.; Bragazzi, N.L.; Balzarini, F.; Signorelli, C. Point-of-Care diagnostic of SARS-CoV-2: knowledge, attitudes, and beliefs (KAP) of medical workforce in Italy. Acta Biomed 2020;91:57-67. doi: 10.23750/abm.v91i2.9573.
18. Riccò, M.; Ferraro, P.; Gualerzi, G.; Ranzieri, S.; Henry, B.M.; Said, Y. Ben; Pyatigorskaya, N.V.; Nevolina, E.; Wu, J.; Bragazzi, N.L.; et al. Point-of-Care Diagnostic Tests for Detecting SARS-CoV-2 Antibodies : A Systematic Review and Meta-Analysis of Real-World Data. J. Clin. Med. 2020;9:E1515. doi: 10.3390/jcm9051515.
19. Moher, D.; Liberati, A.; Tetzlaff, J.; Altman, D.G.; Altman, D.; Antes, G.; Atkins, D.; Barbour, V.; Barrowman, N.; Berlin, J.A.; et al. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med. 2009;6:e1000097. doi: 10.1371/journal.pmed.1000097
20. Bai, Y.; Wang, X.; Huang, Q.; Wang, H.; Gurarie, D.; Ndeffo-Mbah, M.; Fan, F.; Fu, P.; Horn, M.A.; Xu, S.; et al. SARS-CoV-2 infection in health care workers: a retrospective analysis and a model study. medRxiv 2020, 2020.03.29.20047159. doi: 10.1101/2020.03.29.20047159
21. Barrett, E.S.; Horton, D.B.; Roy, J.; Gennaro, M.L.; Brooks, A.; Tischfield, J.; Greenberg, P.; Andrews, T.; Jagpal, S.; Reilly, N.; et al. Prevalence of SARS-CoV-2 infection in previously undiagnosed health care workers at the onset of the U.S. COVID-19 epidemic. medRxiv 2020, 2020.04.20.20072470.
22. Kabesch, M.; Roth, S.; Brandstetter, S.; Häusler, S.; Juraschko, E.; Weigl, M.; Wellmann, S.; Lang, T.; Schmidt, B.; Salzberger, B.; et al. Successful containment of COVID‐19 outbreak in a large maternity and perinatal center while continuing clinical service. Pediatr. Allergy Immunol. 2020. epub ahead of print doi: 10.1111/pai.13265
23. Keeley, A.J.; Evans, C.; Colton, H.; Ankcorn, M.; Cope, A.; State, A.; Bennett, T.; Giri, P.; de Silva, T.I.; Raza, M. Roll-out of SARS-CoV-2 testing for healthcare workers at a large NHS Foundation Trust in the United Kingdom, March 2020. Euro Surveill. 2020;25:2000433. doi: 10.2807/1560-7917.ES.2020.25.14.2000433
24. Kluytmans-van den Bergh, M.; Buiting, A.; Pas, S.; Bentvelsen, R.; van den Bijllaardt, W.; van Oudheusden, A.; van Rijen MML; Verweij, J.; Koopmans, M.; Kluytmans, J. SARS- CoV- 2 infection in 86 healthcare workers in two Dutch hospitals in March. medRxiv 2020, 2020.03.23.20041913. doi: 10.1101/2020.03.23.20041913
25. Lombardi, A.; Consonni, D.; Carugno, M.; Bozzi, G.; Muscatello, A.; Castelli, V.; Palomba, E.; Cantù, A.P.; Ceriotti, F.; Tiso, B.; et al. Characteristics of 1,573 healthcare workers who underwent nasopharyngeal swab for SARS-CoV-2 in Milano, Lombardy, Italy. medRxiv 2020, 2020.05.07.20094276. doi: 10.1101/2020.03.23.20041913
26. Ran, L.; Chen, X.; Wang, Y.; Wu, W.; Zhang, L.; Tan, X. Risk Factors of Healthcare Workers with Corona Virus Disease 2019: A Retrospective Cohort Study in a Designated Hospital of Wuhan in China. Clin Infect Dis 2020;ciaa287. doi: 10.1093/cid/ciaa287.
27. Rivett, L.; Sridhar, S.; Sparkes, D.; Routledge, M.; Jones, N.K.; Forrest, S.; Young, J.; Pereira-Dias, J.; Hamilton, W.L.; Ferris, M.; et al. Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission. Elife 2020;9:e58728. doi: 10.7554/eLife.58728
28. Reusken, C.B.; Buiting, A.; Bleeker-Rovers, C.; Diederen, B.; Hooiveld, M.; Friesema, I.; Koopmans, M.; Kortbeek, T.; Lutgens, S.P.; Meijer, A.; et al. Rapid assessment of regional SARS-CoV-2 community transmission through a convenience sample of healthcare workers, the Netherlands, March 2020. Eurosurveillance 2017;25:2000334. doi: 10.2807/1560-7917.ES.2020.25.12.2000334.
29. Schwierzeck, V.; König, J.C.; Kühn, J.; Mellmann, A.; Correa-martínez, L.; Omran, H.; Konrad, M.; Kaiser, T. First reported nosocomial outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a pediatric dialysis unit. Clin Infect Dis 2020;ciaa491. doi: 10.1093/cid/ciaa491
30. Shields, A.M.; Faustini, S.E.; Perez-Toledo, M.; Jossi, S.; Aldera, E.; Allen, J.D.; Al-Taei, S.; Backhouse, C.; Bosworth, A.; Dunbar, L.; et al. SARS-CoV-2 seroconversion in health care workers. medRxiv 2020, 2020.05.18.20105197 doi: 10.1101/2020.05.18.20105197
31. Sikkema, R.S.; Pas, S.; Nieuwenhuijse, D.F. COVID-19 in healthcare workers in three hospitals in the South of the Netherlands , March 2020. medRxiv 2020, 2020.04.26.20079418. doi: 10.1101/2020.04.26.20079418
32. Comar, M.; Brumat, M.; Concas, M.P.; Argentini, G.; Bianco, A.; Bicego, L.; Bottega, R.; Carli, P.; Cassone, A.; Catamo, E.; et al. COVID-19 experience: first Italian survey on healthcare staff members from a Mother-Child Research hospital using combined molecular and rapid immunoassays test. medRxiv 2020, 2020.04.19.20071563. doi: 10.1101/2020.04.19.20071563
33. Tosato, F.; Pelloso, M.; Gallo, N.; Giraudo, C.; Llanaj, G.; Cosma, C.; Pozzato, C.; Padoan, A.; Donato D, Plebani, M. Severe Acute Respiratory Syndrome Coronaviru 2 Serology in Asymptomatic Healthcare Professionals: preliminary experience of a Tertiary Italian Academic Center. medRxiv 2020, 2020.04.27.20073858. doi: 10.1101/2020.04.27.20073858
34. Tostmann, A.; Bradley, J.; Bousema, T.; Yiek, W.-K.; Holwerda, M.; Bleeker-Rovers, C.; ten Oever, J.; Meijer, C.; Rahamat-Langendoen, J.; Hopman, J.; et al. Strong associations and moderate predictive value of early symptoms for SARS-CoV-2 test positivity among healthcare workers, the Netherlands, March 2020. Eurosurveillance 2020;25:2000508. doi: 10.2807/1560-7917.ES.2020.25.16.2000508
35. Treibel, T.; Manisty, C.; Burton, M.; McKnight, Á.; Lambourne, J.; Augusto, J.B.; Couto-Parada, X.; Cutino-Moguel, T.; Noursadeghi, M.; Moon, J.C. COVID-19: PCR screening of asymptomatic health- care workers at London hospital. Lancet 2020;395:1608-1610. doi: 10.1016/S0140-6736(20)31100-4.
36. Virgilio Paradiso, A.; De Summa, S.; Silvestris, N.; Tommasi, S.; Tufaro, A.; De Palma, G.; Maria Vittoria Larocca, A.; Raffaele, D.; Cafagna, V.; Garrisi, V.; et al. COVID-19 screening and monitoring of asymptomatic health workers with a rapid serological test. medRxiv 2020, 2020.05.05.20086017. doi: 10.1101/2020.05.05.20086017
37. Wang, Q.; Huang, X.; Bai, Y.; Wang, X.; Wang, H.; Hu, X.; Wang, F.; Wang, X.; Chen, J.; Chen, Q.; et al. Epidemiological characteristics of COVID-19 in medical staff members of neurosurgery departments in Hubei province: A multicentre descriptive study. medRxiv 2020, 2020.04.20.20064899. doi: 10.1101/2020.04.20.20064899
38. Olalla, J.; Correa, A.M.; Martín-Escalante, M.D.; Hortas, M.L.; Martín-Sendarrubias, M.J.; Fuentes, V.; Sena, G.; Garcia-Alegria, J. Search for asymptomatic carriers of SARS-CoV-2 in healthcare workers during the pandemic: a Spanish experience. medRxiv 2020, 2020.05.18.20103283. doi: 10.1101/2020.05.18.20103283
39. Durante-Mangoni, E.; Andini, R.; Bertolino, L.; Mele, F.; Bernardo, M.; Grimaldi, M.; Cuomo, N.; Tiberio, C.; Falco, E.; Di Spirito, A.; et al. Low rate of SARS-CoV-2 spread among health care personnel using ordinary personal protection equipment in a medium-incidence setting. Clin. Microbiol. Infect. 2020;S1198-743X(20)30270-6. doi: 10.1016/j.cmi.2020.04.042.
40. Folgueira, M.D.; Munoz-Ruiperez, C.; Alonso-Lopez, M.A.; Delgado, R. SARS-CoV-2 infection in Health Care Workers in a large public hospital in Madrid, Spain, during March 2020. medRxiv 2020, 2020.04.07.20055723. doi: 10.1101/2020.04.07.20055723
41. Garcia-Basteiro, A.L.; Moncunill, G.; Tortajada, M.; Vidal, M.; Santano, R.; Sanz, S.; Aguilar, R.; Alonso, S.; Barrios, D.; Carolis, C.; et al. Seroprevalence of antibodies against SARS-CoV-2 in a large Spanish reference hospital. medRxiv 2020, 2020.04.27.20082289. doi: 10.1101/2020.04.27.20082289
42. Heinzerling, A.; Stuckey, M.J.; Scheuer, T.; Xu, K.; Perkins, K.M.; Resseger, ; Heather; Magill, S.; Verani, J.R.; Jain, S.; Acosta, M.; et al. Transmission of COVID-19 to Health Care Personnel During Exposures to a Hospitalized Patient-Solano County, California, February 2020. Morb. Mortal. Wkly. Rep. 2020;69:472–476. doi: 10.15585/mmwr.mm6915e5
43. Hirotsu, Y.; Maejima, M.; Shibusawa, M.; Nagakubo, Y.; Hosaka, K.; Amemiya, K.; Sueki, H.; Hayakawa, M.; Mochizuki, H.; Omata, M. Pooling RT-PCR test of SARS-CoV-2 for large cohort of “healthy” and infection-suspected patients: A prospective and consecutive study on 1,000 individuals. medRxiv 2020, 2020.05.04.20088146. doi: 10.1101/2020.05.04.20088146.
44. Htet, L.H.; Wee Lim, D.; Mar Kyaw, W.; Janis Loh MCom, W.-N.; Tin Lee, L.; Ang, B.; Chow, A. Responding to the COVID-19 outbreak in Singapore: Staff Protection and Staff Temperature and Sickness Surveillance Systems. Clin Infect Dis 2020;ciaa468. doi: 10.1093/cid/ciaa468.
45. Hunter, E.; Price, D.A.; Murphy, E.; van der Loeff, I.S.; Baker, K.F.; Lendrem, D.; Lendrem, C.; Schmid, M.L.; Pareja-Cebrian, L.; Welch, A.; et al. First experience of COVID-19 screening of health-care workers in England. Lancet 2020;395:e77–e78. doi: 10.1016/S0140-6736(20)30970-3
46. Takita, M.; Mathsumura, T.; Yamamoto, K.; Yamashita, E.; Hosoda, K.; Hamaki, T.; Kusumi, E. Preliminary Results of Seroprevalence of SARS-CoV-2 at Community Clinics in Tokyo. medRxiv 2020, 2020.04.29.20085449. doi: 10.1101/2020.04.29.20085449
47. Sikora, K.; Barwick, I.; Hamilton, C. Serological prevalence of antibodies to SARS CoV-2 amongst cancer centre staff. medRxiv 2020, 2020.05.16.20099408. doi: 10.1101/2020.05.16.20099408
48. Behrens, G.M.N.; Cossmann, A.; Stankov, M. V; Witte, T.; Ernst, D.; Happle, C.; Jablonka, A.; Behrens, G.M.N. Perceived versus proven SARS-CoV-2 specific immune responses in health care professionals Corresponding author : Key words : Abbreviations : Abstract There have been concerns about high rates of thus far undiagnosed SARS-CoV-2 infections in the health car. medRxiv 2020, 2020.05.12.20094524. doi: 10.1101/2020.05.12.20094524
49. Fujita, K.; Kada, S.; Kanai, O.; Hata, H.; Odagaki, T.; Satoh-Asahara, N.; Tagami, T.; Yasoda, A. Experience of quantitative SARS-CoV-2 antibody screening of health-care workers in the southern part of Kyoto city during COVID-19 peri-pandemic period. medRxiv 2020, 2020.05.12.20098962. doi: 10.1101/2020.05.12.20098962
50. Korth, J.; Wilde, B.; Dol, S.; Anastasiou, O.E.; Krawczyk, A.; Jahn, M.; Cordes, S.; Ross, B.; Esser, S.; Lindemann, M.; et al. SARS-CoV-2-specific antibody detection in healthcare workers in Germany with direct contact to COVID-19 patients. J. Clin. Virol. 2020;128:104437. doi: 10.1016/j.jcv.2020.104437
51. Hains, D.S.; Schwaderer, A.L.; Carroll, A.E.; Starr, M.C.; Wilson, A.C.; Amanat, F.; Krammer, F. Asymptomatic Seroconversion of Immunoglobulins to SARS-CoV-2 in a Pediatric Dialysis Unit. JAMA 2020;e208438. doi: 10.1001/jama.2020.8438.
52. Nguyen, L.H.; Drew, D.A.; Ph, D.; Joshi, A.D.; Ph, D.; Guo, C. Risk of symptomatic Covid-19 among frontline healthcare workers. medRxiv 2020, 2020.04.29.20084111. doi: 10.1101/2020.04.29.20084111
53. Schiavone, M.; Forleo, G.B.; Mitacchione, G.; Gasperetti, A.; Viecca, M.; Tondo, C. Quis custodiet ipsos custodes: are we taking care of healthcare workers in the Italian Covid-19 outbreak? J. Hosp 2020;S0195-6701(20)30230-9. doi: 10.1016/j.jhin.2020.04.045.
54. Santé Publique France COVID-19 Point épidémiologique hebdomadaire du 21 mai 2020; Saint-Maurice, 2020; available from: https://www.santepubliquefrance.fr/maladies-et-traumatismes/maladies-et-infections-respiratoires/infection-a-coronavirus/documents/bulletin-national/covid-19-point-epidemiologique-du-21-mai-2020 Accessed on June 3rd, 2020
55. Long, Q.; Liu, B.; Deng, H.; Wu, G.; Deng, K.; Chen, Y.; Liao, P.; Qiu, J.; Lin, Y.; Cai, X.; et al. Antibody responses to SARS-CoV-2 in patients with COVID-19. Nat Med 2020, epub ahead of print. doi: 10.1038/s41591-020-0897-1.
56. Lippi, G.; Mattiuzzi, C.; Bovo, C.; Plebani, M.; Services, S. Current laboratory diagnostics of coronavirus disease 2019 ( COVID-19). Acta Biomed. 2019;91:137–145. doi: 10.23750/abm.v91i2.9548.
57. Odone, A.; Delmonte, D.; Scognamiglio, T.; Signorelli, C. COVID-19 deaths in Lombardy, Italy: data in context. Lancet Public Heal. 2020;S2468-2667(20)30099–2. doi: doi: 10.1016/S2468-2667(20)30099-2.
58. Signorelli, C.; Scognamiglio, T.; Odone, A. COVID-19 in Italy: impact of containment measures and prevalence estimates of infection in the general population. Acta Biomed. 2020;91: 175–179. doi: 10.23750/abm.v91i3-S.9511.
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Riccò M, Gualerzi G, Ranzieri S, et al. Occurrence of SARS-CoV-2 infection among healthcare personnel: results from an early systematic review and meta-analysis. Acta Biomed. 2021;92(5):e2021311. doi:10.23750/abm.v92i5.10438
