Abstract
Background: Providing frontline support places first responders at a high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
Aims: This study was aimed to determine the anti-SARS-CoV-2 seroprevalence in a cohort of first responders (i.e. firefighters/paramedics), to detect the underascertainment rate and to assess risk factors associated with seropositivity.
Methods: We conducted a serological survey among 745 first responders in Germany during 27 November and 4 December 2020 to determine the anti-SARS-CoV-2 seroprevalence using Elecsys® Anti-SARS-CoV-2 immunoassay (Roche Diagnostics, Mannheim, Germany). As part of the examination, participants were asked to provide information on coronavirus disease 2019 (COVID-19)-like-symptoms, information on sociodemographic characteristics and workplace risk factors for a SARS-CoV-2 infection and any prior COVID-19 infection. Descriptive statistics and logistic regression analysis were performed and seroprevalence estimates were adjusted for test sensitivity and specificity.
Results: The test-adjusted seroprevalence was 4% (95% CI 3.1-6.2) and the underascertainment rate was 2.3. Of those tested SARS-CoV-2 antibody positive, 41% were aware that they had been infected in the past. Seropositivity was elevated among paramedics who worked in the emergency rescue team providing first level of pre-hospital emergency care (6% [95% CI 3.4-8.6]) and those directly exposed to a COVID-19 case (5% [95% CI 3.5-8.1]). Overall, the seroprevalence and the underascertainment rate were higher among first responders than among the general population.
Conclusions: The high seroprevalence and underascertainment rate highlight the need to mitigate potential transmission within and between first responders and patients. Workplace control measures such as increased and regular COVID-19-testing and the prompt vaccination of all personnel are necessary.
Keywords: COVID-19; SARS-CoV-2; firefighters; infection risk; occupational medicine; paramedics; seroprevalence.
【저자키워드】 COVID-19, SARS-CoV-2, occupational medicine, infection risk, seroprevalence., firefighters, paramedics, 【초록키워드】 coronavirus disease, Coronavirus disease 2019, coronavirus, vaccination, Risk factors, antibody, SARS-COV-2 infection, Seroprevalence, Infection, occupational medicine, risk factor, severe acute respiratory syndrome Coronavirus, anti-SARS-CoV-2, immunoassay, Cohort, Workplace, SARS-CoV-2 antibody, Sensitivity and specificity, COVID-19 infection, Germany, Seropositivity, General population, infection risk, Responder, respiratory, estimate, information, Care, patients, first responders, paramedics, high risk, Emergency Care, Sociodemographic characteristics, Support, acute respiratory syndrome, Logistic regression analysis, 95% CI, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, examination, COVID-19 case, past, Descriptive statistics, measure, participant, positive, Roche Diagnostics, Elecsys, serological survey, potential transmission, mitigate, highlight, tested, performed, detect, elevated, conducted, adjusted, determine, Providing, asked,