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The Socio-Economic and Demographic Risk Factors for SARS-CoV-2 Seropositivity Among Healthcare Workers in a UK Hospital: A Prospective Cohort Study

Lam, Tanya; Saso, Anja; Ortiz, Arturo Torres; Hatcher, James; Woodman, Marc; Chandran, Shruthi; Thistlethwayte, Rosie; ... Co-STARs study team; + view all (2023) The Socio-Economic and Demographic Risk Factors for SARS-CoV-2 Seropositivity Among Healthcare Workers in a UK Hospital: A Prospective Cohort Study. Clinical Infectious Diseases , Article ciad522. 10.1093/cid/ciad522. Green open access

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Abstract

BACKGROUND: In order to protect healthcare workers from the consequences of disease due to SARS-CoV-2 it is necessary to understand the risk factors that drive exposure and infection within hospitals. Insufficient consideration of key socio-economic variables is a limitation of existing studies that can lead to bias and residual confounding of proposed risk factors for infection. METHODS: The Co-STARS study prospectively enrolled 3679 HCWs between April 2020 and September 2020. We used multivariate logistic regression to comprehensively characterise the demographic, occupational, socio-economic and environmental risk factors for SARS-CoV-2 seropositivity. RESULTS: After adjusting for key confounders relative household overcrowding (OR 1.4 [CI 1.1-1.9] p = 0.006), Black, Black British, Caribbean or African ethnicity (OR 1.7 [CI 1.2-2.3] p = 0.003), increasing age (50-60 age group OR 1.8 [CI 1.3-2.4] p=<0.001), lack of access to sick pay (OR 1.8 [CI 1.3-2.4] p=<0.001) and out of hospital contact with COVID-19; staff contact (OR 1.8 [CI 1.4-2.4] p=<0.001), travel contact (OR 1.9 [CI 1.2-3.0] p = 0.008), household contact (OR 1.6 [CI 1.2-2.2] p = 0.002), other contact (OR 1.9 [CI 1.3-3.3] p = 0.029) were significantly associated with SARS-CoV-2 seropositivity. In this paediatric tertiary hospital setting, contact with known infected patients was not significantly associated with seropositivity (OR 1.2 [CI 0.6-2.1] p = 0.651). CONCLUSIONS: Socio-economic and demographic factors outside the hospital were the main drivers of infection and exposure to SARS-CoV-2 during the first wave of the pandemic in an urban paediatric referral hospital. Overcrowding and out of hospital SARS-CoV-2 contact are less amenable to intervention. However, lack of access to sick pay among externally contracted staff is more easily rectifiable. Our findings suggest that, if addressed, providing easier access to sick pay would lead to a decrease in SARS-CoV-2 transmission and potentially that of other infectious diseases in hospital settings.

Type: Article
Title: The Socio-Economic and Demographic Risk Factors for SARS-CoV-2 Seropositivity Among Healthcare Workers in a UK Hospital: A Prospective Cohort Study
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/cid/ciad522
Publisher version: http://dx.doi.org/10.1093/cid/ciad522
Language: English
Additional information: © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: BAME/ethnicity, SARS-CoV-2/COVID-19, health care workers, overcrowding, risk factors, sick-pay/leave, socio-economic status
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10176156
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