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      Prevalence, Persistence, and Factors Associated with SARS-CoV-2 IgG Seropositivity in a Large Cohort of Healthcare Workers in a Tertiary Care University Hospital in Northern Italy

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          Abstract

          This observational study evaluated SARS-CoV-2 IgG seroprevalence and related clinical, demographic, and occupational factors among workers at the largest tertiary care University-Hospital of Northwestern Italy and the University of Turin after the first pandemic wave of March–April 2020. Overall, about 10,000 individuals were tested; seropositive subjects were retested after 5 months to evaluate antibodies waning. Among 8769 hospital workers, seroprevalence was 7.6%, without significant differences related to job profile; among 1185 University workers, 3.3%. Self-reporting of COVID-19 suspected symptoms was significantly associated with positivity (Odds Ratio (OR) 2.07, 95%CI: 1.76–2.44), although 27% of seropositive subjects reported no previous symptom. At multivariable analysis, contacts at work resulted in an increased risk of 69%, or 24% for working in a COVID ward; contacts in the household evidenced the highest risk, up to more than five-fold (OR 5.31, 95%CI: 4.12–6.85). Compared to never smokers, being active smokers was inversely associated with seroprevalence (OR 0.60, 95%CI: 0.48–0.76). After 5 months, 85% of previously positive subjects still tested positive. The frequency of SARS-COV-2 infection among Health Care Workers was comparable with that observed in surveys performed in Northern Italy and Europe after the first pandemic wave. This study confirms that infection frequently occurred as asymptomatic and underlines the importance of household exposure, seroprevalence (OR 0.60, 95%CI: 0.48–0.76).

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          Most cited references52

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          A Novel Coronavirus from Patients with Pneumonia in China, 2019

          Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)
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            Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections

            The clinical features and immune responses of asymptomatic individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have not been well described. We studied 37 asymptomatic individuals in the Wanzhou District who were diagnosed with RT-PCR-confirmed SARS-CoV-2 infections but without any relevant clinical symptoms in the preceding 14 d and during hospitalization. Asymptomatic individuals were admitted to the government-designated Wanzhou People's Hospital for centralized isolation in accordance with policy1. The median duration of viral shedding in the asymptomatic group was 19 d (interquartile range (IQR), 15-26 d). The asymptomatic group had a significantly longer duration of viral shedding than the symptomatic group (log-rank P = 0.028). The virus-specific IgG levels in the asymptomatic group (median S/CO, 3.4; IQR, 1.6-10.7) were significantly lower (P = 0.005) relative to the symptomatic group (median S/CO, 20.5; IQR, 5.8-38.2) in the acute phase. Of asymptomatic individuals, 93.3% (28/30) and 81.1% (30/37) had reduction in IgG and neutralizing antibody levels, respectively, during the early convalescent phase, as compared to 96.8% (30/31) and 62.2% (23/37) of symptomatic patients. Forty percent of asymptomatic individuals became seronegative and 12.9% of the symptomatic group became negative for IgG in the early convalescent phase. In addition, asymptomatic individuals exhibited lower levels of 18 pro- and anti-inflammatory cytokines. These data suggest that asymptomatic individuals had a weaker immune response to SARS-CoV-2 infection. The reduction in IgG and neutralizing antibody levels in the early convalescent phase might have implications for immunity strategy and serological surveys.
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              Antibody responses to SARS-CoV-2 in patients with COVID-19

              We report acute antibody responses to SARS-CoV-2 in 285 patients with COVID-19. Within 19 days after symptom onset, 100% of patients tested positive for antiviral immunoglobulin-G (IgG). Seroconversion for IgG and IgM occurred simultaneously or sequentially. Both IgG and IgM titers plateaued within 6 days after seroconversion. Serological testing may be helpful for the diagnosis of suspected patients with negative RT-PCR results and for the identification of asymptomatic infections.
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                Author and article information

                Contributors
                Role: Academic Editor
                Role: Academic Editor
                Journal
                Viruses
                Viruses
                viruses
                Viruses
                MDPI
                1999-4915
                03 June 2021
                June 2021
                : 13
                : 6
                : 1064
                Affiliations
                [1 ]Hospital Medical Direction, Ospedale Molinette, University Hospital Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy; gscozzari@ 123456cittadellasalute.to.it (G.S.); lsavio@ 123456cittadellasalute.to.it (L.S.); ascarmozzino@ 123456cittadellasalute.to.it (A.S.)
                [2 ]Microbiology and Virology Unit, University Hospital Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy; rossana.cavallo@ 123456unito.it
                [3 ]Clinical Epidemiology Unit, University Hospital Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy; emigliore@ 123456cittadellasalute.to.it (E.M.); gciccone@ 123456cittadellasalute.to.it (G.C.); cgalassi@ 123456cittadellasalute.to.it (C.G.)
                [4 ]Cancer Epidemiology Unit, University Hospital Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy
                [5 ]Occupational Medicine Unit, University Hospital Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy; mcoggiola@ 123456cittadellasalute.to.it (M.C.); enrico.pira@ 123456unito.it (E.P.)
                [6 ]Department of Medical Sciences, Pathology Unit, University of Turin, 10126 Turin, Italy; paola.cassoni@ 123456unito.it
                Author notes
                [* ]Correspondence: cristina.costa@ 123456unito.it ; Tel.: +39-(11)6335953
                [†]

                G.S. and C.C. equally contributed to this work and share first authorship.

                [‡]

                Membership of The Collaborative Group is provided in the Acknowledgments.

                Author information
                https://orcid.org/0000-0003-2754-0827
                https://orcid.org/0000-0001-8655-8707
                Article
                viruses-13-01064
                10.3390/v13061064
                8229066
                34205134
                176dd74f-8730-4c74-8fe9-cff5d41b250c
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 05 May 2021
                : 02 June 2021
                Categories
                Article

                Microbiology & Virology
                covid-19 serological testing,sars-cov-2,health personnel,surveys and questionnaires,population surveillance

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