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Sims MD, Maine GN, Childers KL, Podolsky RH, Voss DR, Berkiw-Scenna N, Oh J, Heinrich KE, Keil H, Kennedy RH, Homayouni R; BLAST COVID-19 Study Group. COVID-19 seropositivity and asymptomatic rates in healthcare workers are associated with job function and masking. Clin Infect Dis. 2020 Nov 5:ciaa1684. doi: 10.1093/cid/ciaa1684. Epub ahead of print. PMID: 33150375.

Background: Although the risk of exposure to SARS-CoV-2 is higher for frontline healthcare workers, not all personnel have similar risks. Determining infection rate is difficult due to the limits on testing and the high rate of asymptomatic individuals. Detection of antibodies against SARS-CoV-2 may be useful for determining prior exposure to the virus and assessing mitigation strategies, such as isolation, masks, and other protective equipment.

Methods: An online assessment that included demographic, clinical, and exposure information and a blood sample was collected from 20,614 participants out of ~43,000 total employees at Beaumont Health, which includes eight hospitals distributed across the Detroit metropolitan area in southeast Michigan. The presence of anti-SARS-CoV-2 IgG was determined using the EUROIMMUN assay.

Results: A total of 1,818 (8.8%) participants were seropositive between April 13 and May 28, 2020. Among the seropositive individuals, 44% reported that they were asymptomatic during the month prior to blood collection. Healthcare roles such as phlebotomy, respiratory therapy, and nursing/nursing support exhibited significantly higher seropositivity. Among participants reporting direct exposure to a COVID-19 positive individual, those wearing an N95/PAPR mask had a significantly lower seropositivity rate (10.2%) compared to surgical/other masks (13.1%) or no mask (17.5%).

Conclusions: Direct contact with COVID-19 patients increased the likelihood of seropositivity among employees but study participants who wore a mask during COVID-19 exposures were less likely to be seropositive. Additionally, a large proportion of seropositive employees self-reported as asymptomatic

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