Socioeconomic and Demographic Risk Factors for SARS-CoV-2 Seropositivity Among Healthcare Workers in a UK Hospital: A Prospective Cohort Study
Authors: Lam Tanya , Saso Anja , Torres Ortiz Arturo , Hatcher James , Woodman Marc , Chandran Shruthi , Thistlethwayte Rosie , Best Timothy , Johnson Marina , Wagstaffe Helen , Mai Annabelle , Buckland Matthew , Gilmour Kimberly , Goldblatt David , Grandjean Louis ,   COVID-19 Staff Testing of Antibody Responses (Co-STARs) Study Team, Mirambe-Korsah Dorcas , Torrente Fernanda Fenn , Wyszynski Jakub , Gander Victoria , Leonard Amy , Myers Louise , Vallot Aimee , Paillas Camille , Fitzgerald Rose , Twigg Adam , Manaf Rabia , Gibbons Lois , Powell Hollie , Nar-Dorh Richard , Gray Ally , Fernandez Elias , Minja Aline , Beech Emily , Girshab Waffa , Chia Pei Shi , Webb Kate , Nakrani Malti , Gardiner Kim , Karaluka Valerija , Ryan Karen , Lee Dorothy , Groves Katie , Khan Hamad , Nsubuga Shamime , Rosie-Wilkinson Olivia , Spires Julia , Sanchez-Clemente Nuria , Kaur Sapriya , Carroll Natasha , Efford Jemma , Bredin Gabriel , Dos Santos Domingues Celma Marisa , Foxall Sophie , Ashton Helen , Afzal Abbey , Mainland Sally , Crumpler Kate , Dawson Lucinda , Smith Claire , Tabbu Maria , Chiverton Laura , Sugars Jade , Mooney Jordan , Chikusu Dorothy , Tahami Fariba , Samy Baratth , Begum Shomona , Patel Dhimple , Wiltshire Philippa , Susay Annie , Ryan Anna , Lancaster Luke , Thind Kavita , Speller Kate , Sterling Rachel , Tugulu Connor , Ghurburrun Sandhya , Gray Steffi , Mugas Joy , Kishma Moe , Akpokomua Kathleen , White Sophie , Pieri Eleana , Shamsad Sabina , Alexandrou Demi , Aguele Odera , Miles Katherine , Jain Anamika , Gautam Subishma , Simms Oliver , Goff Rachel , Shams Zarif , Chirinda Tinya , Nur Aaliya , Rahman Tarekur 
Published: August 2023

Background

To protect healthcare workers (HCWs) from the consequences of disease due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is necessary to understand the risk factors that drive exposure and infection within hospitals. Insufficient consideration of key socioeconomic 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 characterize the demographic, occupational, socioeconomic, and environmental risk factors for SARS-CoV-2 seropositivity.

Results

After adjusting for key confounders, relative household overcrowding (odds ratio [OR], 1.4 [95% confidence interval {CI}, 1.1–1.9]; P = .006), Black, Black British, Caribbean, or African ethnicity (OR, 1.7 [95% CI, 1.2–2.3]; P = .003), increasing age (ages 50–60 years: OR, 1.8 [95% CI, 1.3–2.4]; P &lt; .001), lack of access to sick pay (OR, 1.8 [95% CI, 1.3–2.4]; P &lt; .001).

Conclusions

Socioeconomic 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 pediatric 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 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.

Clinical Trials Registration

NCT04380896.