Underascertainment of COVID-19 cases among first responders: a seroepidemiological study. (9th December 2021)

• Record Type: Journal Article
• Authors: Backhaus, I; Hermsen, D; Timm, J; Boege, F; Lübke, N; Göbels, K; von der Lieth, D; Dragano, N
• Is Part Of: Occupational medicine. Volume 72:Part 3(2022)
• Page Start: 225
• Page End: 228
• Publication Date: 2021-12-09
• Subjects: COVID-19 -- firefighters -- infection risk -- occupational medicine -- paramedics -- SARS-CoV-2 -- seroprevalence; Medicine, Industrial -- Periodicals; Employee health promotion -- Periodicals; 616.9803
• DOI: 10.1093/occmed/kqab164
• Languages: English
• ISSNs: 0962-7480

Abstract

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.