| Abstract |
Background: The prevalence of antibodies to SARS-CoV-2 in pediatric health care workers (HCWs) in areas with high rates of COVID-19 infection is unknown Working at the front line, emergency department (ED) HCWs are uniquely at high risk It is unknown if seropositivity in this population is similar to community levels or is substantially higher as a result of work-based exposure to infectious children who may demonstrate mild symptoms Further, the experience of pediatric HCWs may be disparate from adult focused facilities because prior to implementation of social distancing, children presented for care at pediatric facilities in high numbers with mild illness Many were evaluated in pediatric EDs which may have put pediatric HCWs at higher risk during the COVID-19 pandemic before universal personal protective equipment (PPE) utilization became standard practice The milder nature of COVID-19 in children has also led some to believe that children are not affected, although the emergence of multisystem inflammatory syndrome in children (MIS-C) refutes this notion However, this belief and the lack of data may result in lax utilization to PPE in pediatric settings Data describing seropositivity among pediatric HCWs is not yet available Study Objective: Determine the prevalence of IgG antibodies to SARS-CoV-2 in pediatric HCWs Methods: We performed a cross-sectional study, analyzing data from the baseline visit of a prospective cohort to determine the prevalence of IgG antibodies to SARS-CoV-2 in HCWs at a large pediatric health care facility in April-May 2020 Prior SARS-CoV-2 testing history, potential risk factors and level of anxiety about COVID-19 was determined Symptomatic or febrile HCWs were excluded Metrics were analyzed overall and by HCW roles and tested for differences using chi-square estimates of independence Prevalence of IgG antibodies were compared in ED vs non-ED HCWs Results: Of 300 HCWs enrolled from April 16-May 18, 2020, their mean age range is 41-50 years, 83% are female and 75% have no comorbidities HCWs include 33% physicians, 25% nurses 10% respiratory therapists, 7% advance practice providers, and 25% other Forty-seven percent were emergency department (ED) staff, 13% worked in pediatric intensive care, 40% elsewhere Half of all HCWs had children in their home, 45% had traveled outside the state, and 47% reported an illness since January Overall, 28% had a known COVID-19+ exposure Most participants (90%) believed they were at high risk to develop COVID-19 as HCWs, and 70% reported high anxiety due to the pandemic The prevalence of SARS-CoV-2 IgG antibody positivity in this cohort is 4 7% Of the 14 HCWs with positive serology, only 3 (21%) had a history of any prior COVID-19 testing, all of which were positive;43% (6/14) had no prior flu-like illness or symptoms Eighty-six percent of antibody-positive HCWs were ED-based staff;SARS-CoV-2 IgG antibodies were identified in 9% of ED HCWs enrolled compared to 1% in non-ED based HCWs, p=0 003 Conclusions: Overall prevalence of SARS-CoV-2 IgG antibodies is low in pediatric HCWs living in a region with high COVID-19 activity Most cases were found in HCWs from the pediatric ED, and nearly half were asymptomatic ED-based pediatric HCWs may be uniquely at higher risk of exposure to children with COVID-19, and particularly may have been at higher risk of infection before awareness of the evolving pandemic;ongoing universal PPE utilization is essential
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