A Screening Strategy to Prevent Hospital Acquired Covid -19 in Peak Pandemic Period

Objective: Health Care Worker (HCW) who is consistently at higher risk for Severe Acute Respiratory Syndrome Corona Virus 2 (SARSCoV-2) infection can possibly transmit the virus to vulnerable patients and other co-workers. The study is aimed to determine seroprevalence of SARS CoV-2 IgG antibody among risk group of HCW during peak pandemic period and to plan a screening strategy for early identification and isolation of HCW for safety of both HCW and exposed community.

Study setting: Hospital.

Study design: This prospective cross sectional study was conducted in North India between August-October 2020 (Peak period of pandemic). Recruited HCW grouped into high risk and low risk and were tested for the presence of SARS-CoV-2 IgG antibodies using architect automated analyser.

Data collection methods: Self-administered questionnaire were given to HCW for sociodemographic, clinical and laboratory tests results analysis related to COVID-19.

Principal findings: Out of 264 HCW, 36 (13.6%) HCW tested positive for SARS CoV-2 IgG antibodies. Seroprevalence was 14.7% in low risk group while 13.2% among high risk group. Serosurvey could detect antibody in 47.3% HCW which were either negative by COVID-19 RTPCR or were never tested owing to absence of clinical symptoms. SARS-CoV-2 IgG antibody were absent in 39% previously COVID-19 positive HCW.

Conclusion: Equal seroprevalence in both the groups of HCW during peak of pandemic is suggestive of community transmission in India and robust infection control policy of hospital. Also, after analysing pros and cons of both serological and molecular tests, we conclude that there is need of multiprong approach with serial diagnostic screening of COVID infection in health care worker which should include both RTPCR and serological test.