PCR is costly and requires skill in sample collection. symptomatic HCWs. Seroconversion was independently associated with older age; lower education; contact with a confirmed case 15 min; chronic kidney disease; pregnancy; change/loss of smell; and negatively associated with workplace contact. Conclusions Most seroconversions were asymptomatic, emphasizing need for regular universal testing. Seropositivity was three-fold that observed at baseline. Cumulative Rabbit Polyclonal to EPN1 infections increased nationally by a similar rate, suggesting HCW infections reflect community not nosocomial transmission. values are provided. All analyses were done using SPSS version 25. Results Between 14 May and 10 June 2020, 2282 (59.0%) HCWs returned for testing at follow-up out of the 3870 HCWs who tested negative at baseline for IgM, IgG and PCR ( Physique 1 ). The median follow-up period was 25 days (IQR 21-27). The incidence of SARS-CoV-2 seroconversion (positive IgM and/or IgG) was 100/2282 (4.4%, 95% CI 3.6-5.3) and the daily hazard was 0.21% (95% CI 0.17-0.25) over 48746 person-days of follow-up. Of the 100 seroconverted HCWs, 59 (59.0%) tested positive GNE 477 only for IgM, 6 (6.0%) tested positive only for IgG, and 11 (11.0%) tested positive for both IgM and IgG. Twenty-one (21.0%) tested positive for both PCR and IgM, 1 (1.0%) tested positive for both PCR and IgG, and 2 (2.0%) tested positive for all those 3 assessments ( Physique 1 ). The overall description for the follow-up group is usually presented in Table 1 . The median age was 32 years (IQR 27-42) for the follow-up group and 40 years (IQR 33.0-47.0) for seroconverters. Most seroconverters were female HCWs 78/100 (78.0%) and nurses 54 (54.0%). Three of the seroconverters were pregnant and all were symptomatic. Background characteristics of the study cohort at baseline and follow-up are presented in Supplementary Table 1. Table 1 Baseline characteristics and the risk of seroconversion among the cohort of health care workers in the follow-up screening, May-June 2020, Cairo, Egypt (N = 2282). thead th align=”left” rowspan=”1″ colspan=”1″ /th th align=”left” rowspan=”1″ colspan=”1″ Total /th th align=”left” rowspan=”1″ colspan=”1″ Event/Person-days /th th align=”left” rowspan=”1″ colspan=”1″ Hazard (daily) /th th align=”left” rowspan=”1″ colspan=”1″ Unadjusted hazard ratio (95% CI)a /th th align=”left” rowspan=”1″ colspan=”1″ em P /em -value /th th align=”left” rowspan=”1″ colspan=”1″ Overall /th th align=”left” rowspan=”1″ colspan=”1″ N = 2282 no. (%) /th th align=”left” rowspan=”1″ colspan=”1″ 100/48746 /th th align=”left” rowspan=”1″ colspan=”1″ 0.21% /th th align=”left” rowspan=”1″ colspan=”1″ /th th align=”left” rowspan=”1″ colspan=”1″ /th /thead Age18 to 29960 (42.1)15/195540.08%Ref30 to 39587 (25.7)33/124520.27%3.42 (1.86C6.30) 0.00140 to 49465 (20.4)29/102320.28%3.58 (1.91C6.70) 0.001 50270 (11.8)23/65080.35%4.19 (2.18C8.08) 0.001 br / br / GenderMale792 (34.7)22/163200.13%RefFemale1490 (65.3)78/324260.24%1.63 (1.01C2.61)0.044 br / br / Governorate of residenceOutside Cairo525 (23.0)18/109370.16%RefCairo1757 (77.0)82/378090.22%1.24 (0.75C2.07)0.407 br / br / Urban/rural residenceUrban2004 (87.8)89/429990.21%RefRural278 (12.2)11/57470.19%0.96 (0.51C1.80)0.895 br / br / GNE 477 Marital statusNot married971 (42.6)21/202260.10%RefMarried1311 (57.4)79/285200.28%2.43 (1.50C3.94) 0.001 br / br / EducationUniversity or higher1125 (49.3)24/238570.10%RefSecondary928 (40.7)55/197830.28%2.56 (1.58C4.14) 0.001Primary or preparatory153 (6.7)13/33370.39%4.42 (2.24C8.70) 0.001Less than primary76 (3.3)8/17690.45%4.68 (2.09C10.47) 0.001 br / br / OccupationPhysician777 (34.0)13/159680.08%RefNurse946 (41.5)54/201390.27%3.01 (1.64C5.53) 0.001Non-clinical care559 (24.5)33/126390.26%3.26 (1.70C6.22) 0.001 br / br / Tobacco useNo1983 (86.9)91/425920.21%RefCurrent257 (11.3)8/53580.15%0.74 (0.36C1.53)0.417Past42 (1.8)1/7960.13%0.73 (0.10C5.26)0.757 br / br / Self-reported pre-existing medical conditionNo1852 (81.2)70/391670.18%RefYes430 (18.8)30/95790.31%1.6 (1.04C2.45)0.031 Open in a separate window aHazard ratio (95% CI) were calculated using Cox regression Only 36/100 (36.0%) seroconverters reported GNE 477 being symptomatic during the follow-up period; 3/36 (8.3%) reported severe symptoms ( Table 2 ). Experiencing symptoms suggestive of SARS-CoV-2 infection were more frequently reported during follow-up than at baseline ( Figure 2 ), such as sneezing, muscle pain, change/loss of smell, shortness of breath, change/loss of taste, abdominal discomfort, loss of GNE 477 appetite, and conjunctivitis. Symptoms that were not reported at baseline, but only at the follow-up stage among seroconverters were chest pain, other respiratory symptoms, vomiting, wheezing, and dizziness ( Figure 2 ). The incidence of seroconversion was 4.0% (64/1596, 95% CI 3.1-5.1) among asymptomatic and 5.3% among symptomatic HCWs (36/686, 95% CI 3.7-7.2). Table 2 Exposures, presence of symptoms, and the risk of seroconversion among the cohort of health care workers in the follow-up screening, May-June 2020, Cairo, Egypt (N = 2282). thead th align=”left” rowspan=”1″ colspan=”1″ /th th align=”left” rowspan=”1″ colspan=”1″ Total /th th align=”left” rowspan=”1″ colspan=”1″ Event/Person-days /th th align=”left” rowspan=”1″ colspan=”1″ Hazard (daily) /th th align=”left” rowspan=”1″ colspan=”1″ Unadjusted hazard ratio (95% CI)a /th th.