• Mai-Chi Trieu, Amit Bansal, Anders Madsen, Fan Zhou, Marianne Sævik, Juha Vahokoski, Karl Albert Brokstad, Florian Krammer, Camilla Tøndel, MohnKristin G IKGIDepartment of Clinical Science, Influenza Centre, University of Bergen, Bergen, Norway.Emergency Care Clinic, Haukeland University Hospital, Bergen, Norway., Bjørn Blomberg, Nina Langeland, Rebecca J Cox, and Bergen COVID-19 Research Group .
• Department of Clinical Science, Influenza Centre, University of Bergen, Bergen, Norway.
• J. Infect. Dis. 2021 Feb 24; 223 (4): 589-599.

BackgroundDuring the coronavirus disease 2019 (COVID-19) pandemic, many countries experienced infection in health care workers (HCW) due to overburdened health care systems. Whether infected HCW acquire protective immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unclear.MethodsIn a Norwegian prospective cohort study, we enrolled 607 HCW before and after the first COVID-19 wave. Exposure history, COVID-19-like symptoms, and serum samples were collected. SARS-CoV-2-specific antibodies were characterized by spike-protein IgG/IgM/IgA enzyme-linked immunosorbent and live-virus neutralization assays.ResultsSpike-specific IgG/IgM/IgA antibodies increased after the first wave in HCW with, but not in HCW without, COVID-19 patient exposure. Thirty-two HCW (5.3%) had spike-specific antibodies (11 seroconverted with ≥4-fold increase, 21 were seropositive at baseline). Neutralizing antibodies were found in 11 HCW that seroconverted, of whom 4 (36.4%) were asymptomatic. Ninety-seven HCW were tested by reverse transcriptase polymerase chain reaction (RT-PCR) during follow-up; 8 were positive (7 seroconverted, 1 had undetectable antibodies).ConclusionsWe found increases in SARS-CoV-2 neutralizing antibodies in infected HCW, especially after COVID-19 patient exposure. Our data show a low number of SARS-CoV-2-seropositive HCW in a low-prevalence setting; however, the proportion of seropositivity was higher than RT-PCR positivity, highlighting the importance of antibody testing.© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.

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