Incidence of unknown COVID-19 infection in a cohort of emergency physicians and advance practice providers

• Published in: The American journal of emergency medicine 2023-02, Vol.64, p.155-160
• Main Authors: Aaron Nathan Barksdale, Wood, Macy G., Branecki, Chad E., Zimmerman, Brooklin, Lyden, Elizabeth, Nguyen, Thang T., Hatfield, Andrew, Koepsell, Scott, Langenfeld, Jason, Zeger, Wesley G., Wadman, Michael C.
• Format: Article
• Language: English
• Subjects: Adaptive immunity; Adult; Advanced practice nurses; Antibodies; Antibodies, Viral; Antigens; Child; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 Vaccines; Demography; Disease transmission; Emergency medical care; Emergency medicine; Female; Humans; Immunoglobulin G; Incidence; Infection; Infections; Male; Medical personnel; Medicine; Mortality; Nucleocapsids; Observational studies; Pandemics; Pandemics - prevention & control; Personal protective equipment; Physicians; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Statistical analysis; United States - epidemiology
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2022.12.012

In United States, health care workers have been immersed in the COVID-19 pandemic since February 2020. Since availability of COVID-19 vaccines, there is limited literature investigating the incidence of unknown COVID-19 infections in physicians and Advanced Practitioner Providers (APPs) working in emergency departments (EDs). The primary objective is to determine the incidence unknown COVID-19 infection within a cohort of emergency physicians (EPs) and APPs. Prospective observational study at a tertiary academic center with emergency medicine residency and 64,000 annual ED visits. EPs/APPs providing care to ED patients over the prior 12 months were eligible. Serum samples were collected between May 1 and June 30, 2022. Analysis utilized Luminex xMAP® SARS-CoV-2 Multi-Antigen IgG Assay for antibodies to Nucleocapsid, Receptor-binding domain, and Spike subunit 1. Mean Fluorescent Intensity (MFI) ≥ 700 was considered positive. Subjects completed 12 question survey assessing demographics and previously confirmed COVID-19 infection. Fisher's exact test evaluated associations of demographics and clinical characteristics with confirmed COVID-19 status. Analyses performed using SAS, Version 9.4. P < 0.05 considered statistically significant. Sixty-nine of 81 eligible subjects (85.2%) participated, 58.0% were male, 97.1% white, with mean age of 37. Eighteen subjects had MFI ≥ 700 strongly suggestive of prior infection, with 17.7% unknown. No statistically significant difference between age, gender, race, children in home, or household member with previously COVID-19 infection. Unknown previous COVID-19 infection was less then expected in this cohort of EPs/APPs, and no association with individual characteristics, previously infected household member, or children in the home.