We aimed to estimate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence and describe its determinants and associated symptoms among unvaccinated healthcare workers (HCWs) after the first wave of the pandemic. HCWs from 13 Dutch hospitals were screened for antibodies against the spike protein of SARS-CoV-2 in June-July 2020 and after three months. Participants completed a retrospective questionnaire on determinants for occupational and community exposure to SARS-CoV-2 and symptoms suggestive of COVID-19 experienced since January 2020. The seroprevalence was calculated per baseline characteristic and symptom at baseline and after follow-up. Adjusted odds ratios (aOR) for seropositivity were determined using logistic regression. Among 2328 HCWs, 323 (13.9%) were seropositive at enrolment, 49 of whom (15%) reported no previous symptoms suggestive of COVID-19. During follow-up, only 1% of the tested participants seroconverted. Seroprevalence was higher in younger HCWs compared to the mid-age category (aOR 1.53, 95% CI 1.07–2.18). Nurses (aOR 2.21, 95% CI 1.34–3.64) and administrative staff (aOR 1.87, 95% CI 1.02–3.43) had a higher seroprevalence than physicians. The highest seroprevalence was observed in HCWs in the emergency department (ED) (aOR 1.79, 95% CI 1.10–2.91), the lowest in HCWs in the intensive, high, or medium care units (aOR 0.47, 95% CI 0.31–0.71). Chronic respiratory disease, smoking, and having a dog were independently associated with a lower seroprevalence, while HCWs with diabetes mellitus had a higher seroprevalence. In a multivariable model containing all self-reported symptoms since January 2020, altered smell and taste, fever, general malaise/fatigue, and muscle aches were positively associated with developing antibodies, while sore throat and chills were negatively associated. The SARS-CoV-2 seroprevalence in unvaccinated HCWs of 13 Dutch hospitals was 14% in June-July 2020 and remained stable after three months. A higher seroprevalence was observed in the ED and among nurses, administrative and young staff, and those with diabetes mellitus, while a lower seroprevalence was found in HCWs in intensive, high, or medium care, and those with self-reported lung disease, smokers, and dog owners. A history of altered smell or taste, fever, muscle aches and fatigue were independently associated with the presence of SARS-CoV-2 antibodies in unvaccinated HCWs.

中文翻译：

---

2020 年第一波疫情后荷兰医院医护人员中 SARS-CoV-2 抗体的血清阳性率：一项多中心横断面研究和前瞻性随访

我们的目的是估计第一波大流行后未接种疫苗的医护人员 (HCW) 中严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 的血清流行率，并描述其决定因素和相关症状。2020 年 6 月至 7 月以及三个月后，对荷兰 13 家医院的医护人员进行了针对 SARS-CoV-2 刺突蛋白的抗体筛查。参与者完成了一份回顾性调查问卷，内容涉及职业和社区暴露于 SARS-CoV-2 的决定因素以及自 2020 年 1 月以来经历的暗示 COVID-19 的症状。血清阳性率是根据基线特征和基线时和随访后的症状计算的。使用逻辑回归确定血清阳性的调整优势比（aOR）。在 2328 名医护人员中，有 323 名 (13.9%) 在入组时呈血清阳性，其中 49 名 (15%) 报告称之前没有任何提示 COVID-19 的症状。在随访期间，只有 1% 的测试参与者发生了血清转化。与中年类别相比，年轻医护人员的血清阳性率较高（aOR 1.53，95% CI 1.07-2.18）。护士（aOR 2.21，95% CI 1.34–3.64）和行政人员（aOR 1.87，95% CI 1.02–3.43）的血清阳性率高于医生。急诊科 (ED) 的医护人员血清阳性率最高（aOR 1.79，95% CI 1.10–2.91），重症、高级或中度护理病房的医护人员血清阳性率最低（aOR 0.47，95% CI 0.31–0.71） ）。慢性呼吸道疾病、吸烟和养狗与较低的血清阳性率独立相关，而患有糖尿病的医务人员的血清阳性率较高。在包含自 2020 年 1 月以来所有自我报告症状的多变量模型中，嗅觉和味觉改变、发烧、全身不适/疲劳和肌肉疼痛与抗体的产生呈正相关，而喉咙痛和发冷则呈负相关。2020 年 6 月至 7 月，荷兰 13 家医院未接种疫苗的医护人员中 SARS-CoV-2 血清流行率为 14%，三个月后保持稳定。在急诊室、护士、行政人员和年轻工作人员以及患有糖尿病的人中观察到血清阳性率较高，而在重症、高级或中度护理中的医务人员以及自我报告的肺病患者、吸烟者中发现血清阳性率较低和狗主人。未接种疫苗的医护人员的嗅觉或味觉改变、发烧、肌肉疼痛和疲劳史与 SARS-CoV-2 抗体的存在独立相关。