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Serological evidence of SARS-CoV-2 infection in a hospital based cohort study of healthcare workers following the 2023 COVID-19 vaccination program

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Objective: Healthcare workers (HCWs) are a high-risk population to acquire SARS-CoV-2 infection and becoming a focus of transmission. It is therefore important to monitor these professionals, especially due to asymptomatic infections. The objective the study was to assess SARS-CoV-2 infection rates in healthcare professionals at a central Portuguese hospital using serological tests, three and six months after the 2023 COVID-19 booster vaccination program. Methods: A prospective cohort study was established through serological follow-up in a cohort of healthcare professionals from a central Portuguese hospital, with three rounds of tests: pre-COVID-19 vaccination (September/October 2023), 3 months (January/February 2024) and 6 months (April/May 2024) post-vaccination. IgG antibodies specific to the SARS-CoV-2 nucleocapsid protein (anti-N) were measured. Data was analyzed trough descriptive statistics (frequency, mean, percentages) and infection rates at each testing moment (0, 3 and 6 months). Results: At baseline, all participants (n=177, median age: 47years, 77,4% females) had the complete primary COVID-19 vaccination, with 78% having received 2 additional booster doses prior to 2023 vaccination program. Pre vaccination, 48,6% (86/177) of HCWs had detectable anti-N IgG antibodies, of which 24,4% (21/86) self-reported having had a SARS-Cov-2 infection in 2022/2023. After 3 months, 17,7% (n=11/62) had detectable anti-N IgG antibodies although being negative in the pre-vaccination testing. After 6 months, 4,3% (n=2/47) had detectable anti-N IgG antibodies but were negative in the previous two rounds. Conclusions: During the study period, several cases of SAR-CoV-2 infection (n=13) were identified serologically among the HCW monitored, without concomitant signs and symptoms that would allow the identification of a potential infection. These results support that monitoring the infection among HCW (regardless of history of symptoms) can provide valuable information for assessing the level of exposure among hospital personnel and identifying high-risk departments. This information could allow early intervention by, for example, reminding and reinforcing the importance of personal protection standards for HCWs.

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SARS-CoV-2 COVID-19 Serological Status Vaccines VEBIS Public Health Estados de Saúde e de Doença Infecções Respiratórias

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