Journal of Infection

BackgroundThere is an urgent need to better understand whether individuals who have recovered from COVID-19 are protected from future SARS-CoV-2 infection. MethodsA large multi-centre prospective cohort was recruited from publicly funded hospital staff in the UK. Participants attended regular SARS-CoV-2 PCR and antibody testing (every 2-4 weeks) and completed fortnightly questionnaires on symptoms and exposures. At enrolment, participants were assigned to either the positive cohort (antibody po...

BackgroundSARS-CoV-2 can spread efficiently in hospitals, but the transmission pathways amongst patients and healthcare workers are unclear. MethodsWe analysed data from four teaching hospitals in Oxfordshire, UK, from January to October 2020. Associations between infectious SARS-CoV-2 individuals and infection risk were quantified using logistic, generalised additive and linear mixed models. Cases were classified as community- or hospital-acquired using likely incubation periods. ResultsNine-...

ObjectivesThis study examined the natural history, including incidence and prevalence, of SARS-CoV-2 antibodies serially up to 6 months post infection in Irish Healthcare Workers (HCWs) at an academic tertiary maternity hospital, during the first pandemic peak from March to September 2020. DesignThis single centre observational study profiled SARS-CoV-2 incidence and infection using viral RNA detected using oro/nasopharyngeal swabs accompanied by serological assessment of study participants for...

BackgroundPersonal protective equipment (PPE) and social distancing are designed to mitigate risk of occupational SARS-CoV-2 infection in hospitals. Why healthcare workers nevertheless remain at increased risk is uncertain. MethodsWe conducted voluntary Covid-19 testing programmes for symptomatic and asymptomatic staff at a UK teaching hospital using nasopharyngeal PCR testing and immunoassays for IgG antibodies. A positive result by either modality determined a composite outcome. Risk-factors ...

BackgroundSyndromic surveillance often relies on patients presenting to healthcare. Community cohorts, although more challenging to recruit, could provide additional population-wide insights, particularly with SARS-CoV-2 co-circulating with other respiratory viruses. MethodsWe estimated positivity and incidence of SARS-CoV-2, influenza A/B, and RSV, and trends in self-reported symptoms including influenza-like illness (ILI), over the 2022/23 winter season in a broadly representative UK communit...

It has been recognised that health and social care workers (HSCW) experience higher rates of infection with SARS-CoV-2. Widespread testing of HSCWs and their symptomatic household contacts (SHCs) has not been fully implemented in the United Kingdom. We describe the results of a testing programme for HSCWs and SHCs in a single UK region (Tayside, Scotland). The testing service was established 17 th March 2020 as the first in the country, and samples were collected at a drive-through testing hub b...

The availability of early serological assays for COVID-19 infection allows investigation of aspects of SARS-CoV-2 transmission which may not be evident on PCR testing. Here we describe two serological surveys in different settings in 2020 which assess the effectiveness of local infection prevention practices: i) a retrospective cohort of household contacts previously quarantined; and ii) health care workers in a tertiary hospital. Serological testing of household contacts did not diagnose any ad...

Australias early COVID-19 experience involved clusters in northern Sydney, including hospital and aged-care facility (ACF) outbreaks. We explore transmission dynamics, drivers and outcomes of a metropolitan hospital COVID-19 outbreak that occurred in the context of established local community transmission. A retrospective cohort analysis is presented, with integration of viral genome sequencing, clinical and epidemiological data. We demonstrate using genomic epidemiology that the hospital outbre...

BackgroundHealthcare worker (HCW) associated COVID-19 is of global concern due to the potential for nosocomial spread and depletion of staff numbers. However, the literature on transmission routes and risk factors for COVID-19 in HCWs is limited. AimTo examine the characteristics and transmission dynamics of SARS-CoV-2 in HCWs in a university teaching hospital in London, UK. MethodsStaff records and virology testing results were combined to identify staff sickness and COVID-19 rates from March...

ObjectivesTo determine the sensitivity and specificity of RT-PCR testing of upper respiratory tract (URT) samples from hospitalised patients with COVID-19, compared to the gold standard of a clinical diagnosis. MethodsAll URT RT-PCR testing for SARS-CoV-2 in NHS Lothian, Scotland, United Kingdom between the 7th of February and 19th April 2020 (inclusive) was reviewed, and hospitalised patients were identified. All URT RT-PCR tests were analysed for each patient to determine the sequence of nega...

BackgroundWith the impact of SARS-CoV-2 upon public health directly and socioeconomically, further information was required to inform policy decisions designed to limit virus spread. This study sought to contribute to serosurveillance work within Northern Ireland to track SARS-CoV-2 progression and guide health strategy. MethodsSera/plasma samples from clinical biochemistry laboratories were analysed for anti-SARS-CoV-2 immunoglobulins (Ig). Samples were assessed using an Elecsys anti-SARS-CoV-...

ObjectiveTo estimate the percentage of individuals infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) over time in the community in England and to quantify risk factors. DesignRepeated cross-sectional surveys of population-representative households with longitudinal follow-up if consent given. SettingEngland Participants34,992 Individuals aged 2 years and over from 16,722 private residential households. Data were collected in a pilot phase of the survey between 26 Apri...

BackgroundWe have successfully used whole-genome sequencing to provide additional information for transmission pathways in infectious spread. We report and interpret genomic sequencing results in clinical context from a large outbreak of COVID-19 with 46 cases across staff and patients in a community hospital in the UK. MethodsFollowing multiple symptomatic cases within a two-week period, all staff and patients were screened by RT-PCR and staff subsequently had serology tests. ResultsThirty st...

BackgroundSARS-CoV-2 has disproportionately affected nursing home (NH) residents. In Ireland, the first NH case of COVID-19 occurred on 16/03/2020. A national point-prevalence testing program of all NH residents and staff took place from 18/04/2020-05/05/2020. AimsTo examine characteristics of NHs across three Community Health Organisations (CHOs) in Ireland, proportions with COVID-19 outbreaks, staff and resident, symptom-profile and resident case-fatality. MethodsForty-five NHs surveyed acro...

ObjectiveTo describe COVID-19 infections amongst healthcare workers at the Royal Melbourne Hospital from 1st July to 31st August 2020 DesignProspective observational study SettingA 550 bed tertiary referral hospital in metropolitan Melbourne ParticipantsAll healthcare workers identified with COVID-19 infection in the period of interest Results262 healthcare worker infections were identified over 9 weeks. 68.3% of infected healthcare workers were nurses and the most affected locations were th...

BackgroundWe aimed to measure SARS-CoV-2 seroprevalence in a cohort of healthcare workers (HCWs) during the first UK wave of the COVID-19 pandemic, explore risk factors associated with infection, and investigate the impact of antibody titres on assay sensitivity. MethodsHCWs at Sheffield Teaching Hospitals NHS Foundation Trust (STH) were prospectively enrolled and sampled at two time points. SARS-CoV-2 antibodies were tested using an in-house assay for IgG and IgA reactivity against Spike and N...

ObjectivesTo describe a cohort of self-isolating healthcare workers (HCWs) with presumed COVID-19. DesignA cross-sectional, single-centre study. SettingA large, teaching hospital based in Central London with tertiary infection services. Participants236 HCWs completed a survey distributed by internal staff email bulletin. 167 were female and 65 MeasuresInformation on symptomatology, exposures and health-seeking behaviour were collected from participants by self-report. ResultsThe 236 respond...

Unlike previous epidemics, in addressing COVID-19 nearly all international health organizations and national health ministries have treated a single positive result from a PCR-based test as confirmation of infection, even in asymptomatic persons without any history of exposure. This is based on a widespread belief that positive results in these tests are highly reliable. However, data on PCR-based tests for similar viruses show that PCR-based testing produces enough false positive results to mak...

BackgroundElderly SARS-CoV-2 patients are associated with higher hospitalization and mortality. Co-infection is critical in the severity of respiratory diseases. It is largely understudied for SARS-CoV-2. MethodsBetween March 24th and April 27th, 2020, nasopharyngeal and oropharyngeal swabs from 3,348 patients from nursing homes and assisted living facilities in 22 states in the US were tested by Capstone Healthcare for SARS-CoV-2, 24 other respiratory viruses, and 8 respiratory bacteria. Total...

Reports of COVID-19 prevalence through national statistics, community surveys and targeted testing at places of work or study have guided national and institutional responses to the pandemic. The University of Edinburgh established a mass testing programme, TestEd, for detection of COVID-19 in asymptomatic staff and students who are studying or working on campus. The study has tested more than 100,000 samples with more than 170 confirmed positive results. Since the introduction of a change in po...