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Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission.

Accepted version
Peer-reviewed

Type

Article

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Authors

Sridhar, Sushmita 
Sparkes, Dominic 
Routledge, Matthew 
Jones, Nick K 

Abstract

Significant differences exist in the availability of healthcare worker (HCW) SARS-CoV-2 testing between countries, and existing programmes focus on screening symptomatic rather than asymptomatic staff. Over a 3 week period (April 2020), 1032 asymptomatic HCWs were screened for SARS-CoV-2 in a large UK teaching hospital. Symptomatic staff and symptomatic household contacts were additionally tested. Real-time RT-PCR was used to detect viral RNA from a throat+nose self-swab. 3% of HCWs in the asymptomatic screening group tested positive for SARS-CoV-2. 17/30 (57%) were truly asymptomatic/pauci-symptomatic. 12/30 (40%) had experienced symptoms compatible with coronavirus disease 2019 (COVID-19)>7 days prior to testing, most self-isolating, returning well. Clusters of HCW infection were discovered on two independent wards. Viral genome sequencing showed that the majority of HCWs had the dominant lineage B∙1. Our data demonstrates the utility of comprehensive screening of HCWs with minimal or no symptoms. This approach will be critical for protecting patients and hospital staff.

Description

Keywords

COVID-19, SARS-CoV-2, emerging pathogens, epidemiology, global health, human, human biology, infectious disease, medicine, occupational health, virology, virus, Asymptomatic Infections, Betacoronavirus, COVID-19, COVID-19 Testing, COVID-19 Vaccines, Clinical Laboratory Techniques, Coronavirus Infections, Female, Health Personnel, Humans, Infection Control, Male, Pandemics, Pneumonia, Viral, Real-Time Polymerase Chain Reaction, SARS-CoV-2, United Kingdom

Journal Title

Elife

Conference Name

Journal ISSN

2050-084X
2050-084X

Volume Title

9

Publisher

eLife Sciences Publications, Ltd

Rights

All rights reserved
Sponsorship
Wellcome Trust (108070/Z/15/Z)
Engineering and Physical Sciences Research Council (EP/N031938/1)
Engineering and Physical Sciences Research Council (EP/P031447/1)
Medical Research Council (MR/P008801/1)
Wellcome Trust (via University College London (UCL)) (Ref 17/0008 539724)
Wellcome Trust (200871/Z/16/Z)
Wellcome Trust (206298/B/17/Z)
Wellcome Trust (207498/Z/17/Z)
Wellcome Trust (210688/Z/18/Z)
Wellcome Trust (108082/A/15/Z)
Medical Research Council (MC_PC_12009)
Medical Research Council (MC_PC_17230)
Wellcome Trust (215515/Z/19/Z)
MRC (MR/V011561/1)
This work was supported by the Wellcome Trust Senior Research Fellowships 108070/Z/15/Z to MPW, 215515/Z/19/Z to SGB and 207498/Z/17/Z to IGG; Collaborative award 206298/B/17/Z to IGG; Principal Research Fellowship 210688/Z/18/Z to PJL; Investigator Award 200871/Z/16/Z to KGCS; Addenbrooke’s Charitable Trust (to MPW, SGB, IGG and PJL); the Medical Research Council (CSF MR/P008801/1 to NJM); NHS Blood and Transfusion (WPA15-02 to NJM); National Institute for Health Research (Cambridge Biomedical Research Centre at CUHNFT), to JRB, MET, AC and GD, Academy of Medical Sciences and the Health Foundation (Clinician Scientist Fellowship to MET), Engineering and Physical Sciences Research Council (EP/P031447/1 and EP/N031938/1 to RS),Cancer Research UK (PRECISION Grand Challenge C38317/A24043 award to JY). Components of this work were supported by the COVID-19 Genomics UK Consortium, (COG-UK), which is supported by funding from the Medical Research Council (MRC) part of UK Research & Innovation (UKRI), the National Institute of Health Research (NIHR) and Genome Research Limited, operating as the Wellcome Sanger Institute
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