LAUSR

Background: Identifying factors associated with SARS-CoV-2 infection among healthcare workers (HCW)s may help health systems optimize SARS-CoV-2 infection control strategies. Methods: We conducted a cross-sectional analysis of baseline data from the Northwestern HCW SARS-CoV-2 Serology Cohort Study. The Abbott Architect Nucleocapsid IgG assay was used to determine seropositivity. Logistic regression models (unadjusted and adjusted for demographics and self-reported community exposure to COVID-19) were fit to quantify the associations between occupation group, healthcare delivery tasks, and community exposure and seropositive status. Results: 6,510 HCWs, including 1,794 nurses, and 904 non-patient facing administrators participated. The majority were women (79.6%), 74.9% were white, 9.7% were Asian, 7.3% were Hispanic and 3.1% were Black. The crude prevalence rate of seropositivity was 4.8% (95% confidence interval (CI): 4.6%-5.2%). Out-of-hospital exposure to COVID-19 occurred in 9.3% of HCWs and was strongly associated with seropositivity (OR=4.7, 95% CI: 3.5-6.4). When compared to administrators, nursing was the only occupation group with a significantly higher adjusted-odds (OR: 1.9, 95% CI: 1.3-2.9) of seropositivity. Exposure to COVID-19 patients was reported by 37.8% of participants and was associated with higher positivity than those not exposed (OR= 2.2, 95% CI: 1.6-3.0). Being exposed to patients receiving high-flow oxygen therapy, and hemodialysis also remained significantly associated with a 45% and 57% higher odds for seropositive status, respectively. Conclusions: Exposure to COVID-19 patients, and longer duration patient therapies were each associated with higher risk for seropositive status; however, the community burden of COVID-19 remains a significant source of exposure to SARS CoV-2 infection among HCWs in Chicago.