Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

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Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
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Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




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"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : March | Volume : 16 | Issue : 3 | Page : DC10 - DC13 Full Version

Seroprevalence of SARS-CoV-2 among the Healthcare Workers of a Tertiary Care Hospital of Northeast India during First Wave of COVID-19 Pandemic: A Hospital-based Cross-sectional Study


Published: March 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/51664.16066
Mithu Medhi, Reema Nath, Ezaz Hussain

1. Associate Professor, Department of Microbiology, Assam Medical College and Hospital, Dibrugarh, Assam, India. 2. Professor, Department of Microbiology, Assam Medical College and Hospital, Dibrugarh, Assam, India. 3. Statistician, Department of Microbiology, Assam Medical College and Hospital, Dibrugarh, Assam, India.

Correspondence Address :
Dr. Mithu Medhi,
Associate Professor, Department of Microbiology, Assam Medical College and Hospital, Dibrugarh, Assam, India.
E-mail: drmithum@gmail.com

Abstract

Introduction: During Coronavirus Disease-2019 (COVID-19) pandemic, Healthcare Workers (HCWs) are the frontline personals who are engaged in different facilities of the health system. So they always remain at a greater risk of exposure and acquiring the disease. They may also become a potential source of infection to the other patients as well to the community.

Aim: To estimate the seroprevalence of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) specific Immunoglobulin G (IgG) antibodies among asymptomatic, COVID-19 negative HCWs of a tertiary care hospital.

Materials and Methods: This hospital-based cross-sectional study was conducted in the Department of Microbiology in a tertiary care hospital of Northeast India. A total of 215 HCWs were recruited from 15th October to 14th December 2020 after taking written and informed consent. Inclusion criteria were: a) >18 years of age and both genders, b) asymptomatic, negative for COVID-19 either by Rapid Antigen Test (RAT) or Reverse Transcription Polymerase Chain Reaction (RT-PCR), c) working in the hospital for atleast last four months. Predesigned questionnaire was used for data collection. Serum samples were tested for SARS-CoV-2 IgG antibodies by Enzyme Linked Fluorescence Assay (ELFA) using VIDAS (VITEK ImmunoDiagnostic Assay System) platform. Chi-square test was used (Epi Info version 7 software) for data analysis.

Results: The prevalence of SARS-CoV-2 IgG was 54 (25.12%) out of 215, which was highest in ≤30 years age group, 27 (32.14%) out of 84 (p=0.0261). Significant seropositivity was found among cleaners 22 (61.11%) out of 36 (p<0.01) and participants who reported having COVID-19-related symptoms in the previous months (p<0.013). However gender, daily patient contact, close contact with COVID-19 cases and working in COVID-19 units showed no significance.

Conclusion: The study highlighted a high burden of asymptomatic SARS-CoV-2 infection among HCWs. A proper surveillance system is needed for estimating the burden of COVID-19 among HCWs as well as in the community for better understanding of the dynamics of the infection.

Keywords

Coronavirus disease-2019, Enzyme linked fluorescence assay, Frontline severe acute respiratory syndrome coronavirus-2

The COVID-19 is a novel disease caused by SARS-CoV-2 and the virus was first detected in Wuhan, China in December 2019 (1). World Health Organisation (WHO) declared it as a pandemic in March 2020 (2). This newly emerging virus was also declared as public health emergency by WHO (3).

During the pandemic, HCWs are the frontline personals who are engaged in patient care in different facilities of the health system. So they always remain at a greater risk of exposure as well as acquiring the disease. As they have access to the other patients also, they may become a potential source of infection to the other patients as well to the community (4),(5),(6). During the early stages of the SARS epidemic, a high incidence was observed among the HCWs (6). Serosurvey data can provide relevant information about recent or past infection of a disease as serological tests can detect antibodies for a long period after recovery and these data also tell us the extent of disease transmission. The knowledge of seroprevalence is crucial in the pandemic because it helps to predict the future course of the pandemic (7),(8),(9).

Indian Council of Medical Research (ICMR) conducted Nation-wide population-based serial serosurveys in 70 Indian districts. The first and second survey reports indicated a significantly high 10 fold increase in the prevalence of SARS-CoV-2 infection among adults from 0.73% in May-June 2020 to 7.1% in August-September 2020 (10),(11). The report of third serosurvey showed an overall seroprevalence of 24.1% and in HCWs it was 25.7% (12). The fourth ICMR survey showed state-wise data and the seropositivity in Assam was found to be 50.3% (13).

The data regarding the burden of asymptomatic infection among HCWs are very limited from Northeast part of the country (13). Therefore, this study was conducted to estimate the seroprevalence of SARS-CoV-2 specific IgG antibodies among asymptomatic, COVID-19 negative HCWs of a tertiary care hospital of Assam to know the burden of the disease and its association with different parameters like demographic, clinical, occupational etc.

Material and Methods

This hospital-based cross-sectional study was carried out in the Department of Microbiology in a tertiary care hospital of Northeast India for a period of two months from 15th October to 14th December 2020. HCWs who deliver care and services to patients, either directly as physicians and nurse or indirectly as assistants, technicians, and other support staff (administrative staff, cleaning, kitchen, laundry, maintenance, etc.,) employed under the institution were part of this study. Ethical approval for the study was obtained from Institutional Ethics Committee (IEC) (Human) (No.AMC/EC/5928 Dibrugarh dated 10th June, 2021).

Inclusion criteria: The HCWS with >18 years of age and both genders, asymptomatic, negative for COVID-19 either by RAT or RT-PCR, working in the hospital for at least last four months were included in the study.

Exclusion criteria: Previously, COVID-19 positive or IgG positive HCWs were excluded from the study.

Sample size calculation: Convenient sampling method was used and participants were approached telephonically. Participation in the study was voluntary. A total of 435 HCWs were approached and 215 participants were enrolled. Written and informed consent was obtained from the study subjects prior to the enrolment.

Study Procedure

A predesigned proforma was used for collection of following information from each participants: demographics (age, sex, etc.,), professional information (occupation, department etc.,), clinical information about the history of COVID-19 compatible symptoms during the previous months (cough, sore throat, runny nose, fatigue, shortness of breath, fever, headache, vomiting, diarrhoea, loss of smell, chills etc.,), history of COVID-19 test (RT-PCR/RAT), co-morbidities and history of close contact with COVID-19 cases. The symptoms were categorised according to Ministry of Health and Family Welfare, Govt. of India guideline (14).

A 2 mL of venous blood samples was collected from the study subjects in a clot activator vial maintaining standard precautions. Serum was separated by centrifugation and samples were analysed immediately. The SARS-CoV-2 IgG was tested by ELFA with VIDAS SARS-CoV-2 IgG II (VIDAS 9COG) test kit (biomerieux SA, France, lot no- 1008193120, REF- 423834)) using VIDAS platform according to manufacturer’s instructions. It is an automated qualitative assay which measures antibodies against the Receptor Binding Domain (RBD) of the spike glycoprotein of SARS-CoV-2.

Statistical Analysis

Data were entered and analysed in Epi Info version 7. Chi-square test was done and p<0.05 was considered to be statistically significant.

Results

The baseline characteristics of the 215 study participants are summarised in (Table/Fig 1). The mean±SD was 36.33±10.74 years. Of them 120 (55.81%) were males and 95 (44.19%) were females. 39 (18.14%) nurses, 36 (16.75%) cleaners, 45 (20.93%) laboratory technicians, 18 (8.37%) staff and 77 (35.81%) physicians were included in the study. Co-morbidities were reported by 13 (6.05%) participants. Total 30 (13.95%) participants reported having COVID-19-compatible symptoms in the previous months but they all were negative by RT-PCR.

The seroprevalence of COVID-19 IgG was 54 (25.12%) out of 215 in the present study. Prevalence was observed to be highest in ≤30 years age group and lowest in >50 years (p=0.026). Although IgG positivity was higher in males i.e., 33 (27.50%) out of 120 compared to female 21 (22.11%) out of 95, no statistical significance was found (Table/Fig 2). Different occupational categories of HCWs were compared and observed that most affected group was the cleaners, followed by other staff, nurses, laboratory technicians, and doctors (p<0.01) (Table/Fig 2).

Out of the 30 participants reporting COVID-19 compatible symptoms in the previous months, 22 (73.33%) reported fever, 13 (43.33%) cough, 10 (33.33%) sore throat, 10 (33.33%) nasal discharge, 6 (20.00%) body ache, 6 (20.00%) headache, 5 (16.67%) fatigue and 4 (13.33%) diarrhoea (Table/Fig 3). The symptoms were considered as mild. Seropositivity was found to be significantly high in these previously symptomatic participants (p<0.0131). It was observed that having daily contact with general patients, close contact with COVID-19 cases and working in COVID-19 units had no significance in developing SARS-CoV-2 IgG (Table/Fig 2).

Presence of co-morbidities did not show significance regarding antibody development (p=0.0417). All the 13 participants reported to have co-morbidities were seronegative. The co-morbidities reported are shown in (Table/Fig 3).

Discussion

This hospital based seroprevalence study of SARS-CoV-2 IgG, estimated 25.12% of positivity among HCWs, who did not have a confirmed laboratory diagnosis of COVID-19. However, studies conducted among HCWs in different countries reported a lower IgG positivity. Studies conducted by Korth J et al., in Germany, Garcia-Basteiro AL et al., in Spain, Sotgiu G et al., in Italy and Stock AD et al., in New York showed lower seroprevalence than the present study (9),(15),(16),(17). Similar studies conducted in different states of India also reported lower IgG positivity than present study. Goenka M et al., from West Bengal found 11.94% IgG seroprevalence (18). Kumar A et al., from Kerala showed no IgG positivity among their study subjects (19). Dave M et al., from Rajasthan reported that among seropositive cases 8% developed IgM antibody, 8% developed both IgM and IgG, while none had IgG antibody positivity (20). Positivity of 17.61% and 2.5% was reported by Prakash O et al., from Ahmadabad and Khan MS et al., from Kashmir, respectively (21),(22). Singhal T et al., from Mumbai showed 4.3% prevalence of infection in asymptomatic HCWs but 70% in previously symptomatic untested HCWs (23). Gupta R et al., reported 13% positivity (24). However, a study from China showed 38.89% seropositivity among doctors exposed to COVID-19 patients (25) (Table/Fig 4). The findings of the present study indicate that a substantial proportion of the HCWs have been exposed in our institution and a large percentage of infections remained undetected. As all of these individuals were engaged in patient care, they could have become the source of infection for others. Tian S et al., also observed similar result in their study conducted in Beijing (26). This signifies that periodic screening programs to be implemented among HCWs and the hospital infection control system to be strengthened to decrease hospital transmission of the disease (27).

The significant higher seropositivity in <30 years age group may be explained by higher enrollment of younger age groups in COVID-19 related duties. It was observed that these seropositive HCWs were without any complications of COVID-19, which could be explained by low viral load, younger age groups, absence of associated co-morbidity and good immune function in them. Among the participants, those reported having mild symptoms compatible with COVID-19 in the previous months (but RT-PCR negative), the seropositivity was found to be higher. The symptoms include fever, cough, sore throat, headache, nasal discharge, body ache, fatigue. A study done by Garcia-Basteiro AL et al., found 80% positivity in HCWs with mild-to-moderate symptoms (15). As the antibody level is known to decline after mild infection with COVID-19, so even a negative serological test result might not be reliable to exclude previous infection (28). Cleaner, staff, laboratory technicians and nurses had higher seroprevalence rate than doctors which was also observed by Goenka M et al., (18). This signifies that higher awareness about the disease spread and prevention measures, better adherence to infection control protocols could be responsible for lower infection rate among doctors. However, Garcia-Basteiro AL et al., did not find any relation between professional categories and seropositivity (15). Although male showed higher percentage of positivity than female in this study, it was not statistically significant. Garcia Basteiro AL et al., also found no significance related to gender (female 76% vs male 24%, p=0.52) (15). Similarly, Prakash O et al., from Ahmedabad observed that the positivity percentage was higher among women as compared to the men but the difference was statistically insignificant (21). Sotgiu G et al., showed no significance in IgG positivity but IgM positivity was significantly high in male (male vs female: 10% vs 6.1% for IgG and 24.3% vs 9.1% for IgM) (16). However, Goenka M et al., and Gupta R et al., reported significantly higher seroprevalence in male. (male vs female 13.76% vs 8.51% and 63% vs 37%, respectively) (18),(24).

Working in COVID-19 unit, contact with confirmed COVID-19 positive cases and daily contact with general patients was not associated with seroprevlence, which might be explained by the fact that the higher perception of risk, makes people to strictly follow precautionary measures, so the risk of acquiring the infection become lower. Garcia-Basteiro AL et al., also explained that there was no significant association between the presence of SARS-CoV-2 antibodies with the above mentioned categories of HCWs (15). Sotgiu G et al., in their study on Italian HCWs also found that the percentage of IgG and IgM positive cases did not differ depending on history of contact with COVID-19 patients in comparison with non contacts (6.8% vs 3.5% for IgG, p-value: 0.86; 15.9% vs 13.9% for IgM, p-value: 0.74) (16).

The study showed that, the burden of asymptomatic COVID-19 was high among HCWs and a prior negative testing does not preclude infection.

Limitation(s)

It was a hospital-based study conducted in a less number of subjects and convenient sampling was done. Only serum IgG was tested not other antibodies like IgM and IgA due to which some of the cases in the early part of their antibody generation may be missed. Some of the exposed cases might also have been missed in this cross-sectional study as antibody level is known to wane over a few months.

Conclusion

A high IgG seropositivity among the COVID-19 negative HCWs of our institution in this cross-sectional seroprevalence study conducted during the first wave of COVID-19 pandemic was observed. The findings of the study guided us about the burden of the infection among the HCWs in prevaccination period of this pandemic. There is a need of well managed, organised, systematic and periodic surveillance system for estimating the burden of COVID-19 among HCWs as well as in the community which will help in better understanding of the dynamics of the infection with this novel virus and the future of this ongoing pandemic.

Acknowledgement

The authors are grateful to Professor (Dr.) HK Goswami, Dr. AK Bora, Mr. Lakhi Gogoi, Mr. Surjya Jyoti Saikia, Miss Sewali Thakuria for their assistance during the course of the study.

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DOI and Others

DOI: 10.7860/JCDR/2022/51664.16066

Date of Submission: Jul 30, 2021
Date of Peer Review: Nov 03, 2021
Date of Acceptance: Jan 09, 2022
Date of Publishing: Mar 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Aug 01, 2021
• Manual Googling: Dec 27, 2021
• iThenticate Software: Jan 07, 2022 (13%)

ETYMOLOGY: Author Origin

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