In this study, the frequency of COVID-19 antibodies in hospital staff was investigated in the tests taken as of May 2020, and as a result of the tests, antibody positivity was found in the staff at a rate of 3.6%. It has been observed that the most risky group among the HCW’s is nurses. The probability of antibody positivity in nurses was 3.36 times higher than in other occupational groups. When antibody positivity is investigated according to the professions in the research, the detection of virus-specific antibodies indicates the encounter with COVID-19. Antibodies generally reach detectable levels 1 to 2 weeks after infection. Therefore, antibody tests are not suitable to show acute infection (6). In a study from the US, about 6% of adults hospitalized with COVID-19 were HCWs, and 72% of them were women. More than two-thirds of the HCWs hospitalized with COVID-19 generally work in positions that involve direct contact with patients, and more than one-third were nurses (7).
However, it should not be forgotten that a negative antibody test does not exclude infection. Antibody tests are mainly used in serological surveillance studies. Antibody tests are not suitable for use as immune indicators or to relax preventive measures (6).
One study found that healthcare workers providing healthcare to COVID-19 patients had a higher risk of getting COVID-19. The risk of hospitalization related to covid-19 was compared among the healthcare workers who provided health services to the patient with Covid-19, other healthcare workers, household members of healthcare professionals and the general population,. In the first 3 months, the probability of hospitalization with COVID-19 was three times higher in healthcare workers providing direct care for COVID-19 patients than other healthcare workers. In analyzes adjusted for gender, age, ethnicity, socioeconomic status and comorbidity, the risk was twice as high among household members of employees who directly cared for a COVID-19 patient.(8).
According to our findings, those working in intensive care units (9.2%) and those working in the COVID-19 service had the highest antibody positivity. Because the employees in this group care for more serious patients and are exposed to a more intense virus load. Therefore, this group of HCWs with high risk should be included in the vaccination scope in terms of COVID-19 first. Apart from high-risk areas such as emergency and intensive care, the use of personnel protective equipment should be maintained meticulously, and employees working in this field should not experience any lack of equipment. Also, a limitation should be placed on the number of daily patients to reduce the intense patient contact and flexible work should be created to reduce the virus load on HCWs. It is expected that the positivity in the household of infected HCWs, not only the age-old HCWs, is also expected to be high. Considering this situation, the household of the HCWs should be included in the scope of screening.
In our country, COVID-19 positivity was examined in the general population months after the date of this research. In that study, the COVID-19 antibody positivity in the population was found to be 0.81% in June 2020. However, the 3.6% rate we found in May 2020, when COVID-19 was limited in the population, was well above the average of the general population. (9).
Nurses had the highest antibody positivity among healthcare workers. Most patients with COVID-19 who need hospitalization are patients with significant dyspnea. For this reason, patients who need oxygen support and nursing care the most. Therefore, we think that nurses' intensive work and intense patient contact with these patients may be related to the higher antibody positivity in this occupational group. In a study conducted in Denmark, the group with the highest antibody positivity was nurses (10). It shows that approximately one-tenth of the HCWs screened in this study were diagnosed with acute SARS-CoV-2 infection; about half of them were nurses. The high number of nurses who were positive for SARS-CoV-2 in our study can be explained by the fact that their nurses generally spend more time with direct patient care, the longer the time spent working at the bedside and the practices that require direct patient contact. One of the reasons it is more common in nurses may be that they have to eat during the working period and nurses get together more in social areas during rest periods.
Burnout has also increased in this population due to the increased workload and difficult working hours in HCWs. Increasing burnout causes negative effects on physical and mental health. Any measure to help reduce the burnout levels of HCWs can reduce stress levels and provide effective strategies to improve physical and mental health (11, 12).