Cross-sectional prevalence of SARS-CoV-2 antibodies in healthcare workers in paediatric facilities in eight countries

J Hosp Infect. 2021 Apr;110:60-66. doi: 10.1016/j.jhin.2020.12.019. Epub 2021 Jan 7.


Background: Healthcare workers (HCWs) have been disproportionately affected by coronavirus disease 2019 (COVID-19), which may be driven, in part, by nosocomial exposure. If HCW exposure is predominantly nosocomial, HCWs in paediatric facilities, where few patients are admitted with COVID-19, may lack antibodies to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and be at increased risk during the current resurgence.

Aim: To compare the seroprevalence of SARS-CoV-2 amongst HCWs in paediatric facilities in seven European countries and South Africa (N=8).

Methods: All categories of paediatric HCWs were invited to participate in the study, irrespective of previous symptoms. A single blood sample was taken and data about previous symptoms were documented. Serum was shipped to a central laboratory in London where SARS-CoV-2 immunoglobulin G was measured.

Findings: In total, 4114 HCWs were recruited between 1st May and mid-July 2020. The range of seroprevalence was 0-16.93%. The highest seroprevalence was found in London (16.93%), followed by Cape Town, South Africa (10.36%). There were no positive HCWs in the Austrian, Estonian and Latvian cohorts; 2/300 [0.66%, 95% confidence interval (CI) 0.18-2.4] HCWs tested positive in Lithuania; 1/124 (0.81%, 95% CI 0.14-4.3) HCWs tested positive in Romania; and 1/76 (1.3%, 95% CI 0.23-7.0) HCWs tested positive in Greece.

Conclusion: Overall seroprevalence amongst paediatric HCWs is similar to their national populations and linked to the national COVID-19 burden. Staff working in paediatric facilities in low-burden countries have very low seroprevalence rates and thus are likely to be susceptible to COVID-19. Their susceptibility to infection may affect their ability to provide care in the face of increasing cases of COVID-19, and this highlights the need for appropriate preventative strategies in paediatric healthcare settings.

Keywords: COVID-19; Healthcare workers; Hospital workers; SARS-CoV-2; Seroprevalence.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Antibodies, Viral / blood*
  • COVID-19 / epidemiology*
  • Cross-Sectional Studies
  • Europe / epidemiology
  • Female
  • Health Personnel / statistics & numerical data*
  • Hospitals, Pediatric / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Occupational Diseases / epidemiology*
  • Prevalence
  • Risk Assessment / statistics & numerical data*
  • Seroepidemiologic Studies
  • South Africa / epidemiology
  • Young Adult


  • Antibodies, Viral