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

2020; eLife Sciences Publications Ltd; Volume: 9; Linguagem: Inglês

10.7554/elife.58728

2050-084X

Lucy Rivett, Sushmita Sridhar, Dominic Sparkes, Matthew Routledge, Nick K Jones, Stephen R. Forrest, Jamie Young, Joana Pereira-Dias, William L. Hamilton, Mark Ferris, M. Estée Török, Luke W. Meredith, Ravi Gupta, Paul Lyons, Mark Toshner, Ben Warne, Josefin Bartholdson Scott, Claire Cormie, Harmeet K. Gill, Iain Kean, Mailis Maes, Nicola Reynolds, Michelle Wantoch, Sarah Caddy, Laura Caller, Theresa Feltwell, Grant Hall, Myra Hosmillo, Charlotte J. Houldcroft, Aminu S. Jahun, Fahad Khokhar, Anna Yakovleva, Helen Butcher, Daniela Caputo, Debra Clapham-Riley, Helen Dolling, Anita Furlong, Barbara Graves, Emma Le Gresley, Nathalie Kingston, Sofia Papadia, Hannah Stark, Kathleen Stirrups, Jennifer Webster, Joanna Calder, Julie R. Harris, Sarah Hewitt, Jane Kennet, Anne Meadows, Rebecca Rastall, Criona O Brien, Jo Price, Cherry Publico, Jane Rowlands, Valentina Ruffolo, Hugo Tordesillas, Karen Brookes, Laura Canna, Isabel Cf da Cruz, Katie Dempsey, Anne Elmer, Naidine Escoffery, Heather Jones, Carla M. S. Ribeiro, Caroline Saunders, Angela Wright, Rutendo Nyagumbo, Anne M. Roberts, Ashlea Bucke, Simone Hargreaves, Danielle Johnson, Aileen Narcorda, Debbie Read, Christian Sparke, Lucy Warboys, Kirsty Lagadu, Lenette Mactavous, T Gould, Tim Raine, Claire Mather, Nicola Ramenatte, Anne-Laure Vallier, Mary Kasanicki, Penelope-Jane Eames, Chris McNicholas, Lisa Thake, Neil Bartholomew, Nicholas M. Brown, Surendra Parmar, Hongyi Zhang, Ailsa Bowring, Geraldine Martell, Natalie Quinnell, Jo Rae Wright, Helen Murphy, Benjamin J. Dunmore, Ekaterina Legchenko, Stefan Gräf, Christopher Huang, Josh Hodgson, Kelvin Hunter, Jennifer Martin, Federica Mescia, Ciara O’Donnell, Linda Pointon, Joy Shih, Rachel Sutcliffe, Tobias Tilly, Zhen Tong, Carmen Treacy, Jennifer Wood, Laura Bergamaschi, Ariana Betancourt, Georgie Bowyer, Aloka De, Maddie Epping, Andrew Hinch, Oisín Huhn, Isobel Jarvis, Daniel J. Lewis, Joe Marsden, Simon McCallum, Francescsa Nice, Martin D. Curran, Stewart Fuller, Afzal Chaudhry, Ashley Shaw, Richard J. Samworth, John R. Bradley, Gordon Dougan, Kenneth G. C. Smith, Paul J. Lehner, Nicholas J. Matheson, Giles Wright, Ian Goodfellow, Stephen Baker, Michael P. Weekes,

SARS-CoV-2 detection and testing

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.