Severe Acute Respiratory Syndrome Coronavirus 2 Seroprevalence, Illness Recall, and Work Absenteeism Among Healthcare Workers: A Facility-Based Cross-Sectional Study in the Philippines, 2021.

Publication date: Jul 23, 2025

Healthcare workers (HCWs) have been disproportionately affected by coronavirus disease 2019 (COVID-19). This study assessed HCW severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence trends and indicators’ effectiveness for infection monitoring in the Philippine healthcare setting during 2021 and 2022-2023. We obtained data on HCW demographics at 2 facilities, and COVID-19 symptoms recall and absenteeism at one facility. We collected and tested blood specimens with a SARS-CoV-2 spike and nucleocapsid protein-based serological assay. We calculated crude prevalence ratios (PRs) and 95% confidence intervals (CIs) for risk factors. A total of 253 HCWs were included. Seroprevalence of SARS-CoV-2 infection among HCWs was 34% from September to October 2021 and 92% from October 2022 to April 2023 during the Delta and the Omicron variant surges, respectively, at one facility. At the other facility, seroprevalence was 31% in September-October 2021. Of the 33 seropositive HCWs with questionnaire completed, 14 (42%) did not recall COVID-19-like symptoms in the past year. Serological evidence of SARS-CoV-2 infection was statistically more likely among HCWs who recalled COVID-19-like symptoms in the past year (PR, 2. 69 [95% CI: 1. 53-4. 72]; P < .05). Of the seropositive HCWs, 7 (21%) had no hospital documentation of missed work. Of the 24 HCWs with a positive SARS-CoV-2 test, 12 (50%) tested because of symptoms, 4 (17%) tested after exposure, and 5 (21%) tested following employment screening. Self-reported symptoms may be used to track SARS-CoV-2 prior infections within resource-limited healthcare settings. Occupational health services should consider these findings when developing infection monitoring strategies among HCWs. Combining surveillance strategies may strengthen infection monitoring.

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