ORCHESTRA project in Romania - a prospective occupational cohort to study the impact of COVID-19 pandemic on healthcare workers

ORCHESTRA is a three-year international research project funded by the European Union’s Horizon 2020 research and innovation programme, led by the University of Verona and involving 26 partners (extending to a wider network of 37 partners) from 15 countries. Romania is partner in ORCHESTRA project and is represented by The National Institute of Public Health. The challenge for the Romanian team is to enroll a prospective cohort of more than 1 000 health care workers and to follow-up, for at least 12 months, the impact of the pandemic at three main levels: mental health, long term consequences of COVID-19 and variation of the immune response in vaccinated. Secondary objectives are: the variation of risk perception during the pandemic, the preventive measures at workplace and how these evolved during the pandemic, vaccination acceptance and reasons of refusal. This paper aims to present a brief overview of the study design in Romania and the cohort description at baseline.

SARS-CoV-2 Reinfection: A Case Series from a 12-Month Longitudinal Occupational Cohort

Seven cases of COVID-19 SARS-CoV-2 reinfection from the NBA 2020-2021 occupational testing cohort are described including clinical details, antibody test results, genomic sequencing, and longitudinal RT-PCR results. Reinfections were infrequent and varied in clinical presentation, viral dynamics, and immune response.

Unexplained longitudinal variability in COVID-19 antibody status by Lateral Flow Immuno-Antibody testing

BackgroundCOVID-19 antibody testing allows population studies to classify participants by previous SARS-CoV-2 infection status. Home lateral flow immune-antibody testing devices offer a very convenient way of doing this, but relatively little is known about how measurement and antibody variability will affect consistency in results over time. We examined consistency by looking at the outcome of two tests three months apart while COVID-19 infection rates were low (summer 2020 in the UK).MethodsThe KCL-Coronavirus Health and Experiences in Colleagues at King’s is an occupational cohort of staff and postgraduate research students. Lateral flow immune-antibody testing kits were sent to participant’s homes in late June 2020 and late September 2020. Participants also completed regular surveys that included asking about COVID-19 symptoms and whether they thought they had been infected.ResultsWe studied 1489 participants returned valid results in both June and September (59% of those sent kits). Lateral flow immune-antibody test was positive for 7.2% in June and 5.9% in September, with 3.9% positive in both. Being more symptomatic or suspecting infection increased the probability of ever being positive. Of those positive in June, 46% (49/107) were negative in September (seroreversion), and this was similar regardless of symptom characteristics, suspicion, and timing of possible infection. A possible outlier was those aged over 55 years, where only 3 of 13 (23%) had seroreversion.DiscussionThese results do not follow the pattern reported from studies specifically designed to monitor seropositivity, which have found greater consistency over time and the influence of presence, timing and severity of symptoms on seroreversion. We suggest several factors that may have contributed to this difference: our low bar in defining initial seropositivity (single test); a non-quantitative test known to have relatively low sensitivity; participants carrying out testing. We would encourage other studies to use these real-world performance characteristics alongside those from laboratory studies to plan and analyse any antibody testing.