The seroprevalence of SARS-CoV-2 antibodies among health care workers before the era of vaccination: a systematic review and meta-analysis

İlker Kayı, Bahar Madran, Şiran Keske, Özge Karanfil, Jose Ramon Arribas, Natalia Psheniсhnaya, Nicola Petrosillo, Mehmet Gönen, Önder Ergönül

Research output: Contribution to journalReview articlepeer-review


Background: The prevalence of SARS-CoV-2 infection among health care workers (HCWs) provides information about the spread of COVID-19 within health care facilities, and the risk groups. Objectives: We aimed to describe the rate of SARS-CoV-2 seroprevalence and its determinants among HCWs. Data sources: We used Web of Science, PubMed, Scopus, MEDLINE, EBSCOhost and Cochrane Library. Study eligibility criteria: We included the reports of SARS-CoV-2 seroprevalence with a sample size of minimum 1000 HCWs. Methods: The study was registered at the International Prospective Register of Systematic Reviews (PROSPERO, no. CRD42021230456). We used PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The keywords were “COVID-19”, “SARS-CoV-2”, “Coronavirus”, “seroprevalence”, “health care workers” and “risk factors”. Results: In total 4329 reports were retrieved, duplications were removed; after filtering according to the title and abstract, 25 studies were selected. Risk of bias was assessed in 25 studies; it was low in 13 studies, medium in four studies, and high in eight studies. In meta-analysis using the random effect model, the weighted average of seroprevalence was calculated as 8% (95% CI 6–10%). The pooled seroprevalence rates of the selected variables that have a rate above the average were male HCWs with 9% (95% CI 7–11%); HCWs from ethnic minorities with 13% (95% CI 9–17%); high exposure 9% (95% CI 6–13%); exposure to the virus outside the health care setting 22% (95% CI 14–32%). Conclusions: Our analysis indicates a SARS-CoV-2 seroprevalence rate of 8% among studies that included >1000 HCWs for the year 2020, before vaccinations started. The most common risk factors associated with higher seroprevalence rate were ethnicity, male gender and having a higher number of household contacts. Working as a frontline HCW was inconsistent in its association with higher seroprevalence.

Original languageEnglish
Pages (from-to)1-27
Number of pages27
JournalClinical Microbiology and Infection
Publication statusAccepted/In press - Jun 8 2021


  • Before vaccination
  • Covid-19
  • Healthcare workers
  • Risk factors
  • Seroprevalence

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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