Seroprevalence of SARS-CoV-2 antibodies in a prospective cohort of patients admitted to an acute psychiatric ward in Norway during the initial months of the COVID-19 pandemic

Abstract

Background

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) spread around the world during the first part of 2020. The purpose of the study was to assess the prevalence of SARS-CoV-2 infection among patients acutely admitted to the Psychiatric Clinic, Haukeland University Hospital.

Methods

Serum tests to assess for antibodies to SARS-CoV-2 were administered at admission to the clinic together with a questionnaire on symptoms and demographical information. Further information was obtained from the medical records.

Results

The cumulative seroprevalence in the 266 participants was 0.75%, the cumulative reported cases in the Norwegian general population was 0.61% at the end of the inclusion period of the study. Twenty-five percent of participants had risk factors for a serious course of COVID-19. There was a low prevalence of cohabitation and only 20% had their main income derived from ordinary salaries (not welfare).

Conclusion

The prevalence of SARS-CoV-2 infection in a sample of patients acutely admitted to the Psychiatric Clinic, Haukeland University Hospital, was comparable to reported cases in the general population. A possible link to governmental and municipal restrictions, general low workplace participation and cohabitation is discussed.

Key findings

• Seroprevalence of SARS-CoV-2 antibodies is comparable to the general population.

• Twenty-five percent of patients had elevated risk for a serious course of COVID-19 because of somatic conditions.

• Fifty-seven percent lived alone, 17% with one other person in the household.

• Twenty percent had regular salary as the main income source for the last three months before admission.

Keywords:

• COVID-19
• SARS-CoV-2
• seroprevalence
• emergency psychiatry
• acute ward

Acknowledgements

Thanks to Torstein Andvik, Department of Microbiology, Haukeland University Hospital who designed Figure 1. The authors also wish to express gratitude to the following persons that contributed in the data collection: Maria Fagerbakke Strømme, Kristian Varden Gjerde, Tore Haugsgjerd, Gunnhild Hoprekstad, Ole Kristian Sindland, Jill Bjarke, Lin Lilleskare, Linn Aaberg, Egil Anders Haugen, Solveig Olerud, and hospital staff at the Psychiatric Acute Department (PAM), Psychiatric Clinic, Haukeland University Hospital. Thanks to Rolf Gjestad for supervising the statistical analysis.

Author contributions

RAK, AJL and EJ planned and conducted the study. LAS conducted the data analyses and prepared the tables. HMSG and EU contributed in planning of the study and were responsible for the laboratory analyses and evaluations. RAK and LAS drafted the manuscript, all authors contributed, reviewed and approved the final manuscript.

Ethical approval

The Regional Committee for Medical and Health Research Ethics ethical board authority approved that PAMCOV could collect a delayed informed consent because of the acute setting in which this study was conducted.

Patient consent

Patients admitted to the Psychiatric Clinic were approached after the acute situation at admission was resolved and invited to participate in the PAMCOV project, and all participants consented to participate. A proportion of patients admitted to the Psychiatric Clinic has a reduced capacity to provide a consent for participation in the PAMCOV study. The Regional Committee for Medical and Health Research Ethics gave approval for the PAMCOV study to approach the patient’s next of kin or the patient’s legal guardian and ask them to provide consent on behalf of the patient.

Disclosure statement

The authors declare that they have no competing interests.

Notes on contributors

Rune Andreas Kroken, Associate professor, University of Bergen and researcher, Haukeland University Hospital. Kroken is a Clinical psychiatrist with PhD on antipsychotic treatment for patients with schizophrenia. Currently he is principal investigator on an RCT on semaglutide versus placebo for patients with overweight using antipsychotic treatment. His main interest is problems of somatic health and shortened life expectancy for persons with serious mental illness compared to the general population.

Lena Antonsen Stabell, Mental Health Nurse and M.Sc. in evidence-based practice, Haukeland University Hospital and University of Bergen, Norway. Currently she is a PhD student and holds a part time position as database coordinator in Bergen Psychosis Research Group. Her main interests include clinical psychopharmacology, treatment outcomes, psychometrics and statistical analysis.

Harleen M. S. Grewal, Professor of Microbiology and Global Health, University of Bergen, and Consultant Physician (Microbiology), Haukeland University Hospital, Bergen, Norway. Her recent projects are within the areas of antimicrobial resistance and rapid point-of-care diagnostics for respiratory infections to improve personalised therapy.

Elling Ulvestad, Dr. med., Head of the Department of Microbiology, Professor at the University of Bergen. His ongoing research is on borreliosis, COVID-19, antimicrobial resistance, rapid diagnostics for respiratory infections, metagenomics and theory of science.

Andreas Johan Landsnes, MD, Psychiatrist since 1992, working in different clinical departments, last 11 years head of The Psychiatric Emergency Department in the Psychiatric clinic, Haukeland University Hospital, Bergen, Norway.

Erik Johnsen, Head Psychiatrist, Haukeland University Hospital, and Professor of Psychiatry, University of Bergen, Norway Johnson is Head of Bergen Psychosis Research Group, and Principal Investigator of several researcher-initiated clinical trials. His main interests include clinical psychopharmacology and molecular mechanisms underlying symptoms and treatment effects.

Data availability statement

Data sharing require, according to Norwegian law, approvals from the Data Protection Officer at Haukeland University Hospital and the Regional Committees for Medical and Health Research Ethics on the basis of specific research proposals.

Additional information

Funding

The study did not receive external funding.