First, the study population consists of 80.5% female HCWs and thereby represents the typical female\focused gender composition in the public healthcare sector in Germany with a female share of 75.5% among HCWs in 2019. 34 However, a gender\differentiated data analysis in this large study population allows the transferability of the described findings to both HCWs and the public. of SARS\CoV\2 variants of concern (VOC), the immunity and the vaccine prevention of healthcare workers (HCWs) against SARS\CoV\2 continues to be of high importance. YIL 781 This observational cross\section study assesses factors influencing the level of anti\SARS\CoV\2\spike IgG after SARS\CoV\2 infection or vaccination. One thousand seven hundred and fifty HCWs were recruited meeting the following inclusion criteria: age 18?years, PCR\confirmed SARS\CoV\2 infection convalescence and/or at least one dose of COVID\19 vaccination. anti\SARS\CoV\2\spike IgG titers were determined by SERION ELISA SARS\CoV\2 IgG. Mean YIL 781 anti\SARS\CoV\2\spike IgG levels increased significantly by number of COVID\19 vaccinations (92.2?BAU/ml for single, 140.9 BAU/ml for twice and 1144.3?BAU/ml for threefold vaccination). Hybrid COVID\19 immunized respondents (after infection and vaccination) had significantly higher antibody titers compared with convalescent only HCWs. Anti\SARS\CoV\2\spike IgG titers declined significantly with time after the second vaccination. Smoking and high age were associated with lower titers. Both recovered and vaccinated HCWs presented a predominantly good humoral immune response. Smoking and higher age limited the humoral SARS\CoV\2 immunity, adding to the risk of severe infections within this already health impaired collective. Keywords: anti\SARS\CoV\2\spike IgG, COVID\19 vaccination, healthcare workers, SARS\CoV\2 infection, seroprevalence 1.?INTRODUCTION Against the background of the ongoing COVID\19 pandemic 1 and the current infection dynamics with the rapid spread of SARS\CoV\2 variant of concern (VOC) as well as high incidence levels, 2 , 3 the immunity of healthcare workers (HCWs) against SARS\CoV\2 continues to play a critical role in preventing disease\related staff shortages and keeping up public health care capacities. 4 , 5 , 6 COVID\19 vaccines have evolved as a key prevention strategy to reduce the severity of disease and combat the global spread of SARS\CoV\2. 7 The humoral immune response against SARS\CoV\2 is investigated to provide forecasts regarding immunity and protection against severe courses of disease. 8 The low number of studies published to date show a significant correlation between neutralizing antibody titers and prevention from symptomatic SARS\CoV\2 infections. 9 The available YIL 781 data is still insufficient to make any concrete statements on the influencing factors of antibody titers considering the large number of possible combinations of COVID\19 vaccinations and/or SARS\CoV\2 infection. Previously published studies on humoral anti\SARS\CoV\2\spike antibodies have been conducted predominantly in small cohorts or for only short observation periods without consideration of demographic factors, quality of life as well as ability to work, particularly in HCWs. 10 , 11 , 12 , 13 This study examines the seroprevalence of anti\SARS\CoV\2\spike IgG following SARS\CoV\2 infection YIL 781 and/or COVID\19 vaccination in HCWs and determines factors influencing antibody titers as a cross\section study. 2.?METHODS 2.1. Study setting The data presented is part of the prospective CoVacSer cohort study, which examines SARS\CoV\2 immunity derived from serial blood samples as well as survey\based quality of life and ability to work in HCWs after COVID\19 vaccination and/or SARS\CoV\2 infection. HCW were recruited via intranet messages at a tertiary\care hospital in Germany with approximately 8000 employees. HCW from other institutions were recruited by word\of\mouth recommendation. The CoVacSer study participants had to meet the following inclusion criteria: (i) age 18?years, (ii) signed consent form, (iii) 14?days minimal interval after first polymerase chain reaction (PCR) derived confirmation of SARS\CoV\2 infection and/or at least one dose of COVID\19 vaccination independent of the vaccination concept, and (iv) employment in the healthcare sector. Serum blood samples for anti\SARS\CoV\2\spike IgG determination were collected combined with pseudonymized CoVacSer study surveys including demographic data, physical condition, and personal risk factors in addition to World Health Organization Quality of Life (WHOQOL\BREF) 14 , HMGCS1 15 and Work Ability Index (WAI) questionnaire. 16 Only serum blood samples that were accompanied by a signed consent form as well as a fully completed digital questionnaire have been taken into account for the data analysis. Following pseudonymization, the matching of blood sample and survey was mediated based on date of birth and dates of SARS\CoV\2 infection or COVID\19 vaccination. Participants with vaccines that were not authorized by the European Medicines Agency (EMA) were excluded from this study. The following vaccines have been included due.
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