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Sarjomaa M, Zhang C, Tveten Y, Kersten H, Reiso H, Eikeland R, Kongerud J, Berg KK, Thilesen C, Nordbø SA, Aaberge IS, Vandenbroucke J, Pearce N, Fell AKM. Risk factors for SARS-CoV-2 infection: a test-negative case-control study with additional population controls in Norway. BMJ Open 2024; 14:e073766. [PMID: 38191258 PMCID: PMC10806780 DOI: 10.1136/bmjopen-2023-073766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 12/01/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVES This study aims to assess risk factors for SARS-CoV-2 infection by combined design; first comparing positive cases to negative controls as determined by PCR testing and then comparing these two groups to an additional prepandemic population control group. DESIGN AND SETTING Test-negative design (TND), multicentre case-control study with additional population controls in South-Eastern Norway. PARTICIPANTS Adults who underwent SARS-CoV-2 PCR testing between February and December 2020. PCR-positive cases, PCR-negative controls and additional age-matched population controls. PRIMARY OUTCOME MEASURES The associations between various risk factors based on self- reported questionnaire and SARS-CoV-2 infection comparing PCR-positive cases and PCR-negative controls. Using subgroup analysis, the risk factors for both PCR-positive and PCR-negative participants were compared with a population control group. RESULTS In total, 400 PCR-positive cases, 719 PCR-negative controls and 14 509 population controls were included. Male sex was associated with the risk of SARS-CoV-2 infection only in the TND study (OR 1.9, 95% CI 1.4 to 2.6), but not when PCR-positive cases were compared with population controls (OR 1.2, 95% CI 0.9. to 1.5). Some factors were positively (asthma, wood heating) or negatively (hypertension) associated with SARS-CoV-2 infection when PCR-positive cases were compared with population controls, but lacked convincing association in the TND study. Smoking was negatively associated with the risk of SARS-CoV-2 infection in both analyses (OR 0.5, 95% CI 0.3 to 0.8 and OR 0.6, 95% CI 0.4 to 0.8). CONCLUSIONS Male sex was a possible risk factor for SARS-CoV-2 infection only in the TND study, whereas smoking was negatively associated with SARS-CoV-2 infection in both the TND study and when using population controls. Several factors were associated with SARS-CoV-2 infection when PCR-positive cases were compared with population controls, but not in the TND study, highlighting the strength of combining case-control study designs during the pandemic.
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Affiliation(s)
- Marjut Sarjomaa
- Infection Control, Telemark Hospital, Skien, Norway
- Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway
| | - Chi Zhang
- Department of Biostatistics, University of Oslo, Oslo, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | - Yngvar Tveten
- Department of Clinical Microbiology, Telemark Hospital, Skien, Norway
| | - Hege Kersten
- Department of Research, Telemark Hospital, Skien, Norway
- School of Pharmacy, University of Oslo, Oslo, Norway
| | - Harald Reiso
- The Norwegian Advisory Unit on Tick-borne Diseases, Sørlandet sykehus HF Arendal, Arendal, Norway
| | - Randi Eikeland
- Neurology, Sørlandet sykehus HF Arendal, Arendal, Norway
- Department of Health and Sport Science, University of Agder - Grimstad Campus, Grimstad, Norway
| | | | | | | | - Svein Arne Nordbø
- Department of Medical Microbiology, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway
- Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Jan Vandenbroucke
- Clinical Epidemiology, University of Leiden, Leiden, The Netherlands
- Clinical Medicine-Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Neil Pearce
- Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
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González de Dios J, Martínez Rubio V, Giménez Díaz de Atauri Á, Ochoa Sangrador C, Rodríguez-Salinas Pérez E, Flores Villar S, Cuervo Valdés JJ. Principales modificaciones en la guía de práctica clínica «COVID-19 en pediatría». An Pediatr (Barc) 2022; 97:129.e1-129.e8. [PMID: 35782910 PMCID: PMC9237022 DOI: 10.1016/j.anpedi.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 06/21/2022] [Indexed: 11/29/2022] Open
Abstract
Presentamos el resumen de las principales modificaciones surgidas en la guía de práctica clínica «COVID-19 en Pediatría» entre su versión inicial publicada en el año 2021 y la publicada en el año 2022. El documento se ha elaborado siguiendo los pasos estructurados de la medicina basada en la evidencia e incorporando el sistema GRADE para realizar síntesis de la evidencia, con valoración de su calidad y, cuando se consideró apropiado, emitir recomendaciones jerarquizadas (en función de la calidad de la evidencia, los valores y preferencias, el balance entre beneficios, riesgos y costes, la equidad y la factibilidad). En esta actualización se incluyen también los cambios recomendados por los revisores externos. Se sintetizan las principales modificaciones en los siguientes apartados: epidemiología, clínica, diagnóstico, prevención, tratamiento y vacunas. En el conjunto del conocimiento alcanzado a lo largo del primer año de pandemia, las publicaciones durante el segundo año añaden nuevos datos, sin que en muchas de las áreas se produzcan modificaciones sustanciales. Los principales cambios acaecen en el campo de investigación de las vacunas. Esta actualización finaliza en diciembre de 2021, coincidiendo con el aumento de la infección por ómicron, por lo que será necesario una futura actualización del documento.
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Affiliation(s)
- Javier González de Dios
- Servicio de Pediatría, Hospital General Universitario de Alicante. Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
| | | | | | | | | | - Sergio Flores Villar
- Servicio de Pediatría, Hospital Universitario Mutua Terrasa, Terrasa, Barcelona, España
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González de Dios J, Martínez Rubio V, Giménez Díaz de Atauri Á, Ochoa Sangrador C, Rodríguez-Salinas Pérez E, Flores Villar S, Cuervo Valdés JJ. Main changes in the "COVID-19 in paediatrics" clinical practice guideline. An Pediatr (Barc) 2022; 97:129.e1-129.e8. [PMID: 35871151 PMCID: PMC9259469 DOI: 10.1016/j.anpede.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 06/21/2022] [Indexed: 11/27/2022] Open
Abstract
We present a summary of the main modifications to the “COVID-19 in Paediatrics” clinical practice guideline made from its initial version, published in 2021, and the version published in 2022. The document was developed following the structured steps of evidence-based medicine and applying the GRADE system to synthesize the evidence, assess its quality and, when appropriate, issue graded recommendations (based on the quality of the evidence, values and preferences, the balance between benefits, risks and costs, equity and feasibility). This update also includes the modifications proposed by external reviewers. We summarised the main modifications in the following sections: epidemiology, clinical features, diagnosis, prevention, treatment and vaccines. In relation to the body of knowledge achieved in the first year of the pandemic, the literature published in the second year contributed additional data, but without substantial modifications in many the areas. The main changes took place in the field of vaccine research. This update was completed in December 2021, coinciding with the emergence of infections by the omicron variant, so the document will need to be updated in the future.
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Affiliation(s)
- Javier González de Dios
- Servicio de Pediatría, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante(ISABIAL), Alicante, Spain.
| | | | | | | | | | - Sergio Flores Villar
- Servicio de Pediatría. Hospital Universitario Mutua Terrasa, Terrasa, Barcelona, Spain
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COVID-19 Vulnerability Mapping of Asian Countries. Disaster Med Public Health Prep 2022; 17:e241. [PMID: 35673800 PMCID: PMC9273770 DOI: 10.1017/dmp.2022.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The objective of this study is to map vulnerability of Asian countries to the COVID-19 pandemic. METHOD According to the Intergovernmental Panel on Climate Change (IPCC) 2007 framework for natural hazards, vulnerability is a function of exposure, sensitivity, and adaptive capacity. From an extensive literature review, we identified 16 socioeconomic, meteorological, environmental, and health factors that influence coronavirus disease 2019 (COVID-19) cases and deaths. The underlying factors of vulnerability were identified using principal component analysis. RESULTS Our findings indicate that the percentage of the urban population, obesity rate, air connectivity, and the population aged 65 and over, diabetes prevalence, and PM2.5 levels all contributed significantly to COVID-19 sensitivity. Subsequently, governance effectiveness, human development index (HDI), vaccination rate, and life expectancy at birth, and gross domestic product (GDP) all had a positive effect on adaptive capacity. The estimated vulnerability was corroborated by a Pearson correlation of 0.615 between death per million population and vulnerability. CONCLUSION This study demonstrates the application of universal indicators for assessing pandemic vulnerability for informed policy interventions such as the COVAX vaccine roll-out priority. Despite data limitations and a lack of spatiotemporal analysis, this study's methodological framework allows for ample data incorporation and replication.
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