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Uthman OA, Lyngse FP, Anjorin S, Hauer B, Hakki S, Martinez DA, Ge Y, Jonnerby J, Julin CH, Lin G, Lalvani A, Loss J, Madon KJ, Martinez L, Næss LM, Page KR, Prieto D, Robertson AH, Shen Y, Wurm J, Buchholz U. Susceptibility and infectiousness of SARS-CoV-2 in children versus adults, by variant (wild-type, alpha, delta): A systematic review and meta-analysis of household contact studies. PLoS One 2024; 19:e0306740. [PMID: 39240908 PMCID: PMC11379298 DOI: 10.1371/journal.pone.0306740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/22/2024] [Indexed: 09/08/2024] Open
Abstract
IMPORTANCE Understanding the susceptibility and infectiousness of children and adolescents in comparison to adults is important to appreciate their role in the COVID-19 pandemic. OBJECTIVE To determine SARS-CoV-2 susceptibility and infectiousness of children and adolescents with adults as comparator for three variants (wild-type, alpha, delta) in the household setting. We aimed to identify the effects independent of vaccination or prior infection. DATA SOURCES We searched EMBASE, PubMed and medRxiv up to January 2022. STUDY SELECTION Two reviewers independently identified studies providing secondary household attack rates (SAR) for SARS-CoV-2 infection in children (0-9 years), adolescents (10-19 years) or both compared with adults (20 years and older). DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data, assessed risk of bias and performed a random-effects meta-analysis model. MAIN OUTCOMES AND MEASURES Odds ratio (OR) for SARS-CoV-2 infection comparing children and adolescents with adults stratified by wild-type (ancestral type), alpha, and delta variant, respectively. Susceptibility was defined as the secondary attack rate (SAR) among susceptible household contacts irrespective of the age of the index case. Infectiousness was defined as the SAR irrespective of the age of household contacts when children/adolescents/adults were the index case. RESULTS Susceptibility analysis: We included 27 studies (308,681 contacts), for delta only one (large) study was available. Compared to adults, children and adolescents were less susceptible to the wild-type and delta, but equally susceptible to alpha. Infectiousness analysis: We included 21 studies (201,199 index cases). Compared to adults, children and adolescents were less infectious when infected with the wild-type and delta. Alpha -related infectiousness remained unclear, 0-9 year old children were at least as infectious as adults. Overall SAR among household contacts varied between the variants. CONCLUSIONS AND RELEVANCE When considering the potential role of children and adolescents, variant-specific susceptibility, infectiousness, age group and overall transmissibility need to be assessed.
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Affiliation(s)
- Olalekan A Uthman
- Warwick Centre for Global Health, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Frederik Plesner Lyngse
- Department of Economics & Center for Economic Behaviour and Inequality, University of Copenhagen, Copenhagen, Denmark
| | - Seun Anjorin
- Warwick Centre for Global Health, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Barbara Hauer
- Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Robert Koch Institute, Berlin, Germany
| | - Seran Hakki
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Diego A Martinez
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
- School of Industrial Engineering, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Yang Ge
- School of Health Professions, University of Southern Mississippi, Hattiesburg, Mississippi, United States of America
| | - Jakob Jonnerby
- School of Public Health, Imperial College London, London, United Kingdom
| | - Cathinka Halle Julin
- Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Gary Lin
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Ajit Lalvani
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Julika Loss
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Kieran J Madon
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Leonardo Martinez
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States of America
| | - Lisbeth Meyer Næss
- School of Public Health, Imperial College London, London, United Kingdom
| | - Kathleen R Page
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Diana Prieto
- School of Industrial Engineering, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | | | - Ye Shen
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, United States of America
| | - Juliane Wurm
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Udo Buchholz
- Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Robert Koch Institute, Berlin, Germany
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Huang HL, Lu CY, Liu YC, Chang TH, Yen TY, Huang KYA, Tang HJ, Chang LY, Huang LM. Seroprevalence of SARS-CoV-2 in self-reported COVID-19-free children. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2024; 57:546-553. [PMID: 38777654 DOI: 10.1016/j.jmii.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 04/15/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION COVID-19 poses risks and leads to complications for vulnerable populations, including children. Unreported cases of COVID-19 among children hinder our understanding of the true disease burden. In this study, we aimed to investigate the proportion of children who report no prior infection to SARS-CoV-2 but who nevertheless exhibit serological evidence of prior infection. METHODS Between November 2022 and February 2023, we recruited children and adolescents under 19 years of age who lacked a prior history of SARS-CoV-2 infection. Participants underwent SARS-CoV-2 antibody testing to assess the presence of IgG antibodies specific to nucleocapsid (N) and spike (S) proteins. Demographic and contact information were also collected. RESULTS Among 260 COVID-19-free children, the overall anti-N antibody positivity rate, which varied across age groups (4%-25%), was 9.2% (24/260). Contact with individuals who were positive for COVID-19, particularly the children's mothers, significantly increased the likelihood of antibody positivity. The median age of the 34 children who remained unvaccinated against COVID-19 was lower than that of the children who were vaccinated (6.5 vs. 9 years; p < 0.001). Until January 2024, the overall infection rate was 41.9% (99/236) among children who were negative for anti-N antibodies, irrespective of vaccination status or the presence of chronic disease. CONCLUSION We discovered previously undisclosed cases of SARS-CoV-2 infection among children. The risk of seropositivity increases substantially with household contact. Regarding children who report no prior exposure to COVID-19, clinicians must remain vigilant, as SARS-CoV-2 remains a concern.
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Affiliation(s)
- Hsiao-Lun Huang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan; Division of Pediatric Infectious Diseases, Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Chun-Yi Lu
- Division of Pediatric Infectious Diseases, Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Yun-Chung Liu
- Division of Pediatric Infectious Diseases, Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Tu-Hsuan Chang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan.
| | - Ting-Yu Yen
- Division of Pediatric Infectious Diseases, Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuan-Ying A Huang
- Division of Pediatric Infectious Diseases, Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Hung-Jen Tang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Luan-Yin Chang
- Division of Pediatric Infectious Diseases, Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
| | - Li-Min Huang
- Division of Pediatric Infectious Diseases, Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
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Smith P, Little F, Hermans S, Davies MA, Wood R, Orrell C, Pike C, Peters F, Dube A, Georgeu-Pepper D, Curran R, Fairall L, Bekker LG. A prospective randomised controlled trial investigating household SARS-CoV-2 transmission in a densely populated community in Cape Town, South Africa - the transmission of COVID-19 in crowded environments (TRACE) study. BMC Public Health 2024; 24:1924. [PMID: 39020307 PMCID: PMC11256445 DOI: 10.1186/s12889-024-19462-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 07/12/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND South Africa's first SARS-CoV-2 case was identified 5th March 2020 and national lockdown followed March 26th. Households are an important location for secondary SARS-CoV-2 infection. Physical distancing and sanitation - infection mitigation recommended by the World Health Organization (WHO) at the time - are difficult to implement in limited-resource settings because of overcrowded living conditions. METHODS This study (ClinicalTrials.gov NCT05119348) was conducted from August 2020 to September 2021 in two densely populated, low socioeconomic Cape Town community sub-districts. New COVID-19 index cases (ICs) identified at public clinics were randomised to an infection mitigation intervention (STOPCOV) delivered by lay community health workers (CHWs) or standard of care group. STOPCOV mitigation measures included one initial household assessment conducted by a CHW in which face masks, sanitiser, bleach and written information on managing and preventing spread were provided. This was followed by regular telephonic follow-up from CHWs. SARS-CoV-2 PCR and IgM/IgG serology was performed at baseline, weeks 1, 2, 3 and 4 of follow-up. RESULTS The study randomised 81 ICs with 245 HHCs. At baseline, no HHCs in the control and 7 (5%) in the intervention group had prevalent SARS-CoV-2. The secondary infection rate (SIR) based on SARS-CoV-2 PCR testing was 1.9% (n = 2) in control and 2.9% (n = 4) in intervention HHCs (p = 0.598). At baseline, SARS-CoV-2 antibodies were present in 15% (16/108) of control and 38% (52/137) of intervention participants. At study end incidence was 8.3% (9/108) and 8.03% (11/137) in the intervention and control groups respectively. Antibodies were present in 23% (25/108) of control HHCs over the course of the study vs. 46% (63/137) in the intervention arm. CHWs made twelve clinic and 47 food parcel referrals for individuals in intervention households in need. DISCUSSION Participants had significant exposure to SARS-CoV-2 infections prior to the study. In this setting, household transmission mitigation was ineffective. However, CHWs may have facilitated other important healthcare and social referrals.
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Affiliation(s)
- Philip Smith
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.
| | - Francesca Little
- Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa
| | - Sabine Hermans
- Amsterdam UMC, Department of Global Health, University of Amsterdam, Amsterdam, The Netherlands
- Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam Institute for Immunology and Infectious Diseases, University of Amsterdam, Amsterdam Public Health - Global Health, Amsterdam, The Netherlands
| | - Mary-Ann Davies
- Center for Infectious Diseases Epidemiology and Research, University of Cape Town, Cape Town, South Africa
| | - Robin Wood
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Catherine Orrell
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Carey Pike
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Fatima Peters
- Western Cape Department of Health, Cape Town, South Africa
| | - Audry Dube
- Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa
| | | | - Robyn Curran
- Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa
| | - Lara Fairall
- Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa
| | - Linda-Gail Bekker
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.
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Tuschhoff BM, Kennedy DA. Detecting and quantifying heterogeneity in susceptibility using contact tracing data. PLoS Comput Biol 2024; 20:e1012310. [PMID: 39074159 PMCID: PMC11309420 DOI: 10.1371/journal.pcbi.1012310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 08/08/2024] [Accepted: 07/10/2024] [Indexed: 07/31/2024] Open
Abstract
The presence of heterogeneity in susceptibility, differences between hosts in their likelihood of becoming infected, can fundamentally alter disease dynamics and public health responses, for example, by changing the final epidemic size, the duration of an epidemic, and even the vaccination threshold required to achieve herd immunity. Yet, heterogeneity in susceptibility is notoriously difficult to detect and measure, especially early in an epidemic. Here we develop a method that can be used to detect and estimate heterogeneity in susceptibility given contact by using contact tracing data, which are typically collected early in the course of an outbreak. This approach provides the capability, given sufficient data, to estimate and account for the effects of this heterogeneity before they become apparent during an epidemic. It additionally provides the capability to analyze the wealth of contact tracing data available for previous epidemics and estimate heterogeneity in susceptibility for disease systems in which it has never been estimated previously. The premise of our approach is that highly susceptible individuals become infected more often than less susceptible individuals, and so individuals not infected after appearing in contact networks should be less susceptible than average. This change in susceptibility can be detected and quantified when individuals show up in a second contact network after not being infected in the first. To develop our method, we simulated contact tracing data from artificial populations with known levels of heterogeneity in susceptibility according to underlying discrete or continuous distributions of susceptibilities. We analyzed these data to determine the parameter space under which we are able to detect heterogeneity and the accuracy with which we are able to estimate it. We found that our power to detect heterogeneity increases with larger sample sizes, greater heterogeneity, and intermediate fractions of contacts becoming infected in the discrete case or greater fractions of contacts becoming infected in the continuous case. We also found that we are able to reliably estimate heterogeneity and disease dynamics. Ultimately, this means that contact tracing data alone are sufficient to detect and quantify heterogeneity in susceptibility.
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Affiliation(s)
- Beth M. Tuschhoff
- Department of Biology, The Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - David A. Kennedy
- Department of Biology, The Pennsylvania State University, University Park, Pennsylvania, United States of America
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Neil-Sztramko SE, Belita E, Traynor RL, Hagerman L, Akaraci S, Burnett P, Kostopoulos A, Dobbins M. What is the specific role of schools and daycares in COVID-19 transmission? A final report from a living rapid review. THE LANCET. CHILD & ADOLESCENT HEALTH 2024; 8:290-300. [PMID: 38368895 DOI: 10.1016/s2352-4642(23)00312-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 02/20/2024]
Abstract
Due to rapidly evolving conditions, the question of how to safely operate schools and daycares remained a top priority throughout the COVID-19 pandemic. In response to growing and changing evidence, the National Collaborating Centre for Methods and Tools in Canada maintained a living rapid review on the role of schools and daycares in COVID-19 transmission to guide evidence-informed decision making. This Review presents the final iteration of this living rapid review. 31 sources were searched until Oct 17, 2022. In the final version, eligible studies reported data from Jan 1, 2021 onward on transmission of COVID-19 in school or daycare settings, the effect of infection prevention and control measures on transmission, or the effect of operating schools or daycares on community-level COVID-19 rates. As a rapid review, titles and abstracts were screened by a single reviewer with artificial intelligence integrated into later versions. Full-text screening, data extraction, and critical appraisal were completed by one reviewer and checked by a second reviewer. The Johanna Briggs Institute tools were used for critical appraisal. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach, and results were synthesised narratively. Three citizen partners provided input for the final interpretation. This final update includes 73 primary studies. Secondary attack rates were low within school settings when infection prevention and control measures were in place (moderate certainty). Masks might reduce transmission, test-to-stay policies might not increase transmission risk compared with mandatory quarantine, cohorting and hybrid learning might make little to no difference in transmission (low certainty), and the effect of surveillance testing within schools remained inconclusive (very low certainty). Findings indicate that school settings do not substantially contribute to community incidence, hospitalisations, or mortality (low certainty). This living review provides a synthesis of global evidence for the role of schools and daycares during COVID-19, which might be helpful in future pandemics.
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Affiliation(s)
- Sarah E Neil-Sztramko
- National Collaborating Centre for Methods and Tools, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada.
| | - Emily Belita
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Robyn L Traynor
- National Collaborating Centre for Methods and Tools, McMaster University, Hamilton, ON, Canada
| | - Leah Hagerman
- National Collaborating Centre for Methods and Tools, McMaster University, Hamilton, ON, Canada
| | - Selin Akaraci
- Centre for Public Health, Queen's University Belfast, Belfast, UK; Evidence Synthesis Ireland and Cochrane Ireland, University of Galway, Galway, Ireland
| | - Patricia Burnett
- National Collaborating Centre for Methods and Tools, McMaster University, Hamilton, ON, Canada
| | - Alyssa Kostopoulos
- National Collaborating Centre for Methods and Tools, McMaster University, Hamilton, ON, Canada
| | - Maureen Dobbins
- National Collaborating Centre for Methods and Tools, McMaster University, Hamilton, ON, Canada; School of Nursing, McMaster University, Hamilton, ON, Canada
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Gohil VS, Shah VR, Shukla RP. Household secondary attack rate amongst the susceptible contacts of COVID-19 cases and its epidemiological profile: A retrospective study from central Gujarat, India. J Family Med Prim Care 2024; 13:1448-1453. [PMID: 38827718 PMCID: PMC11141985 DOI: 10.4103/jfmpc.jfmpc_1474_23] [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: 09/05/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 06/04/2024] Open
Abstract
Introduction Secondary attack rate (SAR) is a proportion of primary contacts developing the diseases within the incubation period upon exposure to a primary case among the total susceptible household contacts. The epidemiological profile and SAR will help in understanding the transmission dynamics of COVID-19 for further strengthening preventive and effective control measures. Objectives of the Study The study was conducted with the primary objective to estimate the household SAR of COVID-19 cases at Mahisagar District, Gujarat, and to study the epidemiological profile of primary and secondary cases of COVID-19. Methodology A retrospective study was conducted to estimate SAR among 245 confirmed cases of COVID-19 and 898 susceptible household contacts in Mahisagar district through telephonic interview and questionnaire by the Investigator team. Results The household SAR was calculated from the current study in Mahisagar district, Gujarat, and was 13.9%. Among primary cases, 74.7% males were affected, and among secondary cases, 52.8% females were affected. The SAR among elderly was 23.9%, and the SAR among children was 3.9%. 74.1% household contacts had developed disease among symptomatic contacts as compared to asymptomatic household contacts. Conclusion The household SAR in Mahisagar district, Gujarat, was found to be 13.9%. In primary cases, more males, and in secondary cases, more females were found to be affected. The household SAR was increased in elderly as compared to the younger age group. The SAR was more among the contacts of symptomatic cases than asymptomatic cases. Overall hospitalization in public hospitals was more than that in private hospitals.
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Affiliation(s)
- Vaidehi S. Gohil
- Community Medicine Department, Dr. M. K. Shah Medical College, Ahmedabad, Gujarat, India
| | - Venu R. Shah
- Community Medicine Department GCS Medical College, Ahmedabad, Gujarat, India
| | - Rujul P. Shukla
- Community Medicine Department, Ananya Medical College, Ahmedabad, Gujarat, India
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Aguilar Ticona JP, Nery N, Hitchings M, Belitardo EMMA, Fofana MO, Dorión M, Victoriano R, Cruz JS, Oliveira Santana J, de Moraes LEP, Cardoso CW, Ribeiro GS, Reis MG, Khouri R, Costa F, Ko AI, Cummings DAT. Overestimation of Severe Acute Respiratory Syndrome Coronavirus 2 Household Transmission in Settings of High Community Transmission: Insights From an Informal Settlement Community in Salvador, Brazil. Open Forum Infect Dis 2024; 11:ofae065. [PMID: 38516384 PMCID: PMC10957159 DOI: 10.1093/ofid/ofae065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/31/2024] [Indexed: 03/23/2024] Open
Abstract
Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant has spread globally. However, the contribution of community versus household transmission to the overall risk of infection remains unclear. Methods Between November 2021 and March 2022, we conducted an active case-finding study in an urban informal settlement with biweekly visits across 1174 households with 3364 residents. Individuals displaying coronavirus disease 2019 (COVID-19)-related symptoms were identified, interviewed along with household contacts, and defined as index and secondary cases based on reverse-transcription polymerase chain reaction (RT-PCR) and symptom onset. Results In 61 households, we detected a total of 94 RT-PCR-positive cases. Of 69 sequenced samples, 67 cases (97.1%) were attributed to the Omicron BA.1* variant. Among 35 of their households, the secondary attack rate was 50.0% (95% confidence interval [CI], 37.0%-63.0%). Women (relative risk [RR], 1.6 [95% CI, .9-2.7]), older individuals (median difference, 15 [95% CI, 2-21] years), and those reporting symptoms (RR, 1.73 [95% CI, 1.0-3.0]) had a significantly increased risk for SARS-CoV-2 secondary infection. Genomic analysis revealed substantial acquisition of viruses from the community even among households with other SARS-CoV-2 infections. After excluding community acquisition, we estimated a household secondary attack rate of 24.2% (95% CI, 11.9%-40.9%). Conclusions These findings underscore the ongoing risk of community acquisition of SARS-CoV-2 among households with current infections. The observed high attack rate necessitates swift booster vaccination, rapid testing availability, and therapeutic options to mitigate the severe outcomes of COVID-19.
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Affiliation(s)
- Juan P Aguilar Ticona
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Ministério da Saúde, Salvador, Bahia, Brazil
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Nivison Nery
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Ministério da Saúde, Salvador, Bahia, Brazil
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Matt Hitchings
- Department of Biostatistics, University of Florida, Gainesville, Florida, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA
| | | | - Mariam O Fofana
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Murilo Dorión
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Renato Victoriano
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Ministério da Saúde, Salvador, Bahia, Brazil
| | - Jaqueline S Cruz
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Ministério da Saúde, Salvador, Bahia, Brazil
| | - Juliet Oliveira Santana
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Ministério da Saúde, Salvador, Bahia, Brazil
| | | | - Cristiane W Cardoso
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Ministério da Saúde, Salvador, Bahia, Brazil
- Centro de Informações Estratégicas de Vigilância em Saúde (CIEVS), Secretaria Municipal de Saúde de Salvador, Salvador, Brazil
| | - Guilherme S Ribeiro
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Ministério da Saúde, Salvador, Bahia, Brazil
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Mitermayer G Reis
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Ministério da Saúde, Salvador, Bahia, Brazil
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Ricardo Khouri
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Ministério da Saúde, Salvador, Bahia, Brazil
| | - Federico Costa
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Ministério da Saúde, Salvador, Bahia, Brazil
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Albert I Ko
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Ministério da Saúde, Salvador, Bahia, Brazil
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Derek A T Cummings
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA
- Department of Biology, University of Florida, Gainesville, Florida, USA
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Pisaneschi G, Tarani M, Di Donato G, Landi A, Laurino M, Manfredi P. Optimal social distancing in epidemic control: cost prioritization, adherence and insights into preparedness principles. Sci Rep 2024; 14:4365. [PMID: 38388727 PMCID: PMC10883963 DOI: 10.1038/s41598-024-54955-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/19/2024] [Indexed: 02/24/2024] Open
Abstract
The COVID-19 pandemic experience has highlighted the importance of developing general control principles to inform future pandemic preparedness based on the tension between the different control options, ranging from elimination to mitigation, and related costs. Similarly, during the COVID-19 pandemic, social distancing has been confirmed to be the critical response tool until vaccines become available. Open-loop optimal control of a transmission model for COVID-19 in one of its most aggressive outbreaks is used to identify the best social distancing policies aimed at balancing the direct epidemiological costs of a threatening epidemic with its indirect (i.e., societal level) costs arising from enduring control measures. In particular, we analyse how optimal social distancing varies according to three key policy factors, namely, the degree of prioritization of indirect costs, the adherence to control measures, and the timeliness of intervention. As the prioritization of indirect costs increases, (i) the corresponding optimal distancing policy suddenly switches from elimination to suppression and, finally, to mitigation; (ii) the "effective" mitigation region-where hospitals' overwhelming is prevented-is dramatically narrow and shows multiple control waves; and (iii) a delicate balance emerges, whereby low adherence and lack of timeliness inevitably force ineffective mitigation as the only accessible policy option. The present results show the importance of open-loop optimal control, which is traditionally absent in public health preparedness, for studying the suppression-mitigation trade-off and supplying robust preparedness guidelines.
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Affiliation(s)
- Giulio Pisaneschi
- Department of Information Engineering, University of Pisa, Pisa, Italy
| | - Matteo Tarani
- Department of Information Engineering, University of Pisa, Pisa, Italy
| | | | - Alberto Landi
- Department of Information Engineering, University of Pisa, Pisa, Italy
| | - Marco Laurino
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Piero Manfredi
- Department of Economics and Management, University of Pisa, Pisa, Italy.
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Huguet-Torres A, Castro-Sánchez E, Capitán-Moyano L, Sánchez-Rodríguez C, Bennasar-Veny M, Yáñez AM. Personal protective measures and settings on the risk of SARS-COV-2 community transmission: a case-control study. Front Public Health 2024; 11:1327082. [PMID: 38259788 PMCID: PMC10801386 DOI: 10.3389/fpubh.2023.1327082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024] Open
Abstract
Background During the SARS-CoV-2 pandemic, nurses of primary health care has been an important role in Spain. Even so, the data obtained in the tracing have been scarcely used to investigate the possible mechanisms of transmission. Few studies focused on community transmission, evaluating the effectiveness of individual protective measures and exposure environment. The main aim of the study was to evaluate the association between individual protective measures and SARS-CoV-2 transmission in the community and to compare secondary attack rates in different exposure settings. Methods A case-control study from contact tracing of SARS-CoV-2 index patients. COVID-19 contact tracing was led by nurses at the COVID-19 Coordinating Centre in Majorca (Spain). During the systematic tracing, additional information for this study was collected from the index patient (social-demographic variables, symptoms, the number of close contacts). And also, the following variables from their close contacts: contact place, ventilation characteristics mask-wearing, type of mask, duration of contact, shortest distance, case-contact relationship, household members, and handwashing, the test result for SARS-CoV-2 diagnostic. Close contacts with a positive test for SARS-CoV-2 were classified as "cases" and those negative as "controls." Results A total of 1,778 close contacts from 463 index patients were identified. No significant differences were observed between the sexes but between age groups. Overall Secondary Attack Rate (SAR) was 24.0% (95% CI: 22.0-26.0%), 36.9% (95% CI: 33.2-40.6%) in closed spaces without ventilation and 50.7% (95% CI: 45.6-55.8%) in exposure time > 24 h. A total of 49.2% of infections occurred among household members. Multivariate logistic regression analysis showed that open-air setting (OR 0.43, 95% CI: 0.27-0.71), exposure for less than 1 h (OR 0.19, 95% CI: 0.11-0.32), and wearing a mask (OR 0.49, 95% CI: 0.28-0.85) had a protective effect transmission of SARS-CoV-2 in the community. Conclusion Ventilation of the space, mask-wearing and shorter exposure time were associated with a lower risk of transmission in the community. The data obtained allowed an assessment of community transmission mechanisms and could have helped to improve and streamline tracing by identifying close contacts at higher risk.
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Affiliation(s)
- Aina Huguet-Torres
- Department of Nursing and Physiotherapy, University of Balearic Islands, Palma, Spain
- Research Group on Global Health, University of Balearic Islands, Palma, Spain
| | - Enrique Castro-Sánchez
- Research Group on Global Health, University of Balearic Islands, Palma, Spain
- College of Business, Arts, and Social Sciences, Brunel University London, Uxbridge, United Kingdom
- Imperial College London, London, United Kingdom
| | - Laura Capitán-Moyano
- Department of Nursing and Physiotherapy, University of Balearic Islands, Palma, Spain
- Research Group on Global Health, University of Balearic Islands, Palma, Spain
| | - Cristian Sánchez-Rodríguez
- Research Group on Global Health, University of Balearic Islands, Palma, Spain
- Hospital Sant Joan de Déu, Palma, Spain
| | - Miquel Bennasar-Veny
- Department of Nursing and Physiotherapy, University of Balearic Islands, Palma, Spain
- Research Group on Global Health, University of Balearic Islands, Palma, Spain
- Research Group on Global Health and Lifestyle, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - Aina M Yáñez
- Department of Nursing and Physiotherapy, University of Balearic Islands, Palma, Spain
- Research Group on Global Health, University of Balearic Islands, Palma, Spain
- Research Group on Global Health and Lifestyle, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
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10
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Omiyale W, Holliday J, Doherty N, Callen H, Wood N, Horn E, Burnett F, Young A, Lewington S, Fry D, Bešević J, Conroy M, Sheard S, Feng Q, Welsh S, Effingham M, Young A, Collins R, Lacey B, Allen N. Social determinants of ethnic disparities in SARS-CoV-2 infection: UK Biobank SARS-CoV-2 Serology Study. J Epidemiol Community Health 2023; 78:3-10. [PMID: 37699665 PMCID: PMC10715462 DOI: 10.1136/jech-2023-220353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/25/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND The social determinants of ethnic disparities in risk of SARS-CoV-2 infection during the first wave of the pandemic in the UK remain unclear. METHODS In May 2020, a total of 20 195 adults were recruited from the general population into the UK Biobank SARS-CoV-2 Serology Study. Between mid-May and mid-November 2020, participants provided monthly blood samples. At the end of the study, participants completed a questionnaire on social factors during different periods of the pandemic. Logistic regression yielded ORs for the association between ethnicity and SARS-CoV-2 immunoglobulin G antibodies (indicating prior infection) using blood samples collected in July 2020, immediately after the first wave. RESULTS After exclusions, 14 571 participants (mean age 56; 58% women) returned a blood sample in July, of whom 997 (7%) had SARS-CoV-2 antibodies. Seropositivity was strongly related to ethnicity: compared with those of White ethnicity, ORs (adjusted for age and sex) for Black, South Asian, Chinese, Mixed and Other ethnic groups were 2.66 (95% CI 1.94-3.60), 1.66 (1.15-2.34), 0.99 (0.42-1.99), 1.42 (1.03-1.91) and 1.79 (1.27-2.47), respectively. Additional adjustment for social factors reduced the overall likelihood ratio statistics for ethnicity by two-thirds (67%; mostly from occupational factors and UK region of residence); more precise measurement of social factors may have further reduced the association. CONCLUSIONS This study identifies social factors that are likely to account for much of the ethnic disparities in SARS-CoV-2 infection during the first wave in the UK, and highlights the particular relevance of occupation and residential region in the pathway between ethnicity and SARS-CoV-2 infection.
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Affiliation(s)
- Wemimo Omiyale
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jo Holliday
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- UK Biobank, Stockport, UK
| | | | - Howard Callen
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- UK Biobank, Stockport, UK
| | - Natasha Wood
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- UK Biobank, Stockport, UK
| | - Edward Horn
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- UK Biobank, Stockport, UK
| | - Frances Burnett
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Allen Young
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- UK Biobank, Stockport, UK
| | - Sarah Lewington
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Jelena Bešević
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Megan Conroy
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Qi Feng
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | | | - Alan Young
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- UK Biobank, Stockport, UK
| | - Rory Collins
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- UK Biobank, Stockport, UK
| | - Ben Lacey
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- UK Biobank, Stockport, UK
| | - Naomi Allen
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- UK Biobank, Stockport, UK
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11
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Barsch F, Peters V, Morath O, Krumnau O, Maier P, Huzly D, Prettin S, Deibert P. Trends in the numbers of SARS-CoV-2 infections among students: a prospective cohort study comparing students in sports boarding schools with students in day schools during early COVID-19 pandemic. Front Public Health 2023; 11:1223748. [PMID: 38035288 PMCID: PMC10682161 DOI: 10.3389/fpubh.2023.1223748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction During the first months of the COVID pandemic it emerged that facilities where people gather or live together in cohorts, such as nursing homes or schools, were particularly at high risk for becoming hotspots of virus transmission. German political and health institutions responded with far-reaching interventions and preventive strategies to protect the population from infection with SARS-CoV-2. In this context, it remains unclear whether boarding schools for sports particularly pose a risk of infection to their residents. Methods In a single-center prospective cohort study, numbers of SARS-CoV-2 infections of students in sports boarding schools (n = 11) vs. students attending regular day schools (n = 22) in the region Freiburg/Hochschwarzwald in Germany were investigated over a period from October 2020 to January 2021 via regular virus and antibody screening (German Clinical Trials Register; Study ID: DRKS00021909). In addition, individual and behavioral risk factors for infection were stratified via questionnaire, which provide an indication of cohort specific risk factors for infection and the success of the implementation of hygiene concepts, as well as other infection prevention strategies, within the respective facilities. Results Regarding SARS-CoV-2 infection numbers, the screening detected no significant group difference between sports boarding schools vs. day schools. Discussion The study results provide indications that sports boarding schools did not pose an increased risk of infection, assuming that the facilities prevent virus transmissions with appropriate preventive strategies and hygiene measures. In future pandemic scenarios larger-scale and multicenter studies are necessary to achieve more comprehensive epidemiological data in this field.
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Affiliation(s)
- Friedrich Barsch
- Department of Medicine, Medical Center University of Freiburg, Faculty of Medicine, Institute for Exercise and Occupational Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Vera Peters
- Department of Medicine, Medical Center University of Freiburg, Faculty of Medicine, Institute for Exercise and Occupational Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Oliver Morath
- Department of Medicine, Medical Center University of Freiburg, Faculty of Medicine, Institute for Exercise and Occupational Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Oliver Krumnau
- Department of Medicine, Medical Center University of Freiburg, Faculty of Medicine, Institute for Exercise and Occupational Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Philipp Maier
- Department of Medicine, Medical Center University of Freiburg, Faculty of Medicine, Institute for Exercise and Occupational Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Daniela Huzly
- Freiburg University Medical Center, Faculty of Medicine, Institute of Virology, University of Freiburg, Freiburg im Breisgau, Germany
| | - Stephan Prettin
- Department of Medicine, Medical Center University of Freiburg, Faculty of Medicine, Institute for Exercise and Occupational Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Peter Deibert
- Department of Medicine, Medical Center University of Freiburg, Faculty of Medicine, Institute for Exercise and Occupational Medicine, University of Freiburg, Freiburg im Breisgau, Germany
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12
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Vaughan A, Duffell E, Freidl GS, Lemos DS, Nardone A, Valenciano M, Subissi L, Bergeri I, K Broberg E, Penttinen P, Pebody R, Keramarou M. Systematic review of seroprevalence of SARS-CoV-2 antibodies and appraisal of evidence, prior to the widespread introduction of vaccine programmes in the WHO European Region, January-December 2020. BMJ Open 2023; 13:e064240. [PMID: 37931969 PMCID: PMC10632881 DOI: 10.1136/bmjopen-2022-064240] [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: 10/31/2022] [Accepted: 09/04/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVES Systematic review of SARS-CoV-2 seroprevalence studies undertaken in the WHO European Region to measure pre-existing and cumulative seropositivity prior to the roll out of vaccination programmes. DESIGN A systematic review of the literature. DATA SOURCES We searched MEDLINE, EMBASE and the preprint servers MedRxiv and BioRxiv in the WHO 'COVID-19 Global literature on coronavirus disease' database using a predefined search strategy. Articles were supplemented with unpublished WHO-supported Unity-aligned seroprevalence studies and other studies reported directly to WHO Regional Office for Europe and European Centre for Disease Prevention and Control. ELIGIBILITY CRITERIA Studies published before the widespread implementation of COVID-19 vaccination programmes in January 2021 among the general population and blood donors, at national and regional levels. DATA EXTRACTION AND SYNTHESIS At least two independent researchers extracted the eligible studies; a third researcher resolved any disagreements. Study risk of bias was assessed using a quality scoring system based on sample size, sampling and testing methodologies. RESULTS In total, 111 studies from 26 countries published or conducted between 1 January 2020 and 31 December 2020 across the WHO European Region were included. A significant heterogeneity in implementation was noted across the studies, with a paucity of studies from the east of the Region. Sixty-four (58%) studies were assessed to be of medium to high risk of bias. Overall, SARS-CoV-2 seropositivity prior to widespread community circulation was very low. National seroprevalence estimates after circulation started ranged from 0% to 51.3% (median 2.2% (IQR 0.7-5.2%); n=124), while subnational estimates ranged from 0% to 52% (median 5.8% (IQR 2.3%-12%); n=101), with the highest estimates in areas following widespread local transmission. CONCLUSIONS The low levels of SARS-CoV-2 antibody in most populations prior to the start of vaccine programmes underlines the critical importance of targeted vaccination of priority groups at risk of severe disease, while maintaining reduced levels of transmission to minimise population morbidity and mortality.
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Affiliation(s)
- Aisling Vaughan
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Erika Duffell
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Gudrun S Freidl
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Diogo Simão Lemos
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | | | | | | | | | - Eeva K Broberg
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Richard Pebody
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Maria Keramarou
- European Centre for Disease Prevention and Control, Solna, Sweden
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13
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Alpizar SA, Accini J, Anderson DC, Eysa B, Medina-Piñón I, Ohmagari N, Ostrovskyy MM, Aggrey-Amable A, Beck K, Byrne D, Grayson S, Hwang PMT, Lonchar JD, Strizki J, Xu Y, Paschke A, De Anda CS, Sears PS. Molnupiravir for intra-household prevention of COVID-19: The MOVe-AHEAD randomized, placebo-controlled trial. J Infect 2023; 87:392-402. [PMID: 37690669 DOI: 10.1016/j.jinf.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/23/2023] [Accepted: 08/31/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES To evaluate the efficacy and safety of molnupiravir for intra-household post-exposure prophylaxis (PEP) of COVID-19. METHODS MOVe-AHEAD was a randomized, controlled, double-blind, phase 3 trial comparing molnupiravir (800 mg twice daily for 5 days) with placebo. Eligible participants were adult, unvaccinated, asymptomatic household contacts of patients with laboratory-confirmed COVID-19. The primary efficacy endpoint was the incidence of COVID-19 through day 14 in modified intention-to-treat (MITT) participants (those who received ≥1 dose of study intervention) without detectable SARS-CoV-2 at baseline, termed the MITT-VN population. Superiority of molnupiravir was prespecified as a stratified one-sided p-value of <0.0249 for the treatment difference in this endpoint. RESULTS The MITT population comprised 763 participants randomized to molnupiravir and 764 to placebo; 83.6% had anti-SARS-CoV-2 antibodies at baseline. In the MITT-VN population, COVID-19 rates through day 14 were 6.5% with molnupiravir and 8.5% with placebo (one-sided p-value: 0.0848). In the molnupiravir arm, 25/35 of confirmed COVID-19 events (71.4%) occurred after completion of treatment (versus 17/49 [34.7%] for placebo). Adverse event rates were low and similar between molnupiravir and placebo. CONCLUSIONS Molnupiravir was well-tolerated but did not meet the prespecified superiority criterion, possibly influenced in part by the high pre-existing immunity in the trial population.
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Affiliation(s)
- Sady A Alpizar
- Clinical Research Trials of Florida, 2713 W. Virginia Ave., Tampa 33607, FL, USA.
| | - Jose Accini
- IPS Centro Científico Asistencial, Cra. 45 #85-49, Barranquilla 080020, Colombia.
| | - Duane C Anderson
- Excel Clinical Research LLC, 3059 S Maryland Pkwy., Las Vegas, NV 89109, USA.
| | - Basem Eysa
- National Hepatology and Tropical Medicine Research Institute, 10 Kasr El, Eini St., Fom Al Khalig Sq., Cairo 11796, Egypt.
| | - Isaí Medina-Piñón
- ICARO Investigaciones en Medicina, Calle Ignacio Allende No. 1015, Chihuahua 31000, Mexico.
| | - Norio Ohmagari
- National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
| | - Mykola M Ostrovskyy
- Regional Phthisiopulmonological Center, 17 Franka St., Ivano-Frankivsk 76018, Ukraine.
| | | | - Karen Beck
- Merck & Co, Inc., 126 E. Lincoln Ave., Rahway, NJ 07065, USA
| | - Dana Byrne
- Merck & Co, Inc., 126 E. Lincoln Ave., Rahway, NJ 07065, USA
| | - Staci Grayson
- Merck & Co, Inc., 126 E. Lincoln Ave., Rahway, NJ 07065, USA
| | - Peggy M T Hwang
- Merck & Co, Inc., 126 E. Lincoln Ave., Rahway, NJ 07065, USA
| | - Julia D Lonchar
- Merck & Co, Inc., 126 E. Lincoln Ave., Rahway, NJ 07065, USA
| | - Julie Strizki
- Merck & Co, Inc., 126 E. Lincoln Ave., Rahway, NJ 07065, USA
| | - Yayun Xu
- Merck & Co, Inc., 126 E. Lincoln Ave., Rahway, NJ 07065, USA
| | - Amanda Paschke
- Merck & Co, Inc., 126 E. Lincoln Ave., Rahway, NJ 07065, USA
| | | | - Pamela S Sears
- Merck & Co, Inc., 126 E. Lincoln Ave., Rahway, NJ 07065, USA.
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14
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Yadav K, K. J. S, Meena S, Kumar R, Kaur R, Bairwa M, Kant S, Misra P, Rai SK, Ahmad M, Rahman A. Household transmission investigation for Corona Virus Disease 2019 (COVID-19) in a rural and urban population of north India. PLoS One 2023; 18:e0287048. [PMID: 37796802 PMCID: PMC10553284 DOI: 10.1371/journal.pone.0287048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 05/28/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Transmissibility within closed settings, such as households, can provide a strategic way to characterize the virus transmission patterns because the denominator can be well defined. We aimed to characterize the household transmission of Severe Acute Respiratory Syndrome Coronavirus (SARS CoV-2) and its associated risk factors. METHODS This prospective case-ascertained study was conducted among the household contacts of laboratory-confirmed SARS CoV-2 cases residing in Ballabgarh, Haryana. We enrolled 148 index cases and their 645 household contacts between December 16, 2020 and June 24, 2021. We defined household contact as any person who had resided in the same household as a confirmed COVID-19 case. Baseline data collection and sample collection for real time- reverse transcriptase polymerase chain reaction (RT-PCR) and IgM/IgG against SARS CoV-2 were done on day 1 visit, and followed for a period of 28 days. RT-PCR was repeated on day 14 or whenever the contact is symptomatic and blood sample for serology was repeated on day 28. We estimated household secondary infection rate (SIR) and other epidemiological indicators-median incubation period and serial interval. We employed binomial logistic regression to quantify risk factors associated with infection. RESULTS The household SIR was 30.5% (95% CI: 27.1-34.1%). The secondary clinical attack rate was 9.3% (95% CI: 7.2-11.8). The risk factors that showed higher susceptibility to infection were household contacts who were the primary care giver of the case, whose index cases were symptomatic, those with underlying medical conditions, those living in overcrowded households, who were sharing toilet with the index cases and also who were not wearing a mask when coming in contact with the case. The median (IQR) incubation period was 4 days (4, 5), mean (SD) serial interval 6.4 (±2.2) days, and median (IQR) serial interval 5 days (5, 7). CONCLUSION Households favour secondary transmission of SARS CoV- 2, hence, index cases are recommended to self-isolate and wear masks; and household contacts to follow strict COVID infection control measures within households when a family member is infected.
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Affiliation(s)
- Kapil Yadav
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Subhashini K. J.
- Consultant, WHO Unity Project, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Suneeta Meena
- Laboratory Medicine, Microbiology Division, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Kumar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ravneet Kaur
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Mohan Bairwa
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Puneet Misra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay K. Rai
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Mohammad Ahmad
- National Professional Officer (Research), World Health Organization Country Office for India, New Delhi, India
| | - Anisur Rahman
- Health Emergencies and Research Officer, World Health Organization Country Office for India, New Delhi, India
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15
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Zhang WW, Li CX, Cao SJ, Wang YY, Lu ZX, Sun JL, Jing MX. A network meta-analysis of risk factors of infection among close contacts of COVID-19. Heliyon 2023; 9:e20861. [PMID: 37860512 PMCID: PMC10582502 DOI: 10.1016/j.heliyon.2023.e20861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/21/2023] Open
Abstract
Objective We aimed to use network meta-analysis to compare the impact of infection risk factors of close contacts with COVID-19, identify the most influential factors and rank their subgroups. It can provide a theoretical basis for the rapid and accurate tracking and management of close contacts. Methods We searched nine databases from December 1, 2019 to August 2, 2023, which only took Chinese and English studies into consideration. Odd ratios (ORs) were calculated from traditional meta-estimated secondary attack rates (SARs) for different risk factors, and risk ranking of these risk factors was calculated by the surface under the cumulative ranking curve (SUCRA). Results 25 studies with 152647 participants identified. Among all risk factors, the SUCRA of type of contact was 69.6 % and ranked first. Among six types of contact, compared with transportation contact, medical contact, social contact and other, daily contact increased risk of infection by 12.11 (OR: 12.11, 95 % confidence interval (CI): 6.51-22.55), 7.76 (OR: 7.76, 95 % CI: 4.09-14.73), 4.65 (OR: 4.65, 95 % CI: 2.66-8.51) and 8.23 OR: 8.23, 95 % CI: 4.23-16.01) times, respectively. Overall, SUCRA ranks from highest to lowest as daily contact (94.7 %), contact with pollution subjects (78.4 %), social contact (60.8 %), medical contact (31.8 %), other (27.9 %), transportation contact (6.4 %). Conclusion The type of contact had the greatest impact on COVID-19 close contacts infection among the risk factors we included. Daily contact carried the greatest risk of infection among six types of contact, followed by contact with pollution subjects, social contact, other, medical contact and transportation contact. The results can provide scientific basis for rapid assess the risk of infection among close contacts based on fewer risk factors and pay attention to high-risk close contacts during management, thereby reducing tracking and management costs.
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Affiliation(s)
- Wei-wen Zhang
- Department of Preventive Medicine, School of Medicine, Shihezi University. Shihezi, 832003, PR China
- Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, PR China
| | - Chen-xi Li
- Oncological Department of Oral & Maxillofacial Surgery, The First Affiliated Hospital of Xinjiang Medical University, School/Hospital of Stomatology, Xinjiang Medical University, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi, 830054, PR China
| | - Shu-jing Cao
- Department of Preventive Medicine, School of Medicine, Shihezi University. Shihezi, 832003, PR China
- Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, PR China
| | - Yu-yuan Wang
- Department of Preventive Medicine, School of Medicine, Shihezi University. Shihezi, 832003, PR China
- Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, PR China
| | - Ze-xi Lu
- Department of Preventive Medicine, School of Medicine, Shihezi University. Shihezi, 832003, PR China
- Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, PR China
| | - Jia-lin Sun
- Department of Preventive Medicine, School of Medicine, Shihezi University. Shihezi, 832003, PR China
- Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, PR China
| | - Ming -xia Jing
- Department of Preventive Medicine, School of Medicine, Shihezi University. Shihezi, 832003, PR China
- Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, PR China
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Mongin D, Bürgisser N, Laurie G, Schimmel G, Vu DL, Cullati S, Courvoisier DS. Effect of SARS-CoV-2 prior infection and mRNA vaccination on contagiousness and susceptibility to infection. Nat Commun 2023; 14:5452. [PMID: 37673865 PMCID: PMC10482859 DOI: 10.1038/s41467-023-41109-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 08/21/2023] [Indexed: 09/08/2023] Open
Abstract
The immunity conferred by SARS-CoV-2 vaccines and infections reduces the transmission of the virus. To answer how the effect of immunity is shared between a reduction of infectiousness and an increased protection against infection, we examined >50,000 positive cases and >110,000 contacts from Geneva, Switzerland (June 2020 to March 2022). We assessed the association between secondary attack rate (i.e. proportion of new cases among contacts) and immunity from natural infection and/or vaccination, stratifying per four SARS-CoV-2 variants and adjusting for index cases and contacts' socio-demographic characteristics and the propensity of the contacts to be tested. Here we show that immunity protected contacts from infection, rather than reducing infectiousness of index cases. Natural infection conferred the strongest immunity. Hybrid immunity did not surpass recent infection. Although of smaller amplitude, the reduction in infectiousness due to vaccination was less affected by time and by the emergence of new SARS-CoV-2 variants than the susceptibility to infection. These findings support the role of vaccine in reducing infectiousness and underscore the complementary role of interventions reducing SARS-CoV-2 propagation, such as mask use or indoor ventilation.
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Affiliation(s)
- Denis Mongin
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Nils Bürgisser
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- General internal medicine division, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Gustavo Laurie
- Division of General cantonal physician, Geneva Directorate of Health, Geneva, Switzerland
| | - Guillaume Schimmel
- Division of General cantonal physician, Geneva Directorate of Health, Geneva, Switzerland
| | - Diem-Lan Vu
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of General cantonal physician, Geneva Directorate of Health, Geneva, Switzerland
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
- Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Stephane Cullati
- Division Quality of care, University Hospitals of Geneva, Geneva, Switzerland
- Population Health Laboratory (#PopHealthLab), Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Delphine Sophie Courvoisier
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division Quality of care, University Hospitals of Geneva, Geneva, Switzerland
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17
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Bassanello M, Geppini R, Bonsembiante E, Coli U, Farencena A, D’Aquino M, Gambaro A, Buja A, Baldovin T. Risk of SARS-CoV-2 transmission in the close contacts in a small rural area in the Veneto Region (NE-Italy): past evidence for future scenarios. Front Public Health 2023; 11:1223109. [PMID: 37732097 PMCID: PMC10507707 DOI: 10.3389/fpubh.2023.1223109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
Background During the first pandemic phase of COVID-19, an epidemiological study, named First survey, was conducted on the population of a small rural area in northern Italy. In spring 2020, the results showed how a prolonged lockdown slowed down the spread of the virus. Methods After contacting positive First Survey subjects and their families, those who decided to join voluntarily underwent a blood test to assess the presence of qualitative lgG about 2 months after the previous one. This was to determine if IgG persisted in individuals who tested positive in the First Survey as well as to assess the antibody status of their close family members, to determine if they were unintentionally infected. Results Based on serological analysis, 35.1% of the samples contained blood IgG. In subjects who tested positive during the First Survey, 62.5% remained IgG positive more than 2 months later. Among family members who were exposed to a positive relative, 23.7% were infected. Linear regression analysis showed that the presence of an infected person within a household resulted in the infection spreading to the others, but not excessively. Induced isolation extinguished the infection regardless of the extent of the contagion (intra-family or extra-family). Micro-outbreaks of SARS-Cov-2 infection which arose in the same household from extra-familial infections played a decisive role on the statistical significance of IgG-positive subjects (p < 0.001). Discussion The study reveal 52.6% of the IgG-positive subjects in the Second Survey came from the First Survey and 47.4% were family members previously in contact with positive subjects. Data suggest that there have been undiagnosed patients feeding the spread of the virus since the beginning of the pandemic. In conclusion, for future pandemics, it will be necessary: i) to ensure the rapid isolation of symptomatic patients and the early identification of their close contacts, ii) to carry out the maximum number of tests in the shortest possible time, both on symptomatic and asymptomatic subjects, and iii) to implement information campaigns to make people aware of their risks, and implement clear, non-conflicting communication.
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Affiliation(s)
- Marco Bassanello
- Emergency and Health Department, Monastier di Treviso Hospital, Treviso, Italy
- Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, School of Medicine and Surgery, University of Padua, Padua, Italy
| | - Ruggero Geppini
- Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, School of Medicine and Surgery, University of Padua, Padua, Italy
| | | | - Ugo Coli
- Health Department, Monastier di Treviso Hospital, Treviso, Italy
| | - Aldo Farencena
- Laboratory and Microbiology Monastier di Treviso Hospital, Treviso, Italy
| | | | - Andrea Gambaro
- Department of Environmental Sciences, Informatics and Statistics (DAIS), Ca’ Foscari University of Venice, Venice, Italy
| | - Alessandra Buja
- Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, School of Medicine and Surgery, University of Padua, Padua, Italy
| | - Tatjana Baldovin
- Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, School of Medicine and Surgery, University of Padua, Padua, Italy
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18
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Moreira BN, Moura AS, Soares AN, Reis ZSN, Delbone RM. Assessment of the Implementation of a Chatbot-Based Screening for Burnout and COVID-19 Symptoms Among Residents During the Pandemic. J Grad Med Educ 2023; 15:378-381. [PMID: 37363676 PMCID: PMC10286932 DOI: 10.4300/jgme-d-22-00920.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/22/2023] [Accepted: 04/17/2023] [Indexed: 06/28/2023] Open
Abstract
Background Early identification of COVID-19 symptoms and burnout among residents is essential for proper management. Digital assistants might help in the large-scale screening of residents. Objective To assess the implementation of a chatbot for tele-screening emotional exhaustion and COVID-19 among residents at a hospital in Brazil. Methods From August to October 2020, a chatbot sent participants' phones a daily question about COVID-19 symptoms and a weekly question about emotional exhaustion. After 8 weeks, the residents answered the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). The primary outcome was the reliability of the chatbot in identifying suspect cases of COVID-19 and burnout. Results Among the 489 eligible residents, 174 (35.6%) agreed to participate. The chatbot identified 61 positive responses for COVID-19 symptoms, and clinical suspicion was confirmed in 9 residents. User error in the first weeks was the leading cause (57.7%, 30 of 52) of nonconfirmed suspicion. The chatbot failed to identify 3 participants with COVID-19 due to nonresponse. Twelve of 118 (10.2%) participants who answered the MBI-HSS were characterized as having burnout by the MBI-HHS. Two of them were identified as at risk by the chatbot and 8 never answered the emotional exhaustion screening question. Conversely, among the 19 participants identified as at risk for emotional exhaustion by the chatbot, 2 (10.5%) were classified with burnout, and 5 (26.3%) as overextended based on MBI-HHS scores. Conclusions The chatbot was able to identify residents suspected of having COVID-19 and those at risk for burnout. Nonresponse was the leading cause of failure in identifying those at risk.
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Affiliation(s)
- Bruno Nascimento Moreira
- Bruno Nascimento Moreira, MD, MSc, is the Head of Oryx Lab Innovation Center, Faculdade Santa Casa BH, Belo Horizonte, MG, Brazil
| | - Alexandre Sampaio Moura
- Alexandre Sampaio Moura, MD, MPH, PhD, is a Professor, Faculdade Santa Casa BH, Belo Horizonte, MG, Brazil
| | - Aleida Nazareth Soares
- Aleida Nazareth Soares, PhD, is a Professor, Faculdade Santa Casa BH, Belo Horizonte, MG, Brazil
| | - Zilma Silveira Nogueira Reis
- Zilma Silveira Nogueira Reis, MD, PhD, is Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Rosa Malena Delbone
- Rosa Malena Delbone, MD, PhD, is Academic Director, Faculdade Santa Casa BH, Belo Horizonte, MG, Brazil
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19
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Islam F, Alvi Y, Ahmad M, Ahmed F, Rahman A, Singh FHD, Das AK, Dudeja M, Gupta E, Agarwalla R, Alam I, Roy S. Household transmission dynamics of COVID-19 among residents of Delhi, India: a prospective case-ascertained study. IJID REGIONS 2023; 7:22-30. [PMID: 36852156 PMCID: PMC9946776 DOI: 10.1016/j.ijregi.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/25/2023]
Abstract
Objective The aim of this study was to observe the secondary infection rate and transmission dynamics of COVID-19 among household contacts, and their associations with various factors across four dimensions of interaction. Methods This was a case-ascertained study among unvaccinated household contacts of a laboratory-confirmed COVID-19 case in New Delhi between December 2020 and July 2021. For this study, 99 index cases and their 316 household contacts were interviewed and sampled (blood and oro-nasal swab) on days 1, 7, 14, and 28. Results The secondary infection rate among unvaccinated household contacts was 44.6% (95% confidence interval (CI) 39.1-50.1). The predictors of secondary infection among individual contact levels were: being female (odds ratio (OR) 2.13), increasing age (OR 1.01), symptoms at baseline (OR 3.39), and symptoms during follow-up (OR 3.18). Among index cases, age of the primary case (OR 1.03) and symptoms during follow-up (OR 6.29) were significantly associated with secondary infection. Among household-level and contact patterns, having more rooms (OR 4.44) and taking care of the index case (OR 2.02) were significantly associated with secondary infection. Conclusion A high secondary infection rate highlights the need to adopt strict measures and advocate COVID-19-appropriate behaviors. A targeted approach for higher-risk household contacts would efficiently limit infections among susceptible contacts.
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Affiliation(s)
- Farzana Islam
- Department of Community Medicine, Hamdard Institute of Medical Science and Research, New Delhi, India
| | - Yasir Alvi
- Department of Community Medicine, Hamdard Institute of Medical Science and Research, New Delhi, India
| | | | - Faheem Ahmed
- Department of Community Medicine, Hamdard Institute of Medical Science and Research, New Delhi, India.,Department of Public Health, King Khalid University, Abha, Kingdom of Saudi Arabia
| | | | - Farishta Hannah D Singh
- Department of Community Medicine, Hamdard Institute of Medical Science and Research, New Delhi, India
| | - Ayan Kumar Das
- Department of Microbiology, Hamdard Institute of Medical Science and Research, New Delhi, India
| | - Mridu Dudeja
- Department of Microbiology, Hamdard Institute of Medical Science and Research, New Delhi, India
| | - Ekta Gupta
- Scientist-E, National Institute of Cancer Prevention and Research, ICMR, Noida, India
| | - Rashmi Agarwalla
- Department of Community and Family Medicine, All India Institute of Medical Science, Guwahati, India
| | - Iqbal Alam
- Department of Physiology, Hamdard Institute of Medical Science and Research, New Delhi, India
| | - Sushovan Roy
- Department of Community Medicine, Hamdard Institute of Medical Science and Research, New Delhi, India
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20
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Zirbes J, Sterr CM, Keller C, Engenhart-Cabillic R, Nonnenmacher-Winter C, Günther F. Efficiency analysis of rapid antigen test based SARS-CoV-2 in hospital contact tracing and screening regime: test characteristics and cost effectiveness. Diagn Microbiol Infect Dis 2023; 106:115991. [PMID: 37295183 DOI: 10.1016/j.diagmicrobio.2023.115991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 05/10/2023] [Accepted: 05/17/2023] [Indexed: 06/12/2023]
Abstract
In the context of the current SARS-CoV-2 pandemic, reliable and cost-efficient screening and testing strategies are crucial to prevent disease transmission and reduce socioeconomic losses. To assess the efficiency of a rapid antigen test (RAT)-based SARS-CoV-2 contact-tracing and screening regime, we conducted a retrospective analysis of RAT and polymerase chain reaction (PCR) test data over a 1-year period, assessed test characteristics and estimated cost-effectiveness. The RAT had a sensitivity of 70.2% overall and 89.3% for people with a high risk of infectivity. We estimated inpatient treatment and quarantined healthcare worker costs of over € 5860.83, whereas the cost of identifying one SARS-CoV-2 positive person by RAT for our patient cohort was € 1210.75. In contrast, the estimated respective PCR cost was € 5043.32. Therefore, a RAT-based contract tracing and screening regime may be an efficient and cost-effective way to contribute to the early identification and prevention of SARS-CoV-2 transmission.
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Affiliation(s)
- Julian Zirbes
- Division of Infection Control and Hospital Epidemiology, Philipps University Marburg, Marburg, Germany
| | - Christian M Sterr
- Division of Infection Control and Hospital Epidemiology, Philipps University Marburg, Marburg, Germany
| | - Christian Keller
- Institute for Virology, Philipps University Marburg, Marburg, Germany
| | | | | | - Frank Günther
- Division of Infection Control and Hospital Epidemiology, Philipps University Marburg, Marburg, Germany.
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21
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Loo BPY, Tsoi KH, Axhausen KW, Cao M, Lee Y, Koh KP. Spatial risk for a superspreading environment: Insights from six urban facilities in six global cities across four continents. Front Public Health 2023; 11:1128889. [PMID: 37089495 PMCID: PMC10113652 DOI: 10.3389/fpubh.2023.1128889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/20/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction This study sets out to provide scientific evidence on the spatial risk for the formation of a superspreading environment. Methods Focusing on six common types of urban facilities (bars, cinemas, gyms and fitness centers, places of worship, public libraries and shopping malls), it first tests whether visitors' mobility characteristics differ systematically for different types of facility and at different locations. The study collects detailed human mobility and other locational data in Chicago, Hong Kong, London, São Paulo, Seoul and Zurich. Then, considering facility agglomeration, visitors' profile and the density of the population, facilities are classified into four potential spatial risk (PSR) classes. Finally, a kernel density function is employed to derive the risk surface in each city based on the spatial risk class and nature of activities. Results Results of the human mobility analysis reflect the geographical and cultural context of various facilities, transport characteristics and people's lifestyle across cities. Consistent across the six global cities, geographical agglomeration is a risk factor for bars. For other urban facilities, the lack of agglomeration is a risk factor. Based on the spatial risk maps, some high-risk areas of superspreading are identified and discussed in each city. Discussion Integrating activity-travel patterns in risk models can help identify areas that attract highly mobile visitors and are conducive to superspreading. Based on the findings, this study proposes a place-based strategy of non-pharmaceutical interventions that balance the control of the pandemic and the daily life of the urban population.
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Affiliation(s)
- Becky P. Y. Loo
- Department of Geography, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- School of Geography and Environment, Jiangxi Normal University, Nanchang, China
| | - Ka Ho Tsoi
- Department of Geography, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kay W. Axhausen
- Department of Civil, Environment and Geomatic Engineering, ETH Zürich, Zürich, Switzerland
| | - Mengqiu Cao
- School of Architecture and Cities, University of Westminster, London, United Kingdom
| | - Yongsung Lee
- Department of Geography, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Keumseok Peter Koh
- Department of Geography, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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22
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Prosser A, Helfer B, Streiner DL. Estimating the risk reduction of isolation on COVID-19 nonhousehold transmission and severe/critical illness in nonimmune individuals: September to November 2021. J Eval Clin Pract 2023; 29:438-446. [PMID: 36755507 DOI: 10.1111/jep.13813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 02/10/2023]
Abstract
There is growing scientific interest in immunity mandates/passports (IMP) for viral diseases in light of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. IMP isolate those who remain nonimmune from various settings to reduce nonhousehold transmissions from the nonimmune and reduce severe/critical illness among the nonimmune. A major limitation in the scientific literature is that there are currently no methods to quantify how many nonimmune individuals need to be isolated to achieve these purported benefits. This paper develops a procedure for estimating the benefits of IMP using a novel variant of the number needed to treat which we call the number needed to isolate (NNI). We use data from the SARS-CoV-2 pandemic to demonstrate the properties and utility of the NNI and to inform the debate about IMP. We focus on data from the European Union, United Kingdom, United States, Canada, Australia, and Israel during the fall 2021 when the Delta (B.1.617.2) variant predominated.
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Affiliation(s)
- Aaron Prosser
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Bartosz Helfer
- Institute of Psychology, University of Wrocław, Wrocław, Poland.,Academic Excellence Incubator - Meta Research Centre, University of Wrocław, Wrocław, Poland
| | - David L Streiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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23
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Narayan A, Saraswati U, Kaur I, Kumari A, Kumar A, Vishwakarma VK, Kumar U, Sahoo V, Wig N. Household secondary attack rate in mild COVID-19. J Family Med Prim Care 2023; 12:743-747. [PMID: 37312765 PMCID: PMC10259546 DOI: 10.4103/jfmpc.jfmpc_156_22] [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] [Received: 01/20/2022] [Revised: 04/17/2022] [Accepted: 01/20/2023] [Indexed: 06/15/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has reached a staggering number of almost 280 million cases worldwide, with over 5.4 million deaths as of 29 December 2021. A further understanding of the factors related to the household spread of the infection might help to bring about specific protocols to curb such transmission. Objective This study aims to find the secondary attack rate (SAR) and factors affecting SAR among the households of mild COVID-19 cases. Methods An observational study was designed where data of patients admitted at All India Institute of Medical Sciences, New Delhi due to mild COVID-19 were collected, and outcome was noted after the discharge of the patient. Index cases who were the first in the household to have a positive infection only were included. Based on these data, the overall household SAR, factors related to the index case and contacts that affected transmissibility were noted. Results A total of 60 index cases having contacts with 184 household members were included in the present study. The household SAR was measured to be 41.85%. At least one positive case was present in 51.67% households. Children below 18 years old had lower odds of getting a secondary infection compared to adults and elderly [odds ratio (OR) = 0.46, 95%CI = 0.22-0.94, p = 0.0383). An exposure period of more than a week was significantly associated with a higher risk of infection (p = 0.029). The rate of transmissibility drastically declined with effective quarantine measures adopted by the index case (OR = 0.13, 95%CI = 0.06-0.26, p < 0.00001). Symptomatic index cases contributed more to the SAR than asymptomatic primaries (OR = 4.74, 95%CI = 1.03-21.82, P = 0.045). Healthcare worker index cases had lower rates of spread (OR = 0.29, 95%CI = 0.15-0.58, P = 0.0003). Conclusion The high SAR shows the household is a potential high-risk unit for transmissibility of COVID-19. Proper quarantine measures of all those exposed to the index case can mitigate such spread and lead to reduction of risk of COVID-19 within a household.
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Affiliation(s)
- Ananthu Narayan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ushasi Saraswati
- Department of Medicine, Maulana Azad Medical College, Delhi, India
| | - Ishmeet Kaur
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - Aakansha Kumari
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Arvind Kumar
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | | | - Upendra Kumar
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vishwajeet Sahoo
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Naveet Wig
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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24
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Zhang C, Zhou C, Xu W, Zheng S, Gao Y, Li P, Deng L, Zhang X, Jiang Q, Qian F, Li X, Wang H, Zou H, Xia Y, Wang T, Lu H, Qian HZ. Transmission risk of asymptomatic SARS-CoV-2 infection: a systematic review and meta-analysis. INFECTIOUS MEDICINE 2023; 2:11-18. [PMID: 38013777 PMCID: PMC9757919 DOI: 10.1016/j.imj.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/24/2022] [Accepted: 12/03/2022] [Indexed: 12/23/2022]
Abstract
Background Global evidence on the transmission of asymptomatic SARS-CoV-2 infection needs to be synthesized. Methods A search of 4 electronic databases (PubMed, EMBASE, Cochrane Library, and Web of Science databases) as of January 24, 2021 was performed. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Studies which reported the transmission rate among close contacts with asymptomatic SARS-CoV-2 cases were included, and transmission activities occurred were considered. The transmission rates were pooled by zero-inflated beta distribution. The risk ratios (RRs) were calculated using random-effects models. Results Of 4923 records retrieved and reviewed, 15 studies including 3917 close contacts with asymptomatic indexes were eligible. The pooled transmission rates were 1.79 per 100 person-days (or 1.79%, 95% confidence interval [CI] 0.41%-3.16%) by asymptomatic index, which is significantly lower than by presymptomatic (5.02%, 95% CI 2.37%-7.66%; p<0.001), and by symptomatic (5.27%, 95% CI 2.40%-8.15%; p<0.001). Subgroup analyses showed that the household transmission rate of asymptomatic index was (4.22%, 95% CI 0.91%-7.52%), four times significantly higher than non-household transmission (1.03%, 95% CI 0.73%-1.33%; p=0.03), and the asymptomatic transmission rate in China (1.82%, 95% CI 0.11%-3.53%) was lower than in other countries (2.22%, 95% CI 0.67%-3.77%; p=0.01). Conclusions People with asymptomatic SARS-CoV-2 infection are at risk of transmitting the virus to their close contacts, particularly in household settings. The transmission potential of asymptomatic infection is lower than symptomatic and presymptomatic infections. This meta-analysis provides evidence for predicting the epidemic trend and promulgating vaccination and other control measures. Registered with PROSPERO International Prospective Register of Systematic Reviews, CRD42021269446; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269446.
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Affiliation(s)
- Ci Zhang
- Xiangya School of Nursing, Central South University, Changsha, China
- Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation (A JBI Affiliated Group), Changsha, Hunan Province, China
| | - Chao Zhou
- Department of Bioinformatics and Biostatistics, Shanghai Jiao Tong University, Shanghai, China
| | - Wanqing Xu
- T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Shimin Zheng
- Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, TN, USA
| | - Yanxiao Gao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Peiqi Li
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Luojia Deng
- Department of Bioinformatics and Biostatistics, Shanghai Jiao Tong University, Shanghai, China
| | | | - Qianxue Jiang
- Department of Bioinformatics and Biostatistics, Shanghai Jiao Tong University, Shanghai, China
| | - Frank Qian
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Xianhong Li
- Xiangya School of Nursing, Central South University, Changsha, China
- Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation (A JBI Affiliated Group), Changsha, Hunan Province, China
| | - Honghong Wang
- Xiangya School of Nursing, Central South University, Changsha, China
- Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation (A JBI Affiliated Group), Changsha, Hunan Province, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yinglin Xia
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Tao Wang
- Department of Bioinformatics and Biostatistics, Shanghai Jiao Tong University, Shanghai, China
| | - Hui Lu
- Department of Bioinformatics and Biostatistics, Shanghai Jiao Tong University, Shanghai, China
| | - Han-Zhu Qian
- School of Public Health, Yale University, New Haven, CT, USA
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25
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Martínez-Baz I, Miqueleiz A, Egüés N, Casado I, Burgui C, Echeverría A, Navascués A, Fernández-Huerta M, García Cenoz M, Trobajo-Sanmartín C, Guevara M, Ezpeleta C, Castilla J. Effect of COVID-19 vaccination on the SARS-CoV-2 transmission among social and household close contacts: A cohort study. J Infect Public Health 2023; 16:410-417. [PMID: 36724697 PMCID: PMC9876028 DOI: 10.1016/j.jiph.2023.01.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 01/18/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND COVID-19 vaccination was expected to reduce SARS-CoV-2 transmission, but the relevance of this effect remains unclear. We aimed to estimate the effectiveness of COVID-19 vaccination of the index cases and their close contacts in reducing the probability of SARS-CoV-2 transmission. METHODS Transmission of SARS-CoV-2 infection was evaluated in two cohorts of adult close contacts of COVID-19 confirmed cases (social and household settings) by COVID-19 vaccination status of the index case and the close contact, from April to November 2021 in Navarre, Spain. The effects of vaccination of the index case and the close contact were estimated as (1-adjusted relative risk) × 100%. RESULTS Among 19,631 social contacts, 3257 (17%) were confirmed with SARS-CoV-2. COVID-19 vaccination of the index case reduced infectiousness by 44% (95% CI, 27-57%), vaccination of the close contact reduced susceptibility by 69% (95% CI, 65-73%), and vaccination of both reduced transmissibility by 74% (95% CI, 70-78%) in social settings, suggesting some synergy of effects. Among 20,708 household contacts, 6269 (30%) were infected, and vaccine effectiveness estimates were 13% (95% CI, -5% to 28%), 61% (95% CI, 58-64%), and 52% (95% CI, 47-56%), respectively. These estimates were lower in older people and had not relevant differences between the Alpha (April-June) and Delta (July-November) variant periods. CONCLUSIONS COVID-19 vaccination reduces infectiousness and susceptibility; however, these effects are insufficient for complete control of SARS-CoV-2 transmission, especially in older people and household setting. Relaxation of preventive behaviors after vaccination may counteract part of the vaccine effect on transmission.
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Affiliation(s)
- Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Ana Miqueleiz
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Irunlarrea, 31008 Pamplona, Spain
| | - Nerea Egüés
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | | | - Ana Navascués
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Irunlarrea, 31008 Pamplona, Spain
| | - Miguel Fernández-Huerta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Irunlarrea, 31008 Pamplona, Spain
| | - Manuel García Cenoz
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Camino Trobajo-Sanmartín
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Marcela Guevara
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Carmen Ezpeleta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Irunlarrea, 31008 Pamplona, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain; CIBER Epidemiología y Salud Pública, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
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García-García E, Calle-Miguel L, Pérez-Solís D, Urueña IC, Merino ÁG, Gómez HH, Poladura MM, Rodríguez-Pérez M. Household Transmission of SARS-CoV-2 and Long-term Immunity in Children: A Prospective Study in Northern Spain. Pediatr Infect Dis J 2023; 42:226-231. [PMID: 36730092 PMCID: PMC9935233 DOI: 10.1097/inf.0000000000003790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND The role of children in SARS-CoV-2 transmission and their immune response after infection have been profoundly discussed. Hereby, we analyze both aspects in a Spanish pediatric population. METHODS Prospective, multicentre, longitudinal study performed from July 2020 to September 2021 in children up to 14 years old. Venous blood samples were collected every 6 months and serum was analyzed for antibodies against SARS-CoV-2 using a spike (S) and a nucleocapsid (N) protein assays. Household contacts of seropositive children were tested. Household transmission, antibody dynamics, and durability were analyzed. RESULTS Two hundred children were recruited and 28 had SARS-CoV-2 antibodies at the end of the study, resulting in an overall seroprevalence of 16.6% (95% CI: 9.5%-19.6%). Most of children (18/28) were secondary cases. The secondary attack rate (SAR) was lower in households with pediatric index cases than in those with adult index cases ( P = 0.023). The median antibody titers in the first positive serology, for the seropositive patients, were 137 BAU/mL (IQR 83.3-427.4) for the S-assay and 132.5 COI (IQR 14.5-170.5) for the N-assay without significant differences between symptomatic and asymptomatic children. The median time between the RT-PCR and the last serology was 7.5 months (IQR 5.2-8.8), and the duration of SARS-CoV-2 antibodies after infection was proven to be at least 18 months. There were no cases of seroreversion. CONCLUSIONS (1) Children are not the main drivers of SARS-CoV-2 household transmission. (2) They maintain SARS-CoV-2 antibodies for up to 18 months after infection and the titers are similar between symptomatic and asymptomatic children.
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Affiliation(s)
| | - Laura Calle-Miguel
- Pediatrics Department, Hospital Universitario Central de Asturias, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - David Pérez-Solís
- Pediatrics Department, Hospital Universitario San Agustín, Avilés, Spain
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27
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Bugallo-Sanz X, Balboa-Barreiro V, Pérez-Martínez O, García-Rodríguez R, Gómez-Besteiro I, Pereira-Rodríguez MJ. [COVID-19 epidemiology in health and social health workers in the health area of A Coruña and Cee]. Semergen 2023; 49:101938. [PMID: 36889056 PMCID: PMC9870758 DOI: 10.1016/j.semerg.2023.101938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/17/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Since the beginning of the pandemic, it has become necessary to know the epidemiological evolution of SARS-CoV-2. Therefore, this study aims to describe the characteristics of the casuistry of COVID-19 in health and social-health workers in the health area of A Coruña and Cee during the first epidemic wave, as well as to determine the association between the clinical profile and/or its duration and the condition of RT-PCR repositivization. MATERIALS AND METHODS During the study period, 210 cases belonging to healthcare and social-healthcare workers from the healthcare area of A Coruña and Cee were diagnosed. A descriptive analysis of sociodemographic factors was carried out, as well as the search for association between the clinical picture and the duration of detection of a positive RT-PCR. RESULTS The most affected categories were nursing (33.3%) and nursing assistants (16.2%). The mean time taken for cases to become RT-PCR negative was 18.3±9.1 days, with a median of 17. It was observed that 26 cases (13.8%) had a positive result in a subsequent RT-PCR, without meeting criteria for reinfection. The existence of skin manifestations and arthralgias was associated with repositivization after adjusting for age and sex (OR=4.6 and OR=6.5, respectively). CONCLUSIONS In healthcare professionals diagnosed with COVID-19 during the first wave, symptoms such as dyspnea, skin manifestations and arthralgias led to RT-PCR repositivization after a previous negative result and without meeting criteria for reinfection.
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Affiliation(s)
- X Bugallo-Sanz
- Servicio de Medicina Preventiva y Salud Laboral, Complexo Hospitalario Universitario A Coruña (CHUAC), Área Sanitaria de A Coruña y Cee, A Coruña, España.
| | - V Balboa-Barreiro
- Unidad de Apoyo a la Investigación, Complexo Hospitalario Universitario A Coruña (CHUAC) - Instituto de Investigación Biomédica A Coruña (INIBIC), A Coruña, España
| | - O Pérez-Martínez
- Servicio de Medicina Preventiva y Salud Laboral, Complexo Hospitalario Universitario A Coruña (CHUAC), Área Sanitaria de A Coruña y Cee, A Coruña, España; Servizo de Epidemioloxía. Dirección Xeral de Saúde Pública, Consellería de Sanidade-Xunta de Galicia, A Coruña, España
| | - R García-Rodríguez
- Servicio de Medicina Preventiva y Salud Laboral, Complexo Hospitalario Universitario A Coruña (CHUAC), Área Sanitaria de A Coruña y Cee, A Coruña, España
| | - I Gómez-Besteiro
- Unidad de Apoyo a la Investigación, Complexo Hospitalario Universitario A Coruña (CHUAC) - Instituto de Investigación Biomédica A Coruña (INIBIC), A Coruña, España
| | - M J Pereira-Rodríguez
- Servicio de Medicina Preventiva y Salud Laboral, Complexo Hospitalario Universitario A Coruña (CHUAC), Área Sanitaria de A Coruña y Cee, A Coruña, España
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Mori T, Nagata T, Ikegami K, Hino A, Tateishi S, Tsuji M, Matsuda S, Fujino Y, Mori K, Ando H, Eguchi H, Muramatsu K, Mafune K, Okawara M, Kuwamura M, Matsugaki R, Ishimaru T, Igarashi Y. Effect of COVID-19 infection related experiences on social behaviors when a state of emergency is declared: a cohort study. BMC Public Health 2022; 22:2445. [PMID: 36577963 PMCID: PMC9795144 DOI: 10.1186/s12889-022-14864-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 12/13/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Restricting the movement of the public to gathering places and limiting close physical contact are effective measures against COVID-19 infection. In Japan, states of emergency have been declared in specific prefectures to reduce public movement and control COVID-19 transmission. We investigated how COVID-19 infection related experiences including people with a history of infection, people with a history of close contact, and people whose acquaintances have been infected, affected self-restraint from social behaviors during the second state of emergency in Japan. METHODS A prospective cohort study was conducted among workers aged 20-65 years using data from an internet survey. The baseline survey was conducted on December 22-25, 2020, and a follow-up survey was on February 18-19, 2021. There were 19,051 participants who completed both surveys and were included in the final analysis. We identified eight social behaviors: (1) eating out (4 people or fewer); (2) eating out (5 people or more); (3) gathering with friends and colleagues; (4) day trip; (5) overnight trip (excluding visiting home); (6) visiting home; (7) shopping for daily necessities; and (8) shopping for other than daily necessities. We set self-restraint regarding each social behavior after the second state of emergency was declared in January 2021 as the dependent variable, and COVID-19 infection related experiences as independent variables. Odds ratios were estimated using multilevel logistic regression analyses nested in the prefecture of residence. RESULTS Significant differences by COVID-19 infection related experiences were identified: compared to people without COVID-19 related experiences, people with a history of COVID-19 were less likely self-restraint from most social behaviors. People whose acquaintance had been diagnosed with COVID-19 were significantly more likely to refrain from most social behaviors. There was no significant difference in any social behaviors for people with a history of close contact only. CONCLUSION To maximize the effect of a state of emergency, health authorities should disseminate information for each person in the target population, taking into account potential differences related to the infection related experiences.
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Affiliation(s)
- Takahiro Mori
- grid.271052.30000 0004 0374 5913Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu, Fukuoka 807-8555 Japan
| | - Tomohisa Nagata
- grid.271052.30000 0004 0374 5913Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu, Fukuoka 807-8555 Japan
| | - Kazunori Ikegami
- grid.271052.30000 0004 0374 5913Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu, Fukuoka 807-8555 Japan
| | - Ayako Hino
- grid.271052.30000 0004 0374 5913Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu , Fukuoka 807-8555 Japan
| | - Seiichiro Tateishi
- grid.271052.30000 0004 0374 5913Disaster Occupational Health Center, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu , Fukuoka 807-8555 Japan
| | - Mayumi Tsuji
- grid.271052.30000 0004 0374 5913Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu, Fukuoka 807-8555 Japan
| | - Shinya Matsuda
- grid.271052.30000 0004 0374 5913Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu, Fukuoka 807-8555 Japan
| | - Yoshihisa Fujino
- grid.271052.30000 0004 0374 5913Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu, Fukuoka 807-8555 Japan
| | - Koji Mori
- grid.271052.30000 0004 0374 5913Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu, Fukuoka 807-8555 Japan
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Ramírez Varela A, Contreras-Arrieta S, Tamayo-Cabeza G, Salas Zapata L, Caballero-Díaz Y, Hernández Florez LJ, Benavidez AP, Laajaj R, De la Hoz F, Buitrago Gutierrez G, Restrepo S, Behrentz E. Risk factors for SARS-CoV-2 transmission in close contacts of adults at high risk of infection due to occupation: results from the contact tracing strategy of the CoVIDA epidemiological surveillance study in Bogotá, Colombia, in 2020-2021. BMJ Open 2022; 12:e062487. [PMID: 36564109 PMCID: PMC9791111 DOI: 10.1136/bmjopen-2022-062487] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To estimate the risk factors for SARS-CoV-2 transmission in close contacts of adults at high risk of infection due to occupation, participants of the CoVIDA study, in Bogotá D.C., Colombia. SETTING The CoVIDA study was the largest COVID-19 intensified sentinel epidemiological surveillance study in Colombia thus far, performing over 60 000 RT-PCR tests for SARS-CoV-2 infection. The study implemented a contact tracing strategy (via telephone call) to support traditional surveillance actions performed by the local health authority. PARTICIPANTS Close contacts of participants from the CoVIDA study. PRIMARY AND SECONDARY OUTCOME MEASURES SARS-CoV-2 testing results were obtained (RT-PCR with CoVIDA or self-reported results). The secondary attack rate (SAR) was calculated using contacts and primary cases features. RESULTS The CoVIDA study performed 1257 contact tracing procedures on primary cases. A total of 5551 close contacts were identified and 1050 secondary cases (21.1%) were found. The highest SAR was found in close contacts: (1) who were spouses (SAR=32.7%; 95% CI 29.1% to 36.4%), (2) of informally employed or unemployed primary cases (SAR=29.1%; 95% CI 25.5% to 32.8%), (3) of symptomatic primary cases (SAR of 25.9%; 95% CI 24.0% to 27.9%) and (4) living in households with more than three people (SAR=22.2%; 95% CI 20.7% to 23.8%). The spouses (OR 3.85; 95% CI 2.60 to 5.70), relatives (OR 1.89; 95% CI 1.33 to 2.70) and close contacts of a symptomatic primary case (OR 1.48; 95% CI 1.24 to 1.77) had an increased risk of being secondary cases compared with non-relatives and close contacts of an asymptomatic index case, respectively. CONCLUSIONS Contact tracing strategies must focus on households with socioeconomic vulnerabilities to guarantee isolation and testing to stop the spread of the disease.
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Affiliation(s)
| | | | | | - Leonardo Salas Zapata
- Observatorio de Salud, Secretaría Distrital de Salud de Bogotá, Bogotá D.C, Colombia
| | | | | | | | - Rachid Laajaj
- Department of Economics, Universidad de los Andes, Bogotá DC, Colombia
| | - Fernando De la Hoz
- Departamento de Salud Pública, Universidad Nacional de Colombia, Bogotá DC, Colombia
| | | | - Silvia Restrepo
- Department of Food and Chemical Engineering, Universidad de los Andes, Bogotá, Colombia
| | - Eduardo Behrentz
- Vicerrectoría Administrativa y Financiera, Universidad de los Andes, Bogotá DC, Colombia
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Liu CY, Smith S, Chamberlain AT, Gandhi NR, Khan F, Williams S, Shah S. Use of surveillance data to elucidate household clustering of SARS-CoV-2 in Fulton County, Georgia a major metropolitan area. Ann Epidemiol 2022; 76:121-127. [PMID: 36210009 PMCID: PMC9536872 DOI: 10.1016/j.annepidem.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Households are important for SARS-CoV-2 transmission due to high intensity exposure in enclosed spaces over prolonged durations. We quantified and characterized household clustering of COVID-19 cases in Fulton County, Georgia. METHODS We used surveillance data to identify all confirmed COVID-19 cases in Fulton County. Household clustered cases were defined as cases with matching residential address. We described the proportion of COVID-19 cases that were clustered, stratified by age over time and explore trends in age of first diagnosed case within households and subsequent household cases. RESULTS Between June 1, 2020 and October 31, 2021, 31,449(37%) of 106,233 cases were clustered in households. Children were the most likely to be in household clusters than any other age group. Initially, children were rarely (∼ 10%) the first cases diagnosed in the household but increased to almost 1 of 3 in later periods. DISCUSSION One-third of COVID-19 cases in Fulton County were part of a household cluster. Increasingly children were the first diagnosed case, coinciding with temporal trends in vaccine roll-out among the elderly and the return to in-person schooling in Fall 2021. Limitations include restrictions to cases with a valid address and unit number and that the first diagnosed case may not be the infection source for the household.
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Affiliation(s)
- Carol Y Liu
- Emory University Rollins School of Public Health, Atlanta, GA.
| | | | | | - Neel R Gandhi
- Emory University Rollins School of Public Health, Atlanta, GA; Emory School of Medicine, Atlanta, GA
| | - Fazle Khan
- Fulton County Board of Health, Atlanta, GA
| | | | - Sarita Shah
- Emory University Rollins School of Public Health, Atlanta, GA; Emory School of Medicine, Atlanta, GA
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Moek F, Rohde A, Schöll M, Seidel J, Baum JHJ, der Heiden MA. Attack Rate for Wild-Type SARS-CoV-2 during Air Travel: Results from 46 Flights Traced by German Health Authorities, January-March and June-August 2020. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2022; 2022:8364666. [PMID: 36317155 PMCID: PMC9617719 DOI: 10.1155/2022/8364666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/19/2022] [Accepted: 10/12/2022] [Indexed: 11/24/2022]
Abstract
Background Evidence on the risk of SARS-CoV-2 transmission during air travel is scarce. We aimed to estimate the attack rate for wild-type SARS-CoV-2 to improve the evidence base for the adaptation of nonpharmaceutical intervention (NPI) strategies aboard airplanes. Methods In collaboration with German Public Health Authorities (PHA), we conducted a follow-up of in-flight SARS-CoV-2 contact persons. We included those contact persons whom the Emergency Operations Centre at the Robert Koch-Institute had forwarded to PHA between January to March 2020 (before masking on flights became mandatory) and June to August 2020 (after the introduction of mandatory masking). We retrospectively collected data on whether these contact persons had been successfully contacted, had become symptomatic and had been tested for SARS-CoV-2, and whether alternative exposures other than the flight were known. Results Complete data that allowed for the calculation of attack rates were available for 108 contact persons (median age of 36 (IQR 24-53), 40% female), traveling on 46 flights with a median flight duration of 3 hours (IQR 2-3.5). 62 of these persons travelled after masking on flights became mandatory. 13/87 developed symptoms, 44/77 were tested (no data for 21 and 31). 13 persons (9 of whom had been SARS-CoV-2 positive) were excluded from the analysis of attack rates due to a likely alternative exposure. We thus identified 4 probable in-flight transmissions (2 of which occurred after the introduction of mandatory masking). The overall attack rate resulted in 4.2% (4/95; 95% CI: 1.4%-11.0%). Considering flights after mandatory masking, the attack rate was 3.6% (2/56, 95% CI 0.6%-13.4%), before masking 5.1% (2/39, 95% CI 0.9%-18.6%). Conclusions The risk of wild-type SARS-CoV-2 transmission during air travel seemed low, but not negligible. In order to formulate an effective, evidence-based NPI protocol for air travel, further studies considering the different transmissibility of SARS-CoV-2 variants of concern and vaccination status are needed.
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Affiliation(s)
- Felix Moek
- Postgraduate Training for Applied Epidemiology (PAE), Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Anna Rohde
- Unit for Gastrointestinal Infections, Zoonoses and Tropical Infections (Unit 35), Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Meike Schöll
- Postgraduate Training for Applied Epidemiology (PAE), Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Unit for Crisis Management, Outbreak Investigations and Training Programmes, Focal Point for the Public Health Service (Unit 38), Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Juliane Seidel
- Unit for Crisis Management, Outbreak Investigations and Training Programmes, Focal Point for the Public Health Service (Unit 38), Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Jonathan H. J. Baum
- Postgraduate Training for Applied Epidemiology (PAE), Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Maria an der Heiden
- Unit for Crisis Management, Outbreak Investigations and Training Programmes, Focal Point for the Public Health Service (Unit 38), Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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van Ingen T, Brown KA, Buchan SA, Akingbola S, Daneman N, Warren CM, Smith BT. Neighbourhood-level socio-demographic characteristics and risk of COVID-19 incidence and mortality in Ontario, Canada: A population-based study. PLoS One 2022; 17:e0276507. [PMID: 36264984 PMCID: PMC9584389 DOI: 10.1371/journal.pone.0276507] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/07/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES We aimed to estimate associations between COVID-19 incidence and mortality with neighbourhood-level immigration, race, housing, and socio-economic characteristics. METHODS We conducted a population-based study of 28,808 COVID-19 cases in the provincial reportable infectious disease surveillance systems (Public Health Case and Contact Management System) which includes all known COVID-19 infections and deaths from Ontario, Canada reported between January 23, 2020 and July 28, 2020. Residents of congregate settings, Indigenous communities living on reserves or small neighbourhoods with populations <1,000 were excluded. Comparing neighbourhoods in the 90th to the 10th percentiles of socio-demographic characteristics, we estimated the associations between 18 neighbourhood-level measures of immigration, race, housing and socio-economic characteristics and COVID-19 incidence and mortality using Poisson generalized linear mixed models. RESULTS Neighbourhoods with the highest proportion of immigrants (relative risk (RR): 4.0, 95%CI:3.5-4.5) and visible minority residents (RR: 3.3, 95%CI:2.9-3.7) showed the strongest association with COVID-19 incidence in adjusted models. Among individual race groups, COVID-19 incidence was highest among neighbourhoods with the high proportions of Black (RR: 2.4, 95%CI:2.2-2.6), South Asian (RR: 1.9, 95%CI:1.8-2.1), Latin American (RR: 1.8, 95%CI:1.6-2.0) and Middle Eastern (RR: 1.2, 95%CI:1.1-1.3) residents. Neighbourhoods with the highest average household size (RR: 1.9, 95%CI:1.7-2.1), proportion of multigenerational families (RR: 1.8, 95%CI:1.7-2.0) and unsuitably crowded housing (RR: 2.1, 95%CI:2.0-2.3) were associated with COVID-19 incidence. Neighbourhoods with the highest proportion of residents with less than high school education (RR: 1.6, 95%CI:1.4-1.8), low income (RR: 1.4, 95%CI:1.2-1.5) and unaffordable housing (RR: 1.6, 95%CI:1.4-1.8) were associated with COVID-19 incidence. Similar inequities were observed across neighbourhood-level sociodemographic characteristics and COVID-19 mortality. CONCLUSIONS Neighbourhood-level inequities in COVID-19 incidence and mortality were observed in Ontario, with excess burden experienced in neighbourhoods with a higher proportion of immigrants, racialized populations, large households and low socio-economic status.
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Affiliation(s)
| | - Kevin A. Brown
- Public Health Ontario, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sarah A. Buchan
- Public Health Ontario, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Nick Daneman
- Public Health Ontario, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Brendan T. Smith
- Public Health Ontario, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
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Lui KL, Daher N, López D, Kim V, Tan L, Cohen PM, Alismail A. Surgical mask wearing behaviour in COVID-19 pandemic and influenza seasons: a cross-sectional study on healthcare professional students and staff's perspective in Southern California. BMJ Open 2022; 12:e064677. [PMID: 36220314 PMCID: PMC9556740 DOI: 10.1136/bmjopen-2022-064677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/30/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To investigate healthcare professional staff and students' perception of wearing surgical masks before and after their experience with the COVID-19 pandemic, and to evaluate the impact on mask wearing behaviour in future influenza seasons. DESIGN Cross-sectional study using anonymous survey. SETTING AND PARTICIPANTS Healthcare students and staff from a healthcare academic institution in Southern California participated in the mask survey study. Survey results were collected from June to November 2021. A total of 305 respondents responded to the survey, with 173 being healthcare students and 132 being working healthcare staff. OUTCOMES The study examined respondents' perceptions and hospital mask wearing behaviour before and after their COVID-19 pandemic experience, as well as during previous and future influenza seasons. RESULTS Two hundred and sixty-four (86.6%) respondents agreed that wearing a surgical mask reduces infection and limits transmission of infectious disease, yet prior to the pandemic, only a small proportion wore a mask in the hospital or during patient care. After experiencing the COVID-19 pandemic, more respondents indicated that they would continue to wear a mask when they are in a hospital in general (n=145, 47.5%), during patient care (n=262, 85.9%), during influenza seasons throughout the hospital (n=205, 67.2%) and during influenza seasons during patient care (n=270, 88.5%). CONCLUSION The pandemic experience has greatly influenced the health prevention behaviours of healthcare students and staff. After the pandemic, many respondents will continue to practice surgical mask wearing behaviour in the hospital, especially during face-to-face patient care. This demonstrates a significant change in health prevention perceptions among the current and the future generation of healthcare professionals.
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Affiliation(s)
- Kin Long Lui
- Department of Cardiopulmonary Sciences, Loma Linda University Health, Loma Linda, California, USA
- Respiratory Department, Adventist Health White Memorial, Los Angeles, California, USA
| | - Noha Daher
- Allied Health Studies, Loma Linda University, Loma Linda, California, USA
| | - David López
- Cardiopulmonary Sciences, Loma Linda University, Loma Linda, California, USA
| | - Veronica Kim
- Department of Cardiopulmonary Sciences, Loma Linda University Health, Loma Linda, California, USA
| | - Laren Tan
- Department of Cardiopulmonary Sciences, Loma Linda University Health, Loma Linda, California, USA
- Department of Pulmonary, Critical Care, Hyperbaric, Allergy and Sleep Medicine, Loma Linda University Medical Center, Loma Linda, California, USA
- Department of Medicine, Loma Linda University, Loma Linda, California, USA
| | - Pamela Monterroso Cohen
- Department of Cardiopulmonary Sciences, Loma Linda University Health, Loma Linda, California, USA
| | - Abdullah Alismail
- Cardiopulmonary Sciences, Loma Linda University, Loma Linda, California, USA
- Department of Medicine, Loma Linda University, Loma Linda, California, USA
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Kleynhans J, Walaza S, Martinson NA, Neti M, von Gottberg A, Bhiman JN, Toi D, Amoako DG, Buys A, Ndlangisa K, Wolter N, Genade L, Maloma L, Chewparsad J, Lebina L, de Gouveia L, Kotane R, Tempia S, Cohen C. Household Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 From Adult Index Cases With and Without Human Immunodeficiency Virus in South Africa, 2020-2021: A Case-Ascertained, Prospective, Observational Household Transmission Study. Clin Infect Dis 2022; 76:e71-e81. [PMID: 35925613 PMCID: PMC9384657 DOI: 10.1093/cid/ciac640] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/27/2022] [Accepted: 08/02/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In South Africa, 19% of adults are living with human immunodeficiency virus (HIV; LWH). Few data on the influence of HIV on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) household transmission are available. METHODS We performed a case-ascertained, prospective household transmission study of symptomatic adult index SARS-CoV-2 cases LWH and not living with HIV (NLWH) and their contacts from October 2020 to September 2021. Households were followed up 3 times a week for 6 weeks to collect nasal swabs for SARS-CoV-2 testing. We estimated household cumulative infection risk (HCIR) and duration of SARS-CoV-2 positivity (at a cycle threshold value <30 as proxy for high viral load). RESULTS HCIR was 59% (220 of 373), not differing by index HIV status (60% LWH vs 58% NLWH). HCIR increased with index case age (35-59 years: adjusted OR [aOR], 3.4; 95% CI, 1.5-7.8 and ≥60 years: aOR, 3.1; 95% CI, 1.0-10.1) compared with 18-34 years and with contacts' age, 13-17 years (aOR, 7.1; 95% CI, 1.5-33.9) and 18-34 years (aOR, 4.4; 95% CI, 1.0-18.4) compared with <5 years. Mean positivity was longer in cases LWH (adjusted hazard ratio, 0.4; 95% CI, .1-.9). CONCLUSIONS Index HIV status was not associated with higher HCIR, but cases LWH had longer positivity duration. Adults aged >35 years were more likely to transmit and individuals aged 13-34 to be infected SARS-CoV-2 in the household. As HIV infection may increase transmission, health services must maintain HIV testing and antiretroviral therapy initiation.
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Affiliation(s)
- Jackie Kleynhans
- Correspondence: J. Kleynhans, Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa. School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 1 Modderfontein Road, Sandringham, 2192, Johannesburg, South Africa ()
| | - Sibongile Walaza
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Neil A Martinson
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa,Center for TB Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mzimasi Neti
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jinal N Bhiman
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Dylan Toi
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Daniel G Amoako
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa,School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - Amelia Buys
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Kedibone Ndlangisa
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Leisha Genade
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Lucia Maloma
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Juanita Chewparsad
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Limakatso Lebina
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa,Africa Health Research Institute, Durban, South Africa
| | - Linda de Gouveia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Retshidisitswe Kotane
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Stefano Tempia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Krieg SJ, Schnur JJ, Miranda ML, Pfrender ME, Chawla NV. Symptomatic, Presymptomatic, and Asymptomatic Transmission of SARS-CoV-2 in a University Student Population, August-November 2020. Public Health Rep 2022; 137:1023-1030. [PMID: 35848117 PMCID: PMC9358125 DOI: 10.1177/00333549221110300] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES The impact and risk of SARS-CoV-2 transmission from asymptomatic and presymptomatic hosts remains an open question. This study measured the secondary attack rates (SARs) and relative risk (RR) of SARS-CoV-2 transmission from asymptomatic and presymptomatic index cases as compared with symptomatic index cases. METHODS We used COVID-19 test results, daily health check reports, and contact tracing data to measure SARs and corresponding RRs among close contacts of index cases in a cohort of 12 960 young adults at the University of Notre Dame in Indiana for 103 days, from August 10 to November 20, 2020. Further analysis included Fisher exact tests to determine the association between symptoms and COVID-19 infection and z tests to determine statistical differences between SARs. RESULTS Asymptomatic rates of transmission of SARS-CoV-2 were higher (SAR = 0.19; 95% CI, 0.14-0.24) than was estimated in prior studies, producing an RR of 0.75 (95% CI, 0.54-1.07) when compared with symptomatic transmission. In addition, the transmission rate associated with presymptomatic cases (SAR = 0.25; 95% CI, 0.21-0.30) was approximately the same as that for symptomatic cases (SAR = 0.25; 95% CI, 0.19-0.31). Furthermore, different symptoms were associated with different transmission rates. CONCLUSIONS Asymptomatic and presymptomatic hosts of SARS-CoV-2 are a risk for community spread of COVID-19, especially with new variants emerging. Moreover, typical symptom checks may easily miss people who are asymptomatic or presymptomatic but still infectious. Our study results may be used as a guide to analyze the spread of SARS-CoV-2 variants and help inform appropriate public health measures as they relate to asymptomatic and presymptomatic cases.
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Affiliation(s)
- Steven J. Krieg
- Lucy Family Institute for Data and
Society, University of Notre Dame, Notre Dame, IN, USA
| | - Jennifer J. Schnur
- Lucy Family Institute for Data and
Society, University of Notre Dame, Notre Dame, IN, USA
| | - Marie Lynn Miranda
- Lucy Family Institute for Data and
Society, University of Notre Dame, Notre Dame, IN, USA
| | - Michael E. Pfrender
- Lucy Family Institute for Data and
Society, University of Notre Dame, Notre Dame, IN, USA
| | - Nitesh V. Chawla
- Lucy Family Institute for Data and
Society, University of Notre Dame, Notre Dame, IN, USA
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Lewis HC, Marcato AJ, Meagher N, Valenciano M, Villanueva‐Cabezas J, Spirkoska V, Fielding JE, Karahalios A, Subissi L, Nardone A, Cheng B, Rajatonirina S, Okeibunor J, Aly EA, Barakat A, Jorgensen P, Azim T, Wijesinghe PR, Le L, Rodriguez A, Vicari A, Van Kerkhove MD, McVernon J, Pebody R, Price DJ, Bergeri I. Transmission of SARS-CoV-2 in standardised first few X cases and household transmission investigations: A systematic review and meta-analysis. Influenza Other Respir Viruses 2022; 16:803-819. [PMID: 36825117 PMCID: PMC9343340 DOI: 10.1111/irv.13002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 11/29/2022] Open
Abstract
We aimed to estimate the household secondary infection attack rate (hSAR) of SARS-CoV-2 in investigations aligned with the WHO Unity Studies Household Transmission Investigations (HHTI) protocol. We conducted a systematic review and meta-analysis according to PRISMA 2020 guidelines. We searched Medline, Embase, Web of Science, Scopus and medRxiv/bioRxiv for "Unity-aligned" First Few X cases (FFX) and HHTIs published 1 December 2019 to 26 July 2021. Standardised early results were shared by WHO Unity Studies collaborators (to 1 October 2021). We used a bespoke tool to assess investigation methodological quality. Values for hSAR and 95% confidence intervals (CIs) were extracted or calculated from crude data. Heterogeneity was assessed by visually inspecting overlap of CIs on forest plots and quantified in meta-analyses. Of 9988 records retrieved, 80 articles (64 from databases; 16 provided by Unity Studies collaborators) were retained in the systematic review; 62 were included in the primary meta-analysis. hSAR point estimates ranged from 2% to 90% (95% prediction interval: 3%-71%; I 2 = 99.7%); I 2 values remained >99% in subgroup analyses, indicating high, unexplained heterogeneity and leading to a decision not to report pooled hSAR estimates. FFX and HHTI remain critical epidemiological tools for early and ongoing characterisation of novel infectious pathogens. The large, unexplained variance in hSAR estimates emphasises the need to further support standardisation in planning, conduct and analysis, and for clear and comprehensive reporting of FFX and HHTIs in time and place, to guide evidence-based pandemic preparedness and response efforts for SARS-CoV-2, influenza and future novel respiratory viruses.
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Affiliation(s)
- Hannah C. Lewis
- World Health OrganizationGenevaSwitzerland
- World Health Organization, Regional Office for AfricaBrazzavilleRepublic of Congo
| | - Adrian J. Marcato
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | - Niamh Meagher
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
| | | | - Juan‐Pablo Villanueva‐Cabezas
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
- The Nossal Institute for Global HealthThe University of MelbourneMelbourneAustralia
| | - Violeta Spirkoska
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
- Victorian Infectious Diseases Reference LaboratoryRoyal Melbourne Hospital, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | - James E. Fielding
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
- Victorian Infectious Diseases Reference LaboratoryRoyal Melbourne Hospital, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | - Amalia Karahalios
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
| | | | - Anthony Nardone
- World Health OrganizationGenevaSwitzerland
- EpiconceptParisFrance
| | - Brianna Cheng
- World Health OrganizationGenevaSwitzerland
- School of Population and Global HealthMcGill UniversityMontrealQuebecCanada
| | | | - Joseph Okeibunor
- World Health Organization, Regional Office for AfricaBrazzavilleRepublic of Congo
| | - Eman A. Aly
- World Health Organization, Regional Office for the Eastern MediterraneanCairoEgypt
| | - Amal Barakat
- World Health Organization, Regional Office for the Eastern MediterraneanCairoEgypt
| | | | - Tasnim Azim
- World Health Organization, Regional Office for South‐East AsiaNew DelhiIndia
| | | | - Linh‐Vi Le
- World Health Organization, Regional Office for the Western PacificManilaPhilippines
| | - Angel Rodriguez
- World Health Organization, Regional Office for the Americas (Pan American Health Organization)WashingtonDCUSA
| | - Andrea Vicari
- World Health Organization, Regional Office for the Americas (Pan American Health Organization)WashingtonDCUSA
| | | | - Jodie McVernon
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
- Murdoch Children's Research InstituteMelbourneAustralia
| | - Richard Pebody
- World Health Organization Regional Office for EuropeCopenhagenDenmark
| | - David J. Price
- Department of Infectious DiseasesThe University of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
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Chen F, Tian Y, Zhang L, Shi Y. The role of children in household transmission of COVID-19: a systematic review and meta-analysis. Int J Infect Dis 2022; 122:266-275. [PMID: 35562045 PMCID: PMC9091150 DOI: 10.1016/j.ijid.2022.05.016] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/03/2022] [Accepted: 05/07/2022] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES To explore household transmissibility of SARS-CoV-2 in children in new-variants dominating periods. METHODS Through retrieval in PubMed and Embase, studies were included in two parts: meta-analysis of the household secondary attack rate (SAR) and case analysis of household pediatric infections. RESULTS A total of 95 articles were included: 48 for meta-analysis and 47 for case analysis. Pediatric COVID-19 only comprised a minority of the household transmission. The total pooled household SAR of child index cases and contacts were 0.20 (95% confidence interval [CI]: 0.15-0.26) and 0.24 (95% CI: 0.18-0.30). Lower household transmissibility was reported in both child index cases and contacts than in adults (relative risk [RR] = 0.64, 95% CI: 0.50-0.81; RR = 0.74, 95% CI: 0.64-0.85). Younger children were as susceptible as the older children (RR = 0.89, 95% CI: 0.72-1.10). Through subgroup analyses of different variants and periods, increased household SAR was observed in children (Wild: 0.20; Alpha: 0.42; Delta: 0.35; Omicron: 0.56), and no significant difference was found in household SAR between children and adults when new variants dominated. CONCLUSION Although children were found not to be dominant in the household transmission, their transmissibility of SARS-CoV-2 appeared to be on the rise as new variants emerged.
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Affiliation(s)
- Feifan Chen
- Department of Neonatology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Yan Tian
- Department of Neonatology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Lixin Zhang
- Department of Neonatology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Yuan Shi
- Department of Neonatology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.
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Ritsema F, Bosdriesz JR, Leenstra T, Petrignani MWF, Coyer L, Schreijer AJM, van Duijnhoven YTHP, van de Wijgert JHHM, Schim van der Loeff MF, Matser A. Factors Associated With Using the COVID-19 Mobile Contact-Tracing App Among Individuals Diagnosed With SARS-CoV-2 in Amsterdam, the Netherlands: Observational Study. JMIR Mhealth Uhealth 2022; 10:e31099. [PMID: 35867842 PMCID: PMC9407157 DOI: 10.2196/31099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 12/22/2021] [Accepted: 04/04/2022] [Indexed: 11/19/2022] Open
Abstract
Background Worldwide, efforts are being made to stop the COVID-19 pandemic caused by SARS-CoV-2. Contact tracing and quarantining are key in limiting SARS-CoV-2 transmission. Mathematical models have shown that the time between infection, isolation of cases, and quarantining of contacts are the most important components that determine whether the pandemic can be controlled. Mobile contact-tracing apps could accelerate the tracing and quarantining of contacts, including anonymous contacts. However, real-world observational data on the uptake and determinants of contact-tracing apps are limited. Objective The aim of this paper is to assess the use of a national Dutch contact-tracing app among notified cases diagnosed with SARS-CoV-2 infection and investigate which characteristics are associated with the use of the app. Methods Due to privacy regulations, data from the app could not be used. Instead, we used anonymized SARS-CoV-2 routine contact-tracing data collected between October 28, 2020, and February 26, 2021, in the region of Amsterdam, the Netherlands. Complete case logistic regression analysis was performed to identify which factors (age, gender, country of birth, municipality, number of close contacts, and employment in either health care or education) were associated with using the app. Age and number of close contacts were modelled as B-splines due to their nonlinear relationship. Results Of 29,766 SARS-CoV-2 positive cases, 4824 (16.2%) reported app use. Median age of cases was 41 (IQR 29-55) years, and 46.7% (n=13,898) were male. In multivariable analysis, males (adjusted odds ratio [AOR] 1.11, 95% CI 1.04-1.18) and residents of municipalities surrounding Amsterdam were more likely to use the app (Aalsmeer AOR 1.34, 95% CI 1.13-1.58; Ouder-Amstel AOR 1.96, 95% CI 1.54-2.50), while people born outside the Netherlands, particularly those born in non-Western countries (AOR 0.33, 95% CI 0.30-0.36), were less likely to use the app. Odds of app use increased with age until the age of 58 years and decreased sharply thereafter (P<.001). Odds of app use increased with number of contacts, peaked at 8 contacts, and then decreased (P<.001). Individuals working in day care, home care, and elderly nursing homes were less likely to use the app. Conclusions Contact-tracing app use among people with confirmed SARS-CoV-2 infection was low in the region of Amsterdam. This diminishes the potential impact of the app by hampering the ability to warn contacts. Use was particularly low among older people, people born outside the Netherlands, and people with many contacts. Use of the app was also relatively low compared to those from some other European countries, some of which had additional features beyond contact tracing, making them potentially more appealing. For the Dutch contact-tracing app to have an impact, uptake needs to be higher; therefore, investing more into promotional efforts and additional features could be considered.
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Affiliation(s)
- Feiko Ritsema
- Department of Infectious Diseases, GGD Amsterdam, Amsterdam, Netherlands
| | - Jizzo R Bosdriesz
- Department of Infectious Diseases, GGD Amsterdam, Amsterdam, Netherlands
- Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Academic Medical Center, Amsterdam, Netherlands
| | - Tjalling Leenstra
- Department of Infectious Diseases, GGD Amsterdam, Amsterdam, Netherlands
| | | | - Liza Coyer
- Department of Infectious Diseases, GGD Amsterdam, Amsterdam, Netherlands
- Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Academic Medical Center, Amsterdam, Netherlands
| | - Anja J M Schreijer
- Department of Infectious Diseases, GGD Amsterdam, Amsterdam, Netherlands
| | | | - Janneke H H M van de Wijgert
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Maarten F Schim van der Loeff
- Department of Infectious Diseases, GGD Amsterdam, Amsterdam, Netherlands
- Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Academic Medical Center, Amsterdam, Netherlands
| | - Amy Matser
- Department of Infectious Diseases, GGD Amsterdam, Amsterdam, Netherlands
- Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Academic Medical Center, Amsterdam, Netherlands
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39
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SARS-CoV-2 viral load is associated with risk of transmission to household and community contacts. BMC Infect Dis 2022; 22:672. [PMID: 35931971 PMCID: PMC9354300 DOI: 10.1186/s12879-022-07663-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 07/29/2022] [Indexed: 12/23/2022] Open
Abstract
Background Factors that lead to successful SARS-CoV-2 transmission are still not well described. We investigated the association between a case’s viral load and the risk of transmission to contacts in the context of other exposure-related factors. Methods Data were generated through routine testing and contact tracing at a large university. Case viral loads were obtained from cycle threshold values associated with a positive polymerase chain reaction test result from October 1, 2020 to April 15, 2021. Cases were included if they had at least one contact who tested 3–14 days after the exposure. Case-contact pairs were formed by linking index cases with contacts. Chi-square tests were used to evaluate differences in proportions of contacts testing positive. Generalized estimating equation models with a log link were used to evaluate whether viral load and other exposure-related factors were associated with a contact testing positive. Results Median viral load among the 212 cases included in the study was 5.6 (1.8–10.4) log10 RNA copies per mL of saliva. Among 365 contacts, 70 (19%) tested positive following their exposure; 36 (51%) were exposed to a case that was asymptomatic or pre-symptomatic on the day of exposure. The proportion of contacts that tested positive increased monotonically with index case viral load (12%, 23% and 25% corresponding to < 5, 5–8 and > 8 log10 copies per mL, respectively; X2 = 7.18, df = 2, p = 0.03). Adjusting for cough, time between test and exposure, and physical contact, the risk of transmission to a close contact was significantly associated with viral load (RR = 1.27, 95% CI 1.22–1.32). Conclusions Further research is needed to understand whether these relationships persist for newer variants. For those variants whose transmission advantage is mediated through a high viral load, public health measures could be scaled accordingly. Index cases with higher viral loads could be prioritized for contact tracing and recommendations to quarantine contacts could be made according to the likelihood of transmission based on risk factors such as viral load.
Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07663-1.
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40
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Mori T, Nagata T, Ikegami K, Hino A, Tateishi S, Tsuji M, Matsuda S, Fujino Y, Mori K. Sociodemographic factors and self-restraint from social behaviors during the COVID-19 pandemic in Japan: A cross-sectional study. Prev Med Rep 2022; 28:101834. [PMID: 35607522 PMCID: PMC9116972 DOI: 10.1016/j.pmedr.2022.101834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/29/2022] [Accepted: 05/16/2022] [Indexed: 11/23/2022] Open
Abstract
The control of human flow has led to better control of COVID-19 infections. Japan's state of emergency, unlike other countries, is not legally binding but is rather a request for individual self-restraint; thus, factors must be identified that do not respond to self-restraint, and countermeasures considered for those factors to enhance its efficacy. We examined the relationship between sociodemographic factors and self-restraint toward social behaviors during a pandemic in Japan. This cross-sectional study used data for February 18-19, 2021, obtained from an internet survey; 19,560 participants aged 20-65 were included in the analysis. We identified five relevant behaviors: (1) taking a day trip; (2) eating out with five people or more; (3) gathering with friends and colleagues; (4) shopping for other than daily necessities; (5) shopping for daily necessities. Multilevel logistic regression analyses were used to examine the relationship between sociodemographic factors and self-restraint for each of the behaviors. Results showed that for behaviors other than shopping for daily necessities, women, those aged 60-65, married people, highly educated people, high-income earners, desk workers and those who mainly work with interpersonal communication, and those with underlying disease reported more self-restraint. Older people had less self-restraint than younger people toward shopping for daily necessities; an underlying disease had no effect on the identified behavior. Specialized interventions for these groups that include recommendations for greater self-restraint may improve the efficacy of the implementing measures that request self-restraint.
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Affiliation(s)
- Takahiro Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
| | - Tomohisa Nagata
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
| | - Kazunori Ikegami
- Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
| | - Ayako Hino
- Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
| | - Seiichiro Tateishi
- Disaster Occupational Health Center, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
| | - Mayumi Tsuji
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
| | - Shinya Matsuda
- Department of Public Health, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
| | - Koji Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
| | - for the CORoNaWork project
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
- Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
- Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
- Disaster Occupational Health Center, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
- Department of Public Health, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
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Sumner KM, Karron RA, Stockwell MS, Dawood FS, Stanford JB, Mellis A, Hacker E, Thind P, Castro MJE, Harris JP, Deloria Knoll M, Schappell E, Hetrich MK, Duque J, Jeddy Z, Altunkaynak K, Poe B, Meece J, Stefanski E, Tong S, Lee JS, Dixon A, Veguilla V, Rolfes MA, Porucznik CA. Impact of Age and Symptom Development on SARS-CoV-2 Transmission in Households With Children-Maryland, New York, and Utah, August 2020-October 2021. Open Forum Infect Dis 2022; 9:ofac390. [PMID: 35991589 PMCID: PMC9384637 DOI: 10.1093/ofid/ofac390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background Households are common places for spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We investigated factors associated with household transmission and acquisition of SARS-CoV-2. Methods Households with children age <18 years were enrolled into prospective, longitudinal cohorts and followed from August 2020 to August 2021 in Utah, September 2020 to August 2021 in New York City, and November 2020 to October 2021 in Maryland. Participants self-collected nasal swabs weekly and with onset of acute illness. Swabs were tested for SARS-CoV-2 using reverse transcription polymerase chain reaction. We assessed factors associated with SARS-CoV-2 acquisition using a multilevel logistic regression adjusted for household size and clustering and SARS-CoV-2 transmission using a logistic regression adjusted for household size. Results Among 2053 people (513 households) enrolled, 180 people (8.8%; in 76 households) tested positive for SARS-CoV-2. Compared with children age <12 years, the odds of acquiring infection were lower for adults age ≥18 years (adjusted odds ratio [aOR], 0.34; 95% CI, 0.14-0.87); however, this may reflect vaccination status, which protected against SARS-CoV-2 acquisition (aOR, 0.17; 95% CI, 0.03-0.91). The odds of onward transmission were similar between symptomatic and asymptomatic primary cases (aOR, 1.00; 95% CI, 0.35-2.93) and did not differ by age (12-17 years vs <12 years: aOR, 1.08; 95% CI, 0.20-5.62; ≥18 years vs <12 years: aOR, 1.70; 95% CI, 0.52-5.83). Conclusions Adults had lower odds of acquiring SARS-CoV-2 compared with children, but this association might be influenced by coronavirus disease 2019 (COVID-19) vaccination, which was primarily available for adults and protective against infection. In contrast, all ages, regardless of symptoms and COVID-19 vaccination, had similar odds of transmitting SARS-CoV-2. Our findings underscore the importance of SARS-CoV-2 mitigation measures for persons of all ages.
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Affiliation(s)
- Kelsey M Sumner
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ruth A Karron
- Center for Immunization Research, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Melissa S Stockwell
- Division of Child and Adolescent Health, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
- Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
| | - Fatimah S Dawood
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia, USA
| | - Joseph B Stanford
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Alexandra Mellis
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia, USA
| | - Emily Hacker
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Priyam Thind
- Division of Child and Adolescent Health, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
| | - Maria Julia E Castro
- Division of Child and Adolescent Health, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
| | - John Paul Harris
- Division of Child and Adolescent Health, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
| | - Maria Deloria Knoll
- International Vaccine Access Center, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Elizabeth Schappell
- Center for Immunization Research, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Marissa K Hetrich
- International Vaccine Access Center, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Zuha Jeddy
- Abt Associates, Cambridge, Massachusetts, USA
| | | | - Brandon Poe
- Abt Associates, Cambridge, Massachusetts, USA
| | - Jennifer Meece
- Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
| | - Elisha Stefanski
- Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
| | - Suxiang Tong
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia, USA
| | - Justin S Lee
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia, USA
| | - Ashton Dixon
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia, USA
| | - Vic Veguilla
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia, USA
| | - Melissa A Rolfes
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia, USA
| | - Christina A Porucznik
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
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David S, Dorado G, Duarte EL, David-Bosne S, Trigueiro-Louro J, Rebelo-de-Andrade H. COVID-19: impact on Public Health and hypothesis-driven investigations on genetic susceptibility and severity. Immunogenetics 2022; 74:381-407. [PMID: 35348847 PMCID: PMC8961091 DOI: 10.1007/s00251-022-01261-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/14/2022] [Indexed: 12/12/2022]
Abstract
COVID-19 is a new complex multisystem disease caused by the novel coronavirus SARS-CoV-2. In slightly over 2 years, it infected nearly 500 million and killed 6 million human beings worldwide, causing an unprecedented coronavirus pandemic. Currently, the international scientific community is engaged in elucidating the molecular mechanisms of the pathophysiology of SARS-CoV-2 infection as a basis of scientific developments for the future control of COVID-19. Global exome and genome analysis efforts work to define the human genetics of protective immunity to SARS-CoV-2 infection. Here, we review the current knowledge regarding the SARS-CoV-2 infection, the implications of COVID-19 to Public Health and discuss genotype to phenotype association approaches that could be exploited through the selection of candidate genes to identify the genetic determinants of severe COVID-19.
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Affiliation(s)
- Susana David
- Departamento de Genética Humana, Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA,IP), Lisboa, Portugal.
- Instituto de Investigação do Medicamento (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, Lisboa, Portugal.
| | - Guillermo Dorado
- Atlántida Centro de Investigación y Desarrollo de Estudios Profesionales (CIDEP), Granada, Spain
| | - Elsa L Duarte
- MED-Instituto Mediterrâneo para a Agricultura, Ambiente e Desenvolvimento, Escola de Ciências e Tecnologia, Universidade de Évora, Évora, Portugal
| | | | - João Trigueiro-Louro
- Departamento de Doenças Infeciosas, INSA, IP, Lisboa, Portugal
- Host-Pathogen Interaction Unit, Instituto de Investigação do Medicamento (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, Lisboa, Portugal
- Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
| | - Helena Rebelo-de-Andrade
- Departamento de Doenças Infeciosas, INSA, IP, Lisboa, Portugal
- Host-Pathogen Interaction Unit, Instituto de Investigação do Medicamento (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, Lisboa, Portugal
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Household Transmission of SARS-CoV-2 in Bhutan. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5644454. [PMID: 35845937 PMCID: PMC9286897 DOI: 10.1155/2022/5644454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/26/2022] [Accepted: 06/22/2022] [Indexed: 11/30/2022]
Abstract
Introduction The transmission trend of SARS-CoV-2 is continuously evolving. Understanding the dynamics in different settings is crucial for any effective containment measures. We aimed to study the characteristics of household transmission of SARS-CoV-2 in Bhutanese households by determining the transmissibility within household contacts of confirmed COVID-19 index cases and their factors of infectivity. Methods We conducted a retrospective observational study on household transmission in 306 household contacts of 93 COVID-19 positive index cases diagnosed from April 16, 2021, to June 30, 2021. A pro forma was used to collect data on the epidemiological, demographic, and clinical profile of all recruited individuals. Secondary attack rates (SAR) were calculated, and risk factors for transmission were estimated. Results 180 of 306 household contacts developed secondary household transmission (SAR 58.8%; 95% CI: 53.2-64.2). The median age of household contacts was 22 years. The median household size was 4 (mean 4.3 ± 2.199) members. Contacts exposed to adult index cases (aPR 1; 95% CI 1, 1.02, p = 0.01) and vaccinated index cases (uPR 0.41, 95% CI 0.25, 0.66, p < 0.001) had a higher SAR and prevalence of secondary infections. Conclusions Our findings suggest substantial evidence of secondary infections among household contacts, especially in the context of public health mandated lockdowns. Aggressive early contact tracing and case identification with subsequent case isolation from other household members remains a crucial step in preventing secondary transmission.
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Nazari S, Poortaghi S, Sharifi F, Gorzin S, Afshar PF. Relationship between moral sensitivity and the quality of nursing care for the elderly with Covid-19 in Iranian hospitals. BMC Health Serv Res 2022; 22:840. [PMID: 35773700 PMCID: PMC9244299 DOI: 10.1186/s12913-022-08258-x] [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: 02/08/2022] [Accepted: 06/28/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The quality of care has a significant impact on the condition of elderly patients. Many factors affect the quality of care, including ethical considerations. Ethical considerations, such as moral sensitivity, change in times of crisis. The present study was conducted to assess the relationship between moral sensitivity and the quality of nursing care for the elderly with Covid-19 in Iranian hospitals. METHODS This was a cross-sectional descriptive correlational study. The participants included 445 nurses that were selected by quota sampling method from hospitals admitting COVID-19 patients. The data were collected using the Moral Sensitivity Questionnaire (MSQ) and Quality Patient Care Scale (QUALPAC) as self-reports. We used the SPSS software v.16 for statistical analysis. RESULTS The total score of moral sensitivity and quality of care was 52.29 ± 16.44 and 2.83 ± 0.23, respectively. Moral sensitivity negatively correlates with psychological, social, and physical aspects (P < 0.05). Modifying autonomy, interpersonal orientation, and experiencing moral conflict predicted β = 0.10 of the psychosocial aspect of quality of care. Structural moral meaning and expressing benevolence predicted the changes in the physical dimension of quality of care (β = 0.02). CONCLUSION The quality of care had a significant inverse correlation with moral sensitivity. Multiple regression analysis showed that modifying autonomy, interpersonal orientation, and experiencing moral conflict could predict the psychosocial dimensions. Structuring moral meaning could predict the physical dimension. The communication aspects were not related to any of the dimensions of moral sensitivity.
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Affiliation(s)
- Shima Nazari
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Sarieh Poortaghi
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Science Institute, Tehran University of Medical Science, Tehran, Iran
| | - Shaghayegh Gorzin
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Pouya Farokhnezhad Afshar
- Department of Gerontology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Shahid Mansouri Street, Niyayesh Street, Satarkhan Avenue, Tehran, 1445613111, Iran.
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Duman M, Şık N, Tekşam Ö, Akça H, Kurt F, Çağlar AA, Yıldız LA, Taşar MA, Fidancı İ, Yayla BCC, Yılmaz D, Güngör E, Demir Ş, Çokuğraş H, Cebeci SO, Önal P, Saz EU, Yurtseven A, Uysalol M, Yıldız R, Gümüş S, Bal A, Bayturan SŞ, Zengin N, Atik S, Çiftdoğan DY, Berksoy E, Çiçek A, Şahin S, Kızıl MC, Kara Y, Apa H, Ulusoy E, Kara AA, Yesil E, Erdem M, Turan C, Arslanoglu S, Duyu M, Besli GE, Arslan G, Oflu AT, Çeleğen M, Buldu E, Pişkin İE, Kardeş H, Yılmaz HL, Yıldızdaş D, Gökulu G, Çay P, Özer U, Güleryüz OD, Çolak Ö, Güneysu ST. COVID-19 disease in children presenting to the pediatric emergency department: A multicenter study with 8886 cases from Turkey. Am J Emerg Med 2022; 59:133-140. [PMID: 35849960 PMCID: PMC9181308 DOI: 10.1016/j.ajem.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/03/2022] [Accepted: 06/04/2022] [Indexed: 11/16/2022] Open
Abstract
Background The aim was to evaluate the epidemiological, clinical, laboratory, and radiologic data of children with SARS-CoV-2 positivity by polymerase chain reaction (PCR) together with treatment strategies and clinical outcomes and to evaluate cases of multisystem inflammatory syndrome in children (MIS-C) in this population. Methods This was a multicenter retrospective observational cohort study performed in the pediatric emergency departments of 19 tertiary hospitals. From March 11, 2020, to May 31, 2021, children who were diagnosed with confirmed nasopharyngeal/tracheal specimen SARS-CoV-2 PCR positivity or positivity for serum-specific antibodies against SARS-CoV-2 were included. Demographics, presence of chronic illness, symptoms, history of contact with SARS-CoV-2 PCR-positive individuals, laboratory and radiologic investigations, clinical severity, hospital admissions, and prognosis were recorded. Results A total of 8886 cases were included. While 8799 (99.0%) cases resulted in a diagnosis of SARS-CoV-2 with PCR positivity, 87 (1.0%) patients were diagnosed with MIS-C. Among SARS-CoV-2 PCR-positive patients, 51.0% were male and 8.5% had chronic illnesses. The median age was 11.6 years (IQR: 5.0–15.4) and 737 (8.4%) patients were aged <1 year. Of the patients, 15.5% were asymptomatic. The most common symptoms were fever (48.5%) and cough (30.7%) for all age groups. There was a decrease in the rate of fever as age increased (p < 0.001); the most common age group for this symptom was <1 year with the rate of 69.6%. There was known contact with a SARS-CoV-2 PCR-positive individual in 67.3% of the cases, with household contacts in 71.3% of those cases. In terms of clinical severity, 83 (0.9%) patients were in the severe-critical group. There was hospital admission in 1269 (14.4%) cases, with 106 (1.2%) of those patients being admitted to the pediatric intensive care unit (PICU). Among patients with MIS-C, 60.9% were male and the median age was 6.4 years (IQR: 3.9–10.4). Twelve (13.7%) patients presented with shock. There was hospital admission in 89.7% of these cases, with 29.9% of the patients with MIS-C being admitted to the PICU. Conclusion Most SARS-CoV-2 PCR-positive patients presented with a mild clinical course. Although rare, MIS-C emerges as a serious consequence with frequent PICU admission. Further understanding of the characteristics of COVID-19 disease could provide insights and guide the development of therapeutic strategies for target groups.
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Affiliation(s)
- Murat Duman
- Division of Pediatric Emergency Care, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
| | - Nihan Şık
- Division of Pediatric Emergency Care, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Özlem Tekşam
- Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Halise Akça
- Ankara City Hospital, Department of Pediatric Emergency Medicine, Ankara, Turkey
| | - Funda Kurt
- Ankara City Hospital, Department of Pediatric Emergency Medicine, Ankara, Turkey
| | - Ayla Akca Çağlar
- Ankara City Hospital, Department of Pediatric Emergency Medicine, Ankara, Turkey
| | - Leman Akcan Yıldız
- Ankara City Hospital, Department of Pediatric Emergency Medicine, Ankara, Turkey
| | - Medine Ayşin Taşar
- University of Health Sciences, Ankara Training and Research Hospital, Pediatric Emergency Department, Ankara, Turkey
| | - İlknur Fidancı
- University of Health Sciences, Ankara Training and Research Hospital, Pediatric Emergency Department, Ankara, Turkey
| | - Burcu Ceylan Cura Yayla
- University of Health Sciences, Ankara Training and Research Hospital, Pediatric Emergency Department, Ankara, Turkey
| | - Durgül Yılmaz
- Division of Pediatric Emergency Care, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Emre Güngör
- Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Şule Demir
- Aydın Gynecology and Childhood Hospital, Pediatric Emergency Department, Aydın, Turkey
| | - Haluk Çokuğraş
- Cerrahpasa Faculty of Medicine, İstanbul University-Cerrahpasa, Istanbul, Turkey
| | - Sinem Oral Cebeci
- Cerrahpasa Faculty of Medicine, İstanbul University-Cerrahpasa, Istanbul, Turkey
| | - Pınar Önal
- Cerrahpasa Faculty of Medicine, İstanbul University-Cerrahpasa, Istanbul, Turkey
| | | | | | - Metin Uysalol
- Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency, Istanbul, Turkey
| | - Raif Yıldız
- Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency, Istanbul, Turkey
| | - Süheyla Gümüş
- Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency, Istanbul, Turkey
| | - Alkan Bal
- Manisa Celal Bayar University Faculty of Medicine, Hafsa Sultan Hospital, Manisa, Turkey
| | - Semra Şen Bayturan
- Manisa Celal Bayar University Faculty of Medicine, Hafsa Sultan Hospital, Manisa, Turkey
| | - Neslihan Zengin
- Manisa Celal Bayar University Faculty of Medicine, Hafsa Sultan Hospital, Manisa, Turkey
| | - Sinem Atik
- Manisa Celal Bayar University Faculty of Medicine, Hafsa Sultan Hospital, Manisa, Turkey
| | - Dilek Yılmaz Çiftdoğan
- Pediatric Emergency Medicine Clinic, University of Health Sciences, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Emel Berksoy
- Pediatric Emergency Medicine Clinic, University of Health Sciences, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Alper Çiçek
- Pediatric Emergency Medicine Clinic, University of Health Sciences, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Sabiha Şahin
- Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Mahmut Can Kızıl
- Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Yalçın Kara
- Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Hurşit Apa
- Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey
| | - Emel Ulusoy
- Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey
| | - Aybüke Akaslan Kara
- Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey
| | - Edanur Yesil
- Mersin City Training and Research Hospital, Mersin, Turkey
| | - Meltem Erdem
- Mersin City Training and Research Hospital, Mersin, Turkey
| | - Caner Turan
- Mersin City Training and Research Hospital, Mersin, Turkey
| | - Sertac Arslanoglu
- Istanbul Medeniyet University Faculty of Medicine, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Muhterem Duyu
- Istanbul Medeniyet University Faculty of Medicine, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Gulser Esen Besli
- Istanbul Medeniyet University Faculty of Medicine, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Gazi Arslan
- Derince Training and Research Hospital, Kocaeli, Turkey
| | - Ayşe Tolunay Oflu
- Afyonkarahisar Health Sciences University Faculty of Medicine, Department of Pediatrics, Afyon, Turkey
| | - Mehmet Çeleğen
- Afyonkarahisar Health Sciences University Faculty of Medicine, Department of Pediatrics, Afyon, Turkey
| | - Ebru Buldu
- Afyonkarahisar Health Sciences University Faculty of Medicine, Department of Pediatrics, Afyon, Turkey
| | - İbrahim Etem Pişkin
- Zonguldak Bulent Ecevit University Faculty of Medicine, Department of Pediatrics, Zonguldak, Turkey
| | - Hakan Kardeş
- Zonguldak Bulent Ecevit University Faculty of Medicine, Department of Pediatrics, Zonguldak, Turkey
| | | | | | - Gamze Gökulu
- Cukurova University, Faculty of Medicine, Adana, Turkey
| | - Pınar Çay
- Cukurova University, Faculty of Medicine, Adana, Turkey
| | - Utku Özer
- Cukurova University, Faculty of Medicine, Adana, Turkey
| | | | - Özlem Çolak
- Gazi University, Faculty of Medicine, Department of Pediatric Emergency, Ankara, Turkey
| | - Songül Tomar Güneysu
- Gazi University, Faculty of Medicine, Department of Pediatric Emergency, Ankara, Turkey
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Mugglestone MA, Ratnaraja NV, Bak A, Islam J, Wilson JA, Bostock J, Moses SE, Price JR, Weinbren M, Loveday HP, Rivett L, Stoneham SM, Wilson APR. Presymptomatic, asymptomatic and post-symptomatic transmission of SARS-CoV-2: joint British Infection Association (BIA), Healthcare Infection Society (HIS), Infection Prevention Society (IPS) and Royal College of Pathologists (RCPath) guidance. BMC Infect Dis 2022; 22:453. [PMID: 35549902 PMCID: PMC9096060 DOI: 10.1186/s12879-022-07440-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/04/2022] [Indexed: 01/19/2023] Open
Affiliation(s)
| | - Natasha V Ratnaraja
- British Infection Association, Preston, UK
- University Hospitals Coventry & Warwickshire NHS Trust, Warwickshire, UK
- Warwick Medical School, Warwick, UK
| | - Aggie Bak
- Healthcare Infection Society, London, UK
| | - Jasmin Islam
- Healthcare Infection Society, London, UK
- King's College Hospital NHS Foundation Trust, London, UK
| | - Jennie A Wilson
- Infection Prevention Society, Seafield, UK
- Richard Wells Research Centre, University of West London, London, UK
| | | | - Samuel E Moses
- British Infection Association, Preston, UK
- East Kent Hospitals University NHS Foundation Trust, Kent, UK
- Royal College of Pathologists, London, UK
| | - James R Price
- Healthcare Infection Society, London, UK
- Imperial College Healthcare NHS Trust, London, UK
- Imperial College London, London, UK
| | - Michael Weinbren
- Healthcare Infection Society, London, UK
- Sherwood Forest Hospitals NHS Foundation Trust, Nottinghamshire, UK
| | - Heather P Loveday
- Infection Prevention Society, Seafield, UK
- Richard Wells Research Centre, University of West London, London, UK
| | - Lucy Rivett
- Healthcare Infection Society, London, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Simon M Stoneham
- Healthcare Infection Society, London, UK
- Imperial College London, London, UK
| | - A Peter R Wilson
- Healthcare Infection Society, London, UK
- University College London Hospitals NHS Foundation Trust, London, UK
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Mksoud M, Ittermann T, Holtfreter B, Söhnel A, Söhnel C, Welk A, Ulm L, Becker K, Hübner NO, Rau A, Kindler S, Kocher T. Prevalence of SARS-CoV-2 IgG antibodies among dental teams in Germany. Clin Oral Investig 2022; 26:3965-3974. [PMID: 35015149 PMCID: PMC8751466 DOI: 10.1007/s00784-021-04363-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/29/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES During the corona pandemic, dental practices temporarily closed their doors to patients except for emergency treatments. Due to the daily occupational exposure, the risk of SARS-CoV-2 transmission among dentists and their team is presumed to be higher than that in the general population. This study examined this issue among dental teams across Germany. MATERIALS AND METHODS In total, 2784 participants provided usable questionnaires and dry blood samples. Dry blood samples were used to detect IgG antibodies against SARS-CoV-2. The questionnaires were analyzed to investigate demographic data and working conditions during the pandemic. Multivariable logistic mixed-effects models were applied. RESULTS We observed 146 participants with positive SARS-CoV-2 IgG antibodies (5.2%) and 30 subjects with a borderline finding (1.1%). Seventy-four out of the 146 participants with SARS-CoV-2 IgG antibodies did not report a positive SARS-CoV-2 PCR test (50.7%), while 27 participants without SARS-CoV-2 IgG antibodies reported a positive SARS-CoV-2 PCR test (1.1%). Combining the laboratory and self-reported information, the number of participants with a SARS-CoV-2 infection was 179 (6.5%). Though after adjustment for region, mixed-effects models indicated associations of use of rubber dams (OR 1.65; 95% CI: 1.01-2.72) and the number of protective measures (OR 1.16; 95% CI: 1.01-1.34) with increased risk for positive SARS-CoV-2 status, none of those variables was significantly associated with a SARS-CoV-2 status in fully adjusted models. CONCLUSIONS The risk of SARS-CoV-2 transmission was not higher among the dental team compared to the general population. CLINICAL RELEVANCE Following hygienic regulations and infection control measures ensures the safety of the dental team and their patients.
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Affiliation(s)
- Maria Mksoud
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, Walther-Rathenau-Str. 42a, 17475 Greifswald, Germany
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Andreas Söhnel
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Carmen Söhnel
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, Walther-Rathenau-Str. 42a, 17475 Greifswald, Germany
| | - Alexander Welk
- Department of Restorative Dentistry, Periodontology Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Lena Ulm
- Friedrich Loeffler-Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Karsten Becker
- Friedrich Loeffler-Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Nils-Olaf Hübner
- Central Unit for Infection Prevention and Control, University Medicine Greifswald, Greifswald, Germany
| | - Andrea Rau
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, Walther-Rathenau-Str. 42a, 17475 Greifswald, Germany
| | - Stefan Kindler
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, Walther-Rathenau-Str. 42a, 17475 Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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48
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Rotevatn TA, Elstrøm P, Greve-Isdahl M, Surén P, Johansen TKB, Astrup E. School Closure Versus Targeted Control Measures for SARS-CoV-2 Infection. Pediatrics 2022; 149:185388. [PMID: 35274128 DOI: 10.1542/peds.2021-055071] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To compare effects of school closures with effects of targeted infection prevention and control (IPC) measures in open schools on SARS-CoV-2 infection rates in students. METHODS We conducted interrupted time-series analyses to compare trends in infection rates in grades 1-10 in 7 boroughs in Oslo, Norway, between February 15 and April 18, 2021. All schools at all levels had implemented strict IPC measures. While grades 1-4 attended school throughout the study period, school closures were implemented for grades 5-10 from March 17. We obtained individual level data from nationwide registries. RESULTS A total of 616, 452, and 446 students in grades 1-4, 5-7 and 8-10, respectively, were registered with a positive SARS-CoV-2 test during the study period, when the α-variant dominated. A statistically significant reduction in postintervention trends was observed for grades 1-4 (coefficient -1.26; 95% confidence interval (CI), -2.44 to -0.09). We did not observe any statistically significant between-group differences in postintervention trends between grades 1-4 and 5-7 (coefficient 0.66; 95% CI, -1.25 to 2.58) nor between grades 1-4 and 8-10 (coefficient -0.63; 95% CI, -2.30 to 1.04). Findings indicate that keeping schools open with strict IPC measures was equally effective as school closures on reducing student infection rates. CONCLUSIONS School closure was not more effective than targeted IPC measures in open schools in reducing student infection rates. Our findings suggest that keeping schools open with appropriate IPC measures should be preferred over school closures, considering the negative consequences closures have on students.
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Barmpounakis P, Demiris N, Kontoyiannis I, Pavlakis GN, Sypsa V. Evaluating the effects of second-dose vaccine-delay policies in European countries: A simulation study based on data from Greece. PLoS One 2022; 17:e0263977. [PMID: 35446847 PMCID: PMC9022792 DOI: 10.1371/journal.pone.0263977] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 02/01/2022] [Indexed: 12/12/2022] Open
Abstract
The results of a simulation-based evaluation of several policies for vaccine rollout are reported, particularly focusing on the effects of delaying the second dose of two-dose vaccines. In the presence of limited vaccine supply, the specific policy choice is a pressing issue for several countries worldwide, and the adopted course of action will affect the extension or easing of non-pharmaceutical interventions in the next months. We employ a suitably generalised, age-structure, stochastic SEIR (Susceptible → Exposed → Infectious → Removed) epidemic model that can accommodate quantitative descriptions of the major effects resulting from distinct vaccination strategies. The different rates of social contacts among distinct age-groups (as well as some other model parameters) are informed by a recent survey conducted in Greece, but the conclusions are much more widely applicable. The results are summarised and evaluated in terms of the total number of deaths and infections as well as life years lost. The optimal strategy is found to be one based on fully vaccinating the elderly/at risk as quickly as possible, while extending the time-interval between the two vaccine doses to 12 weeks for all individuals below 75 years old, in agreement with epidemic theory which suggests targeting a combination of susceptibility and infectivity. This policy, which is similar to the approaches adopted in the UK and in Canada, is found to be effective in reducing deaths and life years lost in the period while vaccination is still being carried out.
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Affiliation(s)
- Petros Barmpounakis
- Department of Statistics, Athens University of Economics and Business, Athens, Greece
| | - Nikolaos Demiris
- Department of Statistics, Athens University of Economics and Business, Athens, Greece
| | - Ioannis Kontoyiannis
- Department of Pure Mathematics and Mathematical Statistics, University of Cambridge, Cambridge, United Kingdom
| | - George N. Pavlakis
- Human Retrovirus Section, VB, National Cancer Institute, Frederick, Maryland, United States of America
| | - Vana Sypsa
- Departments of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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50
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Yan H, Ding Y, Guo W. Epidemiological, Radiographical, and Laboratorial Characteristics of Chinese Asymptomatic Cases With COVID-19: A Systematic Review and Meta-Analysis. Front Public Health 2022; 10:808471. [PMID: 35433622 PMCID: PMC9008196 DOI: 10.3389/fpubh.2022.808471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/11/2022] [Indexed: 12/23/2022] Open
Abstract
The comprehensive understanding of the characteristics of asymptomatic cases are helpful for the identification and management of patients with asymptomatic COVID-19 infection. Four electronic databases were searched from December 1, 2019 to February 8, 2022 for relevant articles. Data synthesis, subgroup analysis, and sensitivity analysis were performed on the included studies. I2 and Q tests were applied to evaluate heterogeneity across studies. The risk of publication bias was assessed and visualized using a funnel plot. A total of 45 studies consisting of 2,655 patients with no symptoms at the screening point were included. Pooled results showed that in China, 65% of initial no-symptoms COVID-19 patients did not present any COVID-19-related symptom during follow-up or by end of disease course (asymptomatic infections). High proportions of initial no-symptoms COVID-19 patients (76%) and patients with asymptomatic infection (55%) had abnormal CT features at the screening point. High proportion of patients with asymptomatic infection had been detected Ig G+ (72%) and/or Ig M+ (57%) at the screening point. The chest CT scan and SARS-CoV-2-specific antibody testing could serve as effective supplementary methods to identify asymptomatic cases in the early stage of SARS-CoV-2 infection. However, the chest CT scan and the SARS-CoV-2-specific IgM and IgG testing should not replace reverse transcription–polymerase chain reaction (RT-PCR) for screening in asymptomatic patients. The combination of repeated RT-PCR, chest CT scans, and the SARS-CoV-2-specific IgM and IgG testing should be performed for those highly suspected SARS-CoV-2 infections.
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Affiliation(s)
- Haohao Yan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yudan Ding
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Wenbin Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.,Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, China
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