1
|
Van der Heyden J, Leclercq V, Duysburgh E, Cornelissen L, Desombere I, Roukaerts I, Gisle L. Prevalence of SARS-CoV-2 antibodies and associated factors in the adult population of Belgium: a general population cohort study between March 2021 and April 2022. Arch Public Health 2024; 82:72. [PMID: 38750563 PMCID: PMC11094959 DOI: 10.1186/s13690-024-01298-1] [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: 04/11/2023] [Accepted: 04/29/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND This study assessed seroprevalence trends of SARS-CoV-2 antibodies in the Belgian adult population between March 2021 and April 2022, and explored factors associated with seropositivity and seroreversion among the vaccinated and unvaccinated population. METHODS A prospective longitudinal surveillance study was conducted within a random sample of the general population (18 + years) in Belgium, selected from the national register through a multistage sampling design. Participants provided a saliva sample and completed a survey questionnaire on three occasions: at baseline and in two follow-up waves. Outcome variables included (1) seropositivity, defined as the presence of SARS-CoV-2 antibodies, assessed with a semi-quantitative measure of anti-RBD (Receptor Binding Domain) IgG ELISA and (2) seroreversion, defined as passing from a positive to a negative antibody test between two measurements. Trends in SARS-CoV-2 antibody prevalence were assessed using binary logistic regression with contrasts applying post-stratification. Potential determinants of seropositivity were assessed through multilevel logistic regressions. RESULTS In total 6,178 valid observations were obtained from 2,768 individuals. SARS-CoV-2 antibody prevalence increased from 25.1% in the beginning of the study period to 92.3% at the end. Among the vaccinated population, factors significantly associated with higher seropositivity rates were being younger, having a bachelor diploma, living with others, having had a vaccine in the last 3 months and having received a nucleic-acid vaccine or a combination. Lower seropositivity rates were observed among vaccinated people with a neurological disease and transplant patients. Factors significantly associated with higher seropositivity rates among the unvaccinated population were having non-O blood type and being non-smoker. Among vaccinated people, the seroreversion rate was much lower (0.3%) in those who had received their latest vaccine in the last 3 months compared to those who had received their latest vaccine more than 3 months ago (2.7%) (OR 0.13; 95%CI 0.04-0.42). CONCLUSIONS The rapid increase in antibody seropositivity in the general adult population in Belgium during the study period was driven by the vaccination campaign which ran at full speed during this period. Among vaccinated people, seropositivity varied in function of the time since last vaccine, the type of vaccine, sociodemographic features and health status.
Collapse
Affiliation(s)
- Johan Van der Heyden
- Epidemiology and public health, Sciensano Juliette Wytsmanstraat 14, Sciensano, Brussels, 1050, Belgium.
| | - Victoria Leclercq
- Epidemiology and public health, Sciensano Juliette Wytsmanstraat 14, Sciensano, Brussels, 1050, Belgium
| | - Els Duysburgh
- Epidemiology and public health, Sciensano Juliette Wytsmanstraat 14, Sciensano, Brussels, 1050, Belgium
| | - Laura Cornelissen
- Epidemiology and public health, Sciensano Juliette Wytsmanstraat 14, Sciensano, Brussels, 1050, Belgium
| | | | | | - Lydia Gisle
- Epidemiology and public health, Sciensano Juliette Wytsmanstraat 14, Sciensano, Brussels, 1050, Belgium
| |
Collapse
|
2
|
Jayaraj VJ, Husin M, Suah JL, Tok PSK, Omar A, Rampal S, Sivasampu S. Effectiveness of COVID-19 vaccines among children 6-11 years against hospitalization during Omicron predominance in Malaysia. Sci Rep 2024; 14:5690. [PMID: 38454077 PMCID: PMC10920657 DOI: 10.1038/s41598-024-55899-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/28/2024] [Indexed: 03/09/2024] Open
Abstract
There is currently limited data on the effectiveness of COVID-19 vaccines for children aged 6-11 years in Malaysia. This study aims to determine vaccine effectiveness (VE) against COVID-19-related hospitalization after receipt of one- and two-doses of BNT162b2 mRNA (Comirnaty-Pfizer/BioNTech) vaccine over a duration of almost 1 year in the predominantly Omicron period of BA.4/BA.5 and X.B.B sub lineages. This study linked administrative databases between May 2022 and March 2023 to evaluate real-world vaccine effectiveness (VE) for the BNT162b2 mRNA (Comirnaty-Pfizer/BioNTech) vaccine against COVID-19-related hospitalization in the Omicron pre-dominant period with BA.4/BA.5 and X.B.B sub lineages. During the Omicron-predominant period, the cumulative hospitalization rate was almost two times higher for unvaccinated children (9.6 per million population) compared to vaccinated children (6 per million population). The estimated VE against COVID-19 hospitalization for one dose of BNT162b2 was 27% (95% CI - 1%, 47%) and 38% (95% CI 27%, 48%) for two doses. The estimated VE against hospitalization remained stable when stratified by time. VE for the first 90 days was estimated to be 45% (95% CI 33, 55%), followed by 47% (95% CI 34, 56%) between 90 and 180 days, and 36% (95% CI 22, 45%) between 180 and 360 days. Recent infection within 6 months does not appear to modify the impact of vaccination on the risk of hospitalization, subject to the caveat of potential underestimation. In our pediatric population, BNT162b2 provided moderate-non-diminishing protection against COVID-19 hospitalization over almost 1 year of Omicron predominance.
Collapse
Affiliation(s)
- Vivek Jason Jayaraj
- Sector for Biostatistics & Data Repository, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia.
| | - Masliyana Husin
- Institute for Clinical Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Jing Lian Suah
- Data, Analytics and Research, Central Bank of Malaysia, Kuala Lumpur, Malaysia
| | - Peter Seah Keng Tok
- Institute for Clinical Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Azahadi Omar
- Sector for Biostatistics & Data Repository, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Sanjay Rampal
- Department of Social and Preventive Medicine, Faculty of Medicine, Centre for Epidemiology and Evidence-Based Practice, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Sheamini Sivasampu
- Institute for Clinical Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| |
Collapse
|
3
|
Deng JS, Ying CQ, Lin XQ, Huang CL, Zhang MX, Tung TH, Zhu JS. Impact of household decision makers' hesitancy to vaccinate children against COVID-19 on other household members: A family-based study in Taizhou, China. SSM Popul Health 2023; 24:101517. [PMID: 37767519 PMCID: PMC10520923 DOI: 10.1016/j.ssmph.2023.101517] [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: 06/03/2023] [Revised: 08/13/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
Background Vaccination is the most effective means of preventing outbreaks of infectious diseases, and family ;decision makers play an important role in decision-making regarding family matters and may influence other family members to take an active role in vaccinating children against COVID-19. Purpose This study examined the influence of family decision makers on the hesitation of other family members to vaccinate their children against COVID-19. Methods A population-based, self-administered online questionnaire was administered in Taizhou, China, from September 1, 2021, to September 15, 2021. The questionnaire included demographic information, knowledge, attitudes, and perceptions about the COVID-19 vaccine as well as hesitation regarding the use of the COVID-19 vaccination in children. In total, 490 respondents were included in this study. Logistic regression was used to assess the factors associated with vaccine hesitancy. Results In total, 490 respondents from 190 households were interviewed. Of the 190 family decision makers, 43.7% (83/190) were hesitant to vaccinate their children against COVID-19. When family decision makers were hesitant to vaccinate children against COVID-19, 65.1% (82/126) of the other family members expressed similar hesitancy regarding vaccination. When family decision makers were not hesitant to vaccinate children, only 21.3% (37/174) of other family members were hesitant to do so. In the regression analysis, family decision makers' hesitation to vaccinate their children was associated with other family members' hesitation (OR=6.264, 95% CI:3.132-12.526). In addition, decision makers' perceptions of the safety of the vaccine (OR=0.422, 95% CI:0.215-0.826) and hesitation to vaccinate themselves (OR=8.967, 95% CI:4.745-16.948) influenced their hesitation to vaccinate their children. Conclusion The present study found that family decision makers' hesitation to vaccinate children against COVID-19 influenced other family members' hesitation to vaccinate children. In addition, family decision makers' perceptions of the safety of the vaccine and their hesitation to vaccinate themselves influenced other family members' hesitation to vaccinate their children.
Collapse
Affiliation(s)
- Jing-Shan Deng
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Chen-Qian Ying
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Xiao-Qing Lin
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Chun-Lian Huang
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Mei-Xian Zhang
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Jian-Sheng Zhu
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| |
Collapse
|
4
|
Brom C, Diviák T, Drbohlav J, Korbel V, Levínský R, Neruda R, Kadlecová G, Šlerka J, Šmíd M, Trnka J, Vidnerová P. Rotation-based schedules in elementary schools to prevent COVID-19 spread: a simulation study. Sci Rep 2023; 13:19156. [PMID: 37932281 PMCID: PMC10628146 DOI: 10.1038/s41598-023-45788-8] [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: 07/10/2022] [Accepted: 10/24/2023] [Indexed: 11/08/2023] Open
Abstract
Rotations of schoolchildren were considered as a non-pharmacological intervention in the COVID-19 pandemic. This study investigates the impact of different rotation and testing schedules.We built an agent-based model of interactions among pupils and teachers based on a survey in an elementary school in Prague, Czechia. This model contains 624 schoolchildren and 55 teachers and about 27 thousands social contacts in 10 layers. The layers reflect different types of contacts (classroom, cafeteria, etc.) in the survey. On this multi-graph structure we run a modified SEIR model of covid-19 infection. The parameters of the model are calibrated on data from the outbreak in the Czech Republic in spring 2020. Weekly rotations of in-class and distance learning are an effective preventative measure in schools reducing the spread of covid-19 by 75-81% . Antigen testing twice a week or PCR once a week significantly reduces infections even when using tests with a lower sensitivity. The structure of social contacts between pupils and teachers strongly influences the transmission. While the density of contact graphs for older pupils is 1.5 times higher than for younger pupils, the teachers' network is an order of magnitude denser. Teachers moreover act as bridges between groups of children, responsible for 14-18% of infections in the secondary school compared to 8-11% in the primary school. Weekly rotations with regular testing are a highly effective non-pharmacological intervention for the prevention of covid-19 spread in schools and a way to keep schools open during an epidemic.
Collapse
Affiliation(s)
- Cyril Brom
- Faculty of Mathematics and Physics, Charles University, Ke Karlovu 2027/3, 121 16, Praha 2, Czech Republic
| | - Tomáš Diviák
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic
- Department of Criminology and Mitchell Centre for Social Network Analysis, School of Social Sciences, University of Manchester, Oxford Rd, Manchester, UK
| | - Jakub Drbohlav
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic
| | - Václav Korbel
- CERGE-EI, Politických vězňů 7, 11121, Praha 1, Czech Republic
- PAQ Research, 28. pluku 458/7, 101 00, Praha 10, Czech Republic
| | - René Levínský
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic
- CERGE-EI, Politických vězňů 7, 11121, Praha 1, Czech Republic
- New Media Studies, Faculty of Arts, Charles University, Na Příkopě 29, 110 00, Praha 1, Czech Republic
| | - Roman Neruda
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic
- Institute of Computer Science, The Czech Academy of Sciences, Pod Vodárenskou věží-2, 18200, Praha 8, Czech Republic
| | - Gabriela Kadlecová
- Faculty of Mathematics and Physics, Charles University, Ke Karlovu 2027/3, 121 16, Praha 2, Czech Republic
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic
- Institute of Computer Science, The Czech Academy of Sciences, Pod Vodárenskou věží-2, 18200, Praha 8, Czech Republic
| | - Josef Šlerka
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic
- New Media Studies, Faculty of Arts, Charles University, Na Příkopě 29, 110 00, Praha 1, Czech Republic
| | - Martin Šmíd
- Faculty of Mathematics and Physics, Charles University, Ke Karlovu 2027/3, 121 16, Praha 2, Czech Republic
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic
- Institute of Information Theory and Automation, The Czech Academy of Sciences, Pod Vodárenskou věží-4, 18200, Praha 8, Czech Republic
| | - Jan Trnka
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic.
- Department of Biochemistry, Cell and Molecular Biology, Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Praha 10, Czech Republic.
| | - Petra Vidnerová
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic
- Institute of Computer Science, The Czech Academy of Sciences, Pod Vodárenskou věží-2, 18200, Praha 8, Czech Republic
| |
Collapse
|
5
|
Galmiche S, Charmet T, Rakover A, Schaeffer L, Chény O, von Platen C, Omar F, David C, Mailles A, Carrat F, Fontanet A. Risk of SARS-CoV-2 Infection Among Households With Children in France, 2020-2022. JAMA Netw Open 2023; 6:e2334084. [PMID: 37713194 PMCID: PMC10504612 DOI: 10.1001/jamanetworkopen.2023.34084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/18/2023] [Indexed: 09/16/2023] Open
Abstract
Importance Understanding the contribution of children to SARS-CoV-2 circulation in households is critical for designing public health policies and mitigation strategies. Objective To identify temporal changes in the risk of SARS-CoV-2 infection in people living with children. Design, Setting, and Participants This case-control study included online questionnaire responses from French adults between October 2020 and October 2022. Eligible cases were adults with ongoing SARS-CoV-2 infection with an email address on record with the national health insurance system, which centralized all new diagnoses in France. Eligible controls were adults who had never tested positive for SARS-CoV-2 until February 2021, when eligibility was extended to all adults without ongoing SARS-CoV-2 infection. Exposure Transmission of SARS-CoV-2 from a child (aged under 18 years) within the household in the descriptive analysis, as reported by the participating case. Sharing household with a child (of any age or broken down by school level) in the case-control analysis. Main Outcome and Measures Ongoing SARS-CoV-2 infection diagnosed by reverse transcription-polymerase chain reaction or supervised rapid antigen test (ie, not self-tests). Results A total of 682 952 cases were included for the descriptive analysis (68.8% female, median [IQR] age, 44 [34-55] years). Among those, 45 108 (6.6%) identified a household child as the source case; this proportion peaked at 10.4% during the Omicron BA.1 wave (December 20, 2021, to April 8, 2022). For the case-control analysis, we matched 175 688 cases (with a 4:1 ratio) for demographic characteristics with 43 922 controls. In multivariable logistic regression analysis, household exposure to children was associated with an increased risk of infection mainly at the end of summer 2021 (receding Delta wave) and during winter 2022 (Omicron BA.1 wave). In subgroup analysis by school level of the child, living with children under the age of 6 was associated with increased odds of infection throughout the study period, peaking at an odds ratio (OR) 1.8 (95% CI, 1.6-2.1) for children looked after by professional in-home caregivers, 1.7 (95% CI, 1.5-1.7) for children in day care facilities, and 1.6 (95% CI, 1.4-1.8) for children in preschool. The ORs associated with household exposure to children aged 6 to 14 years increased during the Delta (August 14, 2021, to December 19, 2021) and Omicron BA.1 waves, reaching 1.6 (95% CI, 1.5-1.7) for primary school children and 1.4 (95% CI, 1.3-1.5) for middle school children. Exposure to older children aged 15 to 17 years was associated with a moderate risk until April 2021, with an OR of 1.2 (95% CI, 1.2-1.3) during curfew in early 2021 (December 4, 2020, to April 8, 2021). Conclusions and Relevance The presence of children, notably very young ones, was associated with an increased risk of SARS-CoV-2 infection in other household members, especially during the Delta and Omicron BA.1 waves. These results should help to guide policies targeting children and immunocompromised members of their household.
Collapse
Affiliation(s)
- Simon Galmiche
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, Paris, France
- Sorbonne Université, Ecole Doctorale Pierre Louis de Santé Publique, Paris, France
| | - Tiffany Charmet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - Arthur Rakover
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - Laura Schaeffer
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - Olivia Chény
- Center for Translational Research, Institut Pasteur, Université Paris Cité, Paris, France
| | - Cassandre von Platen
- Center for Translational Research, Institut Pasteur, Université Paris Cité, Paris, France
| | - Faïza Omar
- Department of Public Affairs—Public Statistics, Institut Ipsos, Paris, France
| | - Christophe David
- Department of Public Affairs—Public Statistics, Institut Ipsos, Paris, France
| | | | - Fabrice Carrat
- Sorbonne Université, Inserm, IPLESP, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, Paris, France
- Unité PACRI, Conservatoire National des Arts et Métiers, Paris, France
| |
Collapse
|
6
|
Graham S, Tessier E, Stowe J, Bernal JL, Parker EPK, Nitsch D, Miller E, Andrews N, Walker JL, McDonald HI. Bias assessment of a test-negative design study of COVID-19 vaccine effectiveness used in national policymaking. Nat Commun 2023; 14:3984. [PMID: 37414791 PMCID: PMC10325974 DOI: 10.1038/s41467-023-39674-0] [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: 12/23/2022] [Accepted: 06/21/2023] [Indexed: 07/08/2023] Open
Abstract
National test-negative-case-control (TNCC) studies are used to monitor COVID-19 vaccine effectiveness in the UK. A questionnaire was sent to participants from the first published TNCC COVID-19 vaccine effectiveness study conducted by the UK Health Security Agency, to assess for potential biases and changes in behaviour related to vaccination. The original study included symptomatic adults aged ≥70 years testing for COVID-19 between 08/12/2020 and 21/02/2021. A questionnaire was sent to cases and controls tested from 1-21 February 2021. In this study, 8648 individuals responded to the questionnaire (36.5% response). Using information from the questionnaire to produce a combined estimate that accounted for all potential biases decreased the original vaccine effectiveness estimate after two doses of BNT162b2 from 88% (95% CI: 79-94%) to 85% (95% CI: 68-94%). Self-reported behaviour demonstrated minimal evidence of riskier behaviour after vaccination. These findings offer reassurance to policy makers and clinicians making decisions based on COVID-19 vaccine effectiveness TNCC studies.
Collapse
Affiliation(s)
- Sophie Graham
- London School of Hygiene and Tropical Medicine, London, UK.
- UK Health Security Agency, London, UK.
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London, UK.
| | | | | | | | | | - Dorothea Nitsch
- London School of Hygiene and Tropical Medicine, London, UK
- UK Renal Registry, Bristol, UK
- Renal Unit, Royal Free London NHS Foundation Trust, Hertfordshire, UK
| | - Elizabeth Miller
- London School of Hygiene and Tropical Medicine, London, UK
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London, UK
| | - Nick Andrews
- UK Health Security Agency, London, UK
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London, UK
| | - Jemma L Walker
- London School of Hygiene and Tropical Medicine, London, UK
- UK Health Security Agency, London, UK
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London, UK
| | - Helen I McDonald
- London School of Hygiene and Tropical Medicine, London, UK
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London, UK
| |
Collapse
|
7
|
Munro A, Buonsenso D, González-Dambrauskas S, Hughes RC, Bhopal SS, Vásquez-Hoyos P, Cevik M, Rubio MLM, Roland D. In-person schooling is essential even during periods of high transmission of COVID-19. BMJ Evid Based Med 2023; 28:175-179. [PMID: 37068921 DOI: 10.1136/bmjebm-2023-112277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 04/19/2023]
Affiliation(s)
- Alasdair Munro
- NIHR Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Center for Global Health Research Studies, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sebastián González-Dambrauskas
- Red Colaborativa Pediátrica de Latinoamérica (LARed Network), Montevideo, Uruguay
- Departamento de Pediatría y Unidad de Cuidados Intensivos de Niños del Centro Hospitalario Pereira Rossell, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Robert C Hughes
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Sunil S Bhopal
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Pablo Vásquez-Hoyos
- Departamento de Pediatria, Sociedad de Cirugía de Bogotá Hospital de San José, Bogota, Colombia
- Departamento de Pediatría, Facultad de Medicina, Universidad Nacional de Colombia, Bogota, Colombia
- Red Colaborativa Pediátrica de Latinoamérica (LARed Network), Bogota, Colombia
| | - Muge Cevik
- Division of Infection and Global Health Research, School of Medicine, University of St Andrews, Edinburgh, UK
| | - Maria Lucia Mesa Rubio
- Facultad de Medicina, Universidad de Los Andes, Bogotá, Colombia
- Pediatra Social Hospital Universitario Fundación Santa fe de Bogotá, Bogota, Colombia
| | - Damian Roland
- Paediatric Emergency Medicine Leicester Academic (PEMLA) group, Children's Emergency Department, Leicester Royal Infirmary, Leicester, UK
- SAPPHIRE Group, Health Sciences, University of Leicester, Leicester, UK
| |
Collapse
|
8
|
Pensieroso L, Sommacal A, Spolverini G. Intergenerational coresidence and the Covid-19 pandemic in the United States. ECONOMICS AND HUMAN BIOLOGY 2023; 49:101230. [PMID: 36738638 PMCID: PMC9876014 DOI: 10.1016/j.ehb.2023.101230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 09/14/2022] [Accepted: 01/17/2023] [Indexed: 05/06/2023]
Abstract
This paper investigates the relation between intergenerational coresidence and mortality from Covid-19 in 2020. Using a cross-section of U.S. counties, we show that this association is positive, sizeable, significant, and robust to the inclusion of several demographic and socio-economic controls. Furthermore, using evidence from past, pre-pandemic years, we argue that this positive, sizeable and significant association is somewhat specific to the Covid-19 pandemic.
Collapse
Affiliation(s)
| | | | - Gaia Spolverini
- IRES/LIDAM, UCLouvain, Belgium; Fonds de la Recherche Scientifique - FNRS, Belgium.
| |
Collapse
|
9
|
The spread of SARS-CoV-2 at school through the different pandemic waves: a population-based study in Italy. Eur J Pediatr 2023; 182:173-179. [PMID: 36266518 PMCID: PMC9589607 DOI: 10.1007/s00431-022-04654-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/30/2022] [Accepted: 10/08/2022] [Indexed: 01/21/2023]
Abstract
UNLABELLED Proactive school closures are often considered an effective strategy by policy-makers and the public to limit SARS-CoV-2 transmission. While evidence on the role of students in the spread is debated, the effects of closures on children's well-being are well known. In the light of this, we aimed to assess viral spread in educational settings, by calculating the rate of secondary infections per school class and identifying factors associated with cluster generation. We conducted a combined longitudinal and cross-sectional population-based study between October 2020 and November 2021. Secondary screening was conducted whenever a SARS-CoV-2 positive subject had been in the school environment in 48 h prior to symptoms onset or on the date of swab, if asymptomatic. The effect of selected variables on COVID-19 cluster generation was assessed by logistic regression. We identified 1623 primary COVID-19 cases. Of these, 72.5% resulted in no secondary case, 15.6% in 1, and 11.9% in 2 + . The probability of generating a 2 + cluster was lower when the index case was a student, rather than school staff (AOR = 0.42; 95%CI: 0.29-0.60). The number of clusters per week was in line with COVID-19 incidence trend in the general population. CONCLUSIONS Index cases at school led to no secondary case in about three out of four times and only to a secondary case in about 15%. School environment does not facilitate viral spread, but rather reflects circulation in the community. Appropriate measures and timely monitoring of cases make school a safe place. Given the effects on children's learning and well-being, it is essential to favour school attendance over distance learning. WHAT IS KNOWN • During the COVID-19 pandemic, most European countries resorted to school closures to counter viral transmission. • Although the scientific debate on the suitability of school closures as a non-pharmaceutical intervention is still open and the role of school children in facilitating the spread of SARS-CoV-2 is not supported by unequivocal evidence, there is now a growing awareness of the impact on children's well-being. WHAT IS NEW • The contribution of educational settings and students in facilitating viral spread appears limited, as exposure to a positive individual in the school environment led to no secondary cases among students in 72% of cases and only one secondary case in about 15%. • The likelihood of generating school clusters was approximately halved when the index case was a student compared to teachers or other school personnel.
Collapse
|
10
|
Seriakova I, Yevtushenko V, Kramarov S, Palatna L, Shpak I, Kaminska T. Clinical course of COVID-19 in hospitalized children of Ukraine in different pandemic periods. Eur Clin Respir J 2022; 9:2139890. [DOI: 10.1080/20018525.2022.2139890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
| | | | | | | | - Iryna Shpak
- Bogomolets National Medical University, Kyiv, Ukraine
| | - Tatiana Kaminska
- Bogomolets National Medical University, Kyiv, Ukraine
- Kyiv City Children’s Clinical Infectious Diseases Hospital, Kyiv, Ukraine
| |
Collapse
|
11
|
Wing K, Grint DJ, Mathur R, Gibbs HP, Hickman G, Nightingale E, Schultze A, Forbes H, Nafilyan V, Bhaskaran K, Williamson E, House T, Pellis L, Herrett E, Gautam N, Curtis HJ, Rentsch CT, Wong AYS, MacKenna B, Mehrkar A, Bacon S, Douglas IJ, Evans SJW, Tomlinson L, Goldacre B, Eggo RM. Association between household composition and severe COVID-19 outcomes in older people by ethnicity: an observational cohort study using the OpenSAFELY platform. Int J Epidemiol 2022; 51:1745-1760. [PMID: 35962974 PMCID: PMC9384728 DOI: 10.1093/ije/dyac158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/22/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Ethnic differences in the risk of severe COVID-19 may be linked to household composition. We quantified the association between household composition and risk of severe COVID-19 by ethnicity for older individuals. METHODS With the approval of NHS England, we analysed ethnic differences in the association between household composition and severe COVID-19 in people aged 67 or over in England. We defined households by number of age-based generations living together, and used multivariable Cox regression stratified by location and wave of the pandemic and accounted for age, sex, comorbidities, smoking, obesity, housing density and deprivation. We included 2 692 223 people over 67 years in Wave 1 (1 February 2020-31 August 2020) and 2 731 427 in Wave 2 (1 September 2020-31 January 2021). RESULTS Multigenerational living was associated with increased risk of severe COVID-19 for White and South Asian older people in both waves [e.g. Wave 2, 67+ living with three other generations vs 67+-year-olds only: White hazard ratio (HR) 1.61 95% CI 1.38-1.87, South Asian HR 1.76 95% CI 1.48-2.10], with a trend for increased risks of severe COVID-19 with increasing generations in Wave 2. There was also an increased risk of severe COVID-19 in Wave 1 associated with living alone for White (HR 1.35 95% CI 1.30-1.41), South Asian (HR 1.47 95% CI 1.18-1.84) and Other (HR 1.72 95% CI 0.99-2.97) ethnicities, an effect that persisted for White older people in Wave 2. CONCLUSIONS Both multigenerational living and living alone were associated with severe COVID-19 in older adults. Older South Asian people are over-represented within multigenerational households in England, especially in the most deprived settings, whereas a substantial proportion of White older people live alone. The number of generations in a household, number of occupants, ethnicity and deprivation status are important considerations in the continued roll-out of COVID-19 vaccination and targeting of interventions for future pandemics.
Collapse
Affiliation(s)
- Kevin Wing
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Daniel J Grint
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Rohini Mathur
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Hamish P Gibbs
- Department of Geography, University College London, London, UK
| | - George Hickman
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Emily Nightingale
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Anna Schultze
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Harriet Forbes
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Vahé Nafilyan
- Health Modelling Hub, Office of National Statistics, Newport, UK
| | - Krishnan Bhaskaran
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Elizabeth Williamson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Thomas House
- Department of Mathematics, University of Manchester, Manchester, UK
| | - Lorenzo Pellis
- Department of Mathematics, University of Manchester, Manchester, UK
| | - Emily Herrett
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Nileesa Gautam
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Aetion Inc, Boston, USA
| | - Helen J Curtis
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Christopher T Rentsch
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Angel Y S Wong
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Brian MacKenna
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Amir Mehrkar
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Seb Bacon
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Ian J Douglas
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Stephen J W Evans
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Laurie Tomlinson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Ben Goldacre
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Rosalind M Eggo
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| |
Collapse
|
12
|
Cristini A, Trivin P. Close encounters during a pandemic: Social habits and inter-generational links in the first two waves of COVID-19. ECONOMICS AND HUMAN BIOLOGY 2022; 47:101180. [PMID: 36095863 PMCID: PMC9436881 DOI: 10.1016/j.ehb.2022.101180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/04/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
Social habits are ingrained in a community and affect human behaviour. Have they played any role in the spread of the pandemic? We use high-frequency data for 220 regions in 15 European countries from March to December 2020 to compare the association between social contacts outside the family and within inter-generational families, on the one hand, and cases and excess mortality on the other. We find that a standard deviation increase in the percentage of people having daily face-to-face contacts outside the household is associated with 5 new daily cases and 2.6 additional weekly deaths, while the incidence of inter-generational households exhibits a less robust association with both COVID-19 transmission and mortality. We compare results across the first and the second wave of pandemic and show that differences are related to the average age of the most affected groups. Our findings are robust to the inclusion of a number of controls, fixed effects, the chosen sample of countries, and the estimation method. We argue that type and frequency of social interactions are interweaved with a region culture and habits and are informative on the potential transmission of contagion and on its lethality.
Collapse
Affiliation(s)
- Annalisa Cristini
- Department of Economics, University of Bergamo, 24127 Bergamo, Italy.
| | - Pedro Trivin
- Department of Economics, University of Bergamo, 24127 Bergamo, Italy.
| |
Collapse
|
13
|
Shimamoto K, McElroy E, Ibuka Y. Health inequity in pandemic anxiety about COVID-19 infection and socioeconomic consequences in Japan: A structural equation modeling approach. SSM Popul Health 2022; 20:101269. [PMID: 36276239 PMCID: PMC9574575 DOI: 10.1016/j.ssmph.2022.101269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/30/2022] [Accepted: 10/11/2022] [Indexed: 11/28/2022] Open
Abstract
Background Health inequity in relation to COVID-19 infection and socioeconomic consequences is a major global concern. Mental health issues in vulnerable populations have received special attention in research and practice during the COVID-19 pandemic. However, there is limited evidence on the nature of the anxieties experienced as a result of COVID-19, and how such concerns vary across demographic groups. Aim This study examines anxiety among the working population of Japan (aged 18-59), in terms of both COVID-19 infection and socioeconomic consequences, using an internationally validated tool, the Pandemic Anxiety Scale (PAS). Methods Data were collected using an online survey (n = 2,764). The analyses included an exploratory factor analysis (EFA), a confirmatory factor analysis (CFA), and structural equation modeling (SEM), followed by validation of the Japanese version of the PAS. Results A two-factor latent variable model shows the multidimensionality of anxiety in regard to the COVID-19 pandemic and the disparity across population groups in predicting the two defined anxiety dimensions. Several path coefficients showed somewhat unexpected and/or unique results from Japan compared with previous European studies. Specifically, self-reported health status was not significantly related to disease anxiety, and those who were not in paid employment reported lower consequence anxiety. The SEM results showed a greater number of significant exogenous variables for consequence anxiety compared to disease anxiety, highlighting disparities in pandemic anxiety by socioeconomic status in regard to socioeconomic consequences of the pandemic. Conclusion In contrast to existing European studies, evidence from the current study suggests contextual patterns of health inequity. Due to the prolonged socioeconomic consequences of the pandemic, multidisciplinary research on mental health issues and the quality of life remains an important research agenda in exploring socioeconomic measures in context, towards addressing inequity concerns.
Collapse
Affiliation(s)
- Kyoko Shimamoto
- Keio Global Research Institute, Keio University, 2-15-45 Mita, Minato-ku, Tokyo, 108-8345, Japan,Graduate School of Health Management, Keio University, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan,Corresponding author. Keio Global Research Institute, Keio University, 2-15-45 Mita, Minato-ku, Tokyo, 108-8345, Japan
| | - Eoin McElroy
- School of Psychology, Ulster University, Cromore Road, Coleraine, Co. Londonderry, BT52 1SA, United Kingdom
| | - Yoko Ibuka
- Department of Economics, Keio University, 2-15-45 Mita, Minato-ku, Tokyo, 108-8345, Japan
| |
Collapse
|
14
|
Migliara G, Renzi E, Baccolini V, Cerri A, Donia P, Massimi A, Marzuillo C, De Vito C, Casini L, Polimeni A, Gaudio E, Villari P. Predictors of SARS-CoV-2 Infection in University Students: A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14376. [PMID: 36361257 PMCID: PMC9655450 DOI: 10.3390/ijerph192114376] [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: 08/28/2022] [Revised: 10/30/2022] [Accepted: 10/30/2022] [Indexed: 06/16/2023]
Abstract
Closure of Higher Education Institutions in the early phase of the SARS-CoV-2 pandemic was largely diffused. With their reopening, numerous preventive measures have been enacted, but limited evidence exists on students' behavior that could influence their infection risk. We conducted a case-control study at the Sapienza University of Rome to identify protective and risk factors for SARS-CoV-2 infection. Students attending the campus within 48 h of SARS-CoV-2 infection were considered cases. Controls were students who come in contact with a confirmed case within the campus. Demographic features and activities carried out before positivity or contact were investigated. Multivariable logistic regression models were built to identify factors associated with SARS-CoV-2 infection, estimating adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). The analysis showed an increased risk of SARS-CoV-2 infection for attending the second year or above of university (aOR 17.7, 95% CI 2.21-142.82) and participating in private parties or ceremonies (aOR 15.9, 95% CI 2.30-109.67) while living outside the family (aOR 0.08, 95% CI 0.01-0.54) and attending practical activities or libraries on campus (aOR 0.29, 95% CI 0.08-0.97) reduced the risk. Data strongly suggests that it may be safe to participate in activities organized under strict infection prevention guidelines. Tailored prevention measures might reduce the risk of infection in university students.
Collapse
Affiliation(s)
- Giuseppe Migliara
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Erika Renzi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Valentina Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Ambrogio Cerri
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Pierluigi Donia
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Azzurra Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Carolina Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Corrado De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Leandro Casini
- Special Office for Prevention, Protection and High Vigilance, Sapienza University of Rome, 00185 Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Science, Sapienza University of Rome, 00185 Rome, Italy
| | - Eugenio Gaudio
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Paolo Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | | |
Collapse
|
15
|
Merrick R, Chudasama D, Flannagan J, Campos-Matos I, Howard A, Bindra R, Gill ON, Dabrera G, Lamagni T. Differential impact of quarantine policies for recovered COVID-19 cases in England: a case cohort study of surveillance data, June to December 2020. BMC Public Health 2022; 22:1915. [PMID: 36241977 PMCID: PMC9562076 DOI: 10.1186/s12889-022-14254-x] [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: 02/21/2022] [Revised: 08/24/2022] [Accepted: 09/02/2022] [Indexed: 11/30/2022] Open
Abstract
Background From 12th March 2020, individuals in England were advised to quarantine in their home if a household member tested positive for SARS-CoV-2. A mandatory isolation period of 10 days was introduced on 28th September 2020 and applied to all individuals with COVID-19. We assessed the frequency, timing, and characteristics of recovered COVID-19 cases requiring subsequent quarantine episodes due to household re-exposure. Methods In this case cohort study, all laboratory-confirmed COVID-19 cases notified in England (29th June to 28th December 2020) were analysed to identify consecutive household case(s). Multivariable logistic regression was used to determine associations between case characteristics and need to quarantine following recent infection (within 28 days of diagnosis). Results Among 1,651,550 cases resident in private dwellings and Houses of Multiple Occupancy (HMOs), 744,548 (45.1%) were the only case in their home and 56,179 (3.4%) were succeeded by further household cases diagnosed within 11–28 days of their diagnosis. Of 1,641,412 cases arising in private homes, the likelihood of further household cases was highest for Bangladeshi (aOR = 2.20, 95% CI = 2.10–2.31) and Pakistani (aOR = 2.15, 95% CI = 2.08–2.22) individuals compared to White British, as well as among young people (17-24y vs. 25-64y; aOR = 1.19, 95% CI = 1.16–1.22), men (vs. women; aOR = 1.06, 95% CI = 1.04–1.08), London residents (vs. Yorkshire and Humber; aOR = 1.57, 95% CI = 1.52–1.63) and areas of high deprivation (IMD 1 vs. 10; aOR = 1.13, 95% CI = 1.09–1.19). Conclusion Policies requiring quarantine on re-exposure differentially impact some of the most disadvantaged populations. Quarantine exemption for recently recovered individuals could mitigate the socioeconomic impact of responses to COVID-19 or similar infectious disease outbreaks.
Collapse
Affiliation(s)
- Rachel Merrick
- COVID-19 National Epidemiology Cell, UK Health Security Agency, London, UK.
| | - Dimple Chudasama
- COVID-19 National Epidemiology Cell, UK Health Security Agency, London, UK
| | - Joe Flannagan
- COVID-19 National Epidemiology Cell, UK Health Security Agency, London, UK
| | - Ines Campos-Matos
- COVID-19 National Epidemiology Cell, UK Health Security Agency, London, UK
| | - Annabelle Howard
- COVID-19 International Cell, UK Health Security Agency, London, UK
| | - Renu Bindra
- COVID-19 National Guidance Cell, UK Health Security Agency, London, UK
| | - O Noël Gill
- COVID-19 National Guidance Cell, UK Health Security Agency, London, UK
| | - Gavin Dabrera
- COVID-19 National Epidemiology Cell, UK Health Security Agency, London, UK
| | - Theresa Lamagni
- COVID-19 National Epidemiology Cell, UK Health Security Agency, London, UK
| |
Collapse
|
16
|
Djuric O, Larosa E, Cassinadri M, Cilloni S, Bisaccia E, Pepe D, Vicentini M, Venturelli F, Bonvicini L, Giorgi Rossi P, Pezzotti P, Mateo Urdiales A, Bedeschi E. Surveillance, contact tracing and characteristics of SARS-CoV-2 transmission in educational settings in Northern Italy, September 2020 to April 2021. PLoS One 2022; 17:e0275667. [PMID: 36215304 PMCID: PMC9550042 DOI: 10.1371/journal.pone.0275667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 09/21/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The role of school contacts in the spread of the virus and the effectiveness of school closures in controlling the epidemic is still debated. We aimed to quantify the risk of transmission of SARS-CoV-2 in the school setting by type of school, characteristics of the index case and calendar period in the Province of Reggio Emilia (RE), Italy. The secondary aim was to estimate the speed of implementation of contact tracing. METHODS A population-based analysis of surveillance data on all COVID-19 cases occurring in RE, Italy, from 1 September 2020, to 4 April 2021, for which a school contact and/or exposure was suspected. An indicator of the delay in contact tracing was calculated as the time elapsed since the index case was determined to be positive and the date on which the swab test for classmates was scheduled (or most were scheduled). RESULTS Overall, 30,184 and 13,608 contacts among classmates and teachers/staff, respectively, were identified and were recommended for testing, and 43,214 (98.7%) underwent the test. Secondary transmission occurred in about 40% of the investigated classes, and the overall secondary case attack rate was 4%. This rate was slightly higher when the index case was a teacher but with almost no differences by type of school, and was stable during the study period. Speed of implementation of contact tracing increased during the study period, with the time from index case identification to testing of contacts being reduced from seven to three days. The ability to identify the possible source of infection in the index case also increased. CONCLUSIONS Despite the spread of the Alpha variant during the study period in RE, the secondary case attack rate remained stable from school reopening in September 2020 until the beginning of April 2021.
Collapse
Affiliation(s)
- Olivera Djuric
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Biomedical, Metabolic and Neural Sciences, Centre for Environmental, Nutritional and Genetic Epidemiology (CREAGEN), Public Health Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Elisabetta Larosa
- Public Health Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Mariateresa Cassinadri
- Public Health Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Cilloni
- Public Health Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Eufemia Bisaccia
- Public Health Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Davide Pepe
- Public Health Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Venturelli
- Public Health Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Laura Bonvicini
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Emanuela Bedeschi
- Public Health Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | |
Collapse
|
17
|
Fazekas-Pongor V, Szarvas Z, Nagy ND, Péterfi A, Ungvári Z, Horváth VJ, Mészáros S, Tabák AG. Different patterns of excess all-cause mortality by age and sex in Hungary during the 2 nd and 3 rd waves of the COVID-19 pandemic. GeroScience 2022; 44:2361-2369. [PMID: 35864376 PMCID: PMC9303845 DOI: 10.1007/s11357-022-00622-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/07/2022] [Indexed: 01/06/2023] Open
Abstract
It is well accepted that COVID-19-related mortality shows a strong age dependency. However, temporal changes in the age distribution of excess relative mortality between waves of the pandemic are less frequently investigated. We aimed to assess excess absolute mortality and the age-distribution of all-cause mortality during the second and third waves of the COVID-19 pandemic in Hungary compared to the same periods of non-pandemic years. Rate ratios for excess all-cause mortality with 95% confidence intervals and the number of excess deaths for the second (week 41 of 2020 through week 4 of 2021) and third waves (weeks 7-21 of 2021) of the COVID pandemic for the whole of Hungary compared to the same periods of the pre-pandemic years were estimated for 10-year age strata using Poisson regression. Altogether, 9771 (95% CI: 9554-9988) excess deaths were recorded during the second wave of the pandemic, while it was lower, 8143 (95% CI: 7953-8333) during the third wave. During the second wave, relative mortality peaked for ages 65-74 and 75-84 (RR 1.37, 95%CI 1.33-1.41, RR 1.38, 95%CI 1.34-1.42). Conversely, during the third wave, relative mortality peaked for ages 35-44 (RR 1.43, 95%CI 1.33-1.55), while those ≥65 had substantially lower relative risks compared to the second wave. The reduced relative mortality among the elderly during the third wave is likely a consequence of the rapidly increasing vaccination coverage of the elderly coinciding with the third wave. The hugely increased relative mortality of those 35-44 could point to non-biological causes, such as less stringent adherence to non-pharmaceutical measures in this population.
Collapse
Affiliation(s)
- Vince Fazekas-Pongor
- Department of Public Health, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest, H-1085, Hungary.
| | - Zsófia Szarvas
- Department of Public Health, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest, H-1085, Hungary
| | - Norbert D Nagy
- Department of Public Health, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest, H-1085, Hungary
| | - Anna Péterfi
- Department of Public Health, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest, H-1085, Hungary
| | - Zoltán Ungvári
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Departments of Translational Medicine and Public Health, Semmelweis University, Budapest, Hungary
- The Peggy and Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Viktor J Horváth
- Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest, H-1085, Hungary
| | - Szilvia Mészáros
- Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest, H-1085, Hungary
| | - Adam G Tabák
- Department of Public Health, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest, H-1085, Hungary
- Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest, H-1085, Hungary
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| |
Collapse
|
18
|
Pierce CA, Herold KC, Herold BC, Chou J, Randolph A, Kane B, McFarland S, Gurdasani D, Pagel C, Hotez P, Cobey S, Hensley SE. COVID-19 and children. Science 2022; 377:1144-1149. [PMID: 36074833 PMCID: PMC10324476 DOI: 10.1126/science.ade1675] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
There has been substantial research on adult COVID-19 and how to treat it. But how do severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections afflict children? The COVID-19 pandemic has yielded many surprises, not least that children generally develop less severe disease than older adults, which is unusual for a respiratory disease. However, some children can develop serious complications from COVID-19, such as multisystem inflammatory syndrome in children (MIS-C) and Long Covid, even after mild or asymptomatic COVID-19. Why this occurs in some and not others is an important question. Moreover, when children do contract COVID-19, understanding their role in transmission, especially in schools and at home, is crucial to ensuring effective mitigation measures. Therefore, in addition to nonpharmaceutical interventions, such as improved ventilation, there is a strong case to vaccinate children so as to reduce possible long-term effects from infection and to decrease transmission. But questions remain about whether vaccination might skew immune responses to variants in the long term. As the experts discuss below, more is being learned about these important issues, but much more research is needed to understand the long-term effects of COVID-19 in children.
Collapse
Affiliation(s)
- Carl A Pierce
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Kevan C Herold
- Departments of Immunobiology and of Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Betsy C Herold
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, USA
| | - Janet Chou
- Division of Immunology, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Adrienne Randolph
- Division of Immunology, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Anaesthesia, Harvard Medical School, Boston, MA, USA
| | - Binita Kane
- Manchester University Foundation Trust and School of Biological Sciences, University of Manchester, Manchester, UK
| | | | - Deepti Gurdasani
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Christina Pagel
- Clinical Operational Research Unit, University College London, London, UK
| | - Peter Hotez
- Texas Children's Hospital Center for Vaccine Development, Departments of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA
- Department of Biology, Baylor University, Waco, TX, USA
- Hagler Institute for Advanced Study, Texas A&M University, College Station, TX, USA
- Scowcroft Institute of International Affairs, Texas A&M University, College Station, TX, USA
- James A. Baker III Institute for Public Policy, Rice University, Houston, TX, USA
- School of Public Health, University of Texas, Houston, TX, USA
| | - Sarah Cobey
- Department of Ecology and Evolution, University of Chicago, Illinois, USA
| | - Scott E Hensley
- Department of Microbiology, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
19
|
Nenna R, Zeric H, Petrarca L, Mancino E, Midulla F. Weighing policymaking: A narrative review of school closures as COVID-19 pandemic-mitigation strategies. Pediatr Pulmonol 2022; 57:1982-1989. [PMID: 34894111 DOI: 10.1002/ppul.25787] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/30/2021] [Accepted: 12/07/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION In the era of data-driven decision-making, unacceptable haziness, and inconsistency surrounds the yearlong scientific and public debate on the school closure policy in the coronavirus disease-2019 (COVID-19) pandemic mitigation efforts. AIM The present literature review stems out of the need for a clear scaffold collecting in one place all current evidence, as well as helping to organize incoming future evidence, concerning both the role of schools in driving the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) community spread and the cost-effectiveness of school closure in containing such spread. METHODS References for this review were initially identified through searches of PubMed, Scopus, and Cochrane Library for articles published from March 2020 to March 2021 by the use of key terms "Schools," "COVID-19," "pandemic," "clusters," "outbreak," and "seroprevalence," selecting all articles from 2020 to 2021 with full-text availability. A further search was undertaken by screening citations of articles found in the original search and through Google Scholar and ResearchGate. RESULTS Overall, evidence shows that opening schools and keeping them open in the context of the SARS-CoV-2 pandemic is possible, although behaviorally challenging and unfeasible if educational facilities or testing services are inadequate. Contrary to other respiratory viruses, children are not chief targets of SARS-CoV-2 infection, transmission, and disease. It also appears that the second wave of the SARS-CoV-2 virus spread in the WHO European region has been unrelated to school re-opening. CONCLUSIONS A fact-based understanding of what is currently known on such a consequential policy is required to provide a basis of evidence for advocacy of either school closure or school opening at times of high-intensity community transmission of SARS-CoV-2.
Collapse
Affiliation(s)
- Raffaella Nenna
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Hana Zeric
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Laura Petrarca
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Enrica Mancino
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Fabio Midulla
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
20
|
Gurdasani D, Pagel C, McKee M, Michie S, Greenhalgh T, Yates C, Scally G, Ziauddeen H. Covid-19 in the UK: policy on children and schools. BMJ : BRITISH MEDICAL JOURNAL 2022. [DOI: 10.1136/bmj-2022-071234] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
21
|
胡 亚, 姚 开. Clinical characteristics and epidemiological significance of coronavirus disease 2019 in children and adolescents. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:846-852. [PMID: 36036120 PMCID: PMC9425860 DOI: 10.7499/j.issn.1008-8830.2205026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 06/09/2022] [Indexed: 11/05/2022]
Abstract
The epidemic of coronavirus disease 2019 (COVID-19) started in late December 2019, and spread rapidly throughout the world. In March 2020, the World Health Organization (WHO) declared global epidemic of COVID-19. According to the American Academy of Pediatrics, nearly 13 million children have been diagnosed with COVID-19 since the outbreak. In general, children and teens have milder symptoms and fewer deaths from COVID-19 than adults. Understanding the symptoms, infectivity, and transmission patterns of COVID-19 in children and adolescents is of great significance for timely identifying suspected patients and developing effective control measures. Considering that some children will not be vaccinated for quite some time in the future, it is more important to improve the understanding of the clinical and epidemiological significance of COVID-19 in children and adolescents. This article summarizes the current understanding of the clinical manifestations and epidemiological significance of COVID-19 in children and adolescents to provide a reference for clinical diagnosis and treatment and the formulation of epidemic prevention and control strategies in children's gathering institutions such as kindergartens and schools.
Collapse
|
22
|
Af Geijerstam A, Mehlig K, Hunsberger M, Åberg M, Lissner L. Children in the household and risk of severe COVID-19 during the first three waves of the pandemic: a prospective registry-based cohort study of 1.5 million Swedish men. BMJ Open 2022; 12:e063640. [PMID: 35953248 PMCID: PMC9378946 DOI: 10.1136/bmjopen-2022-063640] [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] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To investigate whether Swedish men living with children had elevated risk for severe COVID-19 or infection with SARS-CoV-2 during the first three waves of the pandemic. DESIGN Prospective registry-based cohort study. PARTICIPANTS 1 557 061 Swedish men undergoing military conscription between 1968 and 2005 at a mean age of 18.3 (SD 0.73) years. MAIN OUTCOME MEASURES Infection with SARS-CoV-2 and hospitalisation due to COVID-19 from March 2020 to September 2021. RESULTS There was a protective association between preschool children at home and hospitalisation due to COVID-19 during the first and third waves compared with only older or no children at all, with ORs (95% CIs) 0.63 (0.46 to 0.88) and 0.75 (0.68 to 0.94) respectively. No association was observed for living with children 6-12 years old, but for 13-17 years old, the risk increased. Age in 2020 did not explain these associations. Further adjustment for socioeconomic and health factors did not attenuate the results. Exposure to preschool children also had a protective association with testing positive with SARS-CoV-2, with or without hospitalisation, OR=0.91 (95% CI 0.89 to 0.93), while living with children of other ages was associated with increased odds of infection. CONCLUSIONS Cohabiting with preschool children was associated with reduced risk for severe COVID-19. Living with school-age children between 6 and 12 years had no association with severe COVID-19, but sharing the household with teenagers and young adults was associated with elevated risk. Our results are of special interest since preschools and compulsory schools (age 6-15 years) in Sweden did not close in 2020.
Collapse
Affiliation(s)
- Agnes Af Geijerstam
- School of Public Health and Community Medicine, University of Gothenburg Institute of Medicine, Goteborg, Sweden
| | - Kirsten Mehlig
- School of Public Health and Community Medicine, University of Gothenburg Institute of Medicine, Goteborg, Sweden
| | - Monica Hunsberger
- School of Public Health and Community Medicine, University of Gothenburg Institute of Medicine, Goteborg, Sweden
| | - Maria Åberg
- School of Public Health and Community Medicine, University of Gothenburg Institute of Medicine, Goteborg, Sweden
- Regionhälsan, Region Västra Götaland, Gothenburg, Sweden
| | - Lauren Lissner
- School of Public Health and Community Medicine, University of Gothenburg Institute of Medicine, Goteborg, Sweden
| |
Collapse
|
23
|
Husby A, Corn G, Grove Krause T. SARS-CoV-2 infection in households with and without young children: Nationwide cohort study, Denmark, 27 February 2020 to 26 February 2021. EURO SURVEILLANCE : BULLETIN EUROPEEN SUR LES MALADIES TRANSMISSIBLES = EUROPEAN COMMUNICABLE DISEASE BULLETIN 2022; 27. [PMID: 35959688 PMCID: PMC9373601 DOI: 10.2807/1560-7917.es.2022.27.32.2101096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BackgroundInfections with seasonally spreading coronaviruses are common among young children during winter months in the northern hemisphere; the immunological response lasts around a year. However, it is not clear if living with young children changes the risk of SARS-CoV-2 infection among adults.AimOur aim was to investigate the association between living in a household with younger children and the risk of SARS-CoV-2 infections and hospitalisation.MethodsIn a nationwide cohort study, we followed all adults in Denmark aged 18 to 60 years from 27 February 2020 to 26 February 2021. Hazard ratios of SARS-CoV-2 infection by number of 10 months to 5 year-old children in the household were estimated using Cox regression adjusted for adult age, sex and other potential confounders. In a sensitivity analysis, we investigated the effect of the children's age.ResultsAmong 450,007 adults living in households with young children, 19,555 were tested positive for SARS-CoV-2, while among 2,628,500 adults without young children in their household, 110,069 were tested positive for SARS-CoV-2 (adjusted hazard ratio (aHR) = 1.10; 95% confidence interval (CI): 1.08-1.12). Among adults with young children, 620 were hospitalised with SARS-CoV-2, while 4,002 adults without children were hospitalised with SARS-CoV-2 (aHR = 0.97; 95% CI: 0.88-1.08). Sensitivity analyses found that an increasing number of younger children substantially increased the risk of SARS-CoV-2 infection but not hospitalisation.ConclusionLiving in a household with young children was associated with a small increased risk of SARS-CoV-2 infection.
Collapse
Affiliation(s)
- Anders Husby
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom.,Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Giulia Corn
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Tyra Grove Krause
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| |
Collapse
|
24
|
Blankenberger J, Kaufmann M, Albanese E, Amati R, Anker D, Camerini AL, Chocano-Bedoya P, Cullati S, Cusini A, Fehr J, Harju E, Kohler P, Kriemler S, Michel G, Rodondi N, Rodondi PY, Speierer A, Tancredi S, Puhan MA, Kahlert CR. Is living in a household with children associated with SARS-CoV-2 seropositivity in adults? Results from the Swiss national seroprevalence study Corona Immunitas. BMC Med 2022; 20:233. [PMID: 35725472 PMCID: PMC9207841 DOI: 10.1186/s12916-022-02431-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 06/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We aimed to determine whether living in a household with children is associated with SARS-CoV-2 seropositivity in adults and investigated interacting factors that may influence this association. METHODS SARS-CoV-2 serology testing was performed in randomly selected individuals from the general population between end of October 2020 and February 2021 in 11 cantons in Switzerland. Data on sociodemographic and household characteristics, employment status, and health-related history was collected using questionnaires. Multivariable logistic regression was used to examine the association of living with children <18 years of age (number, age group) and SARS-CoV-2 seropositivity. Further, we assessed the influence of reported non-household contacts, employment status, and gender. RESULTS Of 2393 working age participants (18-64 years), 413 (17.2%) were seropositive. Our results suggest that living with children and SARS-CoV-2 seropositivity are likely to be associated (unadjusted odds ratio (OR) 1.22, 95% confidence interval [0.98-1.52], adjusted OR 1.25 [0.99-1.58]). A pattern of a positive association was also found for subgroups of children aged 0-11 years (OR 1.21 [0.90-1.60]) and 12-17 years (OR 1.14 [0.78-1.64]). Odds of seropositivity were higher with more children (OR 1.14 per additional child [1.02-1.27]). Men had higher risk of SARS-CoV-2 infection when living with children than women (interaction: OR 1.74 [1.10-2.76]). CONCLUSIONS In adults from the general population living with children seems associated with SARS-CoV-2 seropositivity. However, child-related infection risk is not the same for every subgroup and depends on factors like gender. Further factors determining child-related infection risk need to be identified and causal links investigated. TRIAL REGISTRATION https://www.isrctn.com/ISRCTN18181860 .
Collapse
Affiliation(s)
- Jacob Blankenberger
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Marco Kaufmann
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Emiliano Albanese
- Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Rebecca Amati
- Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Daniela Anker
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Anne-Linda Camerini
- Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Patricia Chocano-Bedoya
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.,Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Stéphane Cullati
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland.,Department of Readaptation and Geriatrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Alexia Cusini
- Division of Infectious Diseases, Kantonsspital Graubünden, Chur, Switzerland
| | - Jan Fehr
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland.,Division of Infectious Disease & Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Erika Harju
- Department of Health Sciences and Medicine, University of Luzern, Luzern, Switzerland
| | - Philipp Kohler
- Division of Infectious Diseases, Kantonsspital Graubünden, Chur, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Gisela Michel
- Department of Health Sciences and Medicine, University of Luzern, Luzern, Switzerland
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.,Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Pierre-Yves Rodondi
- Institute of Family Medicine (IMF), University of Fribourg, Fribourg, Switzerland
| | - Alexandre Speierer
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.,Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stefano Tancredi
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Christian R Kahlert
- Children's Hospital of Eastern Switzerland, Claudiusstrasse 6, 9006, St. Gallen, Switzerland.
| | | |
Collapse
|
25
|
Jannuzzi P, Panza GA. The Association between Contact with Children and the Clinical Course of COVID-19. Epidemiol Infect 2022; 150:1-23. [PMID: 35249579 PMCID: PMC8943224 DOI: 10.1017/s0950268822000474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/11/2022] [Accepted: 03/01/2022] [Indexed: 11/13/2022] Open
Abstract
We examined the association between contact with children and the clinical course of COVID-19 among COVID-19-positive adult patients. Participants completed a survey to assess demographics, medical information related to their COVID-19 diagnosis, contact with children at home and at the workplace. Patients were aged 45.68 ± 14.38 years, mostly female (72.1%), 842 were not hospitalized and 167 were hospitalized. At home, there were no differences between groups for the number of child contact hours or total child hours (hours × number of children) per week (P s > 0.05). The number of children at home was greater among patients not hospitalized (P < 0.05), however this was no longer significant after controlling for covariates (P > 0.05). At the workplace, there were no differences between groups (all P s > 0.05). Sub-group analysis found the proportion of patients that were treated in the intensive care unit (ICU) was greater among patients with no child contact (P < 0.05). A secondary analysis found that patients with no child contact had an increased likelihood of thromboembolism (P < 0.05) and a trend towards more overall COVID-19-related complications (P = 0.076). Overall, an association between contact with children and hospitalization was not found when adjusting for covariates. Sub-group analysis indicated a possible protective effect for more severe disease; however, these findings need further study.
Collapse
Affiliation(s)
- Peter Jannuzzi
- Integrated Care Partners, Hartford HealthCare, Hartford, CT, USA
- Unionville Pediatrics, LLC, Unionville, CT, USA
| | | |
Collapse
|
26
|
Brüssow H. COVID-19 and children: medical impact and collateral damage. Microb Biotechnol 2022; 15:1035-1049. [PMID: 35182108 PMCID: PMC8966019 DOI: 10.1111/1751-7915.14018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 02/02/2022] [Indexed: 12/23/2022] Open
Abstract
Children mostly experience mild SARS‐CoV‐2 infections, but the extent of paediatric COVID‐19 disease differs between geographical regions and the distinct pandemic waves. Not all infections in children are mild, some children even show a strong inflammatory reaction resulting in a multisystem inflammatory syndrome. The assessments of paediatric vaccination depend on the efficacy of protection conferred by vaccination, the risk of adverse reactions and whether children contribute to herd immunity against COVID‐19. Children were also the target of consequential public health actions such as school closure which caused substantial harm to children (educational deficits, sociopsychological problems) and working parents. It is, therefore, important to understand the transmission dynamics of SARS‐CoV‐2 infections by children to assess the efficacy of school closures and paediatric vaccination. The societal restrictions to contain the COVID‐19 pandemic had additional negative effects on children’s health, such as missed routine vaccinations, nutritional deprivation and lesser mother–child medical care in developing countries causing increased child mortality as a collateral damage. In this complex epidemiological context, it is important to have an evidence‐based approach to public health approaches. The present review summaries pertinent published data on the role of children in the pandemic, whether they are drivers or followers of the infection chains and whether they are (after elderlies) major sufferers or mere bystanders of the COVID‐19 pandemic. The present review summaries pertinent published data on the role of children in the pandemic, whether they are drivers or followers of the infection chains and whether they are (after elderlies) major sufferers or mere bystanders of the COVID‐19 pandemic.
Collapse
Affiliation(s)
- Harald Brüssow
- Department of Biosystems, Laboratory of Gene Technology, KU Leuven, Leuven, Belgium
| |
Collapse
|
27
|
Risk factors for territorial spreading of SARS-CoV-2 in North-eastern Italy. Sci Rep 2022; 12:2214. [PMID: 35140254 PMCID: PMC8828836 DOI: 10.1038/s41598-022-05368-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 12/09/2021] [Indexed: 11/09/2022] Open
Abstract
The impact of specific risk factors for SARS-CoV-2 infection spread was investigated among the 215 municipalities in north-eastern Italy. SARS-CoV-2 incidence was gathered fortnightly since April 1, 2020 (21 consecutive periods) to depict three indicators of virus spreading from hierarchical Bayesian maps. Eight explanatory features of the municipalities were obtained from official databases (urbanicity, population density, active population on total, hosting schools or nursing homes, proportion of commuting workers or students, and percent of > 75 years population on total). Multivariate Odds Ratios (ORs), and corresponding 95% Confidence Intervals (CIs), quantified the associations between municipality features and virus spreading. The municipalities hosting nursing homes showed an excess of positive tested cases (OR = 2.61, ever versus never, 95% CI 1.37;4.98), and displayed repeated significant excesses: OR = 5.43, 3-4 times versus 0 (95% CI 1.98;14.87) and OR = 6.10, > 5 times versus 0 (95% CI 1.60;23.30). Municipalities with an active population > 50% were linked to a unique statistical excess of cases (OR = 3.06, 1 time versus 0, 95% CI 1.43;6.57) and were inversely related to repeated statistically significant excesses (OR = 0.25, > 5 times versus 0; 95% CI 0.06;0.98). We highlighted specific municipality features that give clues about SARS-CoV-2 prevention.
Collapse
|
28
|
Harper G, Stables D, Simon P, Ahmed Z, Smith K, Robson J, Dezateux C. Evaluation of the ASSIGN open-source deterministic address-matching algorithm for allocating unique property reference numbers to general practitioner-recorded patient addresses. Int J Popul Data Sci 2021; 6:1674. [PMID: 34970633 PMCID: PMC8678979 DOI: 10.23889/ijpds.v6i1.1674] [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] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Linking places to people is a core element of the UK government's geospatial strategy. Matching patient addresses in electronic health records to their Unique Property Reference Numbers (UPRNs) enables spatial linkage for research, innovation and public benefit. Available algorithms are not transparent or evaluated for use with addresses recorded by health care providers. OBJECTIVES To describe and quality assure the open-source deterministic ASSIGN address-matching algorithm applied to general practitioner-recorded patient addresses. METHODS Best practice standards were used to report the ASSIGN algorithm match rate, sensitivity and positive predictive value using gold-standard datasets from London and Wales. We applied the ASSIGN algorithm to the recorded addresses of a sample of 1,757,018 patients registered with all general practices in north east London. We examined bias in match results for the study population using multivariable analyses to estimate the likelihood of an address-matched UPRN by demographic, registration, and organisational variables. RESULTS We found a 99.5% and 99.6% match rate with high sensitivity (0.999,0.998) and positive predictive value (0.996,0.998) for the Welsh and London gold standard datasets respectively, and a 98.6% match rate for the study population.The 1.4% of the study population without a UPRN match were more likely to have changed registered address in the last 12 months (match rate: 95.4%), be from a Chinese ethnic background (95.5%), or registered with a general practice using the SystmOne clinical record system (94.4%). Conversely, people registered for more than 6.5 years with their general practitioner were more likely to have a match (99.4%) than those with shorter registration durations. CONCLUSIONS ASSIGN is a highly accurate open-source address-matching algorithm with a high match rate and minimal biases when evaluated against a large sample of general practice-recorded patient addresses. ASSIGN has potential to be used in other address-based datasets including those with information relevant to the wider determinants of health.
Collapse
Affiliation(s)
- Gill Harper
- Clinical Effectiveness Group, Centre for Primary Care, Wolfson Institute of Population Health, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London
| | | | | | - Zaheer Ahmed
- Clinical Effectiveness Group, Centre for Primary Care, Wolfson Institute of Population Health, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London
| | - Kelvin Smith
- Clinical Effectiveness Group, Centre for Primary Care, Wolfson Institute of Population Health, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London
| | - John Robson
- Clinical Effectiveness Group, Centre for Primary Care, Wolfson Institute of Population Health, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London
| | - Carol Dezateux
- Clinical Effectiveness Group, Centre for Primary Care, Wolfson Institute of Population Health, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London
| |
Collapse
|
29
|
Wood R, Thomson E, Galbraith R, Gribben C, Caldwell D, Bishop J, Reid M, Shah ASV, Templeton K, Goldberg D, Robertson C, Hutchinson SJ, Colhoun HM, McKeigue PM, McAllister DA. Sharing a household with children and risk of COVID-19: a study of over 300 000 adults living in healthcare worker households in Scotland. Arch Dis Child 2021; 106:1212-1217. [PMID: 33737319 PMCID: PMC7985971 DOI: 10.1136/archdischild-2021-321604] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Children are relatively protected from COVID-19, due to a range of potential mechanisms. We investigated if contact with children also affords adults a degree of protection from COVID-19. DESIGN Cohort study based on linked administrative data. SETTING Scotland. STUDY POPULATION All National Health Service Scotland healthcare workers and their household contacts as of March 2020. MAIN EXPOSURE Number of young children (0-11 years) living in the participant's household. MAIN OUTCOMES COVID-19 requiring hospitalisation, and any COVID-19 (any positive test for SARS-CoV-2) in adults aged ≥18 years between 1 March and 12 October 2020. RESULTS 241 266, 41 198, 23 783 and 3850 adults shared a household with 0, 1, 2 and 3 or more young children, respectively. Over the study period, the risk of COVID-19 requiring hospitalisation was reduced progressively with increasing numbers of household children-fully adjusted HR (aHR) 0.93 per child (95% CI 0.79 to 1.10). The risk of any COVID-19 was similarly reduced, with the association being statistically significant (aHR per child 0.93; 95% CI 0.88 to 0.98). After schools reopened to all children in August 2020, no association was seen between exposure to young children and risk of any COVID-19 (aHR per child 1.03; 95% CI 0.92 to 1.14). CONCLUSION Between March and October 2020, living with young children was associated with an attenuated risk of any COVID-19 and COVID-19 requiring hospitalisation among adults living in healthcare worker households. There was no evidence that living with young children increased adults' risk of COVID-19, including during the period after schools reopened.
Collapse
Affiliation(s)
- Rachael Wood
- Public Health Scotland, Edinburgh, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Emma Thomson
- MRC Centre for Virus Research, University of Glasgow, Glasgow, UK
| | | | | | | | | | | | - Anoop S V Shah
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Kate Templeton
- Department of Medical Microbiology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | | | | | | | - Helen M Colhoun
- Public health Scotland, Glasgow, UK
- Institute of Genetics and Molecular Medicine, The University of Edinburgh, Edinburgh, UK
| | | | - David A McAllister
- Public health Scotland, Glasgow, UK
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| |
Collapse
|
30
|
Genecand C, Mongin D, Koegler F, Lebowitz D, Regard S, Falcone JL, Nehme M, Braillard O, Grira M, Joubert D, Chopard P, Delaporte E, Stirnemann J, Guessous I, Tardin A, Courvoisier DS. Cohort profile: Actionable Register of Geneva Outpatients and inpatients with SARS-CoV-2 (ARGOS). BMJ Open 2021; 11:e048946. [PMID: 34848509 PMCID: PMC8634627 DOI: 10.1136/bmjopen-2021-048946] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE The Actionable Register of Geneva Outpatients and inpatients with SARS-CoV-2 (ARGOS) is an ongoing prospective cohort created by the Geneva Directorate of Health. It consists of an operational database compiling all SARS-CoV-2 test results recorded in the Geneva area since late February 2020. This article aims at presenting this comprehensive cohort, in light of some of the varying public health measures in Geneva, Switzerland, since March 2020. PARTICIPANTS As of 1 June 2021, the database included 360 525 patients, among which 65 475 had at least one positive test result for SARS-CoV-2. Among all positive patients, 37.6% were contacted only once, 10.6% had one follow-up call, 8.5% had two and 27.7% had three or more follow-up calls. Participation rate among positive patients is 94%. Data collection is ongoing. FINDINGS TO DATE ARGOS data illustrates the magnitude of COVID-19 pandemic in Geneva, Switzerland, and details a variety of population factors and outcomes. The content of the cohort includes demographic data, comorbidities and risk factors for poor clinical outcome, self-reported COVID-19 symptoms, environmental and socioeconomic factors, prospective and retrospective contact tracing data, travel quarantine data and deaths. The registry has already been used in several publications focusing on symptoms and long COVID-19, infection fatality rate and re-infection. FUTURE PLANS The data of this large real-world registry provides a valuable resource for various types of research, such as clinical research, epidemiological research or policy assessment as it illustrates the impact of public health policies and overall disease burden of COVID-19.
Collapse
Affiliation(s)
- Camille Genecand
- Division of General Surgeon, Republic and Canton of Geneva Directorate of Health, Geneva, Switzerland
- Division of Primary Care Medicine, Department of Community Medicine and Primary Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Denis Mongin
- Division of General Surgeon, Republic and Canton of Geneva Directorate of Health, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Flora Koegler
- Department of Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Dan Lebowitz
- Infection Control Program, Geneva University Hospitals, Geneva, Switzerland
| | - Simon Regard
- Division of General Surgeon, Republic and Canton of Geneva Directorate of Health, Geneva, Switzerland
- Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Jean-Luc Falcone
- Department of Informatics, University of Geneva, Geneva, Switzerland
| | - Mayssam Nehme
- Division of Primary Care Medicine, Department of Community Medicine and Primary Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Olivia Braillard
- Division of Primary Care Medicine, Department of Community Medicine and Primary Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Marwène Grira
- Division of Primary Care Medicine, Department of Community Medicine and Primary Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Dominique Joubert
- Quality of Care Service, Geneva University Hospitals, Geneva, Switzerland
| | - Pierre Chopard
- Quality of Care Service, Geneva University Hospitals, Geneva, Switzerland
| | - Elisabeth Delaporte
- Division of General Surgeon, Republic and Canton of Geneva Directorate of Health, Geneva, Switzerland
| | - Jérôme Stirnemann
- Department of Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Idris Guessous
- Division of Primary Care Medicine, Department of Community Medicine and Primary Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Aglaé Tardin
- Division of General Surgeon, Republic and Canton of Geneva Directorate of Health, Geneva, Switzerland
| | - Delphine S Courvoisier
- Division of General Surgeon, Republic and Canton of Geneva Directorate of Health, Geneva, Switzerland
- Quality of Care Service, Geneva University Hospitals, Geneva, Switzerland
| |
Collapse
|
31
|
Head JR, Andrejko KL, Remais JV. Model-based assessment of SARS-CoV-2 Delta variant transmission dynamics within partially vaccinated K-12 school populations. LANCET REGIONAL HEALTH. AMERICAS 2021; 5:100133. [PMID: 34849504 PMCID: PMC8614621 DOI: 10.1016/j.lana.2021.100133] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND We examined school reopening policies amidst ongoing transmission of the highly transmissible Delta variant, accounting for vaccination among individuals ≥12 years. METHODS We collected data on social contacts among school-aged children in the California Bay Area and developed an individual-based transmission model to simulate transmission of the Delta variant of SARS-CoV-2 in schools. We evaluated the additional infections in students and teachers/staff resulting over a 128-day semester from in-school instruction compared to remote instruction when various NPIs (mask use, cohorts, and weekly testing of students/teachers) were implemented, across various community-wide vaccination coverages (50%, 60%, 70%), and student (≥12 years) and teacher/staff vaccination coverages (50% - 95%). FINDINGS At 70% vaccination coverage, universal masking reduced infections by >57% among students. Masking plus 70% vaccination coverage enabled achievement of <50 excess cases per 1,000 students/teachers, but stricter risk tolerances, such as <25 excess infections per 1,000 students/teachers, required a cohort approach in elementary and middle school populations. In the absence of NPIs, increasing the vaccination coverage of community members from 50% to 70% or elementary teachers from 70% to 95% reduced the excess rate of infection among elementary school students attributable to school transmission by 24% and 37%, respectively. INTERPRETATIONS Amidst Delta variant circulation, we found that schools are not inherently low risk, yet can be made so with high community vaccination coverages and masking. Vaccination of adults protects unvaccinated children. FUNDING National Science Foundation grant no. 2032210; National Institutes of Health grant nos. R01AI125842 and R01AI148336; MIDAS Coordination Center (MIDASSUP2020-4).
Collapse
Affiliation(s)
- Jennifer R. Head
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Kristin L. Andrejko
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Justin V. Remais
- Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA,Corresponding author: Justin V. Remais, Ph.D., 2121 Berkeley Way West #5301, Berkeley, CA 94720
| |
Collapse
|
32
|
Sorg AL, Kaiser V, Becht S, Simon A, von Kries R. Impact of School Closures on the Proportion of Children in the COVID-19 Pandemic: An Example from the Winter Lockdown in Germany. KLINISCHE PADIATRIE 2021; 234:81-87. [PMID: 34798670 DOI: 10.1055/a-1594-2818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND In addition to widely used basic hygiene measures in school, school closures are applied to contain SARS-CoV-2 spread, although the effect on the pandemic is unclear. We proposed a simple approach to disentangle the effect of school closures from other lockdown measures on the pandemic course based on publicly available data in Germany. METHODS We used data on the number of SARS-CoV-2 cases from the onset of the pandemic to 14th April 2021. We compared the proportion of children (5-14 years old) in all cases prior to the lockdown measures, including school closure, to that during a ten-week lockdown in Germany. The total number of paediatric cases occurring during lockdown was compared to the number expected in absence of school closures. The latter was calculated based on the actual weekly number of all cases and the pre-lockdown proportion of paediatric cases. RESULTS The proportion of children in all cases was 2.3 percentage points lower at the nadir than the proportion before the lockdown. The estimated total number of paediatric cases prevented by school closures was estimated at 13,246 amounting to 24% of the expected cases in absence of school closures. CONCLUSION School closure during the winter lockdown reduced the number of expected SARS-CoV-2 cases in children in absence of school closures. The contribution of these prevented cases to the total population incidence is small. These data might provide the basis to model the effect of school closures in addition to basic hygiene measures on the course of the COVID-19 pandemic.
Collapse
Affiliation(s)
- Anna-Lisa Sorg
- Institute for Social Pediatrics and Adolescent Medicine, Paediatric Epidemiology, Ludwig Maximilians University Munich, Munich
| | - Veronika Kaiser
- Institute for Social Pediatrics and Adolescent Medicine, Paediatric Epidemiology, Ludwig Maximilians University Munich, Munich
| | - Selina Becht
- Institute for Social Pediatrics and Adolescent Medicine, Paediatric Epidemiology, Ludwig Maximilians University Munich, Munich
| | - Arne Simon
- Paediatric Hematology and Oncology, Children's Hospital Medical Center, Homburg, Deutschland
| | - Rüdiger von Kries
- Institute for Social Pediatrics and Adolescent Medicine, Paediatric Epidemiology, Ludwig Maximilians University Munich, Munich
| |
Collapse
|
33
|
Lopes-Júnior LC, Siqueira PC, Maciel ELN. School reopening and risks accelerating the COVID-19 pandemic: A systematic review and meta-analysis protocol. PLoS One 2021; 16:e0260189. [PMID: 34788344 PMCID: PMC8598030 DOI: 10.1371/journal.pone.0260189] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 11/02/2021] [Indexed: 12/24/2022] Open
Abstract
Background One of the most recent concerns of this pandemic regards the role of schools reopening in disease transmission, as well as the impact of keeping schools closed. While school reopening seems critical for the education and mental health of children, adolescents, and adults, so far the literature has not systematically reached a consensus whether to recommend the return to schools in a way that would be safe for students and staff. Objective To synthesize and critically evaluate the scientific evidence on the potential risk of accelerating the Coronavirus Disease 2019 (COVID-19) pandemic among children, adolescents, young adults, and adults with school reopening. Methods This systematic review and meta-analysis protocol was elaborated following the PRISMA-P. We will include all observational study designs, which report on the potential risk of accelerating the COVID-2019 pandemic with school reopening. Electronic databases included were MEDLINE/PubMed, Cochrane Library, EMBASE, Web of Science, SCOPUS and CNKI. Additional sources will be also retrieved, including Clinical trials.gov-NIH, The British Library, Pro Quest Dissertations Database, Public Health Gray Literature Sources and Health Evidence, Google Scholar, and pre-prints [medRXiv]. No restriction to language or date will be used as search strategy. In an independently manner, two investigators will select studies, perform data extraction, as well as perform a critical appraisal of the risk of bias and overall quality of the selected observational studies, based on their designs. The heterogeneity among the studies will be assessed using the I2 statistic test. According to the results of this test, we will verify whether a meta-analysis is feasible. If feasibility is confirmed, a random-effect model analysis will be carried out. For data analysis, the calculation of the pooled effect estimates will consider a 95% CI and alpha will be set in 0.05 using the R statistical software, v.4.0.4. In addition, we will rate the certainty of evidence based on Cochrane methods and in accordance with the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Expected results This systematic review and meta-analysis will provide better insights into safety in the return to school in the context of the COVID-2019 pandemic, at a time when vaccination advances unevenly in several countries around the world. Hence, consistent data and robust evidence will be provided to help decision-makers and stakeholders in the current pandemic scenario. PROSPERO registration number CRD42021265283; https://clinicaltrials.gov.
Collapse
Affiliation(s)
- Luís Carlos Lopes-Júnior
- Health Sciences Center at the Federal University of Espírito Santo (UFES), Vitoria, Espírito Santo, Brazil
- * E-mail:
| | | | - Ethel Leonor Noia Maciel
- Health Sciences Center at the Federal University of Espírito Santo (UFES), Vitoria, Espírito Santo, Brazil
| |
Collapse
|
34
|
Abstract
[Figure: see text].
Collapse
Affiliation(s)
- Shamez N Ladhani
- Immunisation and Countermeasures Division, Public Health England, London, UK.,Paediatric Infectious Diseases Research Group, St. George's University of London, London, UK. The members of the sKIDs Investigation Team are provided in the supplementary materials
| | | |
Collapse
|
35
|
Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection at the time of birth in England: national cohort study. Am J Obstet Gynecol 2021; 225:522.e1-522.e11. [PMID: 34023315 PMCID: PMC8135190 DOI: 10.1016/j.ajog.2021.05.016] [Citation(s) in RCA: 149] [Impact Index Per Article: 49.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/13/2021] [Accepted: 05/14/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Some studies have suggested that women with SARS-CoV-2 infection during pregnancy are at increased risk of adverse pregnancy and neonatal outcomes, but these associations are still not clear. OBJECTIVE This study aimed to determine the association between SARS-CoV-2 infection at the time of birth and maternal and perinatal outcomes. STUDY DESIGN This is a population-based cohort study in England. The inclusion criteria were women with a recorded singleton birth between May 29, 2020, and January 31, 2021, in a national database of hospital admissions. Maternal and perinatal outcomes were compared between pregnant women with a laboratory-confirmed SARS-CoV-2 infection recorded in the birth episode and those without. Study outcomes were fetal death at or beyond 24 weeks' gestation (stillbirth), preterm birth (<37 weeks' gestation), small for gestational age infant (small for gestational age; birthweight at the <tenth centile), preeclampsia or eclampsia, induction of labor, mode of birth, specialist neonatal care, composite neonatal adverse outcome indicator, maternal and neonatal length of hospital stay after birth (3 days or more), and 28-day neonatal and 42-day maternal hospital readmission. Adjusted odds ratios and their 95% confidence interval for the association between SARS-CoV-2 infection status and outcomes were calculated using logistic regression, adjusting for maternal age, ethnicity, parity, preexisting diabetes mellitus, preexisting hypertension, and socioeconomic deprivation measured using the Index of Multiple Deprivation 2019. Models were fitted with robust standard errors to account for hospital-level clustering. The analysis of the neonatal outcomes was repeated for those born at term (≥37 weeks' gestation) because preterm birth has been reported to be more common in pregnant women with SARS-CoV-2 infection. RESULTS The analysis included 342,080 women, of whom 3527 had laboratory-confirmed SARS-CoV-2 infection. Laboratory-confirmed SARS-CoV-2 infection was more common in women who were younger, of non-White ethnicity, primiparous, or residing in the most deprived areas or had comorbidities. Fetal death (adjusted odds ratio, 2.21; 95% confidence interval, 1.58-3.11; P<.001) and preterm birth (adjusted odds ratio, 2.17; 95% confidence interval, 1.96-2.42; P<.001) occurred more frequently in women with SARS-CoV-2 infection than those without. The risk of preeclampsia or eclampsia (adjusted odds ratio, 1.55; 95% confidence interval, 1.29-1.85; P<.001), birth by emergency cesarean delivery (adjusted odds ratio, 1.63; 95% confidence interval, 1.51-1.76; P<.001), and prolonged admission after birth (adjusted odds ratio, 1.57; 95% confidence interval, 1.44-1.72; P<.001) were significantly higher for women with SARS-CoV-2 infection than those without. There were no significant differences (P>.05) in the rate of other maternal outcomes. The risk of neonatal adverse outcome (adjusted odds ratio, 1.45; 95% confidence interval, 1.27-1.66; P<.001), need for specialist neonatal care (adjusted odds ratio, 1.24; 95% confidence interval, 1.02-1.51; P=.03), and prolonged neonatal admission after birth (adjusted odds ratio, 1.61; 95% confidence interval, 1.49-1.75; P<.001) were all significantly higher for infants with mothers with laboratory-confirmed SARS-CoV-2 infection. When the analysis was restricted to pregnancies delivered at term (≥37 weeks), there were no significant differences in neonatal adverse outcome (P=.78), need for specialist neonatal care after birth (P=.22), or neonatal readmission within 4 weeks of birth (P=.05). Neonates born at term to mothers with laboratory-confirmed SARS-CoV-2 infection were more likely to have prolonged admission after birth (21.1% compared with 14.6%; adjusted odds ratio, 1.61; 95% confidence interval, 1.49-1.75; P<.001). CONCLUSION SARS-CoV-2 infection at the time of birth is associated with higher rates of fetal death, preterm birth, preeclampsia, and emergency cesarean delivery. There were no additional adverse neonatal outcomes, other than those related to preterm delivery. Pregnant women should be counseled regarding risks of SARS-CoV-2 infection and should be considered a priority for vaccination.
Collapse
|
36
|
Zinszer K, McKinnon B, Bourque N, Pierce L, Saucier A, Otis A, Cheriet I, Papenburg J, Hamelin MÈ, Charland K, Carbonneau J, Zahreddine M, Savard A, Fortin G, Apostolatos A, Haley N, Ratté N, Laurin I, Nguyen CT, Conrod P, Boivin G, De Serres G, Quach C. Seroprevalence of SARS-CoV-2 Antibodies Among Children in School and Day Care in Montreal, Canada. JAMA Netw Open 2021; 4:e2135975. [PMID: 34812845 PMCID: PMC8611475 DOI: 10.1001/jamanetworkopen.2021.35975] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
IMPORTANCE Quebec prioritized in-person learning after the first wave of the COVID-19 pandemic, with school closures being implemented temporarily in selected schools or in hot-spot areas. Quebec's decision to keep most schools open was controversial, especially in Montreal, which was the epicenter of Canada's first and second waves; therefore, understanding the extent to which children were infected with SARS-CoV-2 provides important information for decisions about school closures. OBJECTIVE To estimate the seroprevalence of SARS-CoV-2 antibodies in children and teenagers in 4 neighborhoods of Montreal, Canada. DESIGN, SETTING, AND PARTICIPANTS This cohort study (the Enfants et COVID-19: Étude de séroprévalence [EnCORE] study) enrolled a convenience sample of children aged 2 to 17 years between October 22, 2020, and March 22, 2021, in Montreal, Canada. EXPOSURES Potential exposure to SARS-CoV-2. MAIN OUTCOMES AND MEASURES The main outcome was seroprevalence of SARS-CoV-2 antibodies, collected using dried blood spots (DBSs) and analyzed with a research-based enzyme-linked immunosorbent assay (ELISA). Parents also completed an online questionnaire that included questions on self-reported COVID-19 symptoms and tests, along with sociodemographic questions. RESULTS This study included 1632 participants who provided a DBS sample from 30 day cares, 22 primary schools, and 11 secondary schools. The mean (SD) age of the children who provided a DBS sample was 9.0 (4.4) years; 801 (49%) were female individuals, with 354 participants (22%) from day cares, 725 (44%) from primary schools, and 553 (34%) from secondary schools. Most parents had at least a bachelor's degree (1228 [75%]), and 210 (13%) self-identified as being a racial or ethnic minority. The mean seroprevalence was 5.8% (95% CI, 4.6%-7.0%) but increased over time from 3.2% (95% CI, 0.7%-5.8%) in October to November 2020 to 8.4% (95% CI, 4.4%-12.4%) in March to April 2021. Of the 95 children with positive SARS-CoV-2 antibody results, 78 (82%) were not tested or tested negative with reverse transcription-polymerase chain reaction (RT-PCR) testing, and all experienced mild (49 [52%]) or no clinical symptoms (46 [48%]). The children of parents who self-identified as belonging to a racial and ethnic minority group were more likely to be seropositive compared with children of White parents (adjusted seroprevalence ratio, 1.9; 95% CI, 1.1-2.6). CONCLUSIONS AND RELEVANCE These results provide a benchmark of the seroprevalence status in Canadian children. The findings suggest that there was more transmission occurring in children compared with what was being detected by RT-PCR, although children experienced few or mild symptoms. It will be important to continue monitoring the serological status of children, particularly in the context of new COVID-19 variants of concern and in the absence of mass vaccination campaigns targeting young children.
Collapse
Affiliation(s)
- Kate Zinszer
- University of Montreal, Montreal, Quebec, Canada
- Centre for Public Health Research, Montreal, Quebec, Canada
| | - Britt McKinnon
- University of Montreal, Montreal, Quebec, Canada
- Centre for Public Health Research, Montreal, Quebec, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Noémie Bourque
- University of Montreal, Montreal, Quebec, Canada
- Centre for Public Health Research, Montreal, Quebec, Canada
| | - Laura Pierce
- Centre for Public Health Research, Montreal, Quebec, Canada
| | - Adrien Saucier
- University of Montreal, Montreal, Quebec, Canada
- Centre for Public Health Research, Montreal, Quebec, Canada
| | - Alexandra Otis
- Centre for Public Health Research, Montreal, Quebec, Canada
| | | | - Jesse Papenburg
- Montreal Children’s Hospital, Montreal, Quebec, Canada
- McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Katia Charland
- Centre for Public Health Research, Montreal, Quebec, Canada
| | | | | | - Ashley Savard
- Centre for Public Health Research, Montreal, Quebec, Canada
| | - Geneviève Fortin
- University of Montreal, Montreal, Quebec, Canada
- Centre for Public Health Research, Montreal, Quebec, Canada
| | | | - Nancy Haley
- Direction régionale de la santé publique du Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Île-de-Montréal, Montreal, Quebec, Canada
| | - Nathalie Ratté
- Direction régionale de la santé publique du Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Île-de-Montréal, Montreal, Quebec, Canada
| | - Isabel Laurin
- University of Montreal, Montreal, Quebec, Canada
- Direction régionale de la santé publique du Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Île-de-Montréal, Montreal, Quebec, Canada
| | - Cat Tuong Nguyen
- Direction régionale de la santé publique du Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Île-de-Montréal, Montreal, Quebec, Canada
| | - Patrica Conrod
- University of Montreal, Montreal, Quebec, Canada
- Research Centre of the Sainte-Justine University Hospital, Montreal, Quebec, Canada
| | - Guy Boivin
- Research Centre Laval University, Quebec City, Quebec, Canada
| | - Gaston De Serres
- National Institute of Public Health of Quebec, Quebec City, Quebec, Canada
| | - Caroline Quach
- University of Montreal, Montreal, Quebec, Canada
- Research Centre of the Sainte-Justine University Hospital, Montreal, Quebec, Canada
| |
Collapse
|
37
|
Blanchard-Rohner G, Didierlaurent A, Tilmanne A, Smeesters P, Marchant A. Pediatric COVID-19: Immunopathogenesis, Transmission and Prevention. Vaccines (Basel) 2021; 9:1002. [PMID: 34579240 PMCID: PMC8473426 DOI: 10.3390/vaccines9091002] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 12/18/2022] Open
Abstract
Children are unique in the context of the COVID-19 pandemic. Overall, SARS-CoV-2 has a lower medical impact in children as compared to adults. A higher proportion of children than adults remain asymptomatic following SARS-CoV-2 infection and severe disease and death are also less common. This relative resistance contrasts with the high susceptibility of children to other respiratory tract infections. The mechanisms involved remain incompletely understood but could include the rapid development of a robust innate immune response. On the other hand, children develop a unique and severe complication, named multisystem inflammatory syndrome in children, several weeks after the onset of symptoms. Although children play an important role in the transmission of many pathogens, their contribution to the transmission of SARS-CoV-2 appears lower than that of adults. These unique aspects of COVID-19 in children must be considered in the benefit-risk analysis of vaccination. Several COVID-19 vaccines have been authorized for emergency use in adolescents and clinical studies are ongoing in children. As the vaccination of adolescents is rolled out in several countries, we shall learn about the impact of this strategy on the health of children and on transmission within communities.
Collapse
Affiliation(s)
- Geraldine Blanchard-Rohner
- Center of Vaccinology, Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
- Pediatric Immunology and Vaccinology Unit, Division of General Pediatrics, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, University of Geneva, 1205 Geneva, Switzerland;
- Children’s Hospital of Geneva, 6, Rue Willy-Donzé, 1211 Geneva, Switzerland
| | - Arnaud Didierlaurent
- Pediatric Immunology and Vaccinology Unit, Division of General Pediatrics, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, University of Geneva, 1205 Geneva, Switzerland;
| | - Anne Tilmanne
- Children’s Hospital Queen Fabiola, Université libre de Bruxelles, 1020 Brussels, Belgium; (A.T.); (P.S.)
| | - Pierre Smeesters
- Children’s Hospital Queen Fabiola, Université libre de Bruxelles, 1020 Brussels, Belgium; (A.T.); (P.S.)
| | - Arnaud Marchant
- Institute for Medical Immunology, Université libre de Bruxelles, 1050 Charleroi, Belgium;
| |
Collapse
|
38
|
Meißner U, Carbon CC. ["Co-Ki"-No support for pediatricians on supplying parents with evidence-based information]. Monatsschr Kinderheilkd 2021; 169:963-967. [PMID: 34511642 PMCID: PMC8422049 DOI: 10.1007/s00112-021-01306-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Udo Meißner
- Kinderarztpraxis PD Dr. Meißner, Hainstr. 20, 96047 Bamberg, Deutschland
| | - Claus-Christian Carbon
- Lehrstuhl für Allg. Psychologie & Methodenlehre, Markusplatz 3, 96047 Bamberg, Deutschland
| |
Collapse
|
39
|
Koirala A, Goldfeld S, Bowen AC, Choong C, Ryan K, Wood N, Winkler N, Danchin M, Macartney K, Russell FM. Lessons learnt during the COVID-19 pandemic: Why Australian schools should be prioritised to stay open. J Paediatr Child Health 2021; 57:1362-1369. [PMID: 34101922 PMCID: PMC8242752 DOI: 10.1111/jpc.15588] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/05/2021] [Accepted: 05/05/2021] [Indexed: 11/29/2022]
Abstract
In 2020, school and early childhood educational centre (ECEC) closures affected over 1.5 billion school-aged children globally as part of the COVID-19 pandemic response. Attendance at school and access to ECEC is critical to a child's learning, well-being and health. School closures increase inequities by disproportionately affecting vulnerable children. Here, we summarise the role of children and adolescents in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) transmission and that of schools and ECECs in community transmission and describe the Australian experience. In Australia, most SARS-CoV-2 cases in schools were solitary (77% in NSW and 67% in Victoria); of those that did progress to an outbreak, >90% involved fewer than 10 cases. Australian and global experience has demonstrated that SARS-CoV-2 is predominantly introduced into schools and ECECs during periods of heightened community transmission. Implementation of public health mitigation strategies, including effective testing, tracing and isolation of contacts, means schools and ECECs can be safe, not drivers of transmission. Schools and ECEC are essential services and so they should be prioritised to stay open for face-to-face learning. This is particularly critical as we continue to manage the next phase of the COVID-19 pandemic.
Collapse
Affiliation(s)
- Archana Koirala
- National Centre for Immunisation Research and Surveillance Kids Research, Sydney Children's Hospitals NetworkWestmeadNew South WalesAustralia,School of Child and Adolescent HealthUniversity of SydneySydneyNew South WalesAustralia,Department of Infectious Diseases, Nepean HospitalKingswoodNew South WalesAustralia
| | - Sharon Goldfeld
- Centre for Community Child Health, Royal Children's HospitalParkvilleVictoriaAustralia,Population Health, Murdoch Children's Research InstituteParkvilleVictoriaAustralia,Department of PaediatricsThe University of MelbourneParkvilleVictoriaAustralia
| | - Asha C Bowen
- Department of Infectious DiseasesPerth Children's HospitalNedlandsWestern AustraliaAustralia,Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids InstituteNedlandsWestern AustraliaAustralia,School of Medicine, The University of Western AustraliaPerthWestern AustraliaAustralia,Centre for Child Health ResearchThe University of Western AustraliaPerthWestern AustraliaAustralia,Menzies School of Health ResearchCharles Darwin UniversityDarwinNorthern TerritoryAustralia,Institute for Health ResearchThe University of Notre Dame AustraliaFremantleWestern AustraliaAustralia
| | - Catherine Choong
- School of Medicine, The University of Western AustraliaPerthWestern AustraliaAustralia,Menzies School of Health ResearchCharles Darwin UniversityDarwinNorthern TerritoryAustralia,Department of Endocrinology, Perth Children's HospitalNedlandsWestern AustraliaAustralia
| | - Kathleen Ryan
- Population Health, Murdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Nicholas Wood
- National Centre for Immunisation Research and Surveillance Kids Research, Sydney Children's Hospitals NetworkWestmeadNew South WalesAustralia,School of Child and Adolescent HealthUniversity of SydneySydneyNew South WalesAustralia,Department of Paediatrics, The Children's Hospital at WestmeadWestmeadNew South WalesAustralia
| | - Noni Winkler
- National Centre for Immunisation Research and Surveillance Kids Research, Sydney Children's Hospitals NetworkWestmeadNew South WalesAustralia,National Centre for Epidemiology and Population Health, Research School of Population HealthAustralian National UniversityCanberraAustralian Capitol TerritoryAustralia
| | - Margie Danchin
- Department of PaediatricsThe University of MelbourneParkvilleVictoriaAustralia,Department of General Medicine, Royal Children's HospitalParkvilleVictoriaAustralia,Infection and Immunity, Murdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Kristine Macartney
- National Centre for Immunisation Research and Surveillance Kids Research, Sydney Children's Hospitals NetworkWestmeadNew South WalesAustralia,School of Child and Adolescent HealthUniversity of SydneySydneyNew South WalesAustralia,Department of Infectious Diseases, The Children's Hospital at WestmeadWestmeadNew South WalesAustralia
| | - Fiona M Russell
- Department of PaediatricsThe University of MelbourneParkvilleVictoriaAustralia,Infection and Immunity, Murdoch Children's Research InstituteParkvilleVictoriaAustralia
| |
Collapse
|
40
|
Galmiche S, Charmet T, Schaeffer L, Paireau J, Grant R, Chény O, Von Platen C, Maurizot A, Blanc C, Dinis A, Martin S, Omar F, David C, Septfons A, Cauchemez S, Carrat F, Mailles A, Levy-Bruhl D, Fontanet A. Exposures associated with SARS-CoV-2 infection in France: A nationwide online case-control study. THE LANCET REGIONAL HEALTH. EUROPE 2021; 7:100148. [PMID: 34124709 PMCID: PMC8183123 DOI: 10.1016/j.lanepe.2021.100148] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND We aimed to assess the role of different setting and activities in acquiring SARS-CoV-2 infection. METHODS In this nationwide case-control study, cases were SARS-CoV-2 infected adults recruited between 27 October and 30 November 2020. Controls were individuals from the Ipsos market research database matched to cases by age, sex, region, population density and time period. Participants completed an online questionnaire on recent activity-related exposures. FINDINGS Among 3426 cases and 1713 controls, in multivariable analysis, we found an increased risk of infection associated with any additional person living in the household (adjusted-OR: 1•16; 95%CI: 1•11-1•21); having children attending day-care (aOR: 1•31; 95%CI: 1•02-1•62), kindergarten (aOR: 1•27; 95%CI: 1•09-1•45), middle school (aOR: 1•30; 95%CI: 1•15-1•47), or high school (aOR: 1•18; 95%CI: 1•05-1•34); with attending professional (aOR: 1•15; 95%CI: 1•04-1•26) or private gatherings (aOR: 1•57; 95%CI: 1•45-1•71); and with having frequented bars and restaurants (aOR: 1•95; 95%CI: 1•76-2•15), or having practiced indoor sports activities (aOR: 1•36; 95%CI: 1•15-1•62). We found no increase in risk associated with frequenting shops, cultural or religious gatherings, or with transportation, except for carpooling (aOR: 1•47; 95%CI: 1•28-1•69). Teleworking was associated with decreased risk of infection (aOR: 0•65; 95%CI: 0•56-0•75). INTERPRETATION Places and activities during which infection prevention and control measures may be difficult to fully enforce were those with increased risk of infection. Children attending day-care, kindergarten, middle and high schools, but not primary schools, were potential sources of infection for the household. FUNDING Institut Pasteur, Research & Action Emerging Infectious Diseases (REACTing), Fondation de France (Alliance" Tous unis contre le virus").
Collapse
Affiliation(s)
- Simon Galmiche
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France
| | - Tiffany Charmet
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France
| | - Laura Schaeffer
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France
| | - Juliette Paireau
- Institut Pasteur, Mathematical Modelling of Infectious Diseases Unit; UMR2000; CNRS, Paris, France
- Santé Publique France, Saint-Maurice, France
| | - Rebecca Grant
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France
- Sorbonne University, Paris, France
| | - Olivia Chény
- Institut Pasteur, Centre for Translational Research, Paris, France
| | | | | | - Carole Blanc
- Caisse Nationale d'Assurance Maladie, Paris, France
| | - Annika Dinis
- Caisse Nationale d'Assurance Maladie, Paris, France
| | | | | | | | | | - Simon Cauchemez
- Institut Pasteur, Mathematical Modelling of Infectious Diseases Unit; UMR2000; CNRS, Paris, France
| | - Fabrice Carrat
- Sorbonne Université, Inserm, IPLESP, hôpital Saint-Antoine, APHP, 27 rue Chaligny, Paris, France F75571
| | | | | | - Arnaud Fontanet
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France
- Conservatoire national des arts et métiers, Unité PACRI, Paris, France
| |
Collapse
|
41
|
Galmiche S, Charmet T, Schaeffer L, Paireau J, Grant R, Chény O, Von Platen C, Maurizot A, Blanc C, Dinis A, Martin S, Omar F, David C, Septfons A, Cauchemez S, Carrat F, Mailles A, Levy-Bruhl D, Fontanet A. Exposures associated with SARS-CoV-2 infection in France: A nationwide online case-control study. THE LANCET REGIONAL HEALTH. EUROPE 2021; 7:100148. [PMID: 34124709 DOI: 10.1016/j.lanepe.2021.10014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
BACKGROUND We aimed to assess the role of different setting and activities in acquiring SARS-CoV-2 infection. METHODS In this nationwide case-control study, cases were SARS-CoV-2 infected adults recruited between 27 October and 30 November 2020. Controls were individuals from the Ipsos market research database matched to cases by age, sex, region, population density and time period. Participants completed an online questionnaire on recent activity-related exposures. FINDINGS Among 3426 cases and 1713 controls, in multivariable analysis, we found an increased risk of infection associated with any additional person living in the household (adjusted-OR: 1•16; 95%CI: 1•11-1•21); having children attending day-care (aOR: 1•31; 95%CI: 1•02-1•62), kindergarten (aOR: 1•27; 95%CI: 1•09-1•45), middle school (aOR: 1•30; 95%CI: 1•15-1•47), or high school (aOR: 1•18; 95%CI: 1•05-1•34); with attending professional (aOR: 1•15; 95%CI: 1•04-1•26) or private gatherings (aOR: 1•57; 95%CI: 1•45-1•71); and with having frequented bars and restaurants (aOR: 1•95; 95%CI: 1•76-2•15), or having practiced indoor sports activities (aOR: 1•36; 95%CI: 1•15-1•62). We found no increase in risk associated with frequenting shops, cultural or religious gatherings, or with transportation, except for carpooling (aOR: 1•47; 95%CI: 1•28-1•69). Teleworking was associated with decreased risk of infection (aOR: 0•65; 95%CI: 0•56-0•75). INTERPRETATION Places and activities during which infection prevention and control measures may be difficult to fully enforce were those with increased risk of infection. Children attending day-care, kindergarten, middle and high schools, but not primary schools, were potential sources of infection for the household. FUNDING Institut Pasteur, Research & Action Emerging Infectious Diseases (REACTing), Fondation de France (Alliance" Tous unis contre le virus").
Collapse
Affiliation(s)
- Simon Galmiche
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France
| | - Tiffany Charmet
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France
| | - Laura Schaeffer
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France
| | - Juliette Paireau
- Institut Pasteur, Mathematical Modelling of Infectious Diseases Unit; UMR2000; CNRS, Paris, France
- Santé Publique France, Saint-Maurice, France
| | - Rebecca Grant
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France
- Santé Publique France, Saint-Maurice, France
| | - Olivia Chény
- Sorbonne University, Paris, France
- Institut Pasteur, Centre for Translational Research, Paris, France
| | | | | | - Carole Blanc
- Caisse Nationale d'Assurance Maladie, Paris, France
| | - Annika Dinis
- Caisse Nationale d'Assurance Maladie, Paris, France
| | | | | | | | | | - Simon Cauchemez
- Institut Pasteur, Mathematical Modelling of Infectious Diseases Unit; UMR2000; CNRS, Paris, France
| | - Fabrice Carrat
- Sorbonne Université, Inserm, IPLESP, hôpital Saint-Antoine, APHP, 27 rue Chaligny, Paris, France F75571
| | | | | | - Arnaud Fontanet
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France
- Conservatoire national des arts et métiers, Unité PACRI, Paris, France
| |
Collapse
|
42
|
COVID-19 Pandemic: Influence of Schools, Age Groups, and Virus Variants in Italy. Viruses 2021; 13:v13071269. [PMID: 34209828 PMCID: PMC8428146 DOI: 10.3390/v13071269] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 12/15/2022] Open
Abstract
The estimated smooth curve of the percentage of subjects positive to SARS-CoV-2 started decreasing in Italy at the beginning of January 2021, due to the government containment measures undertaken from Christmas until 7 January. Approximately two weeks after releasing the measures, the curve stopped to decrease and remained approximately constant for four weeks to increase again in the middle of February. This epidemic phase had a public health care impact since, from the beginning of the fourth week of February, the curve of the intensive care unit’s occupancy started to grow. This wave of infection was characterized by the presence of new virus variants, with a higher than 80% dominance of the so-called “English” variant, since 15 April. School activities in Italy started at different times from 7 January until 8 February, depending on every region’s decision. Our present data on the incidence of SARS-CoV-2 in different age groups in Italy are in agreement with literature reports showing that subjects older than 10 years are involved in virus transmission. More importantly, we provide evidence to support the hypothesis that also individuals of age 0–9 years can significantly contribute to the spread of SARS-CoV-2.
Collapse
|
43
|
Kahlert CR, Persi R, Güsewell S, Egger T, Leal-Neto OB, Sumer J, Flury D, Brucher A, Lemmenmeier E, Möller JC, Rieder P, Stocker R, Vuichard-Gysin D, Wiggli B, Albrich WC, Babouee Flury B, Besold U, Fehr J, Kuster SP, McGeer A, Risch L, Schlegel M, Friedl A, Vernazza P, Kohler P. Non-occupational and occupational factors associated with specific SARS-CoV-2 antibodies among hospital workers - A multicentre cross-sectional study. Clin Microbiol Infect 2021; 27:1336-1344. [PMID: 34020033 PMCID: PMC8131187 DOI: 10.1016/j.cmi.2021.05.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/26/2021] [Accepted: 05/05/2021] [Indexed: 12/18/2022]
Abstract
Objectives Protecting healthcare workers (HCWs) from coronavirus disease-19 (COVID-19) is critical to preserve the functioning of healthcare systems. We therefore assessed seroprevalence and identified risk factors for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) seropositivity in this population. Methods Between 22 June 22 and 15 August 2020, HCWs from institutions in northern/eastern Switzerland were screened for SARS-CoV-2 antibodies. We recorded baseline characteristics, non-occupational and occupational risk factors. We used pairwise tests of associations and multivariable logistic regression to identify factors associated with seropositivity. Results Among 4664 HCWs from 23 healthcare facilities, 139 (3%) were seropositive. Non-occupational exposures independently associated with seropositivity were contact with a COVID-19-positive household (adjusted OR 59, 95% CI 33–106), stay in a COVID-19 hotspot (aOR 2.3, 95% CI 1.2–4.2) and male sex (aOR 1.9, 95% CI 1.1–3.1). Blood group 0 vs. non-0 (aOR 0.5, 95% CI 0.3–0.8), active smoking (aOR 0.4, 95% CI 0.2–0.7), living with children <12 years (aOR 0.3, 95% CI 0.2–0.6) and being a physician (aOR 0.2, 95% CI 0.1–0.5) were associated with decreased risk. Other occupational risk factors were close contact to COVID-19 patients (aOR 2.7, 95% CI 1.4–5.4), exposure to COVID-19-positive co-workers (aOR 1.9, 95% CI 1.1–2.9), poor knowledge of standard hygiene precautions (aOR 1.9, 95% CI 1.2–2.9) and frequent visits to the hospital canteen (aOR 2.3, 95% CI 1.4–3.8). Discussion Living with COVID-19-positive households showed the strongest association with SARS-CoV-2 seropositivity. We identified several potentially modifiable work-related risk factors, which might allow mitigation of the COVID-19 risk among HCWs. The lower risk among those living with children, even after correction for multiple confounders, is remarkable and merits further study.
Collapse
Affiliation(s)
- Christian R Kahlert
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland; Children's Hospital of Eastern Switzerland, Department of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Raphael Persi
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Sabine Güsewell
- Clinical Trials Unit, Cantonal Hospital of St Gallen, St. Gallen, Switzerland
| | - Thomas Egger
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Onicio B Leal-Neto
- Epitrack, Recife, Brazil; Department of Economics, University of Zurich, Zurich, Switzerland
| | - Johannes Sumer
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Domenica Flury
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Angela Brucher
- Psychiatry Services of the Canton of St Gallen (South), St Gallen, Switzerland
| | - Eva Lemmenmeier
- Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Littenheid, Switzerland
| | - J Carsten Möller
- Centre for Neurological Rehabilitation, Zihlschlacht, Switzerland
| | | | | | - Danielle Vuichard-Gysin
- Thurgau Hospital Group, Division of Infectious Diseases and Hospital Epidemiology, Muensterlingen, Switzerland; Swiss National Centre for Infection Prevention (Swissnoso), Berne, Switzerland
| | - Benedikt Wiggli
- Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital Baden, Baden, Switzerland
| | - Werner C Albrich
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Baharak Babouee Flury
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | | | - Jan Fehr
- Department of Public and Global Health, University of Zurich, Zurich, Switzerland
| | - Stefan P Kuster
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Zurich, Switzerland
| | | | - Lorenz Risch
- Labormedizinisches Zentrum Dr Risch Ostschweiz AG, Buchs, Switzerland; Private Universität im Fürstentum Liechtenstein, Triesen, Liechtenstein; Centre of Laboratory Medicine, University Institute of Clinical Chemistry, University of Bern, Inselspital, Bern, Switzerland
| | - Matthias Schlegel
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Andrée Friedl
- Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital Baden, Baden, Switzerland
| | - Pietro Vernazza
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Philipp Kohler
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland.
| |
Collapse
|
44
|
Llupià A, Borràs-Santos A, Guinovart C, Utzet M, Moriña D, Puig J. SARS-CoV-2 transmission in students of public schools of Catalonia (Spain) after a month of reopening. PLoS One 2021; 16:e0251593. [PMID: 33979410 PMCID: PMC8115831 DOI: 10.1371/journal.pone.0251593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/29/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION SARS-CoV-2 transmission within schools and its contribution to community transmission are still a matter of debate. METHODS A retrospective cohort study in all public schools in Catalonia was conducted using publicly available data assessing the association between the number of reported SARS-CoV-2 cases among students and staff in weeks 1-2 (Sept 14-27th, 2020) of the academic year with school SARS-CoV-2 incidence among students in weeks 4-5. A multilevel Poisson regression model adjusted for the community incidence in the corresponding basic health area (BHA) and the type of school (primary or secondary), with random effects at the sanitary region and BHA levels, was performed. RESULTS A total of 2184 public schools opened on September 14th with 778,715 students. Multivariate analysis showed a significant association between the total number of SARS-CoV-2 cases in a centre in weeks 1-2 and the SARS-CoV-2 school incidence among students in weeks 4-5 (Risk Ratio (RR) 1.074, 95% CI 1.044-1.105, p-value <0.001). The adjusted BHA incidence in the first two weeks was associated with school incidence in weeks 4-5 (RR 1.002, 95% CI 1.002-1.003, p-value <0.001). Secondary schools showed an increased incidence in weeks 4 and 5 (RR primary vs secondary 1.709 95% CI 1.599-1.897, p-value <0.001). CONCLUSIONS Safety measures adopted by schools were not enough to stop related-to-school transmission in students and could be improved. The safest way to keep schools open is to reduce community transmission down to a minimum.
Collapse
Affiliation(s)
- Anna Llupià
- Department of Preventive Medicine and Epidemiology, Hospital Clínic, Barcelona, Spain
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Alícia Borràs-Santos
- Gimbernat School of Nursing, Universitat Autònoma de Barcelona (UAB), Sant Cugat del Vallès, Barcelona, Spain
| | - Caterina Guinovart
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Mireia Utzet
- Center for Research in Occupational Health (CISAL), Barcelona, Spain
- Universitat Pompeu Fabra, CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - David Moriña
- Department of Econometrics, Statistics and Applied Econometrics, Riskcenter-IREA, Universitat de Barcelona, Barcelona, Spain
| | - Joaquim Puig
- Department of Mathematics, Universitat Politècnica de Catalunya, Barcelona, Spain
| |
Collapse
|
45
|
Ross JS. Covid-19, open science, and the CVD-COVID-UK initiative. BMJ 2021; 373:n898. [PMID: 33827892 DOI: 10.1136/bmj.n898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Joseph S Ross
- Section of General Medicine Department of Internal Medicine, Yale University School of Medicine, PO box 208093, New Haven, CT 06520-8093, USA
| |
Collapse
|
46
|
Head JR, Andrejko KL, Cheng Q, Collender PA, Phillips S, Boser A, Heaney AK, Hoover CM, Wu SL, Northrup GR, Click K, Bardach NS, Lewnard JA, Remais JV. School closures reduced social mixing of children during COVID-19 with implications for transmission risk and school reopening policies. J R Soc Interface 2021; 18:20200970. [PMID: 33849340 PMCID: PMC8086933 DOI: 10.1098/rsif.2020.0970] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/24/2021] [Indexed: 12/14/2022] Open
Abstract
School closures may reduce the size of social networks among children, potentially limiting infectious disease transmission. To estimate the impact of K-12 closures and reopening policies on children's social interactions and COVID-19 incidence in California's Bay Area, we collected data on children's social contacts and assessed implications for transmission using an individual-based model. Elementary and Hispanic children had more contacts during closures than high school and non-Hispanic children, respectively. We estimated that spring 2020 closures of elementary schools averted 2167 cases in the Bay Area (95% CI: -985, 5572), fewer than middle (5884; 95% CI: 1478, 11.550), high school (8650; 95% CI: 3054, 15 940) and workplace (15 813; 95% CI: 9963, 22 617) closures. Under assumptions of moderate community transmission, we estimated that reopening for a four-month semester without any precautions will increase symptomatic illness among high school teachers (an additional 40.7% expected to experience symptomatic infection, 95% CI: 1.9, 61.1), middle school teachers (37.2%, 95% CI: 4.6, 58.1) and elementary school teachers (4.1%, 95% CI: -1.7, 12.0). However, we found that reopening policies for elementary schools that combine universal masking with classroom cohorts could result in few within-school transmissions, while high schools may require masking plus a staggered hybrid schedule. Stronger community interventions (e.g. remote work, social distancing) decreased the risk of within-school transmission across all measures studied, with the influence of community transmission minimized as the effectiveness of the within-school measures increased.
Collapse
Affiliation(s)
- Jennifer R. Head
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
| | - Kristin L. Andrejko
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
| | - Qu Cheng
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Philip A. Collender
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Sophie Phillips
- College of Letters and Science, University of California, Berkeley, CA, USA
| | - Anna Boser
- College of Letters and Science, University of California, Berkeley, CA, USA
| | - Alexandra K. Heaney
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Christopher M. Hoover
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Sean L. Wu
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
| | - Graham R. Northrup
- Center for Computational Biology, College of Engineering, University of California, Berkeley, CA, USA
| | - Karen Click
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
| | - Naomi S. Bardach
- Department of Pediatrics, School of Medicine, University of California, San Francisco, CA, USA
| | - Joseph A. Lewnard
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
- Center for Computational Biology, College of Engineering, University of California, Berkeley, CA, USA
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, CA, USA
| | - Justin V. Remais
- College of Letters and Science, University of California, Berkeley, CA, USA
| |
Collapse
|
47
|
Forbes H, Morton CE, Bacon S, McDonald HI, Minassian C, Brown JP, Rentsch CT, Mathur R, Schultze A, DeVito NJ, MacKenna B, Hulme WJ, Croker R, Walker AJ, Williamson EJ, Bates C, Mehrkar A, Curtis HJ, Evans D, Wing K, Inglesby P, Drysdale H, Wong AYS, Cockburn J, McManus R, Parry J, Hester F, Harper S, Douglas IJ, Smeeth L, Evans SJW, Bhaskaran K, Eggo RM, Goldacre B, Tomlinson LA. Association between living with children and outcomes from covid-19: OpenSAFELY cohort study of 12 million adults in England. BMJ 2021; 372:n628. [PMID: 33737413 PMCID: PMC7970340 DOI: 10.1136/bmj.n628] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/07/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate whether risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and outcomes of coronavirus disease 2019 (covid-19) differed between adults living with and without children during the first two waves of the UK pandemic. DESIGN Population based cohort study, on behalf of NHS England. SETTING Primary care data and pseudonymously linked hospital and intensive care admissions and death records from England, during wave 1 (1 February to 31 August 2020) and wave 2 (1 September to 18 December 2020). PARTICIPANTS Two cohorts of adults (18 years and over) registered at a general practice on 1 February 2020 and 1 September 2020. MAIN OUTCOME MEASURES Adjusted hazard ratios for SARS-CoV-2 infection, covid-19 related admission to hospital or intensive care, or death from covid-19, by presence of children in the household. RESULTS Among 9 334 392adults aged 65 years and under, during wave 1, living with children was not associated with materially increased risks of recorded SARS-CoV-2 infection, covid-19 related hospital or intensive care admission, or death from covid-19. In wave 2, among adults aged 65 years and under, living with children of any age was associated with an increased risk of recorded SARS-CoV-2 infection (hazard ratio 1.06 (95% confidence interval 1.05 to 1.08) for living with children aged 0-11 years; 1.22 (1.20 to 1.24) for living with children aged 12-18 years) and covid-19 related hospital admission (1.18 (1.06 to 1.31) for living with children aged 0-11; 1.26 (1.12 to 1.40) for living with children aged 12-18). Living with children aged 0-11 was associated with reduced risk of death from both covid-19 and non-covid-19 causes in both waves; living with children of any age was also associated with lower risk of dying from non-covid-19 causes. For adults 65 years and under during wave 2, living with children aged 0-11 years was associated with an increased absolute risk of having SARS-CoV-2 infection recorded of 40-60 per 10 000 people, from 810 to between 850 and 870, and an increase in the number of hospital admissions of 1-5 per 10 000 people, from 160 to between 161 and 165. Living with children aged 12-18 years was associated with an increase of 160-190 per 10 000 in the number of SARS-CoV-2 infections and an increase of 2-6 per 10 000 in the number of hospital admissions. CONCLUSIONS In contrast to wave 1, evidence existed of increased risk of reported SARS-CoV-2 infection and covid-19 outcomes among adults living with children during wave 2. However, this did not translate into a materially increased risk of covid-19 mortality, and absolute increases in risk were small.
Collapse
Affiliation(s)
- Harriet Forbes
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Caroline E Morton
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Seb Bacon
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Helen I McDonald
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Caroline Minassian
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Jeremy P Brown
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Christopher T Rentsch
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Rohini Mathur
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Anna Schultze
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Nicholas J DeVito
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Brian MacKenna
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - William J Hulme
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Richard Croker
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Alex J Walker
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Elizabeth J Williamson
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Chris Bates
- The Phoenix Partnership, 129 Low Lane, Horsforth, Leeds, UK
| | - Amir Mehrkar
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Helen J Curtis
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - David Evans
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Kevin Wing
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Peter Inglesby
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Henry Drysdale
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Angel Y S Wong
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Robert McManus
- The Phoenix Partnership, 129 Low Lane, Horsforth, Leeds, UK
| | - John Parry
- The Phoenix Partnership, 129 Low Lane, Horsforth, Leeds, UK
| | - Frank Hester
- The Phoenix Partnership, 129 Low Lane, Horsforth, Leeds, UK
| | - Sam Harper
- The Phoenix Partnership, 129 Low Lane, Horsforth, Leeds, UK
| | - Ian J Douglas
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Liam Smeeth
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Stephen J W Evans
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Krishnan Bhaskaran
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Rosalind M Eggo
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Ben Goldacre
- The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Laurie A Tomlinson
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|