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Domènech-Montoliu S, Puig-Barberà J, Pac-Sa MR, Orrico-Sanchéz A, Gómez-Lanas L, Sala-Trull D, Domènech-Leon C, Del Rio-González A, Sánchez-Urbano M, Satorres-Martinez P, Aparisi-Esteve L, Badenes-Marques G, Blasco-Gari R, Casanova-Suarez J, Gil-Fortuño M, Hernández-Pérez N, Jovani-Sales D, López-Diago L, Notari-Rodríguez C, Pérez-Olaso O, Romeu-Garcia MA, Ruíz-Puig R, Arnedo-Pena A. Cellular Immunity of SARS-CoV-2 in the Borriana COVID-19 Cohort: A Nested Case-Control Study. Epidemiologia (Basel) 2024; 5:167-186. [PMID: 38651389 PMCID: PMC11036210 DOI: 10.3390/epidemiologia5020012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 03/27/2024] [Accepted: 04/05/2024] [Indexed: 04/25/2024] Open
Abstract
Our goal was to determine the cellular immune response (CIR) in a sample of the Borriana COVID-19 cohort (Spain) to identify associated factors and their relationship with infection, reinfection and sequelae. We conducted a nested case-control study using a randomly selected sample of 225 individuals aged 18 and older, including 36 individuals naïve to the SARS-CoV-2 infection and 189 infected patients. We employed flow-cytometry-based immunoassays for intracellular cytokine staining, using Wuhan and BA.2 antigens, and chemiluminescence microparticle immunoassay to detect SARS-CoV-2 antibodies. Logistic regression models were applied. A total of 215 (95.6%) participants exhibited T-cell response (TCR) to at least one antigen. Positive responses of CD4+ and CD8+ T cells were 89.8% and 85.3%, respectively. No difference in CIR was found between naïve and infected patients. Patients who experienced sequelae exhibited a higher CIR than those without. A positive correlation was observed between TCR and anti-spike IgG levels. Factors positively associated with the TCR included blood group A, number of SARS-CoV-2 vaccine doses received, and anti-N IgM; factors inversely related were the time elapsed since the last vaccine dose or infection, and blood group B. These findings contribute valuable insights into the nuanced immune landscape shaped by SARS-CoV-2 infection and vaccination.
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Affiliation(s)
| | - Joan Puig-Barberà
- Vaccines Research Unit, Foundation for the Promotion of Health and Biomedical Research in Valencia Region FISABIO-Public Health, 46020 Valencia, Spain; (J.P.-B.); (A.O.-S.)
| | - María Rosario Pac-Sa
- Public Health Center, 12003 Castelló de la Plana, Spain; (M.R.P.-S.); (M.A.R.-G.)
| | - Alejandro Orrico-Sanchéz
- Vaccines Research Unit, Foundation for the Promotion of Health and Biomedical Research in Valencia Region FISABIO-Public Health, 46020 Valencia, Spain; (J.P.-B.); (A.O.-S.)
- Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Secretary of Chair of Vaccines Catholic University of Valencia, 46001 Valencia, Spain
| | - Lorna Gómez-Lanas
- Emergency Service University Hospital de la Plana, 12540 Vila-real, Spain; (L.G.-L.); (D.S.-T.); (M.S.-U.); (P.S.-M.); (G.B.-M.); (R.B.-G.); (D.J.-S.); (C.N.-R.); (R.R.-P.)
| | - Diego Sala-Trull
- Emergency Service University Hospital de la Plana, 12540 Vila-real, Spain; (L.G.-L.); (D.S.-T.); (M.S.-U.); (P.S.-M.); (G.B.-M.); (R.B.-G.); (D.J.-S.); (C.N.-R.); (R.R.-P.)
| | - Carmen Domènech-Leon
- Department of Medicine, University CEU Cardenal Herrera, 12006 Castelló de la Plana, Spain;
| | | | - Manuel Sánchez-Urbano
- Emergency Service University Hospital de la Plana, 12540 Vila-real, Spain; (L.G.-L.); (D.S.-T.); (M.S.-U.); (P.S.-M.); (G.B.-M.); (R.B.-G.); (D.J.-S.); (C.N.-R.); (R.R.-P.)
| | - Paloma Satorres-Martinez
- Emergency Service University Hospital de la Plana, 12540 Vila-real, Spain; (L.G.-L.); (D.S.-T.); (M.S.-U.); (P.S.-M.); (G.B.-M.); (R.B.-G.); (D.J.-S.); (C.N.-R.); (R.R.-P.)
| | | | - Gema Badenes-Marques
- Emergency Service University Hospital de la Plana, 12540 Vila-real, Spain; (L.G.-L.); (D.S.-T.); (M.S.-U.); (P.S.-M.); (G.B.-M.); (R.B.-G.); (D.J.-S.); (C.N.-R.); (R.R.-P.)
| | - Roser Blasco-Gari
- Emergency Service University Hospital de la Plana, 12540 Vila-real, Spain; (L.G.-L.); (D.S.-T.); (M.S.-U.); (P.S.-M.); (G.B.-M.); (R.B.-G.); (D.J.-S.); (C.N.-R.); (R.R.-P.)
| | | | - María Gil-Fortuño
- Microbiology Service University Hospital de la Plana, 12540 Vila-real, Spain; (M.G.-F.); (N.H.-P.); (O.P.-O.)
| | - Noelia Hernández-Pérez
- Microbiology Service University Hospital de la Plana, 12540 Vila-real, Spain; (M.G.-F.); (N.H.-P.); (O.P.-O.)
| | - David Jovani-Sales
- Emergency Service University Hospital de la Plana, 12540 Vila-real, Spain; (L.G.-L.); (D.S.-T.); (M.S.-U.); (P.S.-M.); (G.B.-M.); (R.B.-G.); (D.J.-S.); (C.N.-R.); (R.R.-P.)
| | - Laura López-Diago
- Clinical Analysis Service University Hospital de la Plana, 12540 Vila-real, Spain;
| | - Cristina Notari-Rodríguez
- Emergency Service University Hospital de la Plana, 12540 Vila-real, Spain; (L.G.-L.); (D.S.-T.); (M.S.-U.); (P.S.-M.); (G.B.-M.); (R.B.-G.); (D.J.-S.); (C.N.-R.); (R.R.-P.)
| | - Oscar Pérez-Olaso
- Microbiology Service University Hospital de la Plana, 12540 Vila-real, Spain; (M.G.-F.); (N.H.-P.); (O.P.-O.)
| | | | - Raquel Ruíz-Puig
- Emergency Service University Hospital de la Plana, 12540 Vila-real, Spain; (L.G.-L.); (D.S.-T.); (M.S.-U.); (P.S.-M.); (G.B.-M.); (R.B.-G.); (D.J.-S.); (C.N.-R.); (R.R.-P.)
| | - Alberto Arnedo-Pena
- Public Health Center, 12003 Castelló de la Plana, Spain; (M.R.P.-S.); (M.A.R.-G.)
- Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Department of Health Science, Public University Navarra, 31006 Pamplona, Spain
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Domènech-Montoliu S, Puig-Barberà J, Badenes-Marques G, Gil-Fortuño M, Orrico-Sánchez A, Pac-Sa MR, Perez-Olaso O, Sala-Trull D, Sánchez-Urbano M, Arnedo-Pena A. Long COVID Prevalence and the Impact of the Third SARS-CoV-2 Vaccine Dose: A Cross-Sectional Analysis from the Third Follow-Up of the Borriana Cohort, Valencia, Spain (2020-2022). Vaccines (Basel) 2023; 11:1590. [PMID: 37896992 PMCID: PMC10611325 DOI: 10.3390/vaccines11101590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/27/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND In March 2020, a COVID-19 outbreak linked to mass gathering dinners at the Falles Festival in Borriana, Spain, resulted in an estimated attack rate of 42.6% among attendees. METHODS In June 2022, we conducted a cross-sectional follow-up study of 473 adults aged 18 to 64 who attended the dinners at the Falles Festival in 2020, examining the cumulative experience after SARS-CoV-2 infection and vaccination responses. Data included demographic details, lifestyle habits, medical history, infection records, and vaccinations from a population-based vaccine registry. Blood samples were analyzed for SARS-CoV-2 antibodies and cellular immunity. We employed a doubly robust inverse-probability weighting analysis to estimate the booster vaccine dose's impact on long COVID prevalence and symptom count. RESULTS A total of 28.1% of participants met the WHO criteria for long COVID, with older individuals showing higher rates. Long COVID diagnosis was less likely with factors including O blood group, higher occupational status, physical activity, three vaccine doses, strong SARS-CoV-2-S-reactive IFNγ-producing-CD8+ response, and infection during the Omicron period. Increased age, high or low social activity, underlying health conditions, a severe initial COVID episode, and reinfection were associated with higher long COVID likelihood. A booster dose, compared to one or two doses, reduced long COVID risk by 74% (95% CI: 56% to 92%) and symptom count by 55% (95% CI: 32% to 79%). CONCLUSION Long COVID was prevalent in a significant portion of those who contracted COVID-19, underscoring the need for sustained follow-up and therapeutic strategies. Vaccinations, notably the booster dose, had a substantial beneficial effect on long-term infection outcomes, affirming the vaccination's role in mitigating SARS-CoV-2 infection consequences.
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Affiliation(s)
| | - Joan Puig-Barberà
- Vaccine Research Unit (AIV), Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), 46020 Valencia, Spain;
| | - Gema Badenes-Marques
- Emergency Service, University Hospital de la Plana, 12540 Vila-real, Spain (M.S.-U.)
| | - María Gil-Fortuño
- Microbiology Service, University Hospital de la Plana, 12540 Vila-real, Spain; (M.G.-F.); (O.P.-O.)
| | - Alejandro Orrico-Sánchez
- Vaccine Research Unit (AIV), Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), 46020 Valencia, Spain;
| | - María Rosario Pac-Sa
- Centro de Salud Pública de Castellón, 12003 Castelló de la Plana, Spain; (M.R.P.-S.)
| | - Oscar Perez-Olaso
- Microbiology Service, University Hospital de la Plana, 12540 Vila-real, Spain; (M.G.-F.); (O.P.-O.)
| | - Diego Sala-Trull
- Emergency Service, University Hospital de la Plana, 12540 Vila-real, Spain (M.S.-U.)
| | - Manuel Sánchez-Urbano
- Emergency Service, University Hospital de la Plana, 12540 Vila-real, Spain (M.S.-U.)
| | - Alberto Arnedo-Pena
- Centro de Salud Pública de Castellón, 12003 Castelló de la Plana, Spain; (M.R.P.-S.)
- Department of Health Science, Universidad Pública de Navarra, 31006 Pamplona, Spain
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Domènech-Montoliu S, Puig-Barberà J, Guerra-Murcia O, Pac-Sa MR, Orrico-Sanchéz A, Gómez-Lanas L, Sala-Trull D, Domènech-Leon C, Del Rio-González A, Sánchez-Urbano M, Satorres-Martinez P, Latorre-Poveda M, Ferrando-Rubert S, Aparisi-Esteve L, Badenes-Marques G, Blasco-Gari R, Casanova-Suarez J, Fontal-Carcel M, Gil-Fortuño M, Hernández-Pérez N, Jovani-Sales D, López-Diago L, Notari-Rodríguez C, Pérez-Olaso O, Romeu-Garcia MA, Ruíz-Puig R, Arnedo-Pena A. ABO Blood Groups and Incidence of COVID-19 in the Mass Gathering Events in Borriana (Spain), March 2020: A Retrospective Cohort Study. Epidemiologia (Basel) 2023; 4:63-73. [PMID: 36810454 PMCID: PMC9944070 DOI: 10.3390/epidemiologia4010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/19/2023] [Accepted: 01/24/2023] [Indexed: 02/01/2023] Open
Abstract
Our objective was to estimate the incidence of COVID-19 and the ABO blood Groups in the mass-gathering events (MGEs) during the Falles Festival in Borriana (Spain) from 6-10 March 2020. We conducted a population-based retrospective cohort study and measured anti-SARS-CoV-2 antibodies and the ABO of participants. We performed laboratory COVID-19 tests and obtained the ABO in 775 subjects (72.8% of the original exposed cohort): O-group (45.2%), A-group (43.1%), B-group (8.5%) and AB-group (3.4%). Adjusted for confounding factors, including COVID-19 exposure during the MGEs, attack rates of COVID-19 for each ABO group were 55.4%, 59.6%, 60.2%, and 63.7%. The adjusted relative risks were for O-group 0.93 (95% Confidence Interval [CI] 0.83-1.04), for A-group 1.06 (95% CI 0.94-1.18), for B-group 1.04 (95%CI 0.88-1.24), and for AB-group 1.11 (95% CI 0.81-1.51) with no significant differences. Conclusions: Our results suggest no effect of ABO on COVID-19 incidence. We observed weak but not significant protection of the O-group and not a significantly greater infection risk for the remaining groups compared with the O-group. More studies are needed to resolve the controversies regarding the association between ABO and COVID-19.
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Affiliation(s)
| | - Joan Puig-Barberà
- Vaccines Research Unit, Fundación Para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, 46020 Valencia, Spain
| | - Olga Guerra-Murcia
- Vaccines Research Unit, Fundación Para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, 46020 Valencia, Spain
| | | | - Alejandro Orrico-Sanchéz
- Vaccines Research Unit, Fundación Para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, 46020 Valencia, Spain
- Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Universidad Católica de Valencia San Vicente Mártir, 46001 Valencia, Spain
| | - Lorna Gómez-Lanas
- Emergency Service University Hospital de la Plana, 12540 Vila-real, Spain
| | - Diego Sala-Trull
- Emergency Service University Hospital de la Plana, 12540 Vila-real, Spain
| | | | | | | | | | | | | | | | | | - Roser Blasco-Gari
- Emergency Service University Hospital de la Plana, 12540 Vila-real, Spain
| | | | | | - María Gil-Fortuño
- Microbiology Service University Hospital de la Plana, 12540 Vila-real, Spain
| | | | - David Jovani-Sales
- Emergency Service University Hospital de la Plana, 12540 Vila-real, Spain
| | - Laura López-Diago
- Clinical Analysis Service University Hospital de la Plana, 12540 Vila-real, Spain
| | | | - Oscar Pérez-Olaso
- Microbiology Service University Hospital de la Plana, 12540 Vila-real, Spain
| | | | - Raquel Ruíz-Puig
- Emergency Service University Hospital de la Plana, 12540 Vila-real, Spain
| | - Alberto Arnedo-Pena
- Public Health Center, 12003 Castelló de la Plana, Spain
- Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Department of Health Science, Public University Navarra, 31006 Pamplona, Spain
- Correspondence:
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Domènech-Montoliu S, Puig-Barberà J, Pac-Sa MR, Vidal-Utrillas P, Latorre-Poveda M, Rio-González AD, Ferrando-Rubert S, Ferrer-Abad G, Sánchez-Urbano M, Aparisi-Esteve L, Badenes-Marques G, Cervera-Ferrer B, Clerig-Arnau U, Dols-Bernad C, Fontal-Carcel M, Gomez-Lanas L, Jovani-Sales D, León-Domingo MC, Llopico-Vilanova MD, Moros-Blasco M, Notari-Rodríguez C, Ruíz-Puig R, Valls-López S, Arnedo-Pena A. ABO Blood Groups and the Incidence of Complications in COVID-19 Patients: A Population-Based Prospective Cohort Study. Int J Environ Res Public Health 2021; 18:ijerph181910039. [PMID: 34639344 PMCID: PMC8507737 DOI: 10.3390/ijerph181910039] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/06/2021] [Accepted: 09/16/2021] [Indexed: 12/16/2022]
Abstract
After a COVID-19 outbreak in the Falles festival of Borriana (Spain) during March 2020, a cohort of patients were followed until October 2020 to estimate complications post-COVID-19, considering ABO blood groups (ABO). From 536 laboratory-confirmed cases, 483 completed the study (90.1%) carried by the Public Health Center of Castelló and the Emergency and Microbiology and Clinical Analysis of Hospital de la Plana Vila-real. The study included ABO determination and telephone interviews of patients. The participants had a mean age of 37.2 ± 17.1 years, 300 females (62.1%). ABO were O (41.4%), A (45.5%), B (9.1%), and AB (3.9%). We found no difference in the incidence of COVID-19 infections. A total of 159 (32.9%) patients reported one or more post-COVID-19 complications with divergent incidences after adjustment: O (32.3%), A (32.6%), B (54.1%), and AB (27.6%); B groups had more complications post-COVID-19 when compared with O group (adjusted relative risk [aRR] 95% confidence interval [CI] 1.68, 95% CI 1.24–2.27), and symptoms of fatigue (1.79, 95% CI 1.08–2.95), myalgia (2.06, 95% CI 1.10–3.84), headache (2.61, 95% CI 1.58–4.31), and disorder of vision (4.26 95% CI 1.33–13.60). In conclusion, we observed significant differences in post-COVID-19 complications by ABO, with a higher incidence in B group. Additional research is justified to confirm our results.
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Affiliation(s)
- Salvador Domènech-Montoliu
- Emergency Service Hospital de la Plana, Health Department 3, 12540 Vila-Real, Spain; (S.D.-M.); (M.L.-P.); (M.S.-U.); (G.B.-M.); (B.C.-F.); (U.C.-A.); (L.G.-L.); (D.J.-S.); (M.D.L.-V.); (R.R.-P.); (S.V.-L.)
| | | | | | - Paula Vidal-Utrillas
- Health Centers I and II, Health Department 2, 12530 Borriana, Spain; (P.V.-U.); (A.D.R.-G.); (S.F.-R.); (G.F.-A.)
| | - Marta Latorre-Poveda
- Emergency Service Hospital de la Plana, Health Department 3, 12540 Vila-Real, Spain; (S.D.-M.); (M.L.-P.); (M.S.-U.); (G.B.-M.); (B.C.-F.); (U.C.-A.); (L.G.-L.); (D.J.-S.); (M.D.L.-V.); (R.R.-P.); (S.V.-L.)
| | - Alba Del Rio-González
- Health Centers I and II, Health Department 2, 12530 Borriana, Spain; (P.V.-U.); (A.D.R.-G.); (S.F.-R.); (G.F.-A.)
| | - Sara Ferrando-Rubert
- Health Centers I and II, Health Department 2, 12530 Borriana, Spain; (P.V.-U.); (A.D.R.-G.); (S.F.-R.); (G.F.-A.)
| | - Gema Ferrer-Abad
- Health Centers I and II, Health Department 2, 12530 Borriana, Spain; (P.V.-U.); (A.D.R.-G.); (S.F.-R.); (G.F.-A.)
| | - Manuel Sánchez-Urbano
- Emergency Service Hospital de la Plana, Health Department 3, 12540 Vila-Real, Spain; (S.D.-M.); (M.L.-P.); (M.S.-U.); (G.B.-M.); (B.C.-F.); (U.C.-A.); (L.G.-L.); (D.J.-S.); (M.D.L.-V.); (R.R.-P.); (S.V.-L.)
| | | | - Gema Badenes-Marques
- Emergency Service Hospital de la Plana, Health Department 3, 12540 Vila-Real, Spain; (S.D.-M.); (M.L.-P.); (M.S.-U.); (G.B.-M.); (B.C.-F.); (U.C.-A.); (L.G.-L.); (D.J.-S.); (M.D.L.-V.); (R.R.-P.); (S.V.-L.)
| | - Belén Cervera-Ferrer
- Emergency Service Hospital de la Plana, Health Department 3, 12540 Vila-Real, Spain; (S.D.-M.); (M.L.-P.); (M.S.-U.); (G.B.-M.); (B.C.-F.); (U.C.-A.); (L.G.-L.); (D.J.-S.); (M.D.L.-V.); (R.R.-P.); (S.V.-L.)
| | - Ursula Clerig-Arnau
- Emergency Service Hospital de la Plana, Health Department 3, 12540 Vila-Real, Spain; (S.D.-M.); (M.L.-P.); (M.S.-U.); (G.B.-M.); (B.C.-F.); (U.C.-A.); (L.G.-L.); (D.J.-S.); (M.D.L.-V.); (R.R.-P.); (S.V.-L.)
| | | | | | - Lorna Gomez-Lanas
- Emergency Service Hospital de la Plana, Health Department 3, 12540 Vila-Real, Spain; (S.D.-M.); (M.L.-P.); (M.S.-U.); (G.B.-M.); (B.C.-F.); (U.C.-A.); (L.G.-L.); (D.J.-S.); (M.D.L.-V.); (R.R.-P.); (S.V.-L.)
| | - David Jovani-Sales
- Emergency Service Hospital de la Plana, Health Department 3, 12540 Vila-Real, Spain; (S.D.-M.); (M.L.-P.); (M.S.-U.); (G.B.-M.); (B.C.-F.); (U.C.-A.); (L.G.-L.); (D.J.-S.); (M.D.L.-V.); (R.R.-P.); (S.V.-L.)
| | | | - Maria Dolores Llopico-Vilanova
- Emergency Service Hospital de la Plana, Health Department 3, 12540 Vila-Real, Spain; (S.D.-M.); (M.L.-P.); (M.S.-U.); (G.B.-M.); (B.C.-F.); (U.C.-A.); (L.G.-L.); (D.J.-S.); (M.D.L.-V.); (R.R.-P.); (S.V.-L.)
| | | | | | - Raquel Ruíz-Puig
- Emergency Service Hospital de la Plana, Health Department 3, 12540 Vila-Real, Spain; (S.D.-M.); (M.L.-P.); (M.S.-U.); (G.B.-M.); (B.C.-F.); (U.C.-A.); (L.G.-L.); (D.J.-S.); (M.D.L.-V.); (R.R.-P.); (S.V.-L.)
| | - Sonia Valls-López
- Emergency Service Hospital de la Plana, Health Department 3, 12540 Vila-Real, Spain; (S.D.-M.); (M.L.-P.); (M.S.-U.); (G.B.-M.); (B.C.-F.); (U.C.-A.); (L.G.-L.); (D.J.-S.); (M.D.L.-V.); (R.R.-P.); (S.V.-L.)
| | - Alberto Arnedo-Pena
- Public Health Center, Health Department 2, 12003 Castello de la Plana, Spain;
- Department of Health Science, Public University Navarra, 31008 Pamplona, Spain
- Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Correspondence: or ; Tel.: +35-622-573979
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Domènech-Montoliu S, Pac-Sa MR, Vidal-Utrillas P, Latorre-Poveda M, Del Rio-González A, Ferrando-Rubert S, Ferrer-Abad G, Sánchez-Urbano M, Aparisi-Esteve L, Badenes-Marques G, Cervera-Ferrer B, Clerig-Arnau U, Dols-Bernad C, Fontal-Carcel M, Gomez-Lanas L, Jovani-Sales D, León-Domingo MC, Llopico-Vilanova MD, Moros-Blasco M, Notari-Rodríguez C, Ruíz-Puig R, Valls-López S, Arnedo-Pena A. "Mass gathering events and COVID-19 transmission in Borriana (Spain): A retrospective cohort study". PLoS One 2021; 16:e0256747. [PMID: 34437628 PMCID: PMC8389516 DOI: 10.1371/journal.pone.0256747] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 08/13/2021] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE Mass gathering events (MGEs) are associated with the transmission of COVID-19. Between 6 and 10 March 2020, several MGEs related to the Falles festival took place in Borriana, a municipality in the province of Castellon (Spain). The aim of this study was to estimate the incidence of COVID-19 and its association with these MGEs, and to quantify the potential risk factors of its occurrence. METHODS During May and June 2020, a population-based retrospective cohort study was carried out by the Public Health Center of Castelló and the Hospital de la Plana in Vila-real. Participants were obtained from a representative sample of 1663 people with potential exposure at six MGEs. A questionnaire survey was carried out to obtain information about attendance at MGEs and COVID-19 disease. In addition, a serologic survey of antibodies against SARS-Cov-2 was implemented. Inverse probability weighted regression was used in the statistical analysis. RESULTS A total of 1338 subjects participated in the questionnaire survey (80.5%), 997 of whom undertook the serologic survey. Five hundred and seventy cases were observed with an attack rate (AR) of 42.6%; average age was 36 years, 62.3% were female, 536 cases were confirmed by laboratory tests, and 514 cases were found with SARS-CoV-2 total antibodies. Considering MGE exposure, AR was 39.2% (496/1264). A dose-response relationship was found between MGE attendance and the disease, (adjusted relative risk [aRR] = 4.11 95% confidence interval [CI]3.25-5.19). Two MGEs with a dinner and dance in the same building had higher risks. Associated risk factors with the incidence were older age, obesity, and upper and middle class versus lower class; current smoking was protective. CONCLUSIONS The study suggests the significance of MGEs in the COVID-19 transmission that could explain the subsequent outbreak in Borriana.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lorna Gomez-Lanas
- Emergency Service, Hospital de la Plana, Vila-real, Castellon, Spain
| | | | | | | | | | | | - Raquel Ruíz-Puig
- Emergency Service, Hospital de la Plana, Vila-real, Castellon, Spain
| | - Sonia Valls-López
- Emergency Service, Hospital de la Plana, Vila-real, Castellon, Spain
| | - Alberto Arnedo-Pena
- Public Health Center, Castelló de la Plana, Castellon, Spain
- Department of Health Science, Public University Navarra, Pamplona, Spain
- Epidemiology and Public Health (CIBERESP), Madrid, Spain
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