At-home Testing and Risk Factors for Acquisition of SARS-CoV-2 Infection in a Major US Metropolitan Area.

Autor: Woolley AE; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA., Dryden-Peterson S; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Botswana Harvard AIDS Institute, Boston, Massachusetts, USA., Kim A; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA., Naz-McLean S; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA., Kelly C; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA., Laibinis HH; Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA., Bagnall J; Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA., Livny J; Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA., Ma P; Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA., Orzechowski M; Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA., Gomez J; Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA., Shoresh N; Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA., Gabriel S; Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA., Hung DT; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.; Department of Molecular Biology and Center for Computational and Integrative Biology, Massachusetts General Hospital, Boston, Massachusetts, USA., Cosimi LA; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2022 Oct 05; Vol. 9 (11), pp. ofac505. Date of Electronic Publication: 2022 Oct 05 (Print Publication: 2022).
DOI: 10.1093/ofid/ofac505
Abstrakt: Background: Unbiased assessment of the risks associated with acquisition of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is critical to informing mitigation efforts during pandemics. The objective of our study was to understand the risk factors for acquiring coronavirus disease 2019 (COVID-19) in a large prospective cohort of adult residents in a large US metropolitan area.
Methods: We designed a fully remote longitudinal cohort study involving monthly at-home SARS-CoV-2 polymerase chain reaction (PCR) and serology self-testing and monthly surveys.
Results: Between October 2020 and January 2021, we enrolled 10 289 adults reflective of the Boston metropolitan area census data. At study entry, 567 (5.5%) participants had evidence of current or prior SARS-CoV-2 infection. This increased to 13.4% by June 15, 2021. Compared with Whites, Black non-Hispanic participants had a 2.2-fold greater risk of acquiring COVID-19 (hazard ratio [HR], 2.19; 95% CI, 1.91-2.50; P < .001), and Hispanics had a 1.5-fold greater risk (HR, 1.52; 95% CI, 1.32-1.71; P < .016). Individuals aged 18-29, those who worked outside the home, and those living with other adults and children were at an increased risk. Individuals in the second and third lowest disadvantaged neighborhood communities were associated with an increased risk of acquiring COVID-19. Individuals with medical risk factors for severe disease were at a decreased risk of SARS-CoV-2 acquisition.
Conclusions: These results demonstrate that race/ethnicity and socioeconomic status are the biggest determinants of acquisition of infection. This disparity is significantly underestimated if based on PCR data alone, as noted by the discrepancy in serology vs PCR detection for non-White participants, and points to persistent disparity in access to testing. Medical conditions and advanced age, which increase the risk for severity of SARS-CoV-2 disease, were associated with a lower risk of COVID-19 acquisition, suggesting the importance of behavior modifications. These findings highlight the need for mitigation programs that overcome challenges of structural racism in current and future pandemics.
Competing Interests: Potential conflicts of interest. D.H. is a founder, consultant to, equity holder in, and inventor of technology licensed to Sherlock Biosciences and serves on the Scientific Advisory Board for Proof Diagnostics; both are infectious disease diagnostic companies, but neither company’s technologies was used in this work. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
(© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
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