ABSTRACT
The WHO and CDC have issued guidance documents on COVID-19 avoidance behaviors. People susceptible to severe disease, such as people with diabetes, should strictly follow these recommendations. We conducted a survey of Covid-19 avoidance behaviors in individuals with and without type 1 diabetes (T1D). We invited participants with and without T1D who are part of complications research cohorts at the Barbara Davis Center to answer an online survey regarding their exposure to COVID-19 and their behaviors to reduce their risk of infection. A total of 321 participants (162 without diabetes [non-DM], 159 with T1D) completed the initial survey. The average ± SD age was 55±12 years (range 29 to 83 years), and 65% of participants were female. The reported prevalence of an illness like COVID-19 was 20% in adults with T1D and 27% in non-DM adults (p=0.13). Participants with T1D were less likely to report hand washing, avoiding gatherings, canceling travel, wearing a mask, avoiding touching people, wiping down surfaces and following government guidelines (Table). In multivariate analysis, factors significantly associated with fewer protective behaviors included younger age, male sex, and T1D (p=0.0005). Despite being at high risk for severe Covid-19 disease, adults with T1D were less likely to report behaviors known to reduce the risk of contracting this illness. These data suggest a need for further education in this high-risk population.
ABSTRACT
IntroductionRapid, high throughput diagnostics are a valuable tool, allowing the detection of SARS-CoV-2 in populations, in order to identify and isolate people with asymptomatic and symptomatic infections. Reagent shortages and restricted access to high throughput testing solutions have limited the effectiveness of conventional assays such as reverse transcriptase quantitative PCR (RT-qPCR), particularly throughout the first months of the COVID-19 pandemic. We investigated the use of LamPORE, where loop mediated isothermal amplification (LAMP) is coupled to nanopore sequencing technology, for the detection of SARS-CoV-2 in symptomatic and asymptomatic populations. MethodsIn an asymptomatic prospective cohort, for three weeks in September 2020 health care workers across four sites (Birmingham, Southampton, Basingstoke and Manchester) self-swabbed with nasopharyngeal swabs weekly and supplied a saliva specimen daily. These samples were tested for SARS-CoV-2 RNA using the Oxford Nanopore LamPORE system and a reference RT-qPCR assay on extracted sample RNA. A second retrospective cohort of 848 patients with influenza like illness from March 2020 - June 2020, were similarly tested from nasopharyngeal swabs. ResultsIn the asymptomatic cohort a total of 1200 participants supplied 23,427 samples (3,966 swab, 19,461 saliva) over a three-week period. The incidence of SARS-CoV-2 detection using LamPORE was 0.95%. Diagnostic sensitivity and specificity of LamPORE was >99.5% in both swab and saliva asymptomatic samples when compared to the reference RT-qPCR test. In the retrospective symptomatic cohort, the incidence was 13.4% and the sensitivity and specificity were 100%. ConclusionsLamPORE is a highly accurate methodology for the detection of SARS-CoV-2 in both symptomatic and asymptomatic population settings and can be used as an alternative to RT-qPCR.