Behavioral and personal characteristics associated with risk of SARS-CoV-2 infection in a Spanish university cohort.

The aim of this study is to analyze the life habits and personal factors associated with an increased SARS-CoV-2 risk in a university environment with in-person lectures during the COVID-19 pandemic. There are no previous longitudinal studies that have analyzed behavioral and personal factors with the risk of SARS-CoV-2 infection on an entire university population. A cohort study was conducted in the three campuses of the University of Navarra between August 24th 2020 and May 30th 2021, including 14,496 students and employees. 10,959 participants were finally included. Descriptive and multivariate adjusted models were performed using Cox regression. A total of 1,032 (9.4%) participants were diagnosed with COVID-19 (879 students, 153 employees), almost 50% living with their family. COVID-19 was associated with living in college or residence (HR:1.96 CI 95% 1.45 to 2.63), motor transportation (HR:1.36 CI 95% 1.14 to 1.62), South American origin (HR:1.41 CI 95% 1.17 to 1.69) and belonging to Madrid's campus (HR:3.15 CI 95% 2.50 to 3.97). In conclusion, international students, especially from Latin America, mostly lived in university apartments or shared flats and cohabited with 4-11 people. Living in a big city (Madrid), was a significant risk factor.

Safety of International Professional Sports Competitions During the COVID-19 Pandemic: The Association Football Experience.

Major sporting events were suspended during the most acute phase of the COVID-19 pandemic. Competitions are resuming with enhanced hygiene protocols and altered mechanics. While risks for players and staff have been studied, the impact of large-scale tournaments on the communities that host them remains largely unstudied. CONMEBOL Copa América is one of the first wide-scale international tournaments to be conducted in its original format since the beginning of the COVID-19 pandemic. The tournament saw 10 national teams compete in four Brazilian cities during a period of heightened viral transmission. The analysis of over 28,000 compulsory PCR tests showed that positive cases did not lead to the uncontrolled spread of the disease among staff and players. More importantly, the data indicate that locally hired staff were not exposed to increased risk while working. The Copa América experience shows that international sporting competitions can be conducted safely even under unfavourable epidemiological situations.

Seroprevalence of SARS-CoV2 Infections in Health Care Personnel in a Long-Term Care Institution After the First Wave of the Pandemic: A Cross-Sectional Study.

BACKGROUND: At the time of our study, occupational health evidence specific for long-term care employees was mostly lacking. The purpose of this study was to determine the proportion of positive cases in employees after the first COVID-19 wave in May 2020. We also determined the prevalence of asymptomatic cases. METHOD: The study population included all health care workers (HCW) employed at one mid-size long-term hospital in Spain (May 2020). A cross-sectional study design included an interviewer-administered self-reported questionnaire (including sociodemographic questions, risk factors for COVID-19 complications such as hypertension or diabetes, and previous polymerase chain reaction [PCR] results) and antibody determination (Biozek rapid test). Data were analyzed using Student's t, Fisher, and chi-square tests. Two multivariate logistic models were created to evaluate exposure factors and symptoms separately on the outcome of having had COVID-19. FINDINGS: Of the 97% of workers who participated (580/596), 300 (51.7%) suffered symptoms of COVID-19, 161 (27.8%) of the rapid antibody tests were positive for IgM and/or IgG, 160 (27.6%) workers had at least one risk factor, and 32 (19.0%) of the 168 SARS-CoV-2-positive cases were asymptomatic. The proportion of negative or unavailable PCRs, with positive antibody, was 11.7% (56/477). Casual contact without protection (odds ratio [OR]: 1.9, 95% confidence interval [CI]: 1.1-3.4), doctor occupation (OR 3.3, 95% CI: 1.1-10.2), and nursing assistant occupation (OR 2.5, 95% CI: 1.2-5.8) were independently associated with SARS-CoV-2 infection. CONCLUSION: Physicians and nursing assistants in a long-term care setting were at a higher risk of SARS-COV-2 infection over other occupations in the first wave of the pandemic, especially when in contact with patients without protection. Almost one-fifth of the workers with a positive PCR test for SARS-COV-2 were asymptomatic and seroprevalence (27.8%) was well below the approximated herd immunity cutoff (60-70%). Essential workers in long-term care must be monitored frequently by Employee Health Service and should be required to wear personal protective equipment including a fit-tested N-95 while in close contact with patients and coworkers.

Effectiveness of a Conversational Chatbot (Dejal@bot) for the Adult Population to Quit Smoking: Pragmatic, Multicenter, Controlled, Randomized Clinical Trial in Primary Care.

BACKGROUND: Tobacco addiction is the leading cause of preventable morbidity and mortality worldwide, but only 1 in 20 cessation attempts is supervised by a health professional. The potential advantages of mobile health (mHealth) can circumvent this problem and facilitate tobacco cessation interventions for public health systems. Given its easy scalability to large populations and great potential, chatbots are a potentially useful complement to usual treatment. OBJECTIVE: This study aims to assess the effectiveness of an evidence-based intervention to quit smoking via a chatbot in smartphones compared with usual clinical practice in primary care. METHODS: This is a pragmatic, multicenter, controlled, and randomized clinical trial involving 34 primary health care centers within the Madrid Health Service (Spain). Smokers over the age of 18 years who attended on-site consultation and accepted help to quit tobacco were recruited by their doctor or nurse and randomly allocated to receive usual care (control group [CG]) or an evidence-based chatbot intervention (intervention group [IG]). The interventions in both arms were based on the 5A's (ie, Ask, Advise, Assess, Assist, and Arrange) in the US Clinical Practice Guideline, which combines behavioral and pharmacological treatments and is structured in several follow-up appointments. The primary outcome was continuous abstinence from smoking that was biochemically validated after 6 months by the collaborators. The outcome analysis was blinded to allocation of patients, although participants were unblinded to group assignment. An intention-to-treat analysis, using the baseline-observation-carried-forward approach for missing data, and logistic regression models with robust estimators were employed for assessing the primary outcomes. RESULTS: The trial was conducted between October 1, 2018, and March 31, 2019. The sample included 513 patients (242 in the IG and 271 in the CG), with an average age of 49.8 (SD 10.82) years and gender ratio of 59.3% (304/513) women and 40.7% (209/513) men. Of them, 232 patients (45.2%) completed the follow-up, 104/242 (42.9%) in the IG and 128/271 (47.2%) in the CG. In the intention-to-treat analysis, the biochemically validated abstinence rate at 6 months was higher in the IG (63/242, 26%) compared with that in the CG (51/271, 18.8%; odds ratio 1.52, 95% CI 1.00-2.31; P=.05). After adjusting for basal CO-oximetry and bupropion intake, no substantial changes were observed (odds ratio 1.52, 95% CI 0.99-2.33; P=.05; pseudo-R2=0.045). In the IG, 61.2% (148/242) of users accessed the chatbot, average chatbot-patient interaction time was 121 (95% CI 121.1-140.0) minutes, and average number of contacts was 45.56 (SD 36.32). CONCLUSIONS: A treatment including a chatbot for helping with tobacco cessation was more effective than usual clinical practice in primary care. However, this outcome was at the limit of statistical significance, and therefore these promising results must be interpreted with caution. TRIAL REGISTRATION: Clinicaltrials.gov NCT03445507; https://tinyurl.com/mrnfcmtd. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12911-019-0972-z.

Control of SARS-CoV-2 Infection Rates at a Spanish University With In-Person Class Attendance.

The "Safe Campus Program," implemented in 2020 through 2021 at the University of Navarra (Spain), aimed to guarantee a safe return to university campus and prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks, avoiding university-wide lockdown. It included COVID-19 education, campus adaptation, and polymerase chain reaction (PCR) testing. We describe the main characteristics of the program and analyze the SARS-CoV-2 cumulative incidence among 14 496 university members. The 14-day cumulative incidence in the university was 415.2 versus 447.7 in the region. The program, sustainable in the long term, achieved low SARS-CoV-2 in-campus rates. (Am J Public Health. 2022;112(4):570-573. https://doi.org/10.2105/AJPH.2021.306682.