ABSTRACT
Background: Tracking person-to-person SARS-CoV-2 transmission in the population is important to under-stand the epidemiology of community transmission and may contribute to the containment of SARS-CoV-2. Neither contact tracing nor genomic surveillance alone, however, are typically sufficient to achieve this objective. Aim: We demonstrate the successful appli-cation of the integrated genomic surveillance (IGS) system of the German city of Dusseldorf for tracing SARS-CoV-2 transmission chains in the population as well as detecting and investigating travel-associated SARS-CoV-2 infection clusters. Methods: Genomic sur-veillance, phylogenetic analysis, and structured case interviews were integrated to elucidate two geneti-cally defined clusters of SARS-CoV-2 isolates detected by IGS in Dusseldorf in July 2021. Results: Cluster 1 (n = 67 Dusseldorf cases) and Cluster 2 (n = 36) were detected in a surveillance dataset of 518 high-quality SARS-CoV-2 genomes from Dusseldorf (53% of total cases, sampled mid-June to July 2021). Cluster 1 could be traced back to a complex pattern of transmission in nightlife venues following a putative importation by a SARS-CoV-2-infected return traveller (IP) in late June;28 SARS-CoV-2 cases could be epidemiologically directly linked to IP. Supported by viral genome data from Spain, Cluster 2 was shown to represent multi-ple independent introduction events of a viral strain circulating in Catalonia and other European coun-tries, followed by diffuse community transmission in Dusseldorf.
ABSTRACT
Background Studies document that adults in disadvantaged socio-economic positions have elevated risks of a severe course of COVID-19, but it is unclear if this holds true for children. We investigate in this population-based study whether young people from socio-economically disadvantaged households in Germany had a higher risk of COVID-19 hospitalization compared with more affluent counterparts. We also examined if differences were related to comorbidities that predict severe courses in children. Methods We included data from all 690,115 children and adolescents (0-18 years) enrolled in a statutory health insurance carrier. Daily hospital diagnoses of COVID-19 were recorded from 1.1.2020 to 13.7.2021. Logistic regressions were used to compare children from households with an indication of poverty (e.g. long- or short-term unemployed) with children from households with insurance holders in regular employment. We also assessed socio-economic characteristics of the area of residence. We controlled for age, sex, days under observation, nationality, and comorbidities (e.g. obesity). Findings A COVID-19 hospital diagnosis was a rare event (n = 1637). Children of long-term unemployed parents had a 1·36 times (95% CI 1·21-1·51) higher adjusted odds of hospitalization compared with those of employed parents. Elevated odds were also found for short-term unemployed or low-wage employment. Those living in poor areas had a 3·02 (1·81-5·22) higher odds of hospitalization than those in less deprived areas. Comorbidities were strongly related to hospitalization, but their adjustment did not change main estimates for household deprivation. Discussion Results suggest that children from poor households are at higher risk of severe courses of COVID-19 than their affluent counterparts. This underlies the need to implement effective Public Health strategies to protect deprived children from COVID-19 and other infectious disease even in high income countries such as Germany. Key messages • Children and adolescents from poor families seem to be at higer risk for sever courses of COVID-19. • Comorbidities were no key mediating factor in this study.
ABSTRACT
OBJECTIVES: Most SARS-CoV-2 seroprevalence studies have focussed on adults and high-risk populations, and little is known about young adults. The objective of the present study was to provide evidence on the SARS-CoV-2 seroprevalence among young adults in Germany and to explore determinants associated with seropositivity in general and, specifically, with previously undetected infections. STUDY DESIGN: This was a population-based SARS-CoV-2 seroprevalence study. METHODS: In November 2020, a population-based study on SARS-CoV-2 seroprevalence in young adults (aged 18-30 years) was conducted in a large German city. Serum samples were obtained to analyse the SARS-CoV-2 antibody status using the Elecsys Anti-SARS-CoV-2 immunoassay. Descriptive statistics and odds ratios (ORs) of seropositivity and of previously undetected infections in relation to different determinants were calculated. RESULTS: Among 2186 participants, SARS-CoV-2 antibodies were detected in 72 individuals, equalling a test performance-adjusted seroprevalence of 3.1% (95% confidence interval [CI]: 2.4-4.0). Based on reported COVID-19 cases to the public health authority, a moderate underascertainment rate of 1.7 was calculated. Seropositivity was higher among individuals who sought COVID-19-related information from social media (OR: 1.83, 95% CI: 1.2-3.1), and undetected COVID-19 infections were more prevalent among men and those not adhering to social distancing. CONCLUSIONS: The results show a substantial underascertainment of SARS-CoV-2 infections among young adults and indicate that seroprevalence is likely to be much higher than the reported COVID-19 prevalence based on confirmed COVID-19 cases in Germany. Preventive efforts should consider the heterogeneity of risk profiles among the young adult population.
Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Viral , COVID-19/epidemiology , Humans , Immunoglobulin G , Male , Seroepidemiologic Studies , Young AdultABSTRACT
BACKGROUND: Providing frontline support places first responders at a high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. AIMS: This study was aimed to determine the anti-SARS-CoV-2 seroprevalence in a cohort of first responders (i.e. firefighters/paramedics), to detect the underascertainment rate and to assess risk factors associated with seropositivity. METHODS: We conducted a serological survey among 745 first responders in Germany during 27 November and 4 December 2020 to determine the anti-SARS-CoV-2 seroprevalence using Elecsys® Anti-SARS-CoV-2 immunoassay (Roche Diagnostics, Mannheim, Germany). As part of the examination, participants were asked to provide information on coronavirus disease 2019 (COVID-19)-like-symptoms, information on sociodemographic characteristics and workplace risk factors for a SARS-CoV-2 infection and any prior COVID-19 infection. Descriptive statistics and logistic regression analysis were performed and seroprevalence estimates were adjusted for test sensitivity and specificity. RESULTS: The test-adjusted seroprevalence was 4% (95% CI 3.1-6.2) and the underascertainment rate was 2.3. Of those tested SARS-CoV-2 antibody positive, 41% were aware that they had been infected in the past. Seropositivity was elevated among paramedics who worked in the emergency rescue team providing first level of pre-hospital emergency care (6% [95% CI 3.4-8.6]) and those directly exposed to a COVID-19 case (5% [95% CI 3.5-8.1]). Overall, the seroprevalence and the underascertainment rate were higher among first responders than among the general population. CONCLUSIONS: The high seroprevalence and underascertainment rate highlight the need to mitigate potential transmission within and between first responders and patients. Workplace control measures such as increased and regular COVID-19-testing and the prompt vaccination of all personnel are necessary.