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1.
Ther Adv Infect Dis ; 9: 20499361221074569, 2022.
Article in English | MEDLINE | ID: covidwho-1666600

ABSTRACT

BACKGROUND/AIMS: Data concerning differences in demographics/disease severity between the first and second waves of COVID-19 are limited. We aimed to examine prognosis in patients presenting to hospital with COVID-19 amongst different ethnic groups between the first and second waves in the UK. METHODS: In this retrospective cohort study, we included 1763 patients presenting to a regional hospital centre in Leicester (UK) and compared those in the first (n = 956) and second (n = 807) waves. Admission National Early Warning Scores, mechanical ventilation and mortality rate were lower in the second wave compared with the first. RESULTS: Thirty-day mortality risk in second wave patients was approximately half that of first wave patients [adjusted hazard ratio (aHR) 0.55, 95% confidence interval (CI) 0.40-0.75]. In the second wave, Black patients were at higher risk of 30-day mortality than White patients (4.73, 1.56-14.3). CONCLUSION: We found that disporportionately higher risks of death in patients from ethnic minority groups were not equivalent across consecutive waves of the pandemic. This suggests that risk factors for death in those from ethnic minority groups are malleable and potentially reversible. Our findings need urgent investigation in larger studies.

2.
The Lancet ; 398, 2021.
Article in English | ProQuest Central | ID: covidwho-1537144

ABSTRACT

Background Little is known about how asymptomatic testing as a method to control the transmission of COVID-19 can be successfully implemented, and the prevalence of asymptomatic infection within university populations. The aim of this study was to describe the methodology of implementing a novel asymptomatic mass testing programme, and to report the number of positive cases diagnosed during the study period. To our knowledge, this study is the first to report prevalence of asymptomatic COVID-19 infection within a UK university population using reverse transcriptase loop-mediated isothermal amplification (RT-LAMP) as a molecular diagnostic tool. Methods An observational study was undertaken to describe the set-up and implementation of a novel COVID-19 testing programme on a UK university campus between Sept 28 and Dec 18, 2020. Students and staff members volunteered for testing throughout the term. The programme used RT-LAMP testing to identify asymptomatic cases within the population. Any positive cases received RT-PCR testing to confirm the result using the current gold-standard testing methodology. Findings 1673 tests were done using RT-LAMP during the study period, of which nine were positive for COVID-19. This gave an overall positivity rate of 0·54%, equivalent to a rate in the tested population of 538 cases per 100 000 over the duration of testing. All positive tests were also found to be positive on RT-PCR testing, giving a false positive rate of 0%. Uptake was affected by changes to delivery of university teaching, leading to lower attendance on campus throughout the term. Interpretation This study shows that it is possible to rapidly set up a universal university testing programme for COVID-19 in collaboration with local health-care providers using RT-LAMP testing, with full concordance between RT-LAMP testing and RT-PCR testing on positive RT-LAMP results. Positive results were similar to those in the local population, although with a different weekly peak of infection. Funding None.

3.
PLoS Med ; 18(11): e1003823, 2021 11.
Article in English | MEDLINE | ID: covidwho-1504361

ABSTRACT

BACKGROUND: Healthcare workers (HCWs) and ethnic minority groups are at increased risk of COVID-19 infection and adverse outcomes. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is now available for frontline UK HCWs; however, demographic/occupational associations with vaccine uptake in this cohort are unknown. We sought to establish these associations in a large UK hospital workforce. METHODS AND FINDINGS: We conducted cross-sectional surveillance examining vaccine uptake amongst all staff at University Hospitals of Leicester NHS Trust. We examined proportions of vaccinated staff stratified by demographic factors, occupation, and previous COVID-19 test results (serology/PCR) and used logistic regression to identify predictors of vaccination status after adjustment for confounders. We included 19,044 HCWs; 12,278 (64.5%) had received SARS-CoV-2 vaccination. Compared to White HCWs (70.9% vaccinated), a significantly smaller proportion of ethnic minority HCWs were vaccinated (South Asian, 58.5%; Black, 36.8%; p < 0.001 for both). After adjustment for age, sex, ethnicity, deprivation, occupation, SARS-CoV-2 serology/PCR results, and COVID-19-related work absences, factors found to be negatively associated with vaccine uptake were younger age, female sex, increased deprivation, pregnancy, and belonging to any non-White ethnic group (Black: adjusted odds ratio [aOR] 0.30, 95% CI 0.26-0.34, p < 0.001; South Asian: aOR 0.67, 95% CI 0.62-0.72, p < 0.001). Those who had previously had confirmed COVID-19 (by PCR) were less likely to be vaccinated than those who had tested negative. Limitations include data being from a single centre, lack of data on staff vaccinated outside the hospital system, and that staff may have taken up vaccination following data extraction. CONCLUSIONS: Ethnic minority HCWs and those from more deprived areas as well as younger staff and female staff are less likely to take up SARS-CoV-2 vaccination. These findings have major implications for the delivery of SARS-CoV-2 vaccination programmes, in HCWs and the wider population, and should inform the national vaccination programme to prevent the disparities of the pandemic from widening.


Subject(s)
COVID-19 Vaccines/pharmacology , COVID-19/prevention & control , Health Personnel/statistics & numerical data , SARS-CoV-2/pathogenicity , Vaccination/statistics & numerical data , COVID-19/epidemiology , Delivery of Health Care/statistics & numerical data , Humans , Minority Groups , United Kingdom/epidemiology
5.
J Public Health (Oxf) ; 2020 Dec 26.
Article in English | MEDLINE | ID: covidwho-990793

ABSTRACT

BACKGROUND: Leicester was the first city in the UK to have 'local lockdown' measures imposed in response to high community rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. As part of this response, a directive was issued by NHS England to offer testing of asymptomatic healthcare workers (HCWs) at University Hospitals of Leicester NHS Trust (UHL) for SARS-CoV-2 infection. METHODS: Between 20 July and 14 August 2020, we invited all HCWs at UHL to attend for SARS-CoV-2 testing by nucleic acid amplification (NAAT). We combined the result of this assay with demographic information from the electronic staff record. RESULTS: A total of 1150 staff (~8% of the workforce) volunteered. The median age was 46 years (IQR 34-55), 972 (84.5%) were female; 234 (20.4%) were of South Asian and 58 (5.0%) of Black ethnicity; 564 (49.0%) were nurses/healthcare assistants. We found no cases of asymptomatic infection. In comparison, average community test positivity rate in Leicester city was 2.6%. CONCLUSIONS: Within the context of local lockdowns due to high community transmission rates, voluntary testing of asymptomatic staff has low uptake and low yield and thus its premise and cost-effectiveness should be re-considered.

6.
J Public Health (Oxf) ; 2020 Nov 16.
Article in English | MEDLINE | ID: covidwho-926296

ABSTRACT

BACKGROUND: Although evidence suggests that demographic characteristics including minority ethnicity increase the risk of infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), it is unclear whether these characteristics, together with occupational factors, influence anti-SARS-CoV-2 IgG seroprevalence in hospital staff. METHODS: We conducted cross-sectional surveillance examining seroprevalence of anti-SARS-CoV-2 IgG amongst staff at University Hospitals of Leicester (UHL) NHS Trust. We quantified seroprevalence stratified by ethnicity, occupation and seniority of practitioner and used logistic regression to examine demographic and occupational factors associated with seropositivity. RESULTS: A total of 1148/10662 (10.8%) hospital staff members were seropositive. Compared to White staff (seroprevalence 9.1%), seroprevalence was higher in South Asian (12.3%) and Black (21.2%) staff. The occupations and department with the highest seroprevalence were nurses/healthcare assistants (13.7%) and the Emergency Department (ED)/Acute Medicine (17.5%), respectively. Seroprevalence decreased with seniority in medical/nursing practitioners. Minority ethnicity was associated with seropositivity on an adjusted analysis (South Asian: aOR 1.26; 95%CI: 1.07-1.49 and Black: 2.42; 1.90-3.09). Anaesthetics/ICU staff members were less likely to be seropositive than ED/Acute medicine staff (0.41; 0.27-0.61). CONCLUSIONS: Ethnicity and occupational factors, including specialty and seniority, are associated with seropositivity for anti-SARS-Cov-2 IgG. These findings could be used to inform occupational risk assessments for front-line healthcare workers.

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