Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 29
Filter
1.
Vaccine ; 2022.
Article in English | ScienceDirect | ID: covidwho-2159908

ABSTRACT

Background The extent to which vaccinated persons who become infected with SARS-CoV-2 contribute to transmission is unclear. During a SARS-CoV-2 Delta variant outbreak among incarcerated persons with high vaccination rates in a federal prison, we assessed markers of viral shedding in vaccinated and unvaccinated persons. Methods Consenting incarcerated persons with confirmed SARS-CoV-2 infection provided mid-turbinate nasal specimens daily for 10 consecutive days and reported symptom data via questionnaire. Real-time reverse transcription-polymerase chain reaction (RT-PCR), viral whole genome sequencing, and viral culture was performed on these nasal specimens. Duration of RT-PCR positivity and viral culture positivity was assessed using survival analysis. Results A total of 957 specimens were provided by 93 participants, of whom 78 (84%) were vaccinated and 17 (16%) were unvaccinated. No significant differences were detected in duration of RT-PCR positivity among vaccinated participants (median: 13 days) versus those unvaccinated (median: 13 days;p=0.50), or in duration of culture positivity (medians: 5 days and 5 days;p=0.29). Among vaccinated participants, overall duration of culture positivity was shorter among Moderna vaccine recipients versus Pfizer (p=0.048) or Janssen (p=0.003) vaccine recipients. In post-hoc analyses, Moderna vaccine recipients demonstrated significantly shorter duration of culture positivity compared to unvaccinated participants (p=0.02). When restricted to participants without reported prior infection, the difference between Moderna vaccine recipients and unvaccinated participants was more pronounced (medians: 3 days and 6 days, p=0.002). Conclusions Infectious periods for vaccinated and unvaccinated persons who become infected with SARS-CoV-2 are similar and can be highly variable, though some vaccinated persons are likely infectious for shorter durations. These findings are critically important, especially in congregate settings where viral transmission can lead to large outbreaks. In such settings, clinicians and public health practitioners should consider vaccinated, infected persons to be no less infectious than unvaccinated, infected persons.

2.
Vaccine ; 2022 Nov 18.
Article in English | MEDLINE | ID: covidwho-2120230

ABSTRACT

The preclinical time course of SARS-CoV-2 shedding is not well-described. Understanding this time course will help to inform risk of SARS-CoV-2 transmission. During an outbreak in a congregate setting, we collected paired mid-turbinate nasal swabs for antigen testing and reverse-transcription polymerase chain reaction (RT-PCR) every other day from all consenting infected and exposed persons. Among 12 persons tested prospectively before and during SARS-CoV-2 infection, ten of 12 participants (83%) had completed a primary COVID-19 vaccination series prior to the outbreak. We recovered SARS-CoV-2 in viral culture from 9/12 (75%) of participants. All three persons from whom we did not recover SARS-CoV-2 in viral culture had completed their primary vaccination series. We recovered SARS-CoV-2 from viral culture in 6/9 vaccinated persons and before symptom onset in 3/6 symptomatic persons. These findings underscore the need for both non-pharmaceutical interventions and vaccination to mitigate transmission.

3.
J Occup Environ Med ; 64(11): e677-e684, 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2107639

ABSTRACT

OBJECTIVE: The aim of this study was to measure the association of working from home (WFH) with work productivity loss due to caregiving responsibilities or health problems during the COVID-19 pandemic. METHODS: We conducted an online survey of family/friend caregivers (n = 150 WFH/75 non-WFH) and patients (n = 95/91) who worked during the past 7 days in May and July 2020, respectively. Absenteeism and presenteeism were measured using the Valuation of Lost Productivity questionnaire. RESULTS: Working from home was associated with higher odds of absenteeism (odds ratio, 2.53; 95% confidence interval, 1.11 to 5.77) and presenteeism (2.79; 1.26 to 6.18) among caregivers and higher odds of presenteeism among patients (2.78; 1.13 to 6.84). However, among caregivers with absenteeism more than 0 days, WFH was significantly associated with fewer absent workdays. CONCLUSIONS: Working from home was not associated with overall absenteeism and presenteeism in caregivers or patients. Working from home allows a more flexible and inclusive workplace without impacting productivity, although further research is needed.


Subject(s)
COVID-19 , Caregivers , Humans , COVID-19/epidemiology , Pandemics , Cross-Sectional Studies , Efficiency , Presenteeism , Absenteeism , Surveys and Questionnaires
4.
JMIR Form Res ; 6(9): e37746, 2022 Sep 30.
Article in English | MEDLINE | ID: covidwho-2054767

ABSTRACT

BACKGROUND: Suicide is a leading cause of death in the United States, and suicidal ideation (SI) is a significant precursor and risk factor for suicide. OBJECTIVE: This study aimed to examine the impact of a telepsychiatric care platform on changes in SI over time and remission, as well as to investigate the relationship between various demographic and medical factors on SI and SI remission. METHODS: Participants included 8581 US-based adults (8366 in the treatment group and 215 in the control group) seeking treatment for depression, anxiety, or both. The treatment group included patients who had completed at least 12 weeks of treatment and had received a prescription for at least one psychiatric medication during the study period. Providers prescribed psychiatric medications for each patient during their first session and received regular data on participants. They also received decision support at treatment onset via the digital platform, which leveraged an empirically derived proprietary precision-prescribing algorithm to give providers real-time care guidelines. Participants in the control group consisted of individuals who completed the initial enrollment data and completed surveys at baseline and 12 weeks but did not receive care. RESULTS: Greater feelings of hopelessness, anhedonia, and feeling bad about oneself were most significantly correlated (r=0.24-0.37) with SI at baseline. Sleep issues and feeling tired or having low energy, although significant, had lower correlations with SI (r=0.13-0.14). In terms of demographic variables, advancing age and education were associated with less SI at baseline (r=-0.16) and 12 weeks (r=-0.10) but less improvement over time (r=-0.12 and -0.11, respectively). Although not different at baseline, the SI expression was evident in 34.4% (74/215) of the participants in the control group and 12.32% (1031/8366) of the participants in the treatment group at 12 weeks. Although the participants in the treatment group improved over time regardless of various demographic variables, participants in the control group with less education worsened over time, after controlling for age and depression severity. A model incorporating the treatment group, age, sex, and 8-item Patient Health Questionnaire scores was 77% accurate in its classification of complete remission. Those in the treatment group were 4.3 times more likely (odds ratio 4.31, 95% CI 2.88-6.44) to have complete SI remission than those in the control group. Female participants and those with advanced education beyond high school were approximately 1.4 times more likely (odds ratio 1.38, 95% CI 1.18-1.62) to remit than their counterparts. CONCLUSIONS: The results highlight the efficacy of an antidepressant intervention in reducing SI, in this case administered via a telehealth platform and with decision support, as well as the importance of considering covariates, or subpopulations, when considering SI. Further research and refinement, ideally via randomized controlled trials, are needed.

5.
J Thromb Haemost ; 20(12): 2896-2908, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2052857

ABSTRACT

BACKGROUND: Vaccine-induced thrombotic thrombocytopenia (VITT) is a rare complication of adenovirus-based vaccines aimed to prevent and minimize COVID-19 and related pathophysiology. OBJECTIVES: To describe patterns of testing for anti-platelet factor 4 (PF4) antibodies using various ELISA assays in a large Australian cohort and comparative functional platelet activation assays in a subset. PATIENTS/METHODS: Asserachrom HPIA IgG ELISA was performed in 1284 patients over a period of 12 months, supplemented in select cohorts by comparative ELISA using three other methods (n = 78-179), three different functional assays (flow cytometry, serotonin release assay, and/or Multiplate; n = 476), and rapid immunological chemiluminescence anti-PF4 assay (n = 460), in a multicenter study. RESULTS: For first episode presentations, 190/1284 (14.8%) ELISA tests were positive. Conversely, most (445/460; 96.7%) chemiluminescence anti-PF4 test results were negative. All functional assays showed associations of higher median ELISA optical density with functional positivity and with high rates of ELISA positivity (64.0% to 85.2%). Data also identified functional positivity in 14.8%-36.0% of ELISA negative samples, suggesting false negative VITT by HPIA IgG ELISA in upward of one third of assessable cases. CONCLUSION: To our knowledge, this is the largest multicenter evaluation of anti-PF4 testing for investigation of VITT. Discrepancies in test results (ELISA vs. ELISA or ELISA vs. functional assay) in some patients highlighted limitations in relying on single methods (ELISA and functional) for PF4 antibody detection in VITT, and also highlights the variability in phenotypic test presentation and pathomechanism of VITT.


Subject(s)
COVID-19 , Thrombocytopenia , Thrombosis , Vaccines , Humans , Platelet Factor 4 , Heparin/adverse effects , Australia , Thrombocytopenia/chemically induced , Thrombocytopenia/diagnosis , Thrombosis/diagnosis , Immunologic Factors/adverse effects , Immunoglobulin G
6.
JPGN reports ; 3(4):e261-e261, 2022.
Article in English | EuropePMC | ID: covidwho-2046636

ABSTRACT

Objectives: As the COVID-19 pandemic persisted into the 2020 to 2021 academic year, there was a continued effect on graduate medical education trainees and graduating trainee job attainment. Our survey aims to investigate how the pandemic has continued to affect job search and attainment for pediatric gastroenterology fellows as well as to re-evaluate the pandemic’s impact on pediatric gastroenterology fellow educational experiences. Methods: An anonymous survey was distributed to all North American pediatric gastroenterology fellows from May to June 2021. Survey questions included topics related to job search and fellowship training and were tailored to respondent year of training. Results: Of 453 pediatric gastroenterology fellows in the 2020 to 2021 academic year, 158 fellows (35%) responded to the survey. Of graduating fellow respondents with job contracts, 74% reported willingness to make compromises in their job search, 76% reported accepting academic positions that were primary clinical, and 42% estimated staying at their accepted job for less than 5 years. When asked about the impact of COVID-19 on various aspects of fellowship education, a negative impact was reported in the following areas: 76% in research, 94% in clinical experience, 73% in procedural skills, and 84% in didactics. Conclusion: The COVID-19 pandemic continues to make a significant impact on pediatric gastroenterology fellowship education and the job attainment process. Regarding accepted job positions, we found substantial willingness to compromise, a shorter duration to stay at the job than expected, and minimal research focus. This raises concern regarding job preparedness and satisfaction as fellows complete their medical training.

7.
J Am Coll Health ; : 1-8, 2022 Jul 01.
Article in English | MEDLINE | ID: covidwho-1915375

ABSTRACT

OBJECTIVE: Characterize college student COVID-19 behaviors and attitudes during the early pandemic. Participants: Students on two university campuses in Wisconsin. METHODS: Surveys administered in September and November 2020. RESULTS: Few students (3-19%) participated in most in-person activities during the semester, with eating at restaurants as the exception (72-80%) and attending work (35%) and parties (33%) also reported more frequently. The majority wore masks in public (94-99%), but comparatively fewer (42%) did so at parties. Mask-wearing at parties decreased from September to November (p < 0.05). Students attending parties, or consuming more alcohol, were less concerned and more likely to take COVID-19-associated risks. CONCLUSIONS: Students were motivated to adhere to COVID-19 prevention measures but gathered socially. Though there was frequent public masking, mask-wearing at parties declined in November and may represent pandemic fatigue. High-yield strategies for decreasing viral spread may include changing masking social norms and engaging with students about creative risk-reduction strategies.

8.
Prev Sci ; 23(6): 853-864, 2022 08.
Article in English | MEDLINE | ID: covidwho-1859064

ABSTRACT

This study examined longitudinal trajectories of young adults' mental health and well-being before and throughout the first year-and-a-half of the COVID-19 pandemic. Repeated assessments of a young adult community cohort (N = 656; Mage = 25.6 years; 59.3% female) were conducted beginning prior to COVID-19 (January 2020) and extending through August 2021. Multilevel spline growth models estimated changes in three segments: (a) from pre-pandemic to April/May 2020, (b) from April/May 2020 to September 2020, and (c) from September 2020 to August 2021. Depression symptoms and loneliness increased significantly in the first segment, plateaued slightly, then decreased significantly across the final segment. Anxiety symptoms were unchanged across the first two segments, but significantly decreased in the final segment. Satisfaction with life decreased significantly across the first two segments, and then increased significantly in the final segment. Direct comparisons of pre-pandemic scores (January 2020) to the last follow-up (July or August 2021) showed a return to pre-pandemic levels of depression symptoms, loneliness, and satisfaction with life, as indicated by non-significant differences, and significantly lower anxiety symptoms, relative to pre-pandemic. Findings support concerns for young adults' mental health and well-being in the initial months of the COVID-19 pandemic, but also indicate that young adults' emotional well-being, on average, may be returning to pre-pandemic levels.


Subject(s)
COVID-19 , Adult , Anxiety/epidemiology , Depression/epidemiology , Depression/psychology , Female , Humans , Loneliness/psychology , Longitudinal Studies , Male , Mental Health , Pandemics , Young Adult
9.
J Med Virol ; 94(9): 4234-4245, 2022 09.
Article in English | MEDLINE | ID: covidwho-1850130

ABSTRACT

To provide a comparative meta-analysis and systematic review of the risk and clinical outcomes of coronavirus 2019 (COVID-19) infection between fully vaccinated and unvaccinated groups. Eighteen studies of COVID-19 infections in fully vaccinated ("breakthrough infections") and unvaccinated individuals were reviewed from Medline/PubMed, Scopus, Embase, and Web of Science databases. The meta-analysis examined the summary effects and between-study heterogeneity regarding differences in the risk of infection, hospitalization, treatments, and mortality between vaccinated and unvaccinated individuals. he overall risk of infection was lower for the fully vaccinated compared to that of the unvaccinated (relative risk [RR] 0.20, 95% confidence interval [CI]: 0.19-0.21), especially for variants other than Delta (Delta: RR 0.29, 95% CI: 0.13-0.65; other variants: RR 0.06, 95% CI: 0.04-0.08). The risk of asymptomatic infection was not statistically significantly different between fully vaccinated and unvaccinated (RR 0.56, 95% CI: 0.27-1.19). There were neither statistically significant differences in risk of hospitalization (RR 1.06, 95% CI: 0.38-2.93), invasive mechanical ventilation (RR 1.65, 95% CI: 0.90-3.06), or mortality (RR 1.19, 95% CI: 0.79-1.78). Conversely, the risk of supplemental oxygen during hospitalization was significantly higher for the unvaccinated (RR 1.40, 95% CI: 1.08-1.82). Unvaccinated people were more vulnerable to COVID-19 infection than fully vaccinated for all variants. Once infected, there were no statistically significant differences in the risk of hospitalization, invasive mechanical ventilation, or mortality. Still, unvaccinated showed an increased need for oxygen supplementation. Further prospective analysis, including patients' risk factors, COVID-19 variants, and the utilized treatment strategies, would be warranted.


Subject(s)
COVID-19 , Coronavirus Infections , COVID-19 Vaccines , Humans , SARS-CoV-2
10.
BMC Infect Dis ; 22(1): 314, 2022 Mar 31.
Article in English | MEDLINE | ID: covidwho-1770495

ABSTRACT

BACKGROUND: To improve understanding of the antibody response to SARS-CoV-2 infection, we examined seroprevalence, incidence of infection, and seroconversion among a cohort of young adults living on university campuses during the fall of 2020. METHODS: At the beginning (semester start) and end (semester end) of an 11-week period, serum collected from 107 students was tested using the qualitative Abbott Architect SARS-CoV-2 IgG and AdviseDx SARS-CoV-2 IgG II assays. Results were matched to interim weekly surveillance viral testing and symptom data. RESULTS: With the SARS-CoV-2 IgG assay, 15 (14.0%) students were seropositive at semester start; 29 (27.1%) students were seropositive at semester end; 10 (9.3%) were seropositive at both times. With the AdviseDx SARS-CoV-2 IgG II assay, 17 (16.3%) students were seropositive at semester start, 37 (35.6%) were seropositive at semester end, and 16 (15.3%) were seropositive at both times. Overall, 23 students (21.5%) had positive viral tests during the semester. Infection was identified by serial testing in a large majority of individuals who seroconverted using both assays. Those seropositive at semester end more frequently reported symptomatic infections (56.5%) than asymptomatic infections (30.4%). CONCLUSION: Differences between antibody targets were observed, with more declines in antibody index values below the threshold of positivity with the anti-nucleocapsid assay compared to the anti-spike assay. Serology testing, combined with serial viral testing, can detect seroconversions, and help understand the potential correlates of protection provided by antibodies to SARS-CoV-2.


Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Viral , COVID-19/diagnosis , COVID-19/epidemiology , Cohort Studies , Enzyme-Linked Immunosorbent Assay , Humans , Seroconversion , Seroepidemiologic Studies , Students , Universities
11.
Blood Adv ; 6(11): 3494-3506, 2022 06 14.
Article in English | MEDLINE | ID: covidwho-1765427

ABSTRACT

Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe prothrombotic complication of adenoviral vaccines, including the ChAdOx1 nCoV-19 (Vaxzevria) vaccine. The putative mechanism involves formation of pathological anti-platelet factor 4 (PF4) antibodies that activate platelets via the low-affinity immunoglobulin G receptor FcγRIIa to drive thrombosis and thrombocytopenia. Functional assays are important for VITT diagnosis, as not all detectable anti-PF4 antibodies are pathogenic, and immunoassays have varying sensitivity. Combination of ligand binding of G protein-coupled receptors (protease-activated receptor-1) and immunoreceptor tyrosine-based activation motif-linked receptors (FcγRIIa) synergistically induce procoagulant platelet formation, which supports thrombin generation. Here, we describe a flow cytometry-based procoagulant platelet assay using cell death marker GSAO and P-selectin to diagnose VITT by exposing donor whole blood to patient plasma in the presence of a protease-activated receptor-1 agonist. Consecutive patients triaged for confirmatory functional VITT testing after screening using PF4/heparin ELISA were evaluated. In a development cohort of 47 patients with suspected VITT, plasma from ELISA-positive patients (n = 23), but not healthy donors (n = 32) or individuals exposed to the ChAdOx1 nCov-19 vaccine without VITT (n = 24), significantly increased the procoagulant platelet response. In a validation cohort of 99 VITT patients identified according to clinicopathologic adjudication, procoagulant flow cytometry identified 93% of VITT cases, including ELISA-negative and serotonin release assay-negative patients. The in vitro effect of intravenous immunoglobulin (IVIg) and fondaparinux trended with the clinical response seen in patients. Induction of FcγRIIa-dependent procoagulant response by patient plasma, suppressible by heparin and IVIg, is highly indicative of VITT, resulting in a sensitive and specific assay that has been adopted as part of a national diagnostic algorithm to identify vaccinated patients with platelet-activating antibodies.


Subject(s)
Purpura, Thrombocytopenic, Idiopathic , Thrombocytopenia , Thrombosis , ChAdOx1 nCoV-19 , Flow Cytometry , Heparin/therapeutic use , Humans , Immunoglobulins, Intravenous/adverse effects , Platelet Factor 4 , Purpura, Thrombocytopenic, Idiopathic/drug therapy , Receptors, Proteinase-Activated/therapeutic use , Thrombocytopenia/diagnosis , Thrombosis/drug therapy
12.
Int J Ment Health Addict ; : 1-14, 2021 Aug 04.
Article in English | MEDLINE | ID: covidwho-1706230

ABSTRACT

Alongside direct health concerns pertaining to the SARS-CoV-2 virus, the stressors and life disruptions associated with the COVID-19 pandemic may provoke secondary concerns for health and well-being. The implications of COVID-19-related stressors may be particularly salient for young adults, who are at higher-risk for mental health concerns and substance use behaviors. We developed a multifaceted scale that assessed distinct domains of COVID-19-related stressors and examined associations between these stressors and indices of mental health, well-being, and substance use (alcohol and marijuana use). In April-June of 2020, 1181 young adults were recruited from two- and four-year colleges to participate in this study (M age = 20.40; 59.95% women). Exploratory factor analysis identified five domains of COVID-19-related stressors: job insecurity, social/relational, financial, illness-related, and school-related. The overall pattern of results indicated that COVID-19-related stressors were related to poorer mental health and well-being. Social/relational stressors emerged as a primary concern most strongly associated with indices of mental health and alcohol use, relative to other stressors. However, illness-related stressors and school-related stressors were associated with less alcohol use. Stressors associated with the COVID-19 pandemic may impact young adults' health and well-being but disentangling various stressor domains informs more tailored intervention and prevention strategies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11469-021-00604-0.

13.
Appl Psychol Health Well Being ; 14(3): 734-756, 2022 08.
Article in English | MEDLINE | ID: covidwho-1662238

ABSTRACT

The COVID-19 pandemic has presented young adults with novel challenges and disruptions to several life domains. The current study examined how COVID-19-related stressors (i.e., job-related, financial-related, social/relational, and illness-related stressors) relate to young adults' symptoms of depression and anxiety, and satisfaction with life (in the US). In Aim 1, we examined associations between COVID-19-related stressors and indices of mental health and well-being in the initial phase of the pandemic (April/May 2020) while accounting for participants' pre-pandemic levels of these outcomes in January of 2020 (N = 519; Mage = 25.4; 62.8% women). Social/relational stressors were most strongly associated with increased symptoms of anxiety/depression, and financial stressors were most strongly associated with decreased satisfaction with life. Extending this research longitudinally (Aim 2), we sampled young adults bi-monthly across a year-long period (September 2020 to August 2021). Multilevel models revealed within-person associations between each stressor domain and mental health/well-being; young adults reported more symptoms of depression/anxiety and lower satisfaction with life in months that stressors were relatively more salient. Interactions between stressors and time revealed associations were generally stronger in earlier months and decreased linearly across the pandemic. Taken together, longitudinal evidence indicates that COVID-19-related stressors, especially social/relational stressors, have direct and time-varying associations with mental health and well-being.


Subject(s)
COVID-19 , Adult , Anxiety/epidemiology , Anxiety/psychology , Depression/epidemiology , Depression/psychology , Female , Humans , Male , Mental Health , Pandemics , Young Adult
14.
Aerosp Med Hum Perform ; 92(11): 898-907, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1533628

ABSTRACT

BACKGROUND: While many COVID-19 studies focus on acute effects of the infection, few examine the intermediate and long-term sequelae of the illness. Studies have shown that a good portion of patients have chronic effects in several body systems for several months or longer. Such effects can potentially adversely impact pilot performance in flight. We sought to determine the long-term effects of COVID-19 infection, how such effects can affect pilot performance, and how to best evaluate pilots for aeromedical flight clearance.METHODS: We used the PubMed literature search engine to review peer-reviewed articles that focused on the intermediate and long-term effects of COVID-19 infection. Chronic signs and symptoms were subdivided based on the particular body organ system affected. Merging information obtained from case reviews, article reviews, and aeromedical standards, we created a risk stratification guide to assist with the aeromedical disposition of affected pilots.RESULTS: Long-term effects of COVID-19 infection can last for several months or longer. The most common effects are fatigue, weakness, pulmonary diffusion defects, depression, and anxiety.DISCUSSION: This review article focuses on the most common intermediate- and long-term COVID-19 conditions of aeromedical significance and the corresponding course of actions recommended for the aeromedical examiner. Aeromedical evaluation should take into consideration factors related to the pilot, aircraft type, and specific aviation environment. Such evaluation may include diagnostic testing, medical specialist consultation, preflight simulation in an altitude chamber, human centrifuge testing, and/or a flight simulator checkride.Ko SY, Nguyen NK, Lee CL, Lee LA, Nguyen KUT, Lee EC. Aeromedical implications of long-term COVID-19 sequelae. Aerosp Med Hum Perform. 2021; 92(11):898-907.


Subject(s)
Aerospace Medicine , Air Ambulances , COVID-19 , Pilots , Humans , SARS-CoV-2
15.
Clin Infect Dis ; 73(6): e1348-e1355, 2021 09 15.
Article in English | MEDLINE | ID: covidwho-1479943

ABSTRACT

BACKGROUND: Real-time reverse transcription polymerase chain reaction (rRT-PCR) and antigen tests are important diagnostics for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Sensitivity of antigen tests has been shown to be lower than that of rRT-PCR; however, data to evaluate epidemiologic characteristics that affect test performance are limited. METHODS: Paired mid-turbinate nasal swabs were collected from university students and staff and tested for SARS-CoV-2 using both Quidel Sofia SARS Antigen Fluorescent Immunoassay (FIA) and rRT-PCR assay. Specimens positive by either rRT-PCR or antigen FIA were placed in viral culture and tested for subgenomic RNA (sgRNA). Logistic regression models were used to evaluate characteristics associated with antigen results, rRT-PCR cycle threshold (Ct) values, sgRNA, and viral culture. RESULTS: Antigen FIA sensitivity was 78.9% and 43.8% among symptomatic and asymptomatic participants, respectively. Among rRT-PCR positive participants, negative antigen results were more likely among asymptomatic participants (odds ratio [OR] 4.6, 95% confidence interval [CI]: 1.3-15.4) and less likely among participants reporting nasal congestion (OR 0.1, 95% CI: .03-.8). rRT-PCR-positive specimens with higher Ct values (OR 0.5, 95% CI: .4-.8) were less likely, and specimens positive for sgRNA (OR 10.2, 95% CI: 1.6-65.0) more likely, to yield positive virus isolation. Antigen testing was >90% positive in specimens with Ct values < 29. Positive predictive value of antigen test for positive viral culture (57.7%) was similar to that of rRT-PCR (59.3%). CONCLUSIONS: SARS-CoV-2 antigen test advantages include low cost, wide availability and rapid turnaround time, making them important screening tests. The performance of antigen tests may vary with patient characteristics, so performance characteristics should be accounted for when designing testing strategies and interpreting results.


Subject(s)
COVID-19 , SARS-CoV-2 , Antigens, Viral , Humans , RNA , Reverse Transcriptase Polymerase Chain Reaction , Reverse Transcription , Sensitivity and Specificity , Universities
16.
Emerg Infect Dis ; 27(11): 2776-2785, 2021 11.
Article in English | MEDLINE | ID: covidwho-1444021

ABSTRACT

University settings have demonstrated potential for coronavirus disease (COVID-19) outbreaks; they combine congregate living, substantial social activity, and a young population predisposed to mild illness. Using genomic and epidemiologic data, we describe a COVID-19 outbreak at the University of Wisconsin-Madison, Madison, Wisconsin, USA. During August-October 2020, a total of 3,485 students, including 856/6,162 students living in dormitories, tested positive. Case counts began rising during move-in week, August 25-31, 2020, then rose rapidly during September 1-11, 2020. The university initiated multiple prevention efforts, including quarantining 2 dormitories; a subsequent decline in cases was observed. Genomic surveillance of cases from Dane County, in which the university is located, did not find evidence of transmission from a large cluster of cases in the 2 quarantined dorms during the outbreak. Coordinated implementation of prevention measures can reduce COVID-19 spread in university settings and may limit spillover to the surrounding community.


Subject(s)
COVID-19 , Universities , Disease Outbreaks , Humans , SARS-CoV-2 , Wisconsin/epidemiology
17.
MMWR Morb Mortal Wkly Rep ; 70(38): 1349-1354, 2021 Sep 24.
Article in English | MEDLINE | ID: covidwho-1436417

ABSTRACT

Incarcerated populations have experienced disproportionately higher rates of COVID-19-related illness and death compared with the general U.S. population, due in part to congregate living environments that can facilitate rapid transmission of SARS-CoV-2, the virus that causes COVID-19, and the high prevalence of underlying medical conditions associated with severe COVID-19 (1,2). The SARS-CoV-2 B.1.617.2 (Delta) variant has caused outbreaks among vaccinated and unvaccinated persons in congregate settings and large public gatherings (3,4). During July 2021, a COVID-19 outbreak involving the Delta variant was identified in a federal prison in Texas, infecting 172 of 233 (74%) incarcerated persons in two housing units. The Federal Bureau of Prisons (BOP) partnered with CDC to investigate. CDC analyzed data on infection status, symptom onset date, hospitalizations, and deaths among incarcerated persons. The attack rate was higher among unvaccinated versus fully vaccinated persons (39 of 42, 93% versus 129 of 185, 70%; p = 0.002).† Four persons were hospitalized, three of whom were unvaccinated, and one person died, who was unvaccinated. Among a subset of 70 persons consenting to an embedded serial swabbing protocol, the median interval between symptom onset and last positive reverse transcription-polymerase chain reaction (RT-PCR) test result in fully vaccinated versus unvaccinated persons was similar (9 versus 11 days, p = 0.37). One or more specimens were culture-positive from five of 12 (42%) unvaccinated and 14 of 37 (38%) fully vaccinated persons for whom viral culture was attempted. In settings where physical distancing is challenging, including correctional and detention facilities, vaccination and implementation of multicomponent prevention strategies (e.g., testing, medical isolation, quarantine, and masking) are critical to limiting SARS-CoV-2 transmission (5).


Subject(s)
COVID-19/epidemiology , COVID-19/virology , Disease Outbreaks , Prisoners/statistics & numerical data , Prisons , SARS-CoV-2/isolation & purification , Adolescent , Adult , Aged , COVID-19/prevention & control , COVID-19/transmission , COVID-19 Testing , COVID-19 Vaccines/administration & dosage , Humans , Male , Middle Aged , Texas/epidemiology , Young Adult
18.
Open Forum Infect Dis ; 8(9): ofab405, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1434432

ABSTRACT

BACKGROUND: Multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks occurred at universities during Fall 2020, but little is known about risk factors for campus-associated infections or immunity provided by anti-SARS-CoV-2 antibodies in young adults. METHODS: We conducted surveys and serology tests among students living in dormitories in September and November to examine infection risk factors and antibody presence. Using campus weekly reverse-transcription polymerase chain reaction (RT-PCR) test results, the relationship between survey responses, SARS-CoV-2 antibodies, and infections was assessed. RESULTS: Of 6136 students, 1197 completed the survey and 572 also completed serologic testing in September compared with 517 and 414 in November, respectively. Participation in fraternity or sorority events (adjusted risk ratio [aRR], 1.9 [95% confidence interval {CI}, 1.4-2.5]) and frequent alcohol consumption (aRR, 1.6 [95% CI, 1.2-2.2]) were associated with SARS-CoV-2 infection. Mask wearing during social events (aRR, 0.6 [95% CI, .6-1.0]) was associated with decreased risk. None of the 20 students with antibodies in September tested positive for SARS-CoV-2 during the semester, while 27.8% of students who tested RT-PCR positive tested negative for antibodies in November. CONCLUSIONS: Frequent drinking and attending social events were associated with SARS-CoV-2 infection. Antibody presence in September appeared to be protective from reinfection, but this finding was not statistically significant.

20.
Frontiers in Marine Science ; 2021.
Article in English | ProQuest Central | ID: covidwho-1218485

ABSTRACT

The COVID-19 pandemic halted human activities globally in multiple sectors including tourism. As a result, nations with heavy tourism, such as Belize, experienced improvements in water quality. Remote sensing technologies can detect impacts of “anthropauses” on coastal water quality. In this study, MODIS satellite data were employed along the Belizean coast to investigate impacts of the COVID-19 shutdown on water quality. The attenuation coefficient at 490 nm, Kd(490), was used as an indicator of water quality, with a lower Kd(490) indicating increased water clarity. Four Coastal Management Zones were characterized by marine traffic as high traffic areas (HTAs) and two as low traffic areas (LTAs). Monthly composites for two periods, 2002-2019 (baseline) and 2020 were examined for Kd(490). For months prior to the COVID-19 shutdown in Belize, there was generally no significant difference in Kd(490) (p>0.05) between 2020 and baseline period in HTAs and LTAs. Through the shutdown, Kd was lower in 2020 at HTAs, but not for LTAs. At the LTAs, the Kd(490)s observed in 2020 were similar to previous years through October. In November, an unusually active hurricane season in 2020 was associated with decreased water clarity along the entire coast of Belize. This study provides proof of concept that satellite-based monitoring of water quality can complement in situ data and provide evidence of significant water quality improvements due to the COVID-19 shutdown, likely due to reduced marine traffic. However, these improvements were no longer observed following an active hurricane season.

SELECTION OF CITATIONS
SEARCH DETAIL