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Association of Age With Likelihood of Developing Symptoms and Critical Disease Among Close Contacts Exposed to Patients With Confirmed SARS-CoV-2 Infection in Italy.
Poletti, Piero; Tirani, Marcello; Cereda, Danilo; Trentini, Filippo; Guzzetta, Giorgio; Sabatino, Giuliana; Marziano, Valentina; Castrofino, Ambra; Grosso, Francesca; Del Castillo, Gabriele; Piccarreta, Raffaella; Andreassi, Aida; Melegaro, Alessia; Gramegna, Maria; Ajelli, Marco; Merler, Stefano.
  • Poletti P; Fondazione Bruno Kessler, Povo, Trento, Italy.
  • Tirani M; Directorate General for Health, Lombardy Region, Milan, Italy.
  • Cereda D; Health Protection Agency of Pavia, Pavia, Italy.
  • Trentini F; Directorate General for Health, Lombardy Region, Milan, Italy.
  • Guzzetta G; Fondazione Bruno Kessler, Povo, Trento, Italy.
  • Sabatino G; Fondazione Bruno Kessler, Povo, Trento, Italy.
  • Marziano V; Directorate General for Health, Lombardy Region, Milan, Italy.
  • Castrofino A; Fondazione Bruno Kessler, Povo, Trento, Italy.
  • Grosso F; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
  • Del Castillo G; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
  • Piccarreta R; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
  • Andreassi A; Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy.
  • Melegaro A; Department of Decision Sciences, Bocconi University, Milan, Italy.
  • Gramegna M; CovidCrisisLab, Bocconi University, Milan, Italy.
  • Ajelli M; Directorate General for Health, Lombardy Region, Milan, Italy.
  • Merler S; Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy.
JAMA Netw Open ; 4(3): e211085, 2021 03 01.
Article in English | MEDLINE | ID: covidwho-1125122
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. Disease PROCESS_OF Persons
Subject
Disease
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PROCESS_OF
Object
Persons
3. Disease INTERACTS_WITH 2019 novel coronavirus
Subject
Disease
Predicate
INTERACTS_WITH
Object
2019 novel coronavirus
4. COVID-19 PRECEDES Critical Illness
Subject
COVID-19
Predicate
PRECEDES
Object
Critical Illness
5. Real-Time Polymerase Chain Reaction USES Nasal Swab (procedure)
Subject
Real-Time Polymerase Chain Reaction
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USES
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Nasal Swab (procedure)
6. COVID-19 PROCESS_OF Persons
Subject
COVID-19
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PROCESS_OF
Object
Persons
7. Confirmed case PROCESS_OF Persons
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Confirmed case
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PROCESS_OF
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Persons
8. Disease PROCESS_OF Person exposed to disease
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Disease
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PROCESS_OF
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Person exposed to disease
9. Infected PROCESS_OF Persons
Subject
Infected
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PROCESS_OF
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Persons
10. Symptoms PROCESS_OF Persons
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Symptoms
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PROCESS_OF
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Persons
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Infected
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Participant
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Disease
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PROCESS_OF
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Participant
13. Fever PROCESS_OF Persons
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Fever
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Persons
14. Signs and Symptom PROCESS_OF C0027361
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Signs and Symptom
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15. COVID-19 PRECEDES Disease
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COVID-19
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PRECEDES
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Disease
16. Fever NEG_PROCESS_OF Persons
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Fever
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NEG_PROCESS_OF
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Persons
17. Signs and Symptom NEG_PROCESS_OF C0027361
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Signs and Symptom
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C0027361
18. Symptoms PROCESS_OF Child
Subject
Symptoms
Predicate
PROCESS_OF
Object
Child
19. Symptoms PROCESS_OF Young Adult
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Symptoms
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PROCESS_OF
Object
Young Adult
20. COVID-19 PROCESS_OF Patients
Subject
COVID-19
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PROCESS_OF
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Patients
21. Disease PROCESS_OF Persons
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Disease
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PROCESS_OF
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Persons
22. Disease INTERACTS_WITH 2019 novel coronavirus
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Disease
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INTERACTS_WITH
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2019 novel coronavirus
23. COVID-19 PRECEDES Critical Illness
Subject
COVID-19
Predicate
PRECEDES
Object
Critical Illness
24. Real-Time Polymerase Chain Reaction USES Nasal Swab (procedure)
Subject
Real-Time Polymerase Chain Reaction
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USES
Object
Nasal Swab (procedure)
25. COVID-19 PROCESS_OF Persons
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COVID-19
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PROCESS_OF
Object
Persons
26. Confirmed case PROCESS_OF Persons
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Confirmed case
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PROCESS_OF
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Persons
27. Disease PROCESS_OF Person exposed to disease
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Disease
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PROCESS_OF
Object
Person exposed to disease
28. Infected PROCESS_OF Persons
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Infected
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PROCESS_OF
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Persons
29. Symptoms PROCESS_OF Persons
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Symptoms
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PROCESS_OF
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Persons
30. Infected PROCESS_OF Participant
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Infected
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PROCESS_OF
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Participant
31. Disease PROCESS_OF Participant
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Disease
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PROCESS_OF
Object
Participant
32. Fever PROCESS_OF Persons
Subject
Fever
Predicate
PROCESS_OF
Object
Persons
33. Signs and Symptoms, Respiratory PROCESS_OF Persons
Subject
Signs and Symptoms, Respiratory
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PROCESS_OF
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Persons
34. COVID-19 PRECEDES Disease
Subject
COVID-19
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PRECEDES
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Disease
35. Fever NEG_PROCESS_OF Persons
Subject
Fever
Predicate
NEG_PROCESS_OF
Object
Persons
36. Signs and Symptoms, Respiratory NEG_PROCESS_OF Persons
Subject
Signs and Symptoms, Respiratory
Predicate
NEG_PROCESS_OF
Object
Persons
37. Symptoms PROCESS_OF Child
Subject
Symptoms
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PROCESS_OF
Object
Child
38. Symptoms PROCESS_OF Young Adult
Subject
Symptoms
Predicate
PROCESS_OF
Object
Young Adult
ABSTRACT
Importance Solid estimates of the risk of developing symptoms and of progressing to critical disease in individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are key to interpreting coronavirus disease 2019 (COVID-19) dynamics, identifying the settings and the segments of the population where transmission is more likely to remain undetected, and defining effective control strategies.

Objective:

To estimate the association of age with the likelihood of developing symptoms and the association of age with the likelihood of progressing to critical illness after SARS-CoV-2 infection. Design, Setting, and

Participants:

This cohort study analyzed quarantined case contacts, identified between February 20 and April 16, 2020, in the Lombardy region of Italy. Contacts were monitored daily for symptoms and tested for SARS-CoV-2 infection, by either real-time reverse transcriptase-polymerase chain reaction using nasopharyngeal swabs or retrospectively via IgG serological assays. Close contacts of individuals with laboratory-confirmed COVID-19 were selected as those belonging to clusters (ie, groups of contacts associated with an index case) where all individuals were followed up for symptoms and tested for SARS-CoV-2 infection. Data were analyzed from February to June 2020. Exposure Close contact with individuals with confirmed COVID-19 cases as identified by contact tracing operations. Main Outcomes and

Measures:

Age-specific estimates of the risk of developing respiratory symptoms or fever greater than or equal to 37.5 °C and of experiencing critical disease (defined as requiring intensive care or resulting in death) in SARS-CoV-2-infected case contacts.

Results:

In total, 5484 case contacts (median [interquartile range] age, 50 [30-61] years; 3086 female contacts [56.3%]) were analyzed, 2824 of whom (51.5%) tested positive for SARS-CoV-2 (median [interquartile range] age, 53 [34-64] years; 1604 female contacts [56.8%]). The proportion of infected persons who developed symptoms ranged from 18.1% (95% CI, 13.9%-22.9%) among participants younger than 20 years to 64.6% (95% CI, 56.6%-72.0%) for those aged 80 years or older. Most infected contacts (1948 of 2824 individuals [69.0%]) did not develop respiratory symptoms or fever greater than or equal to 37.5 °C. Only 26.1% (95% CI, 24.1%-28.2%) of infected individuals younger than 60 years developed respiratory symptoms or fever greater than or equal to 37.5 °C; among infected participants older than 60 years, 6.6% (95% CI, 5.1%-8.3%) developed critical disease. Female patients were 52.7% (95% CI, 24.4%-70.7%) less likely than male patients to develop critical disease after SARS-CoV-2 infection. Conclusions and Relevance In this Italian cohort study of close contacts of patients with confirmed SARS-CoV-2 infection, more than one-half of individuals tested positive for the virus. However, most infected individuals did not develop respiratory symptoms or fever. The low proportion of children and young adults who developed symptoms highlights the possible challenges in readily identifying SARS-CoV-2 infections.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Carrier State / Cough / Dyspnea / Fever / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Country/Region as subject: Europa Language: English Journal: JAMA Netw Open Year: 2021 Document Type: Article Affiliation country: Jamanetworkopen.2021.1085

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Carrier State / Cough / Dyspnea / Fever / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Country/Region as subject: Europa Language: English Journal: JAMA Netw Open Year: 2021 Document Type: Article Affiliation country: Jamanetworkopen.2021.1085