Trends in Incidence and Transmission Patterns of COVID-19 in Valencia, Spain.
JAMA Netw Open
; 4(6): e2113818, 2021 06 01.
Article
in English
| MEDLINE | ID: covidwho-1274645
ABSTRACT
Importance Limited information on the transmission and dynamics of SARS-CoV-2 at the city scale is available. Objective:
To describe the local spread of SARS-CoV-2 in Valencia, Spain. Design, Setting, andParticipants:
This single-center epidemiological cohort study of patients with SARS-CoV-2 was performed at University General Hospital in Valencia (population in the hospital catchment area, 364â¯000), a tertiary hospital. The study included all consecutive patients with COVID-19 isolated at home from the start of the COVID-19 pandemic on February 19 until August 31, 2020. Exposures Cases of SARS-CoV-2 infection confirmed by the presence of IgM antibodies or a positive polymerase chain reaction test result on a nasopharyngeal swab were included. Cases in which patients with negative laboratory results met diagnostic and clinical criteria were also included. Main Outcomes andMeasures:
The primary outcome was the characterization of dissemination patterns and connections among the 20 neighborhoods of Valencia during the outbreak. To recreate the transmission network, the inbound and outbound connections were studied for each region, and the relative risk of infection was estimated.Results:
In total, 2646 patients were included in the analysis. The mean (SD) age was 45.3 (22.5) years; 1203 (46%) were male and 1442 (54%) were female (data were missing for 1); and the overall mortality was 3.7%. The incidence of SARS-CoV-2 cases was higher in neighborhoods with higher household income (ß2 [for mean income per household] = 0.197; 95% CI, 0.057-0.351) and greater population density (ß1 [inhabitants per km2] = 0.228; 95% CI, 0.085-0.387). Correlations with meteorological variables were not statistically significant. Neighborhood 3, where the hospital and testing facility were located, had the most outbound connections (14). A large residential complex close to the city (neighborhood 20) had the fewest connections (0 outbound and 2 inbound). Five geographically unconnected neighborhoods were of strategic importance in disrupting the transmission network. Conclusions and Relevance This study of local dissemination of SARS-COV-2 revealed nonevident transmission patterns between geographically unconnected areas. The results suggest that tailor-made containment measures could reduce transmission and that hospitals, including testing facilities, play a crucial role in disease transmission. Consequently, the local dynamics of SARS-CoV-2 spread might inform the strategic lockdown of specific neighborhoods to stop the contagion and avoid a citywide lockdown.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Catchment Area, Health
/
Residence Characteristics
/
Disease Outbreaks
/
Disease Transmission, Infectious
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
English
Journal:
JAMA Netw Open
Year:
2021
Document Type:
Article
Affiliation country:
Jamanetworkopen.2021.13818
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