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Risk of Severe Acute Respiratory Syndrome Coronavirus 2 Acquisition Is Associated With Individual Exposure but Not Community-Level Transmission.
Friedman-Klabanoff, DeAnna J; Fitzpatrick, Meagan C; Deming, Meagan E; Agrawal, Vaidehi; Sitar, Sandra; Schaafsma, Torin; Brown, Elizabeth; Neuzil, Kathleen M; Barnabas, Ruanne V; Laufer, Miriam K.
  • Friedman-Klabanoff DJ; Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Fitzpatrick MC; Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Deming ME; Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Agrawal V; Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Sitar S; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
  • Schaafsma T; Department of Global Health, University of Washington, Seattle, Washington, USA.
  • Brown E; Department of Biostatistics, University of Washington, Seattle, Washington, USA.
  • Neuzil KM; Vaccine and Infectious Disease Division, University of Washington, Seattle, Washington, USA.
  • Barnabas RV; Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
  • Laufer MK; Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
J Infect Dis ; 226(2): 225-235, 2022 08 24.
Article in English | MEDLINE | ID: covidwho-1730680
ABSTRACT

BACKGROUND:

Transmission rates after exposure to a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive individual within households and healthcare settings varies significantly between studies. Variability in the extent of exposure and community SARS-CoV-2 incidence may contribute to differences in observed rates.

METHODS:

We examined risk factors for SARS-CoV-2 infection in a randomized controlled trial of hydroxychloroquine as postexposure prophylaxis. Study procedures included standardized questionnaires at enrollment and daily self-collection of midturbinate swabs for SARS-CoV-2 polymerase chain reaction testing. County-level incidence was modeled using federally sourced data. Relative risks and 95% confidence intervals were calculated using modified Poisson regression.

RESULTS:

Eighty-six of 567 (15.2%) household/social contacts and 12 of 122 (9.8%) healthcare worker contacts acquired SARS-CoV-2 infection. Exposure to 2 suspected index cases (vs 1) significantly increased risk for both household/social contacts (relative risk [RR], 1.86) and healthcare workers (RR, 8.18). Increased contact time also increased risk for healthcare workers (3-12 hours RR, 7.82, >12 hours RR, 11.81, vs ≤2 hours), but not for household/social contacts. County incidence did not impact risk.

CONCLUSIONS:

In our study, increased exposure to SARS-CoV-2 within household or healthcare settings led to higher risk of infection, but elevated community incidence did not. This reinforces the importance of interventions to decrease transmission in close contact settings.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: J Infect Dis Year: 2022 Document Type: Article Affiliation country: Infdis

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: J Infect Dis Year: 2022 Document Type: Article Affiliation country: Infdis