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ABSTRACT

Background:

Household overcrowding is associated with increased risk of infectious diseases across contexts and countries. Limited data exist linking household overcrowding and risk of COVID-19. We used data collected from the Virus Watch cohort to examine the association between overcrowded households and SARS-CoV-2.

Methods:

The Virus Watch study is a household community cohort of acute respiratory infections in England and Wales. We calculated overcrowding using the measure of persons per room for each household. We considered two primary

outcomes:

PCR-confirmed positive SARS-CoV-2 antigen tests and laboratory-confirmed SARS-CoV-2 antibodies. We used mixed-effects logistic regression models that accounted for household structure to estimate the association between household overcrowding and SARS-CoV-2 infection.

Results:

26,367 participants were included in our analyses. The proportion of participants with a positive SARS-CoV-2 PCR result was highest in the overcrowded group (9.0%;99/1,100) and lowest in the under-occupied group (4.2%;980/23,196). In a mixed-effects logistic regression model, we found strong evidence of an increased odds of a positive PCR SARS-CoV-2 antigen result (odds ratio 2.45;95% CI1.43–4.19;p-value=0.001) and increased odds of a positive SARS-CoV-2 antibody result in individuals living in overcrowded houses (3.32;95% CI1.54–7.15;p-value<0.001) compared with people living in under-occupied houses.

Conclusion:

Public health interventions to prevent and stop the spread of SARS-CoV-2 should consider the risk of infection for people living in overcrowded households and pay greater attention to reducing household transmission.

Full text: Available Collection: Preprints Database: EuropePMC Type of study: Etiology study / Observational study / Risk factors Language: English Year: 2021 Document Type: Preprint

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Full text: Available Collection: Preprints Database: EuropePMC Type of study: Etiology study / Observational study / Risk factors Language: English Year: 2021 Document Type: Preprint