Corpus overview


Overview

MeSH Disease

Infections (1143)

Disease (498)

Death (317)

Coronavirus Infections (258)

Fever (154)


Human Phenotype

Fever (155)

Pneumonia (146)

Cough (122)

Hypertension (106)

Respiratory distress (51)


Transmission

age categories (1172)

gender (382)

Transmission (232)

asymptotic cases (140)

fomite (137)


Seroprevalence
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    Seroprevalence SERO of anti-SARS-CoV-2 IgG antibodies SERO in children TRANS with household exposition to adults TRANS with COVID-19: preliminary findings

    Authors: danilo buonsenso; Piero Valentini; Cristina De Rose; Davide Pata; Dario Sinatti; Domenico Speziale; Rosalba Ricci; Angelo Carfi; Francesco Landi; Maurizio Sanguinetti; Michela Sali

    doi:10.1101/2020.08.10.20169912 Date: 2020-08-12 Source: medRxiv

    wheather children TRANS are easily susceptible to SARS-CoV-2 infection MESHD is still a debated question and a currently a hot topic, particularly in view of important decisions on school opening. For this reason, we decide to describe preliminary data showing the prevalence SERO of anti-SARS-CoV-2 IgG in children TRANS with known household exposure to SARS-CoV-2. Interestingly, our report shows that household transmission TRANS of SARS-CoV-2 is high in both adults TRANS and children TRANS, with similar rates of SARS-CoV-2 IgG in all age groups TRANS, including the younger children TRANS. A total of 44 out of 80 household contacts TRANS (55%) of index patients had anti SARS-CoV-2 IgG. In particular, 16 (59,26%) adult TRANS partners had IgG antibodies SERO compared with 28 (52,83%) of pediatric contacts (P > 0.05). Among the pediatric population, children TRANS [≥] 5 years of age TRANS had similar probability of having SARS-CoV-2 IgG (21/39, 53.8%) compared with those < 5 years (7/14, 50%) (P > 0.05). Adult TRANS partners and children TRANS also had a probability of having SARS-CoV-2 IgG. Interestingly, 35.7% of children TRANS and 33.3% of adults TRANS with SARS-CoV-2 IgG were previously diagnosed as COVID-19 cases. Since this evidence of high rate of IgG in children TRANS exposed to SARS-CoV-2 has public health implication, with this comment we highlight the need of establishing appropriate guidelines for school opening and other social activities related to childhood.

    Low awareness of past SARS-CoV-2 infection MESHD in healthy adults TRANS

    Authors: Katja van den Hurk; Eva-Maria Merz; Femmeke J. Prinsze; Marloes L.C. Spekman; Franke A. Quee; Steven Ramondt; Ed Slot; Hans Vrielink; Elisabeth M.J. Huis in 't Veld; Hans L. Zaaijer; Boris M. Hogema

    doi:10.1101/2020.08.10.20171561 Date: 2020-08-12 Source: medRxiv

    Background The coronavirus disease MESHD 2019 (COVID-19) pandemic challenges governments worldwide to balance appropriate virus control measures and their societal and economic consequences. These control measures include the identification, isolation and testing of potentially infected individuals. As this relies on an individual's awareness of infection MESHD, we investigated the extent to which healthy adults TRANS suspected having had COVID-19, and how COVID-19 suspicion and symptoms relate to antibodies SERO indicative of a past infection MESHD infection with the severe HP with the severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2). Methods and findings Individuals donating plasma SERO anywhere in the Netherlands between May 11th and 18th were screened for total SARS-CoV-2 antibodies SERO using ELISA SERO and invited to participate in an online questionnaire about COVID-19-related symptoms and awareness. Antibody SERO and questionnaire data were complete for 3,676 individuals, including 239 (6.5%) that tested positive for SARS-CoV-2 antibodies SERO. Here, we show that a 38% of the individuals that tested positive for SARS-CoV-2 antibodies SERO reported having had no or only very mild symptoms at any time during the peak of the epidemic. The loss of taste and/or smell in particular was significantly associated with seropositivity, independent of age TRANS and sex. Forty-eight percent of antibody SERO-positive persons did not suspect having had COVID-19, in spite of most of them reporting symptoms. Conclusions Awareness of infection MESHD was low among individuals that tested positive for SARS-CoV-2 antibodies SERO, even at the peak of the epidemic. Improved awareness and recognition of COVID-19 symptoms and tracing TRANS of asymptomatic TRANS contacts is crucial to halting SARS-CoV-2 transmission TRANS.

    High prevalence SERO of SARS-CoV-2 antibodies SERO in care homes affected by COVID-19; a prospective cohort study in England

    Authors: Shamez N Ladhani; Anna J Jeffery-Smith; Monika Patel; Roshni Janarthanan; Jonathan Fok; Emma Crawley-Boevey; Amoolya Vusirikala; Elena Fernandez; Marina Sanchez-Perez; Suzanne Tang; Kate Dun-Campbell; Edward Wynne-Evans; Anita Bell; Bharat Patel; Zahin Amin-Chowdhury; Felicity Aiano; Karthik Paranthaman; Thomas Ma; Maria Saavedra-Campos; Joanna Ellis; Meera Chand; Kevin Brown; Mary E Ramsay; Susan Hopkins; Nandini Shetty; J Yimmy Chow; Robin Gopal; Maria Zambon

    doi:10.1101/2020.08.10.20171413 Date: 2020-08-12 Source: medRxiv

    Background: We investigated six London care homes experiencing a COVID-19 outbreak and found very high rates of SARS-CoV-2 infection MESHD among residents and staff. Here we report follow-up serological analysis in these care homes five weeks later. Methods: Residents and staff had a convalescent blood SERO sample for SARS-CoV-2 antibody SERO levels and neutralising antibodies SERO by SARS-COV-2 RT-PCR five weeks after the primary COVID-19 outbreak investigation. Results: Of the 518 residents and staff in the initial investigation, 208/241 (86.3%) surviving residents and 186/254 (73.2%) staff underwent serological testing SERO. Almost all SARS-CoV-2 RT-PCR positive residents and staff were antibody SERO positive five weeks later, whether symptomatic (residents 35/35, 100%; staff, 22/22, 100%) or asymptomatic TRANS (residents 32/33, 97.0%; staff 21/22, 95.1%). Symptomatic but SARS-CoV-2 RT-PCR negative residents and staff also had high seropositivity rates (residents 23/27, 85.2%; staff 18/21, 85.7%), as did asymptomatic TRANS RT-PCR negative individuals (residents 62/92, 67.3%; staff 95/143, 66.4%). Neutralising antibody SERO was present in 118/132 (89.4%) seropositive individuals and was not associated with age TRANS or symptoms. Ten residents (10/108, 9.3%) remained RT-PCR positive, but with lower RT-PCR cycle threshold values; all 7 tested were seropositive. New infections MESHD were detected in three residents and one staff member. Conclusions: RT-PCR testing for SARS-CoV-2 significantly underestimates the true extent of an outbreak in institutional settings. Elderly TRANS frail residents and younger healthier staff were equally able to mount robust and neutralizing antibody SERO responses to SARS-CoV-2. More than two-thirds of residents and staff members had detectable antibodies SERO against SARS-CoV-2 irrespective of their nasal swab RT-PCR positivity or symptoms status.

    Underdetection of COVID-19 cases in France in the exit phase following lockdown

    Authors: Giulia Pullano; Laura Di Domenico; Chiara E Sabbatini; Eugenio Valdano; Clément Turbelin; Marion Debin; Caroline Guerrisi; Charly Kengne-Kuetche; Cécile Souty; Thomas Hanslik; Thierry Blanchon; Pierre-Yves Boëlle; Julie Figoni; Sophie Vaux; Christine Campèse; Sibylle Bernard-Stoecklin; Vittoria Colizza

    doi:10.1101/2020.08.10.20171744 Date: 2020-08-12 Source: medRxiv

    A novel testing policy was implemented in May in France to systematically screen potential COVID-19 infections MESHD and suppress local outbreaks while lifting lockdown restrictions. 20,736 virologically- confirmed cases TRANS were reported in mainland France from May 13, 2020 (week 20, end of lockdown) to June 28 (week 26). Accounting for missing data and the delay from symptom onset TRANS to confirmation test, this corresponds to 7,258 [95% CI 7,160-7,336] cases with symptom onset TRANS during this period, a likely underestimation of the real number. Using age TRANS-stratified transmission TRANS models parameterized to behavioral data and calibrated to regional hospital admissions, we estimated that 69,115 [58,072-77,449] COVID-19 symptomatic cases occurred, suggesting that 9 out of 10 cases with symptoms were not ascertained. Median detection rate increased from 7% [6-9]% to 31% [28-35]% over time, with regional estimates varying from 11% (Grand Est) to 78% (Normandy) by the end of June. Healthcare-seeking behavior in COVID-19 suspect cases remained low (31%) throughout the period. Model projections for the incidence of symptomatic cases (4.5 [3.9-5.0] per 100,000) were compatible with estimates integrating participatory and virological surveillance data, assuming all suspect cases consulted. Encouraging healthcare-seeking behavior and awareness in suspect cases is critical to improve detection. Substantially more aggressive and efficient testing with easier access is required to act as a pandemic-fighting tool. These elements should be considered in light of the currently observed resurgence of cases in France and other European countries.

    Clustering of age TRANS standardised COVID-19 infection MESHD fatality ratios and death MESHD trajectories

    Authors: Thu-Lan Kelly; Greer Humphrey; Caroline Miller; Jacqueline A Bowden; Joanne Dono; Paddy A Phillips

    doi:10.1101/2020.08.11.20172478 Date: 2020-08-11 Source: medRxiv

    Background An accurate measure of the impact of COVID-19 is the infection MESHD fatality ratio, or the proportion of deaths MESHD among those infected, which does not depend on variable testing rates between nations. The risk of mortality from COVID-19 depends strongly on age TRANS and current estimates of the infection MESHD fatality ratio do not account for differences in national age TRANS profiles. Comparisons of cumulative death MESHD trajectories allow the effect and timing of public health interventions to be assessed. Our purpose is to (1) determine whether countries are clustered according to infection MESHD fatality ratios and (2) compare interventions to slow the spread of the disease TRANS disease MESHD by clustering death MESHD trajectories. Methods National age TRANS standardised infection MESHD fatality ratios were derived from age TRANS stratified estimates from China and population estimates from the World Health Organisation. The IFRs were clustered into groups using Gaussian mixture models. Trajectory analysis clustered cumulative death MESHD rates in two time windows, 50 and 100 days after the first reported death MESHD. Findings Infection MESHD fatality ratios from 201 nations were clustered into three groups: young, medium and older, with corresponding means (SD) of 0.20% (0.03%), 0.38% (0.11%) and 0.93% (0.21%). At 50 and 100 days after the first reported death MESHD, there were two clusters of cumulative death MESHD trajectories from 113 nations with at least 25 deaths MESHD reported at 100 days. The first group had slowly increasing or stable cumulative death MESHD rates, while the second group had accelerating rates at the end of the time window. Fifty-two nations changed group membership between the time windows. Conclusion A cluster of younger nations have a lower estimated infection MESHD fatality ratio than older nations. The effect and timing of public health interventions in preventing the spread of the disease TRANS disease MESHD can be tracked by clustering death MESHD rate trajectories into stable or accelerating and comparing changes over time.

    Characterisation of 22446 patients attending UK emergency MESHD departments with suspected COVID-19 infection MESHD: Observational cohort study

    Authors: Steve Goodacre; Ben Thomas; Ellen Lee; Laura Sutton; Amanda Loban; Simon Waterhouse; Richard Simmonds; Katie Biggs; Carl Marincowitz; Jose Schutter; Sarah Connelly; Elena Sheldon; Jamie Hall; Emma Young; Andrew Bentley; Kirsty Challen; Chris Fitzsimmons; Tim Harris; Fiona Lecky; Andrew Lee; Ian Maconochie; Darren Walter

    doi:10.1101/2020.08.10.20171496 Date: 2020-08-11 Source: medRxiv

    Background Hospital emergency MESHD departments play a crucial role in the initial management of suspected COVID-19 infection MESHD. We aimed to characterise patients attending emergency MESHD departments with suspected COVID-19, including subgroups based on sex, ethnicity and COVID-19 test results. Methods We undertook a mixed prospective and retrospective observational cohort study in 70 emergency MESHD departments across the United Kingdom (UK). We collected presenting data from 22446 people attending with suspected COVID-19 between 26 March 2020 and 28 May 2020. Outcomes were admission to hospital, COVID-19 result, organ support (respiratory, cardiovascular or renal), and death MESHD, by record review at 30 days. Results Adults TRANS were acutely unwell (median NEWS2 score 4) and had high rates of admission (67.1%), COVID-19 positivity (31.2%), organ support (9.8%) and death MESHD (15.9%). Children TRANS had much lower rates of admission (27.4%), COVID-19 positivity (1.2%), organ support (1.4%) and death MESHD (0.3%). Adult TRANS men and women presented in similar numbers (10210 versus 10506), but men were more likely to be admitted (72.9% v 61.4%), require organ support (12.2% v 7.7%) and die (18.7% v 13.3%). Black or Asian adults TRANS tended to be younger than White adults TRANS (median age TRANS 54, 50 and 67 years), were less likely to be admitted (60.8%, 57.3%, 69.6%) or die (11.9%, 11.2%, 16.8%), but were more likely to require organ support (15.9%, 14.3%, 8.9%) or have a positive COVID-19 test (40.8%, 42.1%, 30.0%). Adults TRANS admitted with confirmed COVID-19 had similar age TRANS and comorbidities (except chronic lung disease HP lung disease MESHD) to those who did not have COVID-19 confirmed, but were much more likely to need organ support (22.2% v 8.9%) or die (32.7% v 15.9%). Conclusions Important differences exist between patient groups presenting to the emergency MESHD department with suspected COVID-19. People with confirmed COVID-19 have a poor prognosis, compared with similar emergency MESHD admissions without confirmed COVID-19.

    Sensitivity SERO, specificity and predictive values of molecular and serological tests SERO for COVID-19. A longitudinal study in emergency MESHD room.

    Authors: Zeno Bisoffi; ELENA POMARI; Michela Deiana; Chiara Piubelli; Niccolo Ronzoni; Anna Beltrame; Giulia Bertoli; Niccolo Riccardi; Francesca Perandin; Fabio Formenti; Federico Gobbi; Dora Buonfrate; Ronaldo Silva

    doi:10.1101/2020.08.09.20171355 Date: 2020-08-11 Source: medRxiv

    Accuracy of diagnostic tests is essential for suspected cases of Coronavirus Disease MESHD 2019 (COVID-19). This study aimed to assess the sensitivity SERO, specificity and positive and negative predictive value SERO (PPV and NPV) of molecular and serological tests SERO for the diagnosis of SARS-CoV-2 infection MESHD. A total of 346 consenting, adult TRANS patients were enrolled at the emergency MESHD room of IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy. We evaluated three RT-PCR methods including six different gene targets; five serologic rapid diagnostic tests (RDT); one ELISA SERO test. The final classification of infected/not infected patients was performed using Latent Class Analysis in combination with clinical re-assessment of incongruous cases and was the basis for the main analysis of accuracy. Of 346 patients consecutively enrolled, 85 (24.6%) were classified as infected. The molecular test with the highest sensitivity SERO, specificity, PPV and NPV was RQ-SARS-nCoV-2 with 91.8% (C.I. 83.8-96.6), 100% (C.I. 98.6-100.0), 100.0% (C.I. 95.4-100.0) and 97.4% (C.I. 94.7-98.9) respectively, followed by CDC 2019-nCoV with 76.2% (C.I. 65.7-84.8), 99.6% (C.I. 97.9-100.0), 98.5% (C.I. 91.7-100.0) and 92.9% (C.I. 89.2-95.6) and by in-house test targeting E-RdRp with 61.2% (C.I. 50.0-71.6), 99.6% (C.I. 97.9-100.0), 98.1% (C.I. 89.9-100.0) and 88.7% (C.I. 84.6-92.1). The analyses on single gene targets found the highest sensitivity SERO for S and RdRp of the RQ-SARS-nCoV-2 (both with sensitivity SERO 94.1%, C.I. 86.8-98.1). The in-house RdRp had the lowest sensitivity SERO (62.4%, C.I. 51.2-72.6). The specificity ranged from 99.2% (C.I. 97.3-99.9) for in-house RdRp and N2 to 95.0% (C.I. 91.6-97.3) for E. The PPV ranged from 97.1% (C.I. 89.8-99.6) of N2 to 85.4% (C.I. 76.3-92.00) of E, and the NPV from 98.1% (C.I. 95.5-99.4) of gene S to 89.0% (C.I. 84.8-92.4) of in-house RdRp. All serological tests SERO had <50% sensitivity SERO and low PPV and NPV. One RDT (VivaDiag IgM) had high specificity (98.5%, with PPV 84.0%), but poor sensitivity SERO (24.7%). Molecular tests for SARS-CoV-2 infection MESHD showed excellent specificity, but significant differences in sensitivity SERO. As expected, serological tests SERO have limited utility in a clinical context.

    Assessment of Musculoskeletal Pain MESHD Pain HP, Fatigue MESHD Fatigue HP and Grip Strength in Hospitalized Patients with COVID-19

    Authors: Sansin Tuzun; Aslinur Keles; dilara okutan; Tugbay Yildiran; Deniz Palamar

    doi:10.21203/rs.3.rs-56548/v1 Date: 2020-08-10 Source: ResearchSquare

    IMPORTANCE Coronavirus disease MESHD 2019 (COVID-19) is an emerging disease MESHD that was declared as a pandemic by WHO. Although there are many retrospective studies to present clinical aspects of the COVID-19, still the involvement of the musculoskeletal system has not been deeply investigated.OBJECTIVE To classify the symptoms of musculoskeletal system in COVID-19 patients, to evaluate myalgia MESHD myalgia HP, arthralgia MESHD arthralgia HP and physical/ mental fatigue MESHD fatigue HP, to assess handgrip muscle strength, and to examine the relationship of these parameters with the severity and laboratory values of the disease MESHD. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was performed at the IUC-Cerrahpaşa Pandemic Clinic. Hospitalized 150 adults TRANS with laboratory and radiological confirmation of severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) according to WHO interim guidance were included in the study. Data were recorded from May 15,2020, to June 30, 2020.MAIN OUTCOMES AND MEASURES Demographic data, comorbidities, musculoskeletal symptoms, laboratory findings and CT scans were recorded. To determine the disease MESHD severity 2007 idsa/ats guidelines for community acquired pneumonia MESHD pneumonia HP was used. Myalgia MESHD Myalgia HP severity was calculated by numerical rating scale (NRS). Visual analog scale and Chalder Fatigue MESHD Fatigue HP Scale (CFS) were used for fatigue MESHD fatigue HP severity determination. Handgrip strength (HGS) was measured by Jamar hand dynamometer.RESULTS 103 patients (68.7%) were nonsevere and 47 patients (31.3%) were severe. The most common musculoskeletal symptom was fatigue MESHD fatigue HP (133 [85.3%]), followed by myalgia MESHD myalgia HP (102 [68.0%]), arthralgia MESHD arthralgia HP (65 [43.3%]) and back pain MESHD back pain HP (33 [22.0%]). Arthralgia MESHD Arthralgia HP, which was mostly notable at wrist (25 [16.7%]), ankle (24 [16.0%]) and knee (23 [15.3%]) joints, showed significant correlation with disease MESHD severity. There was severe myalgia MESHD myalgia HP according to NRS regardless of disease MESHD severity. The physical fatigue MESHD fatigue HP severity score was significantly higher in severe cases, whereas no relationship was found with mental fatigue MESHD fatigue HP score. Female patients with severe infection HP infection MESHD had lower grip strength with a mean value of 18.26 kg (P= .010) in dominant hand, whereas no relationship was found between disease MESHD severity and grip strength in male TRANS patients, but the mean values in both genders TRANS and in decades appears below the specified normative values. Lactate dehydrogenase (LDH) level and lymphocyte count were significantly correlated with lower grip strength. LDH, C-reactive protein (CRP) and D-dimer levels were above the normal range in patients with myalgia MESHD myalgia HP, arthralgia MESHD arthralgia HP and fatigue MESHD fatigue HP. CONCLUSIONS AND RELEVANCE Musculoskeletal symptoms are quite common aside from other multi-systemic symptoms in patients with COVID-19. Arthralgia MESHD Arthralgia HP, which is related to the disease MESHD severity, should be considered apart from myalgia MESHD myalgia HP. COVID-19 patients have severe ischemic myalgia MESHD myalgia HP regardless of the disease MESHD activity. Although there is a muscle weakness MESHD muscle weakness HP in all patients, the loss of muscle function is related with the disease MESHD activity especially in women. Muscular involvement in coronavirus disease MESHD is a triangle of myalgia MESHD myalgia HP, physical fatigue MESHD fatigue HP, and functional impairment.

    Kinetics of viral clearance and antibody SERO production across age groups TRANS in SARS-CoV-2 infected children TRANS

    Authors: Burak Bahar; Cyril Jacquot; Yunchuan Delores Mo; Roberta DeBiasi; Meghan Delaney

    doi:10.1101/2020.08.06.20162446 Date: 2020-08-07 Source: medRxiv

    Objectives: To improve understanding of transition from viral infection MESHD to viral clearance, and antibody SERO response in pediatric patients with SARS-CoV-2 infection MESHD. Study design: This retrospective analysis of children TRANS tested for SARS-CoV-2 by RT-PCR and IgG antibody SERO at a quaternary-care, free-standing pediatric hospital between March 13th, 2020 to June 21st, 2020 included 6369 patients who underwent PCR testing and 215 patients who underwent antibody testing SERO. During the initial study period, testing focused primarily on symptomatic children TRANS; the later study period included asymptomatic TRANS patients who underwent testing as preadmission or preprocedural screening. We report the proportion of positive and negative tests, time to viral clearance, and time to seropositivity. Results: The rate of positivity varied over time due to viral circulation in the community and transition from targeted testing of symptomatic patients to more universal screening of hospitalized patients. Median duration of viral shedding (RT-PCR positivity) was 19.5 days and RT-PCR negativity from positivity was 25 days. Of note, patients aged TRANS 6 to 15 years demonstrated a longer period of RT-PCR negativity from positivity, compared to patients aged TRANS 16 to 22 years (median=32 versus 18 days, p=0.015). Median time to seropositivity from RT-PCR positivity was 18 days while median time to reach adequate levels of neutralizing antibodies SERO (defined as equivalent to 160 titer) was 36 days. Conclusions: The majority of patients demonstrated a prolonged period of viral shedding after infection MESHD with SARS CoV-2. Whether this correlates with persistent infectivity is unknown. Only 17 of 33 patients demonstrated neutralizing antibodies SERO, suggesting that some patients may not mount significant immune responses to infection MESHD. It remains unknown if IgG antibody SERO production correlates with immunity and how long measurable antibodies SERO persist and protect against future infection MESHD.

    The effect of school closures and reopening strategies on COVID-19 infection MESHD dynamics in the San Francisco Bay Area: a cross-sectional survey and modeling analysis

    Authors: Jennifer R Head; Kristin Andrejko; Qu Cheng; Philip A Collender; Sophie Phillips; Anna Boser; Alexandra K Heaney; Christopher M Hoover; Sean L Wu; Graham R Northrup; Karen Click; Robert Harrison; Joseph A Lewnard; Justin V Remais

    doi:10.1101/2020.08.06.20169797 Date: 2020-08-07 Source: medRxiv

    Background Large-scale school closures have been implemented worldwide to curb the spread of COVID-19. However, the impact of school closures and re-opening on epidemic dynamics remains unclear. Methods We simulated COVID-19 transmission TRANS dynamics using an individual-based stochastic model, incorporating social- contact data TRANS of school- aged TRANS children TRANS during shelter-in-place orders derived from Bay Area (California) household surveys. We simulated transmission TRANS under observed conditions and counterfactual intervention scenarios between March 17-June 1, and evaluated various fall HP 2020 K-12 reopening strategies. Findings Between March 17-June 1, assuming children TRANS <10 were half as susceptible to infection MESHD as older children TRANS and adults TRANS, we estimated school closures averted a similar number of infections MESHD (13,842 cases; 95% CI: 6,290, 23,040) as workplace closures (15,813; 95% CI: 9,963, 22,617) and social distancing measures (7,030; 95% CI: 3,118, 11,676). School closure effects were driven by high school and middle school closures. Under assumptions of moderate community transmission TRANS, we estimate that fall HP 2020 school reopenings will increase symptomatic illness among high school teachers (an additional 40.7% expected to experience symptomatic infection MESHD, 95% CI: 1.9, 61.1), middle school teachers (37.2%, 95% CI: 4.6, 58.1), and elementary school teachers (4.1%, 95% CI: -1.7, 12.0). Results are highly dependent on uncertain parameters, notably the relative susceptibility and infectiousness of children TRANS, and extent of community transmission TRANS amid re-opening. The school-based interventions needed to reduce the risk to fewer than an additional 1% of teachers infected varies by grade level. A hybrid-learning approach with halved class sizes of 10 students may be needed in high schools, while maintaining small cohorts of 20 students may be needed for elementary schools. Interpretation Multiple in-school intervention strategies and community transmission TRANS reductions, beyond the extent achieved to date, will be necessary to avoid undue excess risk associated with school reopening. Policymakers must urgently enact policies that curb community transmission TRANS and implement within-school control measures to simultaneously address the tandem health crises posed by COVID-19 and adverse child TRANS health and development consequences of long-term school closures.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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