Corpus overview


MeSH Disease

Infections (485)

Disease (224)

Coronavirus Infections (125)

Death (110)

Fever (95)

Human Phenotype

Fever (95)

Cough (78)

Pneumonia (68)

Hypertension (67)

Fatigue (29)


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    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/ 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.

    Strategic anti-SARS-CoV-2 serology testing in a low prevalence SERO pandemic: The COVID-19 Contact (CoCo) Study in health care professionals

    Authors: Georg MN Behrens; Anne Cossmann; Metodi V Stankov; Bianca Schulte; Hendrik Streeck; Reinhold Foerster; Berislav Bosnjak; Stefanie Willenzon; Anna-Lena Boeck; Anh Thu Tran; Thea Thiele; Theresa Graalmann; Moritz Z. Kayser; Anna Zychlinsky Scharff; Christian Dopfer; Alexander Horke; Isabell Pink; Torsten Witte; Martin Wetzke; Diana Ernst; Alexandra Jablonka; Christine Happle

    doi:10.1101/2020.08.06.20169250 Date: 2020-08-07 Source: medRxiv

    Background: Serology testing is explored for epidemiological research and to inform individuals after suspected infection MESHD. During the COVID-19 pandemic, frontline healthcare professionals (HCP) may be at particular risk for infection TRANS risk for infection TRANS infection MESHD. No longitudinal data on functional seroconversion in HCP in regions with low COVID-19 prevalence SERO and low pre-test probability exist. Methods: In a large German university hospital, we performed weekly questionnaire assessments and anti-SARS-CoV-2 IgG measurements with various commercial tests, a novel surrogate virus neutralization test, and a neutralization assay using live SARS-CoV-2. Results: From baseline to week six, n=1,080 screening measurements for anti-SARS CoV-2 (S1) IgG from n=217 frontline HCP (65% female TRANS) were performed. Overall, 75.6% of HCP reported at least one symptom of respiratory infection MESHD. Self-perceived infection MESHD probability declined over time (from mean 20.1% at baseline to 12.4 % in week six, p<0.001). In sera of convalescent PCR-confirmed COVID-19 patients, we measured high anti-SARS-CoV-2 IgG levels, obtained highly concordant results from ELISAs SERO using e.g. the S1 spike protein domain and the nucleocapsid protein (NCP) as targets, and confirmed antiviral neutralization. However, in HCP the cumulative incidence for anti-SARS-CoV-2 (S1) IgG was 1.86% for positive and 0.93% for equivocal positive results over the six week study period. Except for one HCP, none of the eight initial positive results were confirmed by alternative serology tests or showed in vitro neutralization against live SARS CoV-2. The only true seroconversion occurred without symptoms and mounted strong functional humoral immunity. Thus, the confirmed cumulative incidence for neutralizing anti-SARS-CoV-2 IgG was 0.47%. Conclusion: When assessing anti-SARS-CoV-2 immune status in individuals with low pre-test probability, we suggest confirming positive results from single measurements by alternative serology tests or functional assays. Our data highlight the need for a methodical serology screening approach in regions with low SARS-CoV-2 infection MESHD rates.


    Authors: Victoria JE Long; Jean CJ Liu

    doi:10.1101/2020.08.06.20169870 Date: 2020-08-07 Source: medRxiv

    Introduction: As part of infection MESHD control measures for COVID-19, individuals have been encouraged to adopt both preventive (e.g., handwashing) and avoidant behavioural changes (e.g., avoiding crowds). In this study, we examined whether demographics predicted the likelihood that a person would adopt these behaviours in Singapore. Materials and Methods: 1145 participants responded to an online survey conducted between 7 March - 21 April 2020. As part of the survey, we collected demographic information and asked participants to report which of 17 behaviour changes they had undertaken because of the outbreak. We ran regression models to predict, using demographic information: (1) the total number of behavioural changes undertaken, (2) the number of preventive changes undertaken, and (3) the number of avoidant changes undertaken. Finally, we sought to identify predictors of persons who: (4) declared that they had not undertaken any of these measures following the outbreak. Results: Females TRANS and those who were younger adopted more preventive behaviours: whereas females TRANS were more likely to increase handwashing frequency, younger individuals were more likely to wear face masks prior to legislation. Females TRANS and those who were married adopted more avoidant behaviours, with both groups avoiding crowded areas and staying home more than usual. Females TRANS also voluntarily reduced physical contact, whereas those who were married chose outdoor venues and relied on online shopping. Conclusion: Our characterisation of behavioural changes provides a baseline for public health advisories. Moving forward, local health authorities can focus their efforts to encourage segments of the population who do not readily adopt infection MESHD control measures against COVID-19.

    Pre-pandemic psychiatric disorders and risk of COVID-19: a cohort analysis in the UK Biobank

    Authors: Huazhen Yang; Wenwen Chen; Yao Hu; Yilong Chen; Yu Zeng; Yajing Sun; Zhiye Ying; Junhui He; Yuanyuan Qu; Donghao Lu; Fang Fang; Unnur A Valdimarsdóttir; Huan Song

    doi:10.1101/2020.08.07.20169847 Date: 2020-08-07 Source: medRxiv

    Objective To determine the association between pre-pandemic psychiatric disorders and the risk of COVID-19. Design Community-based prospective cohort study. Setting UK Biobank population. Participants 421,048 participants who were recruited in England and alive by January 31st 2020, i.e., the start of COVID-19 outbreak in the UK. 50,815 individuals with psychiatric disorders recorded in the UK Biobank inpatient hospital data before the outbreak were included in the exposed group, while 370,233 participants without such conditions were in the unexposed group. Measurements We obtained information on positive results of COVID-19 test as registered in the Public Health England, COVID-19 related hospitalizations in the UK Biobank inpatient hospital data, and COIVD-19 related deaths MESHD from the death MESHD registers. We also identified individuals who was hospitalized for infections MESHD other than COVID-19 during the follow-up. Logistic regression models were used to estimate odds ratios (ORs) with 95% confidence intervals (CIs), controlling for multiple confounders. Results The mean age TRANS at outbreak was 67.8 years and around 43% of the study participants were male TRANS. We observed an elevated risk of COVID-19 among individuals with pre-pandemic psychiatric disorder, compared with those without such diagnoses. The fully adjusted ORs were 1.44 (95%CI 1.27 to 1.64), 1.67 (1.42 to 1.98), and 2.03 (1.56 to 2.63) for any COVID-19, inpatient COVID-19, COVID-19 related death MESHD, respectively. The excess risk was observed across all levels of somatic comorbidities and subtypes of pre-pandemic psychiatric disorders, while further increased with greater number of pre-pandemic psychiatric disorders. We also observed an association between pre-pandemic psychiatric disorders and increased risk of hospitalization for other infections MESHD (1.85 [1.65 to 2.07]). Conclusions Pre-pandemic psychiatric disorders are associated with increased risk of COVID-19, especially severe and fatal COVID-19. The similar association observed for hospitalization for other infections MESHD suggests a shared pathway between psychiatric disorders and different infections MESHD, including altered immune responses.

    Clinical and intestinal histopathological findings in SARS-CoV-2/COVID-19 patients with hematochezia HP

    Authors: Margaret Cho; Weiguo Liu; Sophie Balzora; Yvelisse Suarez; Deepthi Hoskoppal; Neil D Theise; Wenqing Cao; Suparna A Sarkar

    doi:10.1101/2020.07.29.20164558 Date: 2020-08-07 Source: medRxiv

    Gastrointestinal (GI) symptoms of SARS-CoV2/COVID-19 in the form of anorexia MESHD anorexia HP, nausea MESHD nausea, vomiting HP, vomiting MESHD, abdominal pain MESHD abdominal pain HP and diarrhea MESHD diarrhea HP are usually preceeded by respiratory manifestations and are associated with a poor prognosis. Hematochezia HP is an uncommon clinical presentation of COVID-19 disease MESHD and we hypothesize that older patients with significant comorbidites ( obesity MESHD obesity HP and cardiovascular) and prolonged hospitalization are suspectible to ischemic injury to the bowel. We reviewed the clinical course, key laboratory data including acute phase reactants, drug/medication history in two elderly TRANS male TRANS patients admitted for COVID-19 respiratory failure HP. Both patients had a complicated clinical course and suffered from hematochezia HP and acute blood SERO loss anemia MESHD anemia HP requiring blood SERO transfusion around day 40 of their hospitalization. Colonoscopic impressions were correlated with the histopathological findings in the colonic biopies and changes compatible with ischemia MESHD to nonspecific acute inflammation MESHD, edema MESHD edema HP and increased eosinophils in the lamina propria were noted.Both patients were on anticoagulants, multiple antibiotics and antifungal agents due to respiratory infections MESHD at the time of lower GI bleeding. Hematochezia HP resolved spontaneously with supportive care. Both patients eventually recovered and were discharged. Elderly TRANS patients with significant comorbid conditions are uniquely at risk for ischemic injury to the bowel. Hypoxic conditions due to COVID-19 pneumonia MESHD pneumonia HP and respiratory failure HP, compounded by preexisting cardiovascular complications, and/or cytokine storm orchestrated by the viral infection MESHD leading to alteration in coagulation profile and/or drug/medication injury can be difficult to distinguish in these critically ill patients. Presentation of hematochezia HP may further increase the mortality and morbidity of COVID-19 patients, and prompt consultation and management by gastroenterology is therefore warranted.

    Insights into the first wave of the COVID-19 pandemic in Bangladesh: Lessons learned from a high-risk country

    Authors: Md. Hasanul Banna Siam; Md Mahbub Hasan; Enayetur Raheem; Md. Hasinur rahaman Khan; Mahbubul H Siddiqee; Mohammad Sorowar Hossain

    doi:10.1101/2020.08.05.20168674 Date: 2020-08-06 Source: medRxiv

    Background South Asian countries including Bangladesh have been struggling to control the COVID-19 pandemic despite imposing months of lockdown and other public health measures (as of June 30, 2020). In-depth epidemiological information from these countries is lacking. From the perspective of Bangladesh, this study aims to understand the epidemiological features and gaps in public health preparedness. Method This study used publicly available data (8 March-30 June 2020) from the respective health departments of Bangladesh and Johns Hopkins University Coronavirus Resource Centre. Descriptive statistics was used to report the incidence, case fatality rates (CFR), and trend analysis. Spatial distribution maps were created using ArcGIS Desktop. Infection MESHD dynamics were analyzed via SIR models. Findings In 66 days of nationwide lockdown and other public health efforts, a total of 47,153 cases and 650 deaths MESHD were reported. However, the incidence was increased by around 50% within a week after relaxing the lockdown. Males TRANS were disproportionately affected in terms of infections MESHD (71%) and deaths MESHD (77%) than females TRANS. The CFR for males TRANS was higher than females TRANS (1.38% vs 1.01%). Over 50% of infected cases were reported among young adults TRANS (20-40-year age group TRANS). Geospatial analysis between 7 June 2020 and 20 June 2020 showed that the incidences increased 4 to 10-fold in 12 administrative districts while it decreased in the epicenter. As compared to the EU and USA, trends of the cumulative incidence were slower in South Asia with lower mortality. Conclusion Our findings on gaps in public health preparedness and epidemiological characteristics would contribute to facilitating better public health decisions for managing current and future pandemics like COVID-19 in the settings of developing countries.

    Safety of hot and cold site admissions within a high volume urology department in the United Kingdom at the peak of the COVID-19 pandemic

    Authors: Luke Stroman; Beth Russell; Pinky Kotecha; Anastasia Kantarzi; Luis Ribeiro; Bethany Jackson; Vugar Ismaylov; Adeoye Oluwakanyinsola Debo-Aina; Findlay MacAskill; Francesca Kum; Meghana Kulkarni; Raveen Sandher; Anna Walsh; Ella Doerge; Katherine Guest; Yamini Kailash; Nick Simson; Cassandra R McDonald; Elsie Mensah; Li June Tay; Ramandeep Chalokia; Sharon Clovis; Elizabeth Eversden; Jane Cossins; Jonah Rusere; Grace Zisengwe; Louisa Fleure; Leslie Cooper; Kathryn Chatterton; Amelia Barber; Catherine Roberts; Thomasia Azavedo; Jeffrey Ritualo; Harold Omana; Liza Mills; Lily Studd; Oussama El Hage; Rajesh Nair; Sachin Malde; Arun Sahai; Archana Fernando; Claire Taylor; Ben Challacombe; Ramesh Thurairaja; Rick Popert; Jonathon Olsburgh; Paul Cathcart; Christian Brown; Marios Hadjipavlou; Ella Di Benedetto; Matthew Bultitude; Jonathon Glass; Tet Yap; Rhana Zakri; Majed Shabbir; Susan Willis; Kay Thomas; Tim O'Brien; Muhammad Shamim Khan; Prokar Dasgupta

    doi:10.1101/2020.08.04.20154203 Date: 2020-08-06 Source: medRxiv

    Importance: Contracting COVID-19 peri-operatively has been associated with a mortality rate as high as 23%. Using hot and cold sites has led to a low rate of post-operative diagnosis of COVID-19 infection MESHD and allowed safe continuation of important emergency MESHD and cancer operations in our centre. Objective: The primary objective was to determine the safety of the continuation of surgical admissions and procedures during the height of the COVID-19 pandemic using hot and cold surgical sites. The secondary objective is to determine risk factors of contracting COVID-19 to help guide further prevention. Setting: A single surgical department at a tertiary care referral centre in London, United Kingdom. Participants: All consecutive patients admitted under the care of the urology team over a 3-month period from 1st March to 31st May 2020 over both hot acute admission sites and cold elective sites were included. Exposures: COVID-19 was prevalent in the community over the three months of the study at the height of the pandemic. The majority of elective surgery was carried out in a cold site requiring patients to have a negative COVID-19 swab 72 hours prior to admission and to self-isolate for 14 days pre-operatively, whilst all acute admissions were admitted to the hot site. Main outcomes and measures: COVID-19 was detected in 1.6% of post-operative patients. There was 1 (0.2%) post-operative mortality due to COVID-19. Results: A total of 611 patients, 451 (73.8%) male TRANS and 160 (26.2%) female TRANS, with a median age TRANS of 57 (interquartile range 44-70) were admitted under the surgical team. Of these, 101 (16.5%) were admitted on the cold site and 510 (83.5%) on the hot site. Surgical procedures were performed in 495 patients of which 8 (1.6%) contracted COVID-19 post-operatively with 1 (0.2%) post-operative mortality due to COVID-19. Overall, COVID-19 was detected in 20 (3.3%) patients with 2 (0.3%) deaths MESHD. On multivariate analysis, length of stay was associated with contracting COVID-19 in our cohort (OR 1.25, 95% CI 1.13-1.39). Conclusions and Relevance: Continuation of surgical procedures using hot and cold sites throughout the COVID-19 pandemic was safe practice, although the risk of COVID-19 remained and is underlined by a post-operative mortality. Reducing length of stay may be able to reduce contraction of COVID-19.

    Seroprevalence SERO of COVID-19 in Niger State

    Authors: Hussaini Majiya; Mohammed Aliyu-Paiko; Vincent Tochukwu Balogu; Dickson Achimugu Musa; Ibrahim Maikudi Salihu; Abdullahi Abubakar Kawu; Ishaq Yakubu Bashir; Aishat Rabiu Sani; John Baba; Amina Tako Muhammad; Fatima Ladidi Jibril; Ezekiel Bala; Nuhu George Obaje; Yahaya Badeggi Aliyu; Ramatu Gogo Muhammad; Hadiza Mohammed; Usman Naji Gimba; Abduljaleel Uthman; Hadiza Muhammad Liman; Sule Alfa Alhaji; Joseph Kolo James; Muhammad Muhammad Makusidi; Mohammed Danasabe Isah; Ibrahim Abdullahi; Umar Ndagi; Bala Waziri; Chindo Ibrahim Bisallah; Naomi John Dadi-Mamud; Kolo Ibrahim; Abu Kasim Adamu

    doi:10.1101/2020.08.04.20168112 Date: 2020-08-05 Source: medRxiv

    Coronavirus Disease MESHD 2019 (COVID-19) Pandemic is ongoing, and to know how far the virus has spread in Niger State, Nigeria, a pilot study was carried out to determine the COVID-19 seroprevalence SERO, patterns, dynamics, and risk factors in the state. A cross sectional study design and clustered-stratified-Random sampling strategy were used. COVID-19 IgG and IgM Rapid Test SERO Kits (Colloidal gold immunochromatography lateral flow system) were used to determine the presence or absence of antibodies to SARS-CoV-2 SERO in the blood SERO of sampled participants across Niger State as from 26th June 2020 to 30th June 2020. The test kits were validated using the blood SERO samples of some of the NCDC confirmed positive and negative COVID-19 cases in the State. COVID-19 IgG and IgM Test results were entered into the EPIINFO questionnaire administered simultaneously with each test. EPIINFO was then used for both the descriptive and inferential statistical analyses of the data generated. The seroprevalence SERO of COVID-19 in Niger State was found to be 25.41% and 2.16% for the positive IgG and IgM respectively. Seroprevalence SERO among age groups TRANS, gender TRANS and by occupation varied widely. A seroprevalence SERO of 37.21% was recorded among health care workers in Niger State. Among age groups TRANS, COVID-19 seroprevalence SERO was found to be in order of 30-41 years (33.33%) > 42-53 years (32.42%) > 54-65 years (30%) > 66 years and above (25%) > 6-17 years (19.20%) > 18-29 years (17.65%) > 5 years and below (6.66%). A seroprevalence SERO of 27.18% was recorded for males TRANS and 23.17% for females TRANS in the state. COVID-19 asymptomatic TRANS rate in the state was found to be 46.81%. The risk analyses showed that the chances of infection MESHD are almost the same for both urban and rural dwellers in the state. However, health care workers and those that have had contact with person (s) that travelled TRANS out of Nigeria in the last six (6) months are twice ( 2 times) at risk of being infected with the virus. More than half (54.59%) of the participants in this study did not practice social distancing at any time since the pandemic started. Discussions about knowledge, practice and attitude of the participants are included. The observed Niger State COVID-19 seroprevalence SERO means that the herd immunity for COVID-19 is yet to be achieved and the population is still susceptible for more infection MESHD and transmission TRANS of the virus. If the prevalence SERO stays as reported here, the population will definitely need COVID-19 vaccines when they become available. Niger State should fully enforce the use of face/nose masks and observation of social/physical distancing in gatherings including religious gatherings in order to stop or slow the spread of the virus.

    Ethnic minority groups in England and Wales - factors affecting the size and timing of elevated COVID-19 mortality: a retrospective cohort study linking Census and death MESHD records

    Authors: Daniel Ayoubkhani; Vahe Nafilyan; Chris White; Peter Goldblatt; Charlotte Gaughan; Louisa Blackwell; Nicky Rogers; Amitava Banerjee; Kamlesh Khunti; Myer Glickman; Ben Humberstone; Ian Diamond

    doi:10.1101/2020.08.03.20167122 Date: 2020-08-04 Source: medRxiv

    Objectives: To estimate population-level associations between ethnicity and coronavirus disease MESHD 2019 (COVID-19) mortality, and to investigate how ethnicity-specific mortality risk evolved over the course of the pandemic. Design: Retrospective cohort study using linked administrative data. Setting: England and Wales, deaths MESHD occurring 2 March to 15 May 2020. Participants: Respondents to the 2011 Census of England and Wales aged TRANS [≤]100 years and enumerated in private households, linked to death MESHD registrations and adjusted to account for emigration before the outcome period, who were alive on 1 March 2020 (n=47,872,412). Main outcome measure: Death MESHD related to COVID-19, registered by 29 May 2020. Statistical methods: We estimated hazard ratios (HRs) for ethnic minority groups compared with the White population using Cox regression models, controlling for geographical, demographic, socio-economic, occupational, and self-reported health factors. HRs were estimated on the full outcome period and separately for pre- and post-lockdown periods in the UK. Results: In the age TRANS-adjusted models, people from all ethnic minority groups were at elevated risk of COVID-19 mortality; the HRs for Black males TRANS and females TRANS were 3.13 [95% confidence interval: 2.93 to 3.34] and 2.40 [2.20 to 2.61] respectively. However, in the fully adjusted model for females TRANS, the HRs were close to unity for all ethnic groups except Black (1.29 [1.18 to 1.42]). For males TRANS, COVID-19 mortality risk remained elevated for the Black (1.76 [1.63 to 1.90]), Bangladeshi/Pakistani (1.35 [1.21 to 1.49]) and Indian (1.30 [1.19 to 1.43]) groups. The HRs decreased after lockdown for all ethnic groups, particularly Black and Bangladeshi/Pakistani females TRANS. Conclusions: Differences in COVID-19 mortality between ethnic groups were largely attenuated by geographical and socio-economic factors, although some residual differences remained. Lockdown was associated with reductions in excess mortality risk in ethnic minority populations, which has major implications for a second wave of infection MESHD or local spikes. Further research is needed to understand the causal mechanisms underpinning observed differences in COVID-19 mortality between ethnic groups.

    SARS-CoV-2 Infection MESHD Among Symptom-Free Healthcare Workers

    Authors: Ryan T. Demmer; Angela Ulrich; Talia Wiggen; Ali Strickland; Brianna Naumchik; Shalini Kulasingam; Steven D. Stovitz; Clarisse Marotz; Pedro Belda-Ferre; Greg Humphrey; Peter De Hoff; Louise Laurent; Susan Kline; Rob Knight

    doi:10.1101/2020.07.31.20166066 Date: 2020-08-04 Source: medRxiv

    Importance: Current evidence suggests that transmission TRANS of severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) is possible among symptom-free individuals but limited data are available on this topic in healthcare workers (HCW). The quality and acceptability of self-collected nasopharyngeal swabs (NPS) is unknown. Objective: To estimate the prevalence SERO of SARS-CoV-2 infection MESHD and to assess the acceptability of self-collected NPS among HCW. Design: Cross-sectional convenience sample enrolled between April 20th and June 24th, 2020. We had >95% power to detect at least one positive test if the true underlying prevalence SERO of SARS-CoV2 was > 1%. Setting: The metropolitan area surrounding Minneapolis and St. Paul, Minnesota. Participants: HCW free of self-reported upper respiratory symptoms were recruited. Exposures: Participants completed questionnaires regarding demographics, household characteristics, personal protective equipment (PPE) utilization and comorbidities. Outcomes: A participant self-collected nasopharyngeal swab (NPS) was obtained. SARS-CoV-2 infection MESHD was assessed via polymerase chain reaction. NPS discomfort was assessed on a scale of 1 (no discomfort) - 10 (extreme discomfort). NPS duration and depth into the nasopharynx, and willingness to perform future self-collections were assessed. Results: Among n=489 participants 80% were female TRANS and mean age TRANS+/-SD was 41+/-11. Participants reported being physicians (14%), nurse practitioners (8%), physicians assistants (4%), nurses (51%), medics (3%), or other which predominantly included laboratory technicians and administrative roles (22%). Exposure to a known/suspected COVID-19 case in the 14 days prior to enrollment was reported in 40% of participants. SARS-CoV-2 was not detected in any participant. The mean+/-SD discomfort level of the NPS was 4.5+/-2.0. 95% of participants reported that their self-swab was longer than or equal to the duration of patient swabs they had previously performed, and 89% reported the depth to be deeper than or equal to the depth of previous patient swabs. Over 95% of participants reported a willingness to repeat a self-collected NP swab in the future. Conclusions and Relevance: The point prevalence SERO of SARS-CoV-2 infection MESHD was likely very low in symptom-free Minnesota healthcare workers from April 20th and June 24th, 2020. Self-collected NP swabs are well-tolerated and a viable alternative to provider-collected swabs to preserve PPE.

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MeSH Disease
Human Phenotype

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