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Predictors of SARS-CoV-2 transmission in congregate living settings: a multicenter prospective study.
Leis, Jerome A; Chan, Christina K; Tan, Charlie; Callahan, James; Serapion, Victoria; Pascual, Brigitte; Lee, Wayne; O'Brien, Jaclyn; Thomas, Neethu R; Candon, Heather; Crittenden, Matthew; Kiss, Alex; Chan, Adrienne K; Ofner, Marianna; Powis, Jeff E.
Afiliación
  • Leis JA; Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada.
  • Chan CK; Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
  • Tan C; Sunnybrook Research Institute and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
  • Callahan J; Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, ON, Canada.
  • Serapion V; Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
  • Pascual B; Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
  • Lee W; Michael Garron Hospital, Toronto, ON, Canada.
  • O'Brien J; Michael Garron Hospital, Toronto, ON, Canada.
  • Thomas NR; Michael Garron Hospital, Toronto, ON, Canada.
  • Candon H; Michael Garron Hospital, Toronto, ON, Canada.
  • Crittenden M; Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
  • Kiss A; Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
  • Chan AK; Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
  • Ofner M; Air and Water Precision Balancing Incorporated, Toronto, ON, Canada.
  • Powis JE; Sunnybrook Research Institute and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Infect Control Hosp Epidemiol ; : 1-6, 2024 Apr 02.
Article en En | MEDLINE | ID: mdl-38562085
ABSTRACT

BACKGROUND:

Older adults residing in congregate living settings (CLS) such as nursing homes and independent living facilities remain at increased risk of morbidity and mortality from coronavirus disease 2019. We performed a prospective multicenter study of consecutive severe acute respiratory coronavirus virus 2 (SARS-CoV-2) exposures to identify predictors of transmission in this setting.

METHODS:

Consecutive resident SARS-CoV-2 exposures across 17 CLS were prospectively characterized from 1 September 2022 to 1 March 2023, including factors related to environment, source, and exposed resident. Room size, humidity, and ventilation were measured in locations where exposures occurred. Predictors were incorporated in a generalized estimating equation model adjusting for the correlation within CLS.

RESULTS:

Among 670 consecutive exposures to SARS-CoV-2 across 17 CLS, transmission occurred among 328 (49.0%). Increased risk was associated with nursing homes (odds ratio (OR) = 90.8; 95% CI, 7.8-1047.4), Jack and Jill rooms (OR = 2.2; 95% CI, 1.3-3.6), from source who was pre-symptomatic (OR = 11.2; 95% CI, 4.1-30.9), symptomatic (OR = 6.5; 95% CI, 1.4-29.9), or rapid antigen test positive (OR = 35.6; 95% CI, 5.6-225.6), and in the presence of secondary exposure (OR = 6.3; 95% CI, 1.6-24.0). Exposure in dining room was associated with reduced risk (OR = 0.02; 95% CI, 0.005-0.08) as was medium room size (OR = 0.3; 95% CI, 0.2-0.6). Recent vaccination of exposed resident (OR = 0.5; 95% CI, 0.3-1.0) and increased ventilation of room (OR = 0.9; 95% CI, 0.8-1.0) were marginally associated with reduced risk.

CONCLUSION:

Prospective assessment of SARS-CoV-2 exposures in CLS suggests that source characteristics and location of exposure are most predictive of resident transmission. These findings can inform risk assessment and further opportunities to prevent transmission in CLS.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Infect Control Hosp Epidemiol Asunto de la revista: DOENCAS TRANSMISSIVEIS / ENFERMAGEM / EPIDEMIOLOGIA / HOSPITAIS Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Infect Control Hosp Epidemiol Asunto de la revista: DOENCAS TRANSMISSIVEIS / ENFERMAGEM / EPIDEMIOLOGIA / HOSPITAIS Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos