Risk of Severe Acute Respiratory Syndrome Coronavirus 2 Acquisition Is Associated With Individual Exposure but Not Community-Level Transmission
Author:
Friedman-Klabanoff DeAnna J1ORCID, Fitzpatrick Meagan C1, Deming Meagan E1, Agrawal Vaidehi1, Sitar Sandra2, Schaafsma Torin3, Brown Elizabeth456, Neuzil Kathleen M1, Barnabas Ruanne V378, Laufer Miriam K1, Dull Peter, Miller Scott, Pham Thy, Arroyave Luisa, Berz Jonathan, Buitron Pablo, Camuso Michael, Cardoso Leticia, Cruz Ricardo, Dedier Julien, Dennaoui Husam, Goldman Anna, Greenstein Cheryl, Henault Lori, Johnson Terrell, Kimball Sarah, Martinez Carlie, Martinez Erin, Ng Crystal, Paarz William, Ogunneye Qausarat, Paasche-Orlow Lev, Rogers Margot, Salerno Kathleen, Smithline Michael, Streed Carl, Verma Nisha, Waite Katherine, Hosek Sybil, Balthazar Christopher, Jarris Ann, Greene Leslie Anna, Buist Diana, Aldana Sandra India, Alsaloum Marissa, Anastasiou Elle, Cardozo Rodrigo Arce, Badiei Beita, Bakirova Kamilla, Bakirova Zulfiya, Barnes Caroline, Bedi Sukhleen K, Beggs Dia B, Bendik Stefanie E, Cao Meng, Chang Michelle, Chen Shirley, Cheng Anna, Chong Stella K, Coates Jane, Conderino Sarah, Connery Jacqueline, Connolly Megan, Contreras Aira L, Dreier Matthew S, Duan Emily, Hidalgo Eveline Teresa, Fadzan Maja, Fagan Samantha N, Fried Jamie, Gago Juan, Gakou Nadia, Gill Emily, Gujral Akash, Hao Xiaolei, Hughes Christina, James Robert T, Kim Sean, Krieger Penina, Landon Susan N, Liang Alice Li Juan, Lopez Priscilla M, Mamistvalova Lia, Schwartz Mark D, McQuay Saydee, Miao Wei (William), Mohaimin Sadia, Gabriela Kaicy, Nguyen-Stone Naranjo, Krissy, Peltekci Ashley, Peña Andrea, Perdomo Katherine, Pompeii Mary Lou, Quintana Lindsey, Reynolds Amanda J, Pitts Robert A, Rodriguez Andrea, Sasankan Prabhu, Sharma Sneha R, Shire Amy, Sota Stela, Spoer Ben R, Springer Bethany, Stadelman Jay, Wysota Christina N, Yang Jackie, Yepez Myriam, Cram Danielle, Eustace Stephen, Mandziuk Kathleen, Massaro Michael, Mullenix Colleen, Reichard Toze, Towner Tiara, Abbott Mark, Asiago-Reddy Elizabeth, Baxter Kristen, Caiello Kate, Endy Timothy, Geneva Ivayla, Greco Peter, Harausz Elizabeth, Klick Michelle, Mehlek Patrick, Miller Christopher, Reale Melissa, Ripich Kianna, Shaw Andrea, Terrillion Keely, Thomas Stephen, Anibaba Mueenah, Atkinson Evan, Blyth Michelle, Campbell Mary Beth, Carsch Lillianna, Ganguly Ashita, Gupta Sarina, Larkin Heather, Hall Jake, Huntwork John, Huntwork Margaret, McConville Mariel, McDougal April, Numbi Florice, Ntambwe Cedrick, Palomares Michelle, Plaxico Demetrius, Rady Hamada, Ribando Maria, Sauter Sydney, Triggs Daniel, Upadhyay Neha, Schmidt Norine, Watson Shannon, Zheng Crystal, Arias Rubi, Bhimani Azra J, Blair Cherie, Cambou Catie, Cayabyab Meilani, Corona Rafael, Escobedo Danielle, Furukawa Daisuke, Gonzalez Amanda, Karpf Heather, Kofron Ryan, Largaespada Karla, Lopez Nancy, Mansky Hannah, Martin-Blais Rachel, Petreuse Antonia, Shin Christina, Tran Tran T, Weldon Ameila, Were Gabriela, Agrawal Vaidehi, Billington Melissa, Birkhold Megan, Boyce Colleen, Cloeren Marianne, Palacios Carlo Foppiano, Friedman-Klabanoff DeAnna, Kwon Alyson, LeBuhn Hanna, Liu Esther, Lu Meredith, McDiarmid Melissa, Myers Melissa, Pa’ahana-Brown Faith, Poley Marian, Shrestha Biraj, Wilkerson Gentry, Alidina Nathan, Arnold Samuel, Bauer Marie, Baugh Jennifer, Bayer Cara, Bole Medhavi, Brandstetter Elizabeth, Braun Alyssa, Brown Clare E, Brown Maxwell, Bulterys Michelle, Castor Jared, Dematteis Maianna, Doan Ivy, Drummond Mark, Feutz Erika, Galagan Sean, Hamilton Daphne, Hauge Kirsten, Hay Elsa, Hladik Florian, Hou Xuanlin, Houston Doug, Humphreys Madelaine, Hussein Abir, Ikuma Matthew, Issema Rodal, Johnson Rachel, Kirk Mary, Knauer Jack, Kuntz Steven R, Lawton Savannah, Letterer Rebecca, Lingappa Elina, Lingappa Jairam R, Liou Caroline H, Lund Katie, Maddox Toni, Mathur Anya, Metter Mari, McClellan Lindsey, Montoya Deidra, Moreno Jessica C, Pandey Gregory Morlin, Urvashi, Pepper Gregory, Pettit Alicia, Pholsena Thepthara, Popp Griffin, Purcell Jeff, Quame-Amaglo Justice, Sampoleo Reigran, Sanger Elliott, Seymour Matthew, Shercliffe Alexander, Somani Shabir, Stewart Jenell C, Tamakole Selorm, Taub Jina M, Thuesmunn Zoe, Tungara Amena, Valinetz Ethan, Varon Dana L, Vazquez Vianey, Vo Bao-Chau, Wanga Valentine, Waters Chloe D, Wei Yulun, Welsh Meagan, Wicklander Katie, Wood Brian R, Young Grant, Young Zohdi, Zhao Lucy, Zimmermann Azaad, Brown Deborah J, Davenport Nathaniel, Gambito Omar,
Affiliation:
1. Center for Vaccine Development and Global Health, University of Maryland School of Medicine , Baltimore, Maryland , USA 2. Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health , Bethesda, Maryland , USA 3. Department of Global Health , University of Washington, Seattle, Washington , USA 4. Department of Biostatistics, University of Washington , Seattle, Washington , USA 5. Vaccine and Infectious Disease Division , University of Washington, Seattle, Washington , USA 6. Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, Washington , USA 7. Division of Allergy and Infectious Diseases, University of Washington , Seattle, Washington , USA 8. Department of Epidemiology, University of Washington , Seattle, Washington , USA
Abstract
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.
Funder
Bill & Melinda Gates Foundation through the COVID-19 Therapeutics Accelerator National Institutes of Health
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Immunology and Allergy
Cited by
4 articles.
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