Infection and transmission of SARS-CoV-2 in London care homes reporting no cases or outbreaks of COVID-19 : Prospective observational cohort study, England 2020
Crown Copyright © 2021 Published by Elsevier Ltd..
BACKGROUND: Care homes have been disproportionately affected by the COVID-19 pandemic. We investigated the potential role of asymptomatic infection and silent transmission in London care homes that reported no cases of COVID-19 during the first wave of the pandemic.
METHODS: Five care homes with no cases and two care homes reporting a single case of COVID-19 (non-outbreak homes) were investigated with nasal swabbing for SARS-CoV-2 RT-PCR and serology for SARS-CoV-2 antibodies five weeks later. Whole genome sequencing (WGS) was performed on RT-PCR positive samples. Serology results were compared with those of six care homes with recognised outbreaks.
FINDINGS: Across seven non-outbreak homes, 718 (387 staff, 331 residents) individuals had a nasal swab and 651 (386 staff, 265 residents) had follow-up serology. Sixteen individuals (13 residents, 3 staff) in five care homes with no reported cases were RT-PCR positive (care home positivity rates, 0 to 7.6%) compared to 13 individuals (3.0 and 10.8% positivity) in two homes reporting a single case.Seropositivity across these seven homes varied between 10.7-56.5%, with four exceeding community seroprevalence in London (14.8%). Seropositivity rates for staff and residents correlated significantly (rs 0.84, [95% CI 0.51-0.95] p <0.001) across the 13 homes. WGS identified multiple introductions into some homes and silent transmission of a single lineage between staff and residents in one home.
INTERPRETATION: We found high rates of asymptomatic infection and transmission even in care homes with no COVID-19 cases. The higher seropositivity rates compared to RT-PCR positivity highlights the true extent of the silent outbreak.
FUNDING: PHE.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:3 |
|---|---|
| Enthalten in: |
The Lancet regional health. Europe - 3(2021) vom: 11. Apr., Seite 100038 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Jeffery-Smith, Anna [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Asymptomatic transmission |
|---|
| Anmerkungen: |
Date Revised 03.04.2024 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1016/j.lanepe.2021.100038 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM32424925X |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM32424925X | ||
| 003 | DE-627 | ||
| 005 | 20240403232304.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.lanepe.2021.100038 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1362.xml |
| 035 | |a (DE-627)NLM32424925X | ||
| 035 | |a (NLM)33870248 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Jeffery-Smith, Anna |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Infection and transmission of SARS-CoV-2 in London care homes reporting no cases or outbreaks of COVID-19 |b Prospective observational cohort study, England 2020 |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 03.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Crown Copyright © 2021 Published by Elsevier Ltd. | ||
| 520 | |a BACKGROUND: Care homes have been disproportionately affected by the COVID-19 pandemic. We investigated the potential role of asymptomatic infection and silent transmission in London care homes that reported no cases of COVID-19 during the first wave of the pandemic | ||
| 520 | |a METHODS: Five care homes with no cases and two care homes reporting a single case of COVID-19 (non-outbreak homes) were investigated with nasal swabbing for SARS-CoV-2 RT-PCR and serology for SARS-CoV-2 antibodies five weeks later. Whole genome sequencing (WGS) was performed on RT-PCR positive samples. Serology results were compared with those of six care homes with recognised outbreaks | ||
| 520 | |a FINDINGS: Across seven non-outbreak homes, 718 (387 staff, 331 residents) individuals had a nasal swab and 651 (386 staff, 265 residents) had follow-up serology. Sixteen individuals (13 residents, 3 staff) in five care homes with no reported cases were RT-PCR positive (care home positivity rates, 0 to 7.6%) compared to 13 individuals (3.0 and 10.8% positivity) in two homes reporting a single case.Seropositivity across these seven homes varied between 10.7-56.5%, with four exceeding community seroprevalence in London (14.8%). Seropositivity rates for staff and residents correlated significantly (rs 0.84, [95% CI 0.51-0.95] p <0.001) across the 13 homes. WGS identified multiple introductions into some homes and silent transmission of a single lineage between staff and residents in one home | ||
| 520 | |a INTERPRETATION: We found high rates of asymptomatic infection and transmission even in care homes with no COVID-19 cases. The higher seropositivity rates compared to RT-PCR positivity highlights the true extent of the silent outbreak | ||
| 520 | |a FUNDING: PHE | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Asymptomatic transmission | |
| 650 | 4 | |a Care home | |
| 650 | 4 | |a SARS-CoV-2 outbreak | |
| 700 | 1 | |a Dun-Campbell, Kate |e verfasserin |4 aut | |
| 700 | 1 | |a Janarthanan, Roshni |e verfasserin |4 aut | |
| 700 | 1 | |a Fok, Jonathan |e verfasserin |4 aut | |
| 700 | 1 | |a Crawley-Boevey, Emma |e verfasserin |4 aut | |
| 700 | 1 | |a Vusirikala, Amoolya |e verfasserin |4 aut | |
| 700 | 1 | |a Fernandez Ruiz De Olano, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Sanchez Perez, Marina |e verfasserin |4 aut | |
| 700 | 1 | |a Tang, Suzanne |e verfasserin |4 aut | |
| 700 | 1 | |a Rowland, Thomas Aj |e verfasserin |4 aut | |
| 700 | 1 | |a Wynne-Evans, Edward |e verfasserin |4 aut | |
| 700 | 1 | |a Bell, Anita |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Bharat |e verfasserin |4 aut | |
| 700 | 1 | |a Amin-Chowdhury, Zahin |e verfasserin |4 aut | |
| 700 | 1 | |a Aiano, Felicity |e verfasserin |4 aut | |
| 700 | 1 | |a Paranthaman, Karthik |e verfasserin |4 aut | |
| 700 | 1 | |a Ma, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Saavedra-Campos, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Ellis, Joanna |e verfasserin |4 aut | |
| 700 | 1 | |a Lackenby, Angie |e verfasserin |4 aut | |
| 700 | 1 | |a Whitaker, Heather |e verfasserin |4 aut | |
| 700 | 1 | |a Myers, Richard |e verfasserin |4 aut | |
| 700 | 1 | |a Höschler, Katja |e verfasserin |4 aut | |
| 700 | 1 | |a Brown, Kevin |e verfasserin |4 aut | |
| 700 | 1 | |a Ramsay, Mary E |e verfasserin |4 aut | |
| 700 | 1 | |a Shetty, Nandini |e verfasserin |4 aut | |
| 700 | 1 | |a Chow, J Yimmy |e verfasserin |4 aut | |
| 700 | 1 | |a Ladhani, Shamez |e verfasserin |4 aut | |
| 700 | 1 | |a Zambon, Maria |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Lancet regional health. Europe |d 2021 |g 3(2021) vom: 11. Apr., Seite 100038 |w (DE-627)NLM323979734 |x 2666-7762 |7 nnns |
| 773 | 1 | 8 | |g volume:3 |g year:2021 |g day:11 |g month:04 |g pages:100038 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.lanepe.2021.100038 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 3 |j 2021 |b 11 |c 04 |h 100038 | ||