Predictors of SARS-CoV-2 transmission in congregate living settings: a multicenter prospective study

作者：Jerome A. Leis, Christina K. Chan, Charlie Tan, James Callahan, Victoria Serapion, Brigitte Pascual, Wayne Lee, Jaclyn O’Brien, Neethu Thomas, Heather Candon, Matthew Crittenden, Alex Kiss, Adrienne K. Chan, Marianna Ofner, Jeff Powis · 发表于：Infection Control and Hospital Epidemiology · 年份：2024 · DOI：10.1017/ice.2024.50 · 被引用次数：6 · 研究领域：Geriatric Care and Nursing Homes、Infection Control and Ventilation、COVID-19 epidemiological studies

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%...