Dataset Information

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.

ABSTRACT:

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 (r_s 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.

SUBMITTER: Jeffery-Smith A

PROVIDER: S-EPMC7826003 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

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.

Jeffery-Smith Anna A Dun-Campbell Kate K Janarthanan Roshni R Fok Jonathan J Crawley-Boevey Emma E Vusirikala Amoolya A Fernandez Ruiz De Olano Elena E Sanchez Perez Marina M Tang Suzanne S Rowland Thomas Aj TA Wynne-Evans Edward E Bell Anita A Patel Bharat B Amin-Chowdhury Zahin Z Aiano Felicity F Paranthaman Karthik K Ma Thomas T Saavedra-Campos Maria M Ellis Joanna J Lackenby Angie A Whitaker Heather H Myers Richard R Höschler Katja K Brown Kevin K Ramsay Mary E ME Shetty Nandini N Chow J Yimmy JY Ladhani Shamez S Zambon Maria M

The Lancet regional health. Europe 20210122

<h4>Background</h4>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.<h4>Methods</h4>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 w ...[more]

PMID: 33870248

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Dataset Information

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.

Background

Methods

Findings

Interpretation

Funding

Publications

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.

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