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Schools as a Framework for COVID-19 Epidemiological Surveillance of Children in Catalonia, Spain: A Population-Based Study.

ABSTRACT: Objective: We describe and analyze the childhood (<18 years) COVID-19 incidence in Catalonia, Spain, during the first 36 weeks of the 2020-2021 school-year and to compare it with the incidence in adults. Methods: Data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests were obtained from the Catalan Agency for Quality and Health Assessment. Overall, 7,203,663 SARS-CoV-2 tests were performed, of which 491,819 were positive (6.8%). We collected epidemiological data including age-group incidence, diagnostic effort, and positivity rate per 100,000 population to analyze the relative results for these epidemiological characteristics. Results: Despite a great diagnostic effort among children, with a difference of 1,154 tests per 100,000 population in relation to adults, the relative incidence of SARS-CoV-2 for <18 years was slightly lower than for the general population, and it increased with the age of the children. Additionally, positivity of SARS-CoV-2 in children (5.7%) was lower than in adults (7.2%), especially outside vacation periods, when children were attending school (4.9%). Conclusions: A great diagnostic effort, including mass screening and systematic whole-group contact tracing when a positive was detected in the class group, was associated with childhood SARS-CoV-2 incidence and lower positivity rate in the 2020-2021 school year. Schools have been a key tool in epidemiological surveillance rather than being drivers of SARS-CoV-2 incidence in Catalonia, Spain.

SUBMITTER: Perramon A

PROVIDER: S-EPMC8457047 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Schools as a Framework for COVID-19 Epidemiological Surveillance of Children in Catalonia, Spain: A Population-Based Study.

Perramon Aida A Soriano-Arandes Antoni A Pino David D Lazcano Uxue U Andrés Cristina C Català Martí M Gatell Anna A Carulla Mireia M Canadell Dolors D Ricós Gemma G Riera-Bosch M Teresa MT Burgaya Silvia S Salvadó Olga O Cantero Javier J Vilà Mònica M Poblet Miriam M Sánchez Almudena A Ristol Anna M AM Serrano Pepe P Antón Andrés A Prats Clara C Soler-Palacin Pere P

Frontiers in pediatrics 20210908

<b>Objective:</b> We describe and analyze the childhood (<18 years) COVID-19 incidence in Catalonia, Spain, during the first 36 weeks of the 2020-2021 school-year and to compare it with the incidence in adults. <b>Methods:</b> Data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests were obtained from the Catalan Agency for Quality and Health Assessment. Overall, 7,203,663 SARS-CoV-2 tests were performed, of which 491,819 were positive (6.8%). We collected epidemiological data ...[more]

PMID: 34568244

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Project description:IntroductionEvidence from epidemiological studies based on individual-level data indicates that air pollution may be associated with coronavirus disease 2019 (COVID-19) severity. We aimed to test whether (1) long-term exposure to air pollution is associated with COVID-19-related hospital admission or mortality in the general population; (2) short-term exposure to air pollution is associated with COVID-19-related hospital admission following COVID-19 diagnosis; (3) there are vulnerable population subgroups; and (4) the influence of long-term air pollution exposure on COVID-19-related hospital admissions differed from that for other respiratory infections.MethodsWe constructed a cohort covering nearly the full population of Catalonia through registry linkage, with follow- up from January 1, 2015, to December 31, 2020. Exposures at residential addresses were estimated using newly developed spatiotemporal models of nitrogen dioxide (NO23), particulate matter ≤2.5 μm in aerodynamic diameter (PM2.5), particulate matter ≤10 μm in aerodynamic diameter (PM10), and maximum 8-hr-average ozone (O3) at a spatial resolution of 250 m for the period 2018-2020.ResultsThe general population cohort included 4,660,502 individuals; in 2020 there were 340,608 COVID-19 diagnoses, 47,174 COVID-19-related hospital admissions, and 10,001 COVID-19 deaths. Mean (standard deviation) annual exposures were 26.2 (10.3) μg/m3 for NO2, 13.8 (2.2) μg/m3 for PM2.5, and 91.6 (8.2) μg/m3 for O3. In Aim 1, an increase of 16.1 μg/m3 NO2 was associated with a 25% (95% confidence interval [CI]: 22%-29%) increase in hospitalizations and an 18% (10%-27%) increase in deaths. In Aim 2, cumulative air pollution exposure over the previous 7 days was positively associated with COVID-19-related hospital admission in the second pandemic wave (June 20 to December 31, 2020). Associations of exposure were driven by exposure on the day of the hospital admission (lag0). Associations between short-term exposure to air pollution and COVID-19-related hospital admission were similar in all population subgroups. In Aim 3, individuals with lower individual- and area-level socioeconomic status (SES) were identified as particularly vulnerable to the effects of long-term exposure to NO2 and PM2.5 on COVID-19-related hospital admission. In Aim 4, long-term exposure to air pollution was associated with hospital admission for influenza and pneumonia: (6%; 95% CI: 2-11 per 16.4-μg/m3 NO2 and 5%; 1-8 per 2.6-μg/m3 PM2.5) as well as for all lower respiratory infections (LRIs) (18%; 14-22 per 16.4-μg/m3 NO2 and 14%; 11-17 per 2.6-μg/m3 PM2.5) before the COVID-19 pandemic. Associations for COVID-19-related hospital admission were larger than those for influenza or pneumonia for NO2, PM2.5, and O3 when adjusted for NO2.ConclusionsLinkage across several registries allowed the construction of a large population-based cohort, tracking COVID-19 cases from primary care and testing data to hospital admissions, and death. Long- and short-term exposure to ambient air pollution were positively associated with severe COVID-19 events. The effects of long-term air pollution exposure on COVID-19 severity were greater among those with lower individual- and area-level SES.

Project description:BackgroundThis study aimed to estimate potential undetected cancers over the first 2 years of the COVID-19 pandemic in Catalonia.MethodsCancer incidence was compared between pre-pandemic (2019) and pandemic (March 2020-January 2022) periods in the Catalan Pathology Registry (CPR) according to sex, age, and tumor site. The correlation between cancer diagnosis and COVID-19 health care workload was also evaluated by means of the Pearson's correlation coefficient (R). The expected incident cancers (E) during the pandemic were estimated by applying 2019 CPR cancer incidence specific rates by sex and 5-year age groups to the 2020 and 2021 Catalan population pyramids. CPR incident cancers were considered observed (O). Standardized incidence ratios (SIR) and 95% confidence intervals (CIs) were calculated using the O/E ratio.ResultsAfter two pandemic years, cancer diagnosis decreased by 12% (SIR 0.88, 95% CI 0.87-0.89), or ∼7700 undetected cancers (13 000 with nonmelanoma skin cancer). Without nonmelanoma skin cancer, 72% of the cancer underdiagnosis was generated in 2020. Diagnoses decreased more in men (whole pandemic -14%; 2020 -21%; 2021 -8%) than in women (-9%, -19%, -3%, respectively), dropping significantly overall in all pandemic waves but the fifth (first -37%, second -16%, third -8%, fourth -6%, fifth -2%, sixth -6%), and across all adult age groups. In the first wave, CPR cancer diagnosis was inversely correlated with COVID-19 caseload in primary care (R -0.91, 95% CI -0.97 to -0.75) and occupancy in conventional hospital wards (R -0.91, 95% CI -0.99 to -0.48) and intensive care (R -0.91, 95% CI 95% -0.98 to -0.70).ConclusionsOur study evaluated the overall pandemic impact on cancer diagnosis on a large scale and with minimal selection bias, showing that as of February 2022, cancer detection in Catalonia had not yet recovered to pre-pandemic levels. Pending cancer incidence data from population-based cancer registries, early CPR data could inform the development of Spanish cancer control plans.

Dataset Information

Schools as a Framework for COVID-19 Epidemiological Surveillance of Children in Catalonia, Spain: A Population-Based Study.

Publications

Schools as a Framework for COVID-19 Epidemiological Surveillance of Children in Catalonia, Spain: A Population-Based Study.

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