Epidemiology and Infection
ISSN / EISSN : 0950-2688 / 1469-4409
Published by: Cambridge University Press (CUP) (10.1017)
Total articles ≅ 7,779
Latest articles in this journal
Published: 8 July 2021
Epidemiology and Infection pp 1-22; doi:10.1017/s0950268821001448
Published: 5 July 2021
Epidemiology and Infection pp 1-24; doi:10.1017/s0950268821001540
Published: 2 July 2021
Epidemiology and Infection, Volume 149, pp 1-32; doi:10.1017/s095026882100145x
Clinical and genetic risk factors for severe coronavirus disease 2019 (COVID-19) are often considered independently and without knowledge of the magnitudes of their effects on risk. Using severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) positive participants from the UK Biobank, we developed and validated a clinical and genetic model to predict risk of severe COVID-19. We used multivariable logistic regression on a 70% training dataset and used the remaining 30% for validation. We also validated a previously published prototype model. In the validation dataset, our new model was associated with severe COVID-19 (odds ratio per quintile of risk = 1.77, 95% confidence interval (CI) 1.64–1.90) and had acceptable discrimination (area under the receiver operating characteristic curve = 0.732, 95% CI 0.708–0.756). We assessed calibration using logistic regression of the log odds of the risk score, and the new model showed no evidence of over- or under-estimation of risk (α = −0.08; 95% CI −0.21−0.05) and no evidence or over-or under-dispersion of risk (β = 0.90, 95% CI 0.80–1.00). Accurate prediction of individual risk is possible and will be important in regions where vaccines are not widely available or where people refuse or are disqualified from vaccination, especially given uncertainty about the extent of infection transmission among vaccinated people and the emergence of SARS-CoV-2 variants of concern.
Epidemiology and Infection, Volume 149, pp 1-17; doi:10.1017/s0950268821001503
Two general practitioners (GPs) with SARS-CoV-2 infection provided in-person patient care to patients of their joint medical practice before and after symptom onset, up until SARS-CoV-2 laboratory confirmation. Through active contact tracing, the local public health authorities recruited the cohort of patients that had contact with either GP in their putative infectious period. In this cohort of patient contacts, we assess the frequency and determinants of SARS-CoV-2-transmission from GPs to patients. We calculated incidence rate ratios (IRR) to explore the type of contact as an explanatory variable for COVID-19 cases. Among the cohort of 83 patient contacts, we identified 22 (27%) COVID-19 cases including 17 (21%) possible, three (4%) probable and two (2%) confirmed cases. All 22 cases had contact with a GP when the GP did not wear a mask, and/or when contact was ≥10 min. Importantly, patients who had contact <10 min with a GP wearing a facemask were at reduced risk (IRR 0.21; 95% CI 0.01–0.99) of COVID-19. This outbreak investigation adds to the body of evidence in supporting current guidelines on measures at preventing the transmission of SARS-CoV-2 in an outpatient setting.
Epidemiology and Infection pp 1-19; doi:10.1017/s0950268821001515
Epidemiology and Infection, Volume 149, pp 1-26; doi:10.1017/s0950268821001527
We estimate the delay-adjusted all-cause excess deaths across 53 US jurisdictions. Using provisional data collected from September through December 2020, we first identify a common mean reporting delay of 2.8 weeks, whereas four jurisdictions have prolonged reporting delays compared to the others: Connecticut (mean 5.8 weeks), North Carolina (mean 10.4 weeks), Puerto Rico (mean 4.7 weeks) and West Virginia (mean 5.5 weeks). After adjusting for reporting delays, we estimate the percent change in all-cause excess mortality from March to December 2020 with range from 0.2 to 3.6 in Hawaii to 58.4 to 62.4 in New York City. Comparing the March–December with September–December 2020 periods, the highest increases in excess mortality are observed in South Dakota (36.9–54.0), North Dakota (33.9–50.7) and Missouri (27.8–33.9). Our findings indicate that analysis of provisional data requires caution in interpreting the death counts in recent weeks, while one needs also to account for heterogeneity in reporting delays of excess deaths among US jurisdictions.
Epidemiology and Infection pp 1-7; doi:10.1017/s0950268821001539
Epidemiology and Infection pp 1-23; doi:10.1017/s0950268821001394
Epidemiology and Infection, Volume 149, pp 1-2; doi:10.1017/s0950268821001370
Epidemiology and Infection, Volume 149, pp 1-2; doi:10.1017/s0950268821001382