Risk factors for SARS-CoV-2 infection in primary and secondary school students and staff in England in the 2020/2021 school year: a longitudinal study

Nguipdop-Djomo, Patrick; Oswald, William E.; Halliday, Katherine E.; Cook, Sarah; Sturgess, Joanna; Sundaram, Neisha; Warren‐Gash, Charlotte; Fine, Paul E. M.; Glynn, Judith R.; Allen, Elizabeth; Clark, Taane G.; Ford, Benjamin; Judd, Alison; Ireland, Georgina; Poh, John; Bonell, Chris; Dawe, Fiona; Rourke, Emma; Diamond, Ian; Ladhani, Shamez; Langan, Sinéad M; Hargreaves, James; Mangtani, Punam

doi:10.1016/j.ijid.2022.12.030

Cited by 4 publications

(4 citation statements)

References 21 publications

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“…Schools remained one of the few settings where high frequency of close contacts between large numbers of people was possible. 9,24,25 In the SIS study period, there were several times when schools were closed leading to increased mixing at home, which may have facilitated household transmission.…”

Section: Discussionmentioning

confidence: 99%

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The association between SARS-CoV-2 infections in English primary and secondary school children and staff, and infections in members of their household in the schoolyear 2020-2021: a self-controlled case-series analysis

McClenaghan,

Nguipdop-Djomo,

Lewin

et al. 2023

Preprint

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BackgroundThe role of children and staff in SARS-CoV-2 transmission outside and within households is still not fully understood when large numbers are in regular, frequent contact in schools.MethodsWe used the self-controlled case-series method during the alpha- and delta-dominant periods to explore the incidence of infection in periods around a household member infection, relative to periods without household infection, in a cohort of primary and secondary English school children and staff from November 2020 to July 2021.ResultsWe found the relative incidence of infection in students and staff was highest in the 1-7 days following household infection, remaining high up to 14 days after, with risk also elevated in the 6-12 days before household infection. Younger students had a higher relative incidence following household infection, suggesting household transmission may play a more prominent role compared with older students. The relative incidence was also higher amongst students in the alpha variant dominant period.ConclusionsThis analysis suggests SARS-CoV2 infection in children, young people and staff at English schools were more likely to be associated with within-household transmission than from outside the household, but that a small increased risk of seeding from outside is observed.Key messagesQuestion: With respect to incidence of SARS-CoV-2 infection before and after household member infection, is within-household transmission more likely than community transmission amongst school children and staff?Findings: In this self-controlled case-series analysis, the relative incidence of infection in students and staff was highest in the 1-7 days following household infection, remaining high up to 14 days after, with the highest relative incidence found in younger, primary school-aged children.Importance: Within-household transmission is more likely than from outside the household, but a small increased risk of seeding from outside the household is observed as well as variation by age and variant dominant period.

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Section: Discussionmentioning

confidence: 99%

“…The presence of household co-infections was the strongest risk factor in a study of determinants of incident SARS-CoV-2 infection in the English SIS. 9 The direction of transmission within households was however not possible to investigate.…”

Section: Introductionmentioning

confidence: 99%

The association between SARS-CoV-2 infections in English primary and secondary school children and staff, and infections in members of their household in the schoolyear 2020-2021: a self-controlled case-series analysis

McClenaghan,

Nguipdop-Djomo,

Lewin

et al. 2023

Preprint

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“…In SIS-1, 14,842 students participated in at least one study round [ 21 ], while in CoMMinS, a sample size of ~2,000 participants (~9,000–10,000 saliva samples) was achieved [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

Acute and long-term outcomes of SARS-CoV-2 infection in school-aged children in England: Study protocol for the joint analysis of the COVID-19 schools infection survey (SIS) and the COVID-19 mapping and mitigation in schools (CoMMinS) study

Looker,

McClenaghan,

Judd

et al. 2024

PLoS ONE

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Background The symptom profiles of acute SARS-CoV-2 infection and long-COVID in children and young people (CYP), risk factors, and associated healthcare needs, are poorly defined. The Schools Infection Survey 1 (SIS-1) was a nationwide study of SARS-CoV-2 infection in primary and secondary schools in England during the 2020/21 school year. The Covid-19 Mapping and Mitigation in Schools (CoMMinS) study was conducted in schools in the Bristol area over a similar period. Both studies conducted testing to identify current and previous SARS-CoV-2 infection, and recorded symptoms and school attendance. These research data have been linked to routine electronic health record (EHR) data. Aims To better understand the short- and long-term consequences of SARS-CoV-2 infection, and their risk factors, in CYP. Methods Retrospective cohort and nested case-control analyses will be conducted for SIS-1 and CoMMinS data linked to EHR data for the association between (1) acute symptomatic SARS-CoV-2 infection and risk factors; (2) SARS-CoV-2 infection and long-term effects on health: (a) persistent symptoms; (b) any new diagnosis; (c) a new prescription in primary care; (d) health service attendance; (e) a high rate of school absence. Results Our study will improve understanding of long-COVID in CYP by characterising the trajectory of long-COVID in CYP in terms of things like symptoms and diagnoses of conditions. The research will inform which groups of CYP are more likely to get acute- and long-term outcomes of SARS-CoV-2 infection, and patterns of related healthcare-seeking behaviour, relevant for healthcare service planning. Digested information will be produced for affected families, doctors, schools, and the public, as appropriate. Conclusion Linked SIS-1 and CoMMinS data represent a unique and rich resource for understanding the impact of SARS-CoV-2 infection on children’s health, benefiting from enhanced SARS-CoV-2 testing and ability to assess a wide range of outcomes.

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“…In this context, the identification of risk factors for the transmission of SARS-CoV-2 infection is crucial to guide health policy decisions aimed at limiting virus transmission and, at the same time, preserving the normal activities of everyday life as far as possible [2,3]. However, few analytical epidemiological studies have been conducted worldwide to investigate the risk factors for SARS-CoV-2 acquisition [4][5][6][7][8][9][10][11][12][13], particularly in healthy individuals attending community settings and areas posing unique challenges for transmission control, such as schools [14][15][16] and higher education institutions (HEIs) [17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Keeping university open did not increase the risk of SARS-CoV-2 acquisition: A test negative case-control study among students

Renzi,

Baccolini,

Covelli

et al. 2024

PLoS ONE

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Background During the SARS-CoV-2 testing program offered through the RT-PCR test by Sapienza University of Rome, we conducted a test-negative case-control study to identify risk factors for acquiring SARS-CoV-2 infection among university students. Methods Each SARS-CoV-2-positive case detected was matched to two controls randomly selected from students who tested negative on the same day. 122 positive students and 244 negative students were enrolled in the study. Multivariable conditional logistic regression models were built. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. A second model was limited to students who had attended campus. Results Out of 8223 tests for SARS-CoV-2, 173 students tested positive (2.1%), of whom 122 (71.5%) were included in the case-control study. In the first analysis, being a non-Italian student (aOR: 8.93, 95% CI: 2.71–29.41), having received only the primary vaccination course (aOR: 2.94, 95% CI: 1.24–6.96) compared to the booster dose, known exposure to a COVID-19 case or someone with signs/symptoms suggestive of COVID-19 (aOR: 6.51, 95% CI: 3.48–12.18), and visiting discos (aOR: 4.07, 95% CI: 1.52–10.90) in the two weeks before testing increased the likelihood of SARS-CoV-2 infection. Conversely, students attending in-person lectures on campus seemed less likely to become infected (aOR: 0.34, 95% CI: 0.15–0.77). No association was found with other variables. The results of the second model were comparable to the first analysis. Conclusions This study indicates that if universities adopt strict prevention measures, it is safe for students to attend, even in the case of an infectious disease epidemic.

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Risk factors for SARS-CoV-2 infection in primary and secondary school students and staff in England in the 2020/2021 school year: a longitudinal study

Cited by 4 publications

References 21 publications

The association between SARS-CoV-2 infections in English primary and secondary school children and staff, and infections in members of their household in the schoolyear 2020-2021: a self-controlled case-series analysis

The association between SARS-CoV-2 infections in English primary and secondary school children and staff, and infections in members of their household in the schoolyear 2020-2021: a self-controlled case-series analysis

Acute and long-term outcomes of SARS-CoV-2 infection in school-aged children in England: Study protocol for the joint analysis of the COVID-19 schools infection survey (SIS) and the COVID-19 mapping and mitigation in schools (CoMMinS) study

Keeping university open did not increase the risk of SARS-CoV-2 acquisition: A test negative case-control study among students

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