A Case-Control Study of Contextual Factors for SARS-CoV-2 Transmission

Data de publicação: 04/11/2021

Autores da FMUP

• Teresa Isabel Da Costa Leão

  Autor

• Milton Severo Barros Da Silva

  Autor

• Raquel Lucas Calado Ferreira

  Autor

• Nuno Miguel De Sousa Lunet

  Autor

• José Henrique Dias Pinto De Barros

  Autor

Participantes de fora da FMUP

• Leite, A
• Soares, P
• Moniz, M
• Aguiar, P
• Meireles, P
• Nunes, C

Unidades de investigação

• Ciências da Saúde Pública e Forenses, e Educação Médica

Abstract

Background: Knowledge on the settings and activities associated with a higher risk of SARS-CoV-2 transmission is essential to inform decision-making. We thus designed a case-control study to identify relevant settings for community transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Portugal.Methods: We evaluated 1,088 cases, identified through the national surveillance system, and 787 community controls, recruited using random digit dialing. Sociodemographic characteristics, individual protective measures, and activities or visited settings were obtained through telephone interview. We report sex-, age-, education-, and citizenship-adjusted odds ratios (aOR) with 95% confidence intervals (95% CI).Results: Household overcrowding (aOR = 1.47; 95% CI 1.14-1.91) and work in senior care (4.99; 1.30-33.08) increased while working remotely decreased the risk of infection (0.30; 0.22-0.42). Going to restaurants/other dining spaces (0.73; 0.59-0.91), grocery stores (0.44; 0.34-0.57) or hair salons (0.51; 0.39-0.66), or the use of public transportation did not present a higher risk of infection (0.98; 0.75-1.29), under existing mitigation strategies. Lower education ( <= 4 years vs. tertiary education: 1.79; 1.33-2.42) and no Portuguese citizenship (5.47; 3.43-9.22) were important risk factors.Conclusions: The utilization of public transportation, restaurants, and commercial spaces was not associated with increased risk of infection, under capacity restrictions, physical distancing, use of masks, and hygiene measures. Overcrowding, foreign citizenship, low education and working on-site were positively associated with SARS-CoV-2 infection.

Keywords

• SARS-CoV-2; COVID-19; risk factors; transmission; case-control studies