About: Comparison of viral levels in individuals with or without symptoms at time of COVID-19 testing among 32,480 residents and staff of nursing homes and assisted living facilities in Massachusetts.

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About: Comparison of viral levels in individuals with or without symptoms at time of COVID-19 testing among 32,480 residents and staff of nursing homes and assisted living facilities in Massachusetts. Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Comparison of viral levels in individuals with or without symptoms at time of COVID-19 testing among 32,480 residents and staff of nursing homes and assisted living facilities in Massachusetts.
Creator	Smole, Sandra Mina, Michael Rehm, Heidi Hung, Deborah Lander, Eric Woolley, Ann Gabriel, Stacey Bhattacharyya, Roby Lennon, Niall
topic	covid:e570d8602d7541f599b870eabfc52d91f1945368#this
source	MedRxiv
abstract	Background Transmission of COVID-19 from people without symptoms poses considerable challenges to public health containment measures. The distribution of viral loads in individuals with and without symptoms remains uncertain. Comprehensive cross-sectional screening of all individuals in a given setting provides an unbiased way to assess viral loads independent of symptoms, which informs transmission risks. COVID-19 cases initially peaked in Massachusetts in mid-April 2020 before declining through June, and congregate living facilities were particularly affected during this early surge. We performed a retrospective analysis of data from a large public health-directed outbreak response initiative that involved comprehensive screening within nursing homes and assisted living facilities in Massachusetts to compare nasopharyngeal (NP) viral loads (as measured by RT-PCR cycle threshold (Ct) levels) in residents and staff to inform our ability to detect SARS-CoV-2 in individuals with or without symptoms in the population. Methods Between April 9 and June 9, 2020, we tested NP swabs from 32,480 unique individuals comprising staff and residents of the majority of nursing homes and assisted living facilities in Massachusetts. Under the direction of the MA Department of Public Health (MDPH), symptomatology at the time of sampling and demographic information was provided by each facility for each individual to facilitate reporting to health officials. NP swabs were collected, RNA extracted, and SARS-CoV-2 testing performed using quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR). Results The nursing home and assisted living facilities resident cohort (N =16,966) was 65% female with a mean age of 82 years (SD 13 yrs). The staff cohort (N = 15,514) was 76% female with a median age of 45 (SD 15 yrs). A total 2654 residents (15.5%) and 624 staff (4.1%) tested positive for SARS-CoV-2. 12.7% of residents and 3.7% of staff without symptoms tested positive for SARS-CoV-2, compared to 53.1% of residents and 18.2% of staff with symptoms. Of the individuals who tested positive, 70.8% of residents and 92.4% of staff lacked symptoms at the time of testing. In aggregate, the distributions of Cts for viral probes used in the qRT-PCR assay were very similar, with a statistically but not meaningfully different mean ({triangleup}Ct 0.71 cycles, p = 0.006) and a similar range (12-38 cycles), between populations with and without symptoms over the entire time period, across all sub-categories examined (age, race, ethnicity, sex, resident/staff). Importantly, the Ct mean values and range were indistinguishable between the populations by symptom class during the peak of the outbreak in Massachusetts, with a Ct gap appearing only later in the survey period, reaching >3 cycles (p [≤] 0.001) for facilities sampled during the last two weeks of the study. Conclusions In a large cohort of individuals screened for SARS-CoV-2 by qRT-PCR, we found strikingly similar distributions of viral load in patients with or without symptoms at the time of testing during the local peak of the epidemic; as the epidemic waned, individuals without symptoms at the time of testing had lower viral loads. The size of the study population, including both staff and residents spanning a wide range of ages, provides a comprehensive cross-sectional point prevalence measurement of viral burden in a study spanning 2 months. Because the distributions of viral loads in infected individuals irrespective of symptomatology are very similar, existing testing modalities that have been validated for detection of SARS-CoV-2 RNA in symptomatic patients should perform similarly in individuals without symptoms at the time of testing.
has issue date	2020-07-26(xsd:dateTime)
bibo:doi	10.1101/2020.07.20.20157792
has license	medrxiv
sha1sum (hex)	e570d8602d7541f599b870eabfc52d91f1945368
schema:url	https://doi.org/10.1101/2020.07.20.20157792
resource representing a document's title	Comparison of viral levels in individuals with or without symptoms at time of COVID-19 testing among 32,480 residents and staff of nursing homes and assisted living facilities in Massachusetts.
resource representing a document's body	covid:e570d8602d7541f599b870eabfc52d91f1945368#body_text
is http://vocab.deri.ie/void#inDataset of	https://covidontheweb.inria.fr:4443/about/id/http/ns.inria.fr/covid19/e570d8602d7541f599b870eabfc52d91f1945368
is schema:about of	named entity 'residents' named entity 'inform' named entity 'retrospective' named entity 'facilities' named entity 'residents' named entity 'DECLINING' named entity 'CHALLENGES' named entity 'EARLY' named entity 'PERFORMED' named entity 'RISKS' named entity 'UNCERTAIN' named entity 'GIVEN' named entity 'TO DETECT' named entity 'SARS-COV-2' covid:arg/e570d8602d7541f599b870eabfc52d91f1945368 named entity 'informs' named entity 'symptoms' named entity 'large' named entity 'poses' named entity 'viral' named entity 'ability' named entity 'Transmission' named entity 'measures' named entity 'RT-PCR' named entity 'analysis of data' named entity 'COVID-19' named entity 'Massachusetts' named entity 'nursing homes' named entity 'symptom' named entity 'viral load' named entity 'cDNA' named entity 'symptomatology' named entity 'tested positive' named entity 'viral testing' named entity 'SARS-CoV-2' named entity 'COVID' named entity 'Massachusetts' named entity 'comorbidities' named entity 'public health departments' named entity 'viral load' named entity 'asymptomatic' named entity 'demographic data' named entity 'epidemic' named entity 'MANG' named entity 'Institutional Review Board' named entity 'medRxiv' named entity 'RNA' named entity 'CC-BY-NC-ND 4.0' named entity 'SARS-CoV-2' named entity 'preprint' named entity 'CC-BY-NC-ND 4.0' named entity 'peer review' named entity 'RT-PCR' named entity 'RNA extraction' named entity 'SARS-CoV-2' named entity 'infection' named entity 'expression of the gene' named entity 'RT-PCR' named entity 'virus' named entity 'demographic information' named entity 'CC-BY-NC-ND 4.0' named entity 'symptomatology' named entity 'symptom' named entity 'COVID-19' named entity 'polymerase chain reaction' named entity 'RNA' named entity 'nursing facilities' named entity 'stay home' named entity 'COVID' named entity 'influenza' named entity 'viral load' named entity 'tested positive' named entity 'informed consent' named entity 'asymptomatic' named entity 'viral load'

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