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Low prevalence of active COVID-19 in Slovenia: a nationwide population study of a probability-based sample.

ABSTRACT: OBJECTIVES:Accurate population-level assessment of the coronavirus disease 2019 (COVID-19) burden is fundamental for navigating the path forward during the ongoing pandemic, but current knowledge is scant. We conducted the first nationwide population study using a probability-based sample to assess active severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, combined with a longitudinal follow-up of the entire cohort over the next 6 months. Baseline SARS-CoV-2 RNA testing results and the first 3-week follow-up results are presented. METHODS:A probability-based sample of the Slovenian population comprising data from 2.1 million people was selected from the Central Population Register (n = 3000). SARS-CoV-2 RNA was detected in nasopharyngeal samples using the cobas 6800 SARS-CoV-2 assay. Each participant filled in a detailed baseline questionnaire with basic sociodemographic data and detailed medical history compatible with COVID-19. After 3 weeks, participants were interviewed for the presence of COVID-19-compatible clinical symptoms and signs, including in household members, and offered immediate testing for SARS-CoV-2 RNA if indicated. RESULTS:A total of 1368 individuals (46%) consented to participate and completed the questionnaire. Two of 1366 participants tested positive for SARS-CoV-2 RNA (prevalence 0.15%; posterior mean 0.18%, 95% Bayesian confidence interval 0.03-0.47; 95% highest density region (HDR) 0.01-0.41). No newly diagnosed infections occurred in the cohort during the first 3-week follow-up round. CONCLUSIONS:The low prevalence of active COVID-19 infections found in this study accurately predicted the dynamics of the epidemic in Slovenia over the subsequent month. Properly designed and timely executed studies using probability-based samples combined with routine target-testing figures provide reliable data that can be used to make informed decisions on relaxing or strengthening disease mitigation strategies.

SUBMITTER: Maver Vodicar P

PROVIDER: S-EPMC7367804 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Low prevalence of active COVID-19 in Slovenia: a nationwide population study of a probability-based sample.

Maver Vodičar P P Oštrbenk Valenčak A A Zupan B B Avšič Županc T T Kurdija S S Korva M M Petrovec M M Demšar J J Knap N N Štrumbelj E E Vehovar V V Poljak M M

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases 20200718 11

<h4>Objectives</h4>Accurate population-level assessment of the coronavirus disease 2019 (COVID-19) burden is fundamental for navigating the path forward during the ongoing pandemic, but current knowledge is scant. We conducted the first nationwide population study using a probability-based sample to assess active severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, combined with a longitudinal follow-up of the entire cohort over the next 6 months. Baseline SARS-CoV-2 RNA testi ...[more]

PMID: 32688068

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Project description:ObjectivesSeroprevalence surveys provide crucial information on cumulative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure. This Slovenian nationwide population study is the first longitudinal 6-month serosurvey using probability-based samples across all age categories.MethodsEach participant supplied two blood samples: 1316 samples in April 2020 (first round) and 1211 in October/November 2020 (second round). The first-round sera were tested using Euroimmun Anti-SARS-CoV-2 ELISA IgG (ELISA) and, because of uncertain estimates, were retested using Elecsys Anti-SARS-CoV-2 (Elecsys-N) and Elecsys Anti-SARS-CoV-2 S (Elecsys-S). The second-round sera were concomitantly tested using Elecsys-N/Elecsys-S.ResultsThe populations of both rounds matched the overall population (n = 3000), with minor settlement type and age differences. The first-round seroprevalence corrected for the ELISA manufacturer's specificity was 2.78% (95% highest density interval [HDI] 1.81%-3.80%), corrected using pooled ELISA specificity calculated from published data 0.93% (95% CI 0.00%-2.65%), and based on Elecsys-N/Elecsys-S results 0.87% (95% HDI 0.40%-1.38%). The second-round unadjusted lower limit of seroprevalence on 11 November 2020 was 4.06% (95% HDI 2.97%-5.16%) and on 3 October 2020, unadjusted upper limit was 4.29% (95% HDI 3.18%-5.47%).ConclusionsSARS-CoV-2 seroprevalence in Slovenia increased four-fold from late April to October/November 2020, mainly due to a devastating second wave. Significant logistic/methodological challenges accompanied both rounds. The main lessons learned were a need for caution when relying on manufacturer-generated assay evaluation data, the importance of multiple manufacturer-independent assay performance assessments, the need for concomitant use of highly-specific serological assays targeting different SARS-CoV-2 proteins in serosurveys conducted in low-prevalence settings or during epidemic exponential growth and the usefulness of a Bayesian approach for overcoming complex methodological challenges.

Project description:BackgroundThe potential impact of the COVID-19 pandemic on population mental health is of increasing global concern. We examine changes in adult mental health in the UK population before and during the lockdown.MethodsIn this secondary analysis of a national, longitudinal cohort study, households that took part in Waves 8 or 9 of the UK Household Longitudinal Study (UKHLS) panel, including all members aged 16 or older in April, 2020, were invited to complete the COVID-19 web survey on April 23-30, 2020. Participants who were unable to make an informed decision as a result of incapacity, or who had unknown postal addresses or addresses abroad were excluded. Mental health was assessed using the 12-item General Health Questionnaire (GHQ-12). Repeated cross-sectional analyses were done to examine temporal trends. Fixed-effects regression models were fitted to identify within-person change compared with preceding trends.FindingsWaves 6-9 of the UKHLS had 53 351 participants. Eligible participants for the COVID-19 web survey were from households that took part in Waves 8 or 9, and 17 452 (41·2%) of 42 330 eligible people participated in the web survey. Population prevalence of clinically significant levels of mental distress rose from 18·9% (95% CI 17·8-20·0) in 2018-19 to 27·3% (26·3-28·2) in April, 2020, one month into UK lockdown. Mean GHQ-12 score also increased over this time, from 11·5 (95% CI 11·3-11·6) in 2018-19, to 12·6 (12·5-12·8) in April, 2020. This was 0·48 (95% CI 0·07-0·90) points higher than expected when accounting for previous upward trends between 2014 and 2018. Comparing GHQ-12 scores within individuals, adjusting for time trends and significant predictors of change, increases were greatest in 18-24-year-olds (2·69 points, 95% CI 1·89-3·48), 25-34-year-olds (1·57, 0·96-2·18), women (0·92, 0·50-1·35), and people living with young children (1·45, 0·79-2·12). People employed before the pandemic also averaged a notable increase in GHQ-12 score (0·63, 95% CI 0·20-1·06).InterpretationBy late April, 2020, mental health in the UK had deteriorated compared with pre-COVID-19 trends. Policies emphasising the needs of women, young people, and those with preschool aged children are likely to play an important part in preventing future mental illness.FundingNone.

Project description:The aim of this cross-national longitudinal study was to evaluate the prevalence and sociodemographic predictors of mental health indicators (coronavirus-related post-traumatic stress disorder (PTSD), perceived stress, anxiety, depression, and suicidal/self-harm ideation) during the coronavirus disease-2019 (COVID-19) pandemic in a three-month period among representative samples of young adults from Germany, Israel, Poland, and Slovenia. The participants were 1724 young adults between 20 and 40 years of age (M = 30.74, SD = 5.74). The first measurement (T1) was in February 2021 and the second (T2) was in May-June 2021. The samples were representative of young adults in each country: Germany (n = 418, 24%), Israel (n = 428, 25%), Poland (n = 446, 26%), and Slovenia (n = 431, 25%). Women constituted 54% (n = 935) of the total sample. The mental health indicators were coronavirus-related PTSD measured by PCL-S, perceived stress (PSS-10), anxiety (GAD-7), depression (PHQ-8), and suicidal ideation (PHQ-9). The participants completed an online questionnaire that also included a physical activity (PA) measurement and sociodemographic variables. The Pearson's χ2 independence test was used for prevalence comparisons and McNemar's χ2 was used for longitudinal changes, whereas generalized estimating equations (GEEs) were used for the predictors of change in mental health indices. Significant differences were found between countries in each mental health dimension in both T1 and T2, with moderate effect sizes for coronavirus-related PTSD and suicidal ideation. The highest rate of PTSD and depression risk was in Germany, the highest rates of stress and anxiety risk were in Poland, and there was insufficient PA in Slovenia. The anxiety, depression, and suicidal ideation rates were the lowest in Israel and Slovenia. Israeli participants reported the lowest rate of coronavirus-related PTSD among the other countries in T1 and T2. Significant decreases in coronavirus-related PTSD and stress were observed during T2 compared to T1 in the total sample. There was no change in the risk of anxiety, depression, or suicidal ideation. Being single was a predictor of changes in all mental health indices. Having children was a risk factor for coronavirus-related PTSD and high stress. Being a student was a predictor of depression and suicidal ideation. A younger age (20-29 years) predicted coronavirus-related PTSD risk, whereas female gender predicted high stress. The mental health indices improved over time or remained stable. The groups that are most prone to mental health problems were single individuals, students, and parents in young adulthood across all countries. Future intervention programs for young adults should consider these factors when prioritizing, planning, and implementing such programs.

Project description:ContextThe COVID-19 pandemic has affected almost every aspect of life including youth sports. Little data exists on COVID-19 incidences and risk mitigation strategies in youth club sports.ObjectiveTo determine the reported incidence of COVID-19 cases among youth club sport athletes and the information sources used to develop COVID-19 risk mitigation procedures.DesignCross-sectional study.SettingOnline surveys.PatientsSoccer and volleyball youth club directors.InterventionA survey was completed by directors of youth volleyball and soccer clubs across the country in October 2020. Surveys included self-reported date of re-initiation, number of players, player COVID-19 cases, sources of infection, COVID-19 mitigation strategies, and information sources for the development of COVID-19 mitigation strategies.Main outcome measuresTotal number of cases reported, number of players, and days since club re-initiation were used to calculate an incidence rate of cases per 100,000 player-days. To compare reported incidence rates between soccer and volleyball, a negative binomial model was developed to predict player cases with sport and state incidence as covariates and log(player-days) as an offset. Estimates were exponentiated to yield a reported incidence rate ratio (IRR) with Wald confidence intervals.ResultsA total of 205,136 athletes (soccer=165,580; volleyball=39,556) were represented by 437 clubs (soccer=159; volleyball=278). Club organizers reported 673 COVID-19 cases (soccer=322; volleyball=351), for a reported incidence rate of 2.8 cases per 100,000 player-days (soccer=1.7, volleyball=7.9). Volleyball had a significantly higher reported COVID-19 incidence rate compared to soccer (reported IRR = 3.06 [2.0-4.6], p<0.001). Out of 11 possible mitigation strategies, the median number of strategies used by all clubs was 7 with an interquartile range of 2.ConclusionsThe incidence of self-reported cases of COVID-19 was lower in soccer clubs than volleyball clubs. Most clubs report using many COVID-19 mitigation strategies to reduce the risk of COVID-19.

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Low prevalence of active COVID-19 in Slovenia: a nationwide population study of a probability-based sample.

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Low prevalence of active COVID-19 in Slovenia: a nationwide population study of a probability-based sample.

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