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. 2021 Nov 11;79(1):195.
doi: 10.1186/s13690-021-00715-z.

The prior infection with SARS-CoV-2 study (PICOV) in nursing home residents and staff - study protocol description and presentation of preliminary findings on symptoms

Maria E Goossens #  1 , Kristof Y Neven #  2 , Pieter Pannus  2 , Cyril Barbezange  3 , Isabelle Thomas  3 , Steven Van Gucht  3 , Katelijne Dierick  3 , Marie-Noëlle Schmickler  4 , Mathieu Verbrugghe  4 , Nele Van Loon  4 , Kevin K Ariën  5   6 , Arnaud Marchant  7 , Stanislas Goriely  7 , Isabelle Desombere  3
Affiliations

The prior infection with SARS-CoV-2 study (PICOV) in nursing home residents and staff - study protocol description and presentation of preliminary findings on symptoms

Maria E Goossens et al. Arch Public Health. .

Abstract

Background: The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has presented itself as one of the most important health concerns of the 2020's, and hit the geriatric population the hardest. The presence of co-morbidities and immune ageing in the elderly lead to an increased susceptibility to COVID-19, as is the case for other influenza-like illnesses (ILI) or acute respiratory tract infections (ARI). However, little is known, about the impact of a previous or current infection on the other in terms of susceptibility, immune response, and clinical course. The aim of the "Prior Infection with SARS-COV-2" (PICOV) study is to compare the time to occurrence of an ILI or ARI between participants with a confirmed past SARS-CoV-2 infection (previously infected) and those without a confirmed past infection (naïve) in residents and staff members of nursing homes. This paper describes the study design and population characteristics at baseline.

Methods: In 26 Belgian nursing homes, all eligible residents and staff members were invited to participate, resulting in 1,226 participants. They were classified as naïve or previously infected based on the presence of detectable SARS-CoV-2 antibodies and/or a positive RT-qPCR result before participation in the study. Symptoms from a prior SARS-CoV-2 infection between March and August 2020 were compared between previously infected residents and staff members.

Results: Infection naïve nursing home residents reported fewer symptoms than previously infected residents: on average 1.9 and 3.1 symptoms, respectively (p = 0.016). The same effect was observed for infection naïve staff members and previously infected staff members (3.1 and 6.1 symptoms, respectively; p <0.0001). Moreover, the antibody development after a SARS-CoV-2 infection differs between residents and staff members, as previously infected residents tend to have a higher rate of asymptomatic cases compared to previously infected staff members (20.5% compared to 12.4%; p <0.0001).

Conclusions: We can postulate that COVID-19 disease development and symptomatology are different between a geriatric and younger population. Therefore, the occurrence and severity of a future ILI and/or ARI might vary from resident to staff.

Keywords: ARI; Antibody; Belgium; COVID-19; Cohort; ILI; Multicentric; Nursing home; SARS-CoV-2; Symptoms.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow of the PICOV study. Recruitment of the participants finished on December 8th, 2020, as did the baseline sampling (collection of a nasopharyngeal swab, saliva, serum blood, and heparinised blood for peripheral blood mononuclear cell [PBMC] isolation). Follow-up sampling after flu vaccination concluded on the 22nd of January (collection of serum blood). Sampling at the end of the study is planned for spring 2021 (collection of saliva, serum blood, and heparinised blood for PBMC isolation). If a participant develops an influenza-like illness (ILI) or an acute respiratory infection (ARI), a nasopharyngeal swab is collected at the onset of symptoms to distinguish between a SARS-CoV-2 or influenza infection. After attenuations of the illness, approximately two to three weeks after the onset of symptoms, serum, and heparinised blood is collected
Fig. 2
Fig. 2
Flow chart of the study population. 1,359 participants of nursing homes provided us with an informed consent. Reasons for withdrawal are provided for the 116 drop-outs. 33 participants did not complete the baseline questionnaire, resulting in a final study population of 1,226 with 374 nursing home residents and 852 staff members
Fig. 3
Fig. 3
Number of symptoms in staff members and residents of nursing homes. Residents reported an average of 3.1 (±2.4) symptoms during a past SARS-CoV-2 infection, compared to 1.9 (±1.1) symptoms for residents without a previous infection. For staff members with a past SARS-CoV-2 infection, the number of symptoms averaged at 6.1 (±4.0) while those without an infection averaged 3.1 (±2.2) symptoms
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