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. 2022 Mar 24:10:809356.
doi: 10.3389/fpubh.2022.809356. eCollection 2022.

Risk-Factors for Exposure Associated With SARS-CoV-2 Detection After Recent Known or Potential COVID-19 Exposures Among Patients Seeking Medical Care at a Large Urban, Public Hospital in Fulton County, Georgia - A Cross-Sectional Investigation

Sarah E Smith-Jeffcoat  1 , Sadia Sleweon  1 , Mitsuki Koh  1 , George M Khalil  1 , Marcos C Schechter  2   3 , Paulina A Rebolledo  2   4 , Vyjayanti Kasinathan  2   3 , Adam Hoffman  3   5 , Rebecca Rossetti  1 , Talya Shragai  1 , Kevin O'Laughlin  1 , Catherine C Espinosa  1 , Bettina Bankamp  1 , Michael D Bowen  1 , Ashley Paulick  1 , Amy S Gargis  1 , Jennifer M Folster  1 , Juliana da Silva  1 , Caitlin Biedron  1 , Rebekah J Stewart  1 , Yun F Wang  3   6 , Hannah L Kirking  1 , Jacqueline E Tate  1 ; CDC COVID-19 Emergency Response GA-10 Field
Collaborators, Affiliations

Risk-Factors for Exposure Associated With SARS-CoV-2 Detection After Recent Known or Potential COVID-19 Exposures Among Patients Seeking Medical Care at a Large Urban, Public Hospital in Fulton County, Georgia - A Cross-Sectional Investigation

Sarah E Smith-Jeffcoat et al. Front Public Health. .

Abstract

We aimed to describe frequency of COVID-19 exposure risk factors among patients presenting for medical care at an urban, public hospital serving mostly uninsured/Medicare/Medicaid clients and risk factors associated with SARS-CoV-2 infection. Consenting, adult patients seeking care at a public hospital from August to November 2020 were enrolled in this cross-sectional investigation. Saliva, anterior nasal and nasopharyngeal swabs were collected and tested for SARS-CoV-2 using RT-PCR. Participant demographics, close contact, and activities ≤14 days prior to enrollment were collected through interview. Logistic regression was used to identify risk factors associated with testing positive for SARS-CoV-2. Among 1,078 participants, 51.8% were male, 57.0% were aged ≥50 years, 81.3% were non-Hispanic Black, and 7.6% had positive SARS-CoV-2 tests. Only 2.7% reported COVID-19 close contact ≤14 days before enrollment; this group had 6.79 adjusted odds of testing positive (95%CI = 2.78-16.62) than those without a reported exposure. Among participants who did not report COVID-19 close contact, working in proximity to ≥10 people (adjusted OR = 2.17; 95%CI = 1.03-4.55), choir practice (adjusted OR = 11.85; 95%CI = 1.44-97.91), traveling on a plane (adjusted OR = 5.78; 95%CI = 1.70-19.68), and not participating in an essential indoor activity (i.e., grocery shopping, public transit use, or visiting a healthcare facility; adjusted OR = 2.15; 95%CI = 1.07-4.30) were associated with increased odds of testing positive. Among this population of mostly Black, non-Hispanic participants seeking care at a public hospital, we found several activities associated with testing positive for SARS-CoV-2 infection in addition to close contact with a case. Understanding high-risk activities for SARS-CoV-2 infection among different communities is important for issuing awareness and prevention strategies.

Keywords: COVID-19; SARS-CoV-2; exposure; risk factors; underrepresented.

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Conflict of interest statement

YW, PR, VK, AH, and MS received funding for this study from the CDC Foundation. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Adjusted odds ratios of a positive SARS-CoV-2 RT-PCR result: by COVID-19 exposure and by risk factors for COVID-19 exposure among (A) participants who did not report a prior positive COVID-19 test (n = 1,026) and (B) participants who did not report a prior positive SARS-CoV-2 test and had no known close contact to a COVID-19 case (n = 864); a study at a large urban, public hospital in Fulton County, GA, August-November 2020.
See this image and copyright information in PMC

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