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. 2023 Mar 2;18(3):e0282422.
doi: 10.1371/journal.pone.0282422. eCollection 2023.

Community exposures among Colorado adults who tested positive for SARS-CoV-2 -A case-control study, March-December 2021

Alice E White  1 , Amanda D Tran  1 , Michelle R Torok  1 , Rachel H Jervis  2 , Bernadette A Albanese  3 , Andrea G Buchwald  4 , Emma Schmoll  2 , Ginger Stringer  2 , Rachel K Herlihy  2 , Elaine J Scallan Walter  1
Affiliations

Community exposures among Colorado adults who tested positive for SARS-CoV-2 -A case-control study, March-December 2021

Alice E White et al. PLoS One. .

Abstract

Objectives: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which causes coronavirus disease 2019 (COVID-19), is spread primarily through exposure to respiratory droplets from close contact with an infected person. To inform prevention measures, we conducted a case-control study among Colorado adults to assess the risk of SARS-CoV-2 infection from community exposures.

Methods: Cases were symptomatic Colorado adults (aged ≥18 years) with a positive SARS-CoV-2 test by reverse transcription-polymerase chain reaction (RT-PCR) reported to Colorado's COVID-19 surveillance system. From March 16 to December 23, 2021, cases were randomly selected from surveillance data ≤12 days after their specimen collection date. Cases were matched on age, zip code (urban areas) or region (rural/frontier areas), and specimen collection date with controls randomly selected among persons with a reported negative SARS-CoV-2 test result. Data on close contact and community exposures were obtained from surveillance and a survey administered online.

Results: The most common exposure locations among all cases and controls were place of employment, social events, or gatherings and the most frequently reported exposure relationship was co-worker or friend. Cases were more likely than controls to work outside the home (adjusted odds ratio (aOR) 1.18, 95% confidence interval (CI): 1.09-1.28) in industries and occupations related to accommodation and food services, retail sales, and construction. Cases were also more likely than controls to report contact with a non-household member with confirmed or suspected COVID-19 (aOR 1.16, 95% CI: 1.06-1.27).

Conclusions: Understanding the settings and activities associated with a higher risk of SARS-CoV-2 infection is essential for informing prevention measures aimed at reducing the transmission of SARS-CoV-2 and other respiratory diseases. These findings emphasize the risk of community exposure to infected persons and the need for workplace precautions in preventing ongoing transmission.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Eligibility and enrollment cases (persons with positive SARS-CoV-2 test results) and controls (persons with negative SARS-CoV-2 test results) among Colorado adults aged ≥18 years–specimen collection dates from March 16 to Deceber 23, 2021.
Fig 2
Fig 2. Adjusted odds ratio (aOR)* and 95% confidence intervals for occupations and industries associated with confirmed COVID-19 among symptomatic Colorado adults aged ≥18 years–specimen collection dates from March 16 to December 23, 2021.
* Adjusted for matching criteria (age, geographical region, specimen collection period), race/ethnicity, and gender.
Fig 3
Fig 3. Adjusted odds ratio (aOR)* and 95% confidence intervals for exposures associated with confirmed COVID-19 among symptomatic Colorado adults aged ≥18 years–specimen collection dates from March 16 to December 23, 2021.
*Adjusted for matching criteria (age, geographical region, specimen collection period), race/ethnicity, and gender.
See this image and copyright information in PMC

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