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. 2023 Dec 9;13(12):e071284.
doi: 10.1136/bmjopen-2022-071284.

Cohort profile: evaluation of immune response and household transmission of SARS-CoV-2 in Costa Rica: the RESPIRA study

Viviana Loria  1 , Amada Aparicio  2 , Allan Hildesheim  3 , Bernal Cortés  3 , Gloriana Barrientos  3 , Daniela Retana  3 , Kaiyuan Sun  4 , Rebeca Ocampo  3 , D Rebecca Prevots  5 , Michael Zúñiga  3 , Tim Waterboer  6 , Roy Wong-McClure  2 , Melvin Morera  2 , Julia Butt  6 , Marco Binder  7 , Arturo Abdelnour  8 , Alejandro Calderón  2 , Mitchell H Gail  9 , Ruth M Pfeiffer  9 , Cristina Barboza Solís  10 , Romain Fantin  3 , Juan Carlos Vanegas  3 , Rachel Mercado  11 , Carlos Ávila  3 , Carolina Porras  3 , Rolando Herrero  3
Affiliations

Cohort profile: evaluation of immune response and household transmission of SARS-CoV-2 in Costa Rica: the RESPIRA study

Viviana Loria et al. BMJ Open. .

Abstract

Purpose: The RESPIRA cohort aims to describe the nature, magnitude, time course and efficacy of the immune response to SARS-CoV-2 infection and vaccination, population prevalence, and household transmission of COVID-19.

Participants: From November 2020, we selected age-stratified random samples of COVID-19 cases from Costa Rica confirmed by PCR. For each case, two population-based controls, matched on age, sex and census tract were recruited, supplemented with hospitalised cases and household contacts. Participants were interviewed and blood and saliva collected for antibodies and PCR tests. Participants will be followed for 2 years to assess antibody response and infection incidence.

Findings to date: Recruitment included 3860 individuals: 1150 COVID-19 cases, 1999 population controls and 719 household contacts from 304 index cases. The age and regional distribution of cases was as planned, including four age strata, 30% rural and 70% urban. The control cohort had similar sex, age and regional distribution as the cases according to the study design. Among the 1999 controls recruited, 6.8% reported at enrolment having had COVID-19 and an additional 12.5% had antibodies against SARS-CoV-2. Compliance with visits and specimens has been close to 70% during the first 18 months of follow-up. During the study, national vaccination was implemented and nearly 90% of our cohort participants were vaccinated during follow-up.

Future plans: RESPIRA will enable multiple analyses, including population prevalence of infection, clinical, behavioural, immunological and genetic risk factors for SARS-CoV-2 acquisition and severity, and determinants of household transmission. We are conducting retrospective and prospective assessment of antibody levels, their determinants and their protective efficacy after infection and vaccination, the impact of long-COVID and a series of ancillary studies. Follow-up continues with bimonthly saliva collection for PCR testing and biannual blood collection for immune response analyses. Follow-up will be completed in early 2024.

Trial registration number: NCT04537338.

Keywords: COVID-19; epidemiology; immunology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Number of cases of COVID-19 reported to the national surveillance system and periods of diagnosis and recruitment of cases and recruitment of controls in the RESPIRA study (Immune response to SARS-CoV-2 in Costa Rica).
See this image and copyright information in PMC

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