First wave of the SARS-CoV-2 pandemic in Nouvelle-Aquitaine: factors associated with disease severity, anosmia and/or ageusia, and household transmission, March–April 2020

Background - The Score 19 survey was conducted in Nouvelle-Aquitaine among households affected by COVID-19 between March and April 2020 during the first wave of the pandemic. The objectives of the second phase of this survey were to (i) describe the clinical characteristics of COVID-19 cases, (ii) identify factors associated with hospitalization, admission to intensive care, and the onset of anosmia and/or ageusia, and (iii) assess factors that may have facilitated SARS-CoV-2 transmission within households. Materials and Methods - A cross-sectional study was conducted via telephone interviews with individuals who tested positive for SARS-CoV-2 between March 1 and April 30, 2020, and all members of their households, regardless of whether they had symptoms. The clinical characteristics of COVID-19 cases were described. Prevalence ratios for factors associated with hospitalization, admission to critical care, and reports of anosmia and/or ageusia were estimated using Poisson regression models. To assess intra-household transmission, secondary attack rates (SARs) were calculated for households of 3 to 5 people. Factors independently associated with SAR were examined using ordinal regression models. Results - A total of 940 clusters and 2,536 individuals were included in the study, representing a participation rate of nearly 40%. Among the individuals, 68.3% were COVID-19 cases, 63.5% of whom were biologically confirmed. Nearly half of the cases had experienced anosmia and/or ageusia. The prevalence of anosmia/ageusia was higher among those aged 15–44 (with a tendency to decrease with age), among women, and among individuals who had presented with gastrointestinal symptoms. Men, people aged 65–74, cases with signs of deteriorating general health, and those with comorbidities were at higher risk of being hospitalized in critical care units. The secondary attack rate in households of 3 to 5 individuals was 32.3%. Secondary transmission within households increased when the index case had exhibited gastrointestinal or respiratory symptoms during their infection and when protective measures were less strictly adhered to by the cases. Conclusion - While these results have certain limitations related to this type of study and the period in which it was conducted (first wave of the epidemic, lockdown, limited availability of tests), the investigation confirmed knowledge gained since then and provided new insights, particularly regarding risk factors for transmission within households.

Author(s): Gault Gaëlle, Evain Sullivan, Herteau Alice, Siguier Anna, Vilain Pascal, Trouvain Karine, Filleul Laurent, Castor Christine

Publishing year: 2023

Pages: 106-118

Weekly Epidemiological Bulletin, 2023, n° 6, p. 106-118

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