Predictors of SARS-CoV-2 Infection in Youth at a Large, Urban Healthcare Center in California, March–September 2020

Objective: To understand which social, epidemiologic, and clinical risk factors are associated with SARS-CoV-2 infection in youth accessing care in a large, urban academic institution.Methods: We conducted a prospective cohort study with case–control analyses in youth who received testing for SARS-C...

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Autores principales:	Caitlin N. Newhouse, Tawny Saleh, Trevon Fuller, Tara Kerin, Mary C. Cambou, Emma J. Swayze, Catherine Le, Wonjae Seo, Marisol Trejo, Omai B. Garner, Sukantha Chandrasekaran, Karin Nielsen-Saines
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	COVID-19 SARS-CoV-2 youth testing viral load LA County Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/8be7a64f497941b5a8d91df6f4e2d453
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spelling	oai:doaj.org-article:8be7a64f497941b5a8d91df6f4e2d4532021-11-17T05:32:38ZPredictors of SARS-CoV-2 Infection in Youth at a Large, Urban Healthcare Center in California, March–September 20202296-236010.3389/fped.2021.752247https://doaj.org/article/8be7a64f497941b5a8d91df6f4e2d4532021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fped.2021.752247/fullhttps://doaj.org/toc/2296-2360Objective: To understand which social, epidemiologic, and clinical risk factors are associated with SARS-CoV-2 infection in youth accessing care in a large, urban academic institution.Methods: We conducted a prospective cohort study with case–control analyses in youth who received testing for SARS-CoV-2 at our academic institution in Los Angeles during the first wave of the COVID-19 pandemic (March–September 2020).Results: A total of 27,976 SARS-CoV-2 assays among 11,922 youth aged 0–24 years were performed, including 475 youth with positive SARS-CoV-2 results. Positivity rate was higher among older, African American, and Hispanic/Latinx youth. Cases were more likely to be from non-English-speaking households and have safety-net insurance. Zip codes with higher proportion of Hispanic/Latinx and residents living under the poverty line were associated with increased SARS-CoV-2 cases. Youth were more likely to have positive results if tested for exposure (OR 21.5, 95% CI 14.6–32.1) or recent travel (OR 1.5, 95% CI 1.0–2.3). Students were less likely to have positive results than essential worker youth (OR 0.5, 95% CI 0.3–0.8). Patterns of symptom presentation varied significantly by age group; number of symptoms correlated significantly with age in SARS-CoV-2 cases (r = 0.030, p < 0.001). SARS-CoV-2 viral load did not vary by symptom severity, but asymptomatic youth had lower median viral load than those with symptoms (21.5 vs. 26.7, p = 0.009).Conclusions: Socioeconomic factors are important drivers of SARS-CoV-2 infection in youth. Presence of symptoms, exposure, and travel can be used to drive testing in older youth. Policies for school reopening and infection prevention should be tailored differently for elementary schools and universities.Caitlin N. NewhouseCaitlin N. NewhouseTawny SalehTrevon FullerTrevon FullerTara KerinMary C. CambouEmma J. SwayzeCatherine LeWonjae SeoMarisol TrejoOmai B. GarnerSukantha ChandrasekaranKarin Nielsen-SainesFrontiers Media S.A.articleCOVID-19SARS-CoV-2youthtestingviral loadLA CountyPediatricsRJ1-570ENFrontiers in Pediatrics, Vol 9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 SARS-CoV-2 youth testing viral load LA County Pediatrics RJ1-570
spellingShingle	COVID-19 SARS-CoV-2 youth testing viral load LA County Pediatrics RJ1-570 Caitlin N. Newhouse Caitlin N. Newhouse Tawny Saleh Trevon Fuller Trevon Fuller Tara Kerin Mary C. Cambou Emma J. Swayze Catherine Le Wonjae Seo Marisol Trejo Omai B. Garner Sukantha Chandrasekaran Karin Nielsen-Saines Predictors of SARS-CoV-2 Infection in Youth at a Large, Urban Healthcare Center in California, March–September 2020
description	Objective: To understand which social, epidemiologic, and clinical risk factors are associated with SARS-CoV-2 infection in youth accessing care in a large, urban academic institution.Methods: We conducted a prospective cohort study with case–control analyses in youth who received testing for SARS-CoV-2 at our academic institution in Los Angeles during the first wave of the COVID-19 pandemic (March–September 2020).Results: A total of 27,976 SARS-CoV-2 assays among 11,922 youth aged 0–24 years were performed, including 475 youth with positive SARS-CoV-2 results. Positivity rate was higher among older, African American, and Hispanic/Latinx youth. Cases were more likely to be from non-English-speaking households and have safety-net insurance. Zip codes with higher proportion of Hispanic/Latinx and residents living under the poverty line were associated with increased SARS-CoV-2 cases. Youth were more likely to have positive results if tested for exposure (OR 21.5, 95% CI 14.6–32.1) or recent travel (OR 1.5, 95% CI 1.0–2.3). Students were less likely to have positive results than essential worker youth (OR 0.5, 95% CI 0.3–0.8). Patterns of symptom presentation varied significantly by age group; number of symptoms correlated significantly with age in SARS-CoV-2 cases (r = 0.030, p < 0.001). SARS-CoV-2 viral load did not vary by symptom severity, but asymptomatic youth had lower median viral load than those with symptoms (21.5 vs. 26.7, p = 0.009).Conclusions: Socioeconomic factors are important drivers of SARS-CoV-2 infection in youth. Presence of symptoms, exposure, and travel can be used to drive testing in older youth. Policies for school reopening and infection prevention should be tailored differently for elementary schools and universities.
format	article
author	Caitlin N. Newhouse Caitlin N. Newhouse Tawny Saleh Trevon Fuller Trevon Fuller Tara Kerin Mary C. Cambou Emma J. Swayze Catherine Le Wonjae Seo Marisol Trejo Omai B. Garner Sukantha Chandrasekaran Karin Nielsen-Saines
author_facet	Caitlin N. Newhouse Caitlin N. Newhouse Tawny Saleh Trevon Fuller Trevon Fuller Tara Kerin Mary C. Cambou Emma J. Swayze Catherine Le Wonjae Seo Marisol Trejo Omai B. Garner Sukantha Chandrasekaran Karin Nielsen-Saines
author_sort	Caitlin N. Newhouse
title	Predictors of SARS-CoV-2 Infection in Youth at a Large, Urban Healthcare Center in California, March–September 2020
title_short	Predictors of SARS-CoV-2 Infection in Youth at a Large, Urban Healthcare Center in California, March–September 2020
title_full	Predictors of SARS-CoV-2 Infection in Youth at a Large, Urban Healthcare Center in California, March–September 2020
title_fullStr	Predictors of SARS-CoV-2 Infection in Youth at a Large, Urban Healthcare Center in California, March–September 2020
title_full_unstemmed	Predictors of SARS-CoV-2 Infection in Youth at a Large, Urban Healthcare Center in California, March–September 2020
title_sort	predictors of sars-cov-2 infection in youth at a large, urban healthcare center in california, march–september 2020
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/8be7a64f497941b5a8d91df6f4e2d453
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Predictors of SARS-CoV-2 Infection in Youth at a Large, Urban Healthcare Center in California, March–September 2020

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