英格兰东部养老院中新冠病毒病的基因组流行病学

Genomic epidemiology of COVID-19 in care homes in the east of England.

作者信息

Hamilton William L, Tonkin-Hill Gerry, Smith Emily R, Aggarwal Dinesh, Houldcroft Charlotte J, Warne Ben, Meredith Luke W, Hosmillo Myra, Jahun Aminu S, Curran Martin D, Parmar Surendra, Caller Laura G, Caddy Sarah L, Khokhar Fahad A, Yakovleva Anna, Hall Grant, Feltwell Theresa, Pinckert Malte L, Georgana Iliana, Chaudhry Yasmin, Brown Colin S, Gonçalves Sonia, Amato Roberto, Harrison Ewan M, Brown Nicholas M, Beale Mathew A, Spencer Chapman Michael, Jackson David K, Johnston Ian, Alderton Alex, Sillitoe John, Langford Cordelia, Dougan Gordon, Peacock Sharon J, Kwiatowski Dominic P, Goodfellow Ian G, Torok M Estee

机构信息

Cambridge University Hospitals NHS Foundation Trust, Departments of Infectious Diseases and Microbiology, Cambridge, United Kingdom.

University of Cambridge, Department of Medicine, Cambridge, United Kingdom.

出版信息

Elife. 2021 Mar 2;10:e64618. doi: 10.7554/eLife.64618.

COVID-19 poses a major challenge to care homes, as SARS-CoV-2 is readily transmitted and causes disproportionately severe disease in older people. Here, 1167 residents from 337 care homes were identified from a dataset of 6600 COVID-19 cases from the East of England. Older age and being a care home resident were associated with increased mortality. SARS-CoV-2 genomes were available for 700 residents from 292 care homes. By integrating genomic and temporal data, 409 viral clusters within the 292 homes were identified, indicating two different patterns - outbreaks among care home residents and independent introductions with limited onward transmission. Approximately 70% of residents in the genomic analysis were admitted to hospital during the study, providing extensive opportunities for transmission between care homes and hospitals. Limiting viral transmission within care homes should be a key target for infection control to reduce COVID-19 mortality in this population.

新冠病毒病给养老院带来了重大挑战，因为严重急性呼吸综合征冠状病毒2（SARS-CoV-2）易于传播，且在老年人中会引发格外严重的疾病。在此，从英格兰东部6600例新冠病毒病病例的数据集中识别出了来自337家养老院的1167名居民。高龄和居住在养老院与死亡率增加相关。可获取来自292家养老院700名居民的SARS-CoV-2基因组。通过整合基因组和时间数据，在这292家养老院中识别出了409个病毒簇，这表明存在两种不同模式——养老院居民中的疫情暴发以及传播有限的独立传入。在基因组分析中，约70%的居民在研究期间入院，这为养老院和医院之间的传播提供了大量机会。限制养老院内部的病毒传播应成为感染控制的关键目标，以降低该人群中新冠病毒病的死亡率。