Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University (SUNY), Stony Brook, New York, United States of America.
Program in Public Health, Stony Brook University (SUNY), Stony Brook, New York, United States of America.
PLoS One. 2021 Jul 20;16(7):e0254713. doi: 10.1371/journal.pone.0254713. eCollection 2021.
New York City and Long Island, NY were early foci of the COVID-19 epidemic in the US. The effects of COVID-19 on different sub-populations, and its key epidemiologic parameters remain unknown or highly uncertain. We investigated the epidemiology of COVID-19 from January to August of 2020 in an established academic monitoring cohort of N = 9,697 middle-aged World Trade Center responders residing in Long Island, NY.
A seroprevalence survey and a series of cross-sectional surveys were nested in a prospective cohort study. Measures included IgG antibody testing, SARS-CoV-2 polymerase chain reaction (PCR) testing, review of electronic medical records, and surveys of symptoms. Correlates of infection were analyzed with multivariable logistic regression.
The cohort was predominantly men in their mid-fifties; 6,597 cohort members were successfully contacted (68%); 1,042 (11%) individuals participated in the seroprevalence survey; and 369 individuals (5.6% of 6,597 study participants) underwent PCR testing. The estimated standardized cumulative incidence was 21.9% (95%CI: 20.1-23.9%), the asymptomatic proportion was 16.4% (36/219; 95%CI: 11.8-22.0%), the case hospitalization ratio was 9.4% (36/385; 95%CI: 6.6-12.7%), the case fatality ratio was 1.8% (7/385; 95%CI: 0.7-3.7%), and the hospitalization fatality ratio was 8.3% (3/36; 95%CI: 1.8-22.5%). Confirmed SARS-CoV-2 infection was associated with younger age, race/ethnicity, and being currently employed.
The results of the present study suggest a high cumulative incidence of SARS-CoV-2 among WTC responders in the spring and summer of 2020 and contribute to narrowing the plausible range of the proportion of infections that exhibit no symptoms. An increased risk of infection among younger employed individuals is likely to reflect a higher probability of exposure to the virus, and the racial disparities in the infection risk warrant further investigation.
纽约市和长岛是美国 COVID-19 疫情的早期中心。COVID-19 对不同亚人群的影响及其关键流行病学参数尚不清楚或高度不确定。我们调查了 2020 年 1 月至 8 月期间居住在纽约长岛的 9697 名中年世界贸易中心应对人员的 COVID-19 流行病学情况，该人群是一个成熟的学术监测队列。
在一项前瞻性队列研究中嵌套了一项血清流行率调查和一系列横断面调查。措施包括 IgG 抗体检测、SARS-CoV-2 聚合酶链反应（PCR）检测、电子病历审查和症状调查。使用多变量逻辑回归分析感染的相关性。
队列主要由 50 多岁的男性组成；成功联系了 6597 名队列成员（68%）；1042 名（11%）个体参加了血清流行率调查；369 名（6597 名研究参与者的 5.6%）接受了 PCR 检测。估计的标准化累积发病率为 21.9%（95%CI：20.1-23.9%），无症状比例为 16.4%（36/219；95%CI：11.8-22.0%），病例住院率为 9.4%（36/385；95%CI：6.6-12.7%），病例死亡率为 1.8%（7/385；95%CI：0.7-3.7%），住院死亡率为 8.3%（3/36；95%CI：1.8-22.5%）。确诊的 SARS-CoV-2 感染与年龄较小、种族/民族和当前就业有关。
本研究结果表明，2020 年春季和夏季，世界贸易中心应对人员中 SARS-CoV-2 的累积发病率较高，并有助于缩小无症状感染比例的可能范围。年轻在职个体感染风险增加可能反映了接触病毒的可能性更高，感染风险的种族差异值得进一步调查。
