Huete-Pérez Jorge A, Colgrove Robert C, Cabezas-Robelo Cristiana, Páiz-Medina Lucía, Hunsajarupan Bhanasut, Silva Sheyla, Quant Carlos, Huete Alejandra
Molecular Biology Center, University of Central America, Managua, Nicaragua.
Division of Infectious Diseases, Mount Auburn Hospital, Cambridge, MA, USA.
IJID Reg. 2022 Mar;2:110-117. doi: 10.1016/j.ijregi.2021.12.013. Epub 2022 Jan 5.
To assess the prevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in selected health clinics in the three largest urban areas in Nicaragua, where data regarding coronavirus disease 2019 (COVID-19) testing, morbidity and mortality is severely limited.
In this cross-sectional study, participants were tested for SARS-CoV-2 RNA by loop-mediated isothermal amplification (LAMP), and were tested for antibodies using immunoassays. A questionnaire recorded subjects' COVID-19-associated symptoms and risk factors. Data were collected from 22 February to 19 March 2021, 1 year after the first confirmed cases of SARS-CoV-2 in Nicaragua. Study participants were enrolled while attending routine check-ups or seeking care unrelated to COVID-19. Study participation was random and voluntary. All patients were eligible to participate. Symptom history was not part of the eligibility criteria.
The prevalence of current SARS-CoV-2 infection was high (14%, LAMP-positive/seronegative). Antibody testing showed higher overall seroprevalence (38%). Cough was the symptom most strongly associated with being LAMP-positive (odds ratio 3.57, 95% confidence interval 2.65-4.81). Loss of smell had the highest positive predictive value, and was significantly associated with being LAMP-positive.
The prevalence of current SARS-CoV-2 infection and seropositivity were fairly high. More than half of the sample population had evidence of current or past infection. Knowledge of this previously unknown elevated level of infection is crucial for healthcare providers and policy makers.
评估尼加拉瓜三大城市地区部分健康诊所中严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的流行情况，在这些地区，关于2019冠状病毒病（COVID-19）检测、发病率和死亡率的数据极为有限。
在这项横断面研究中，通过环介导等温扩增法（LAMP）对参与者进行SARS-CoV-2 RNA检测，并使用免疫测定法检测抗体。通过问卷记录受试者与COVID-19相关的症状和风险因素。数据收集于2021年2月22日至3月19日，即尼加拉瓜首次确诊SARS-CoV-2病例后的1年。研究参与者在进行常规检查或寻求与COVID-19无关的医疗护理时被纳入。研究参与是随机且自愿的。所有患者均有资格参与。症状史并非资格标准的一部分（内容）。
当前SARS-CoV-2感染的流行率较高（14%，LAMP阳性/血清阴性）。抗体检测显示总体血清阳性率较高（38%）。咳嗽是与LAMP阳性关联最密切的症状（比值比3.57，95%置信区间2.65 - 4.81）。嗅觉丧失具有最高的阳性预测值，且与LAMP阳性显著相关。
当前SARS-CoV-2感染和血清阳性率相当高。超过一半的样本人群有当前或既往感染的证据。了解这一此前未知的较高感染水平对医疗服务提供者和政策制定者至关重要。
