Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
David Geffen School of Medicine, UCLA (University of California, Los Angeles).
JAMA Netw Open. 2022 Aug 1;5(8):e2227241. doi: 10.1001/jamanetworkopen.2022.27241.
Some individuals who were infected by the SARS-CoV-2 Omicron variant may have been completely unaware of their infectious status while the virus was actively transmissible.
To examine awareness of infectious status among individuals during the recent Omicron variant surge in a diverse and populous urban region of Los Angeles County.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study analyzed the records of adult employees and patients of an academic medical center who were enrolled in a longitudinal COVID-19 serological study in Los Angeles County, California. These participants had 2 or more serial anti-nucleocapsid IgG (IgG-N) antibody measurements at least 1 month apart, with the first occurring after the end of a regional Delta variant surge (September 15, 2021) and a subsequent one occurring after the start of a regional Omicron variant surge (December 15, 2021). Adults with evidence of new SARS-CoV-2 infection occurring during the Omicron variant surge period through May 4, 2022, were included in the present study sample.
Recent Omicron variant infection as evidenced by SARS-CoV-2 seroconversion.
Awareness of recent SARS-CoV-2 infection was ascertained from review of self-reported health updates, medical records, and COVID-19 testing data.
Of the 210 participants (median [range] age, 51 (23-84) years; 136 women [65%]) with serological evidence of recent Omicron variant infection, 44% (92) demonstrated awareness of any recent Omicron variant infection and 56% (118) reported being unaware of their infectious status. Among those who were unaware, 10% (12 of 118) reported having had any symptoms, which they attributed to a common cold or other non-SARS-CoV-2 infection. In multivariable analyses that accounted for demographic and clinical characteristics, participants who were health care employees of the medical center were more likely than nonemployees to be aware of their recent Omicron variant infection (adjusted odds ratio, 2.46; 95% CI, 1.30-4.65).
Results of this study suggest that more than half of adults with recent Omicron variant infection were unaware of their infectious status and that awareness was higher among health care employees than nonemployees, yet still low overall. Unawareness may be a highly prevalent factor associated with rapid person-to-person transmission within communities.
在洛杉矶县的一个多样化和人口众多的城市地区，最近的奥密克戎变体激增期间，一些感染了 SARS-CoV-2 奥密克戎变体的个体在病毒具有高度传染性时可能完全没有意识到自己的感染状态。
在加利福尼亚州洛杉矶县的一个学术医疗中心，对参与一项关于 COVID-19 血清学的纵向研究的成年员工和患者的记录进行分析，以调查在最近的奥密克戎变体激增期间个体对感染状态的认知。
设计、地点和参与者：本队列研究分析了在加利福尼亚州洛杉矶县参与一项关于 COVID-19 血清学的纵向研究的成年员工和患者的记录。这些参与者至少相隔 1 个月接受了 2 次或更多次连续的抗核衣壳 IgG（IgG-N）抗体测量，第一次发生在地区性德尔塔变体激增结束后（2021 年 9 月 15 日），随后一次发生在地区性奥密克戎变体激增开始后（2021 年 12 月 15 日）。本研究样本纳入了在 2022 年 5 月 4 日之前的奥密克戎变体激增期间有新的 SARS-CoV-2 感染证据的成年人。
奥密克戎变体感染的近期证据为 SARS-CoV-2 血清转换。
通过审查自我报告的健康更新、医疗记录和 COVID-19 检测数据来确定对近期 SARS-CoV-2 感染的认识。
在 210 名具有最近奥密克戎变体感染血清学证据的参与者（中位数[范围]年龄，51[23-84]岁；136 名女性[65%]）中，44%（92 名）表现出对任何最近奥密克戎变体感染的认识，而 56%（118 名）报告对其感染状态不知情。在那些不知情的人中，有 10%（118 名中的 12 名）报告有任何症状，他们将这些症状归因于普通感冒或其他非 SARS-CoV-2 感染。在考虑了人口统计学和临床特征的多变量分析中，医疗中心的卫生保健员工比非员工更有可能意识到自己最近的奥密克戎变体感染（调整后的优势比，2.46；95%CI，1.30-4.65）。
这项研究的结果表明，超过一半的最近感染奥密克戎变体的成年人不知道自己的感染状态，而卫生保健员工的知晓率高于非员工，但总体仍然较低。不知晓可能是与社区内人际快速传播密切相关的一个高度普遍的因素。
