Spread of SARS-CoV-2 in the Icelandic Population
Spread of SARS-CoV-2 in the Icelandic Population
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DOI：
10.1056/nejmoa2006100
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发表时间：
2020-06-11
影响因子：
158.5
通讯作者：
Stefansson, Kari
中科院分区：
文献类型：
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作者：
Gudbjartsson, Daniel F.;Helgason, Agnar;Stefansson, Kari
在当前的全球大流行期间，2019冠状病毒病（Covid-19）于2月底在冰岛首次被诊断出来。然而，关于导致Covid-19的病毒SARS-CoV-2如何进入并在人群中传播的数据有限。方法对居住在冰岛的感染高危人群（主要是有症状者、近期去过高风险国家或与感染者有过接触者）进行针对性检测。我们还采用两种策略进行了人口筛查：向10,797人发出公开邀请，并向2283人发出随机邀请。我们从643份样本中对SARS-CoV-2进行了测序。结果截至4月4日，纳入目标检测的9199人中有1221人（13.3%）感染SARS-CoV-2阳性。在普通人群中接受检测的人中，在公开邀请筛查中有87人（0.8%）呈病毒阳性，在随机人群筛查中有13人（0.6%）呈病毒阳性。总共有6%的人接受了筛查。在研究早期接受阳性检测的目标检测组中，与研究后期检测呈阳性的人相比，大多数人最近都有过国际旅行。10岁以下儿童获得阳性结果的可能性低于10岁或以上的人，进行定向检测的百分比分别为6.7%和13.7%；在人群筛查中，10岁以下儿童无阳性结果，而10岁及以上儿童为0.8%。在针对性检测（11.0%对16.7%）和人群筛查（0.6%对0.9%）中，女性的阳性结果均少于男性。测序后的SARS-CoV-2病毒的单倍型多种多样，并随时间发生变化。通过人群筛查确定的受感染参与者的百分比在筛查的20天期间保持稳定。在冰岛的一项基于人群的研究中，10岁以下儿童和女性的SARS-CoV-2感染发病率低于青少年或成年人和男性。在筛查期间，通过人群筛查确定的感染者比例没有发生重大变化，这与遏制措施的有益效果是一致的。
Background During the current worldwide pandemic, coronavirus disease 2019 (Covid-19) was first diagnosed in Iceland at the end of February. However, data are limited on how SARS-CoV-2, the virus that causes Covid-19, enters and spreads in a population. Methods We targeted testing to persons living in Iceland who were at high risk for infection (mainly those who were symptomatic, had recently traveled to high-risk countries, or had contact with infected persons). We also carried out population screening using two strategies: issuing an open invitation to 10,797 persons and sending random invitations to 2283 persons. We sequenced SARS-CoV-2 from 643 samples. Results As of April 4, a total of 1221 of 9199 persons (13.3%) who were recruited for targeted testing had positive results for infection with SARS-CoV-2. Of those tested in the general population, 87 (0.8%) in the open-invitation screening and 13 (0.6%) in the random-population screening tested positive for the virus. In total, 6% of the population was screened. Most persons in the targeted-testing group who received positive tests early in the study had recently traveled internationally, in contrast to those who tested positive later in the study. Children under 10 years of age were less likely to receive a positive result than were persons 10 years of age or older, with percentages of 6.7% and 13.7%, respectively, for targeted testing; in the population screening, no child under 10 years of age had a positive result, as compared with 0.8% of those 10 years of age or older. Fewer females than males received positive results both in targeted testing (11.0% vs. 16.7%) and in population screening (0.6% vs. 0.9%). The haplotypes of the sequenced SARS-CoV-2 viruses were diverse and changed over time. The percentage of infected participants that was determined through population screening remained stable for the 20-day duration of screening. Conclusions In a population-based study in Iceland, children under 10 years of age and females had a lower incidence of SARS-CoV-2 infection than adolescents or adults and males. The proportion of infected persons identified through population screening did not change substantially during the screening period, which was consistent with a beneficial effect of containment efforts.