A cross-sectional and prospective cohort study of the role of schools in the SARS-CoV-2 second wave in Italy.
A cross-sectional and prospective cohort study of the role of schools in the SARS-CoV-2 second wave in Italy.
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DOI：
10.1016/j.lanepe.2021.100092
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Scorrano L
中科院分区：
文献类型：
--
作者：
Gandini S;Rainisio M;Iannuzzo ML;Bellerba F;Cecconi F;Scorrano L
在COVID-19大流行期间，学校被强制关闭，就像它对流感的影响一样，但目前尚不清楚学校是否是COVID-19的早期放大器。在第二波COVID-19期间（从2020年9月30日至至少2021年2月28日），我们在意大利进行了一项横断面和前瞻性队列研究。我们使用了意大利教育部、威尼托地区SARS-CoV-2病例通报系统和学校二级病例追踪系统的数据库，比较了学生/学校工作人员和一般人群中的SARS-CoV-2发病率以及各年龄组的发病率。使用调整后的多变量广义线性回归模型估计检测次数、按指标病例类型划分的继发感染以及每所学校的病例/测试数比率。利用马尔科夫链蒙特卡罗算法的后验分布方法，从意大利民防日发病率数据中估计区域再生产数Rt。学生中SARS-CoV-2的发病率低于一般人群。学校继发感染发生率<1%，5-7%的学校发生≥2例继发病例。教师的发病率与同龄人群相当（P = 0.23）。教师继发感染较少，指示病例为教师的发生率高于学生（37% vs. 10%, P = 0.007）。在威尼托开学之前和前后，SARS-CoV-2的发病率在20-29岁和45 - 49岁的人群中增长最快，而不是在学生中。意大利各地区开学日期与地区COVID-19 Rt增加之间的滞后并不一致。最后，在其他措施实施之前关闭了两个地区的学校，但这些措施并没有影响Rt的下降。这一分析并不支持学校开学是意大利第二次COVID-19浪潮的驱动因素，意大利是一个高SARS-CoV-2发病率的欧洲大国。基金会螨。
During COVID-19 pandemic, school closure has been mandated in analogy to its effect against influenza, but it is unclear whether schools are early COVID-19 amplifiers. We performed a cross-sectional and prospective cohort study in Italy during the second COVID-19 wave (from September 30, 2020 until at least February 28, 2021). We used databases from the Italian Ministry of Education, the Veneto region systems of SARS-CoV-2 cases notification and of schools’ secondary cases tracing to compare SARS-CoV-2 incidence in students/school staff and general population and incidence across age groups. Number of tests, secondary infections by type of index case and ratio cases/ tests per school were estimated using an adjusted multivariable generalized linear regression model. Regional reproduction numbers Rt were estimated from Italian Civil Protection daily incidence data with a method of posterior distribution using a Markov Chain Monte Carlo algorithm. SARS-CoV-2 incidence among students was lower than in the general population. Secondary infections at school were <1%, and clusters of ≥2 secondary cases occurred in 5–7% of the analysed schools. Incidence among teachers was comparable to the population of similar age (P = 0.23). Secondary infections among teachers were rare, occurring more frequently when the index case was a teacher than a student (37% vs. 10%, P = 0.007). Before and around the date of school opening in Veneto, SARS-CoV-2 incidence grew maximally in 20–29- and 45–49-years old individuals, not among students. The lag between school opening dates in Italian regions and the increase in the regional COVID-19 Rt was not uniform. Finally, school closures in two regions where they were implemented before other measures did not affect Rt decrease. This analysis does not support a role for school opening as a driver of the second COVID-19 wave in Italy, a large European country with high SARS-CoV-2 incidence. Fondazione MITE.
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