Size and duration of COVID-19 clusters go along with a high SARS-CoV-2 viral load: A spatio-temporal investigation in Vaud state, Switzerland.
Size and duration of COVID-19 clusters go along with a high SARS-CoV-2 viral load: A spatio-temporal investigation in Vaud state, Switzerland.
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DOI：
10.1016/j.scitotenv.2021.147483
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发表时间：
2021-09-15
期刊：
影响因子：
--
通讯作者：
Greub G
中科院分区：
文献类型：
--
作者：
Ladoy A;Opota O;Carron PN;Guessous I;Vuilleumier S;Joost S;Greub G
为了了解瑞士沃州第一波记录在案的感染浪潮期间 SARS-CoV-2 的地理和时间传播情况，我们使用 2020 年 1 月 10 日至 6 月 30 日期间 33,651 名受检测者的精确居住位置 (RT-PCR) 分析了阳性病例群。我们使用了前瞻性泊松时空扫描统计数据 (SaTScan) 和基于噪声的应用的修改时空密度空间聚类(MST-DBSCAN) 来识别时空和传播集群，并估计集群持续时间、传播行为（出现、增长、减少等）和相对风险。对于每个簇，我们计算了个体数量、个体的中位年龄及其病毒载量。在确定的 1684 个时空簇中，有 457 个（27.1%）是显着的（p ≤ 0.05），因此与簇外区域相比，它们在簇内具有更高的相对感染风险。集群持续时间中位数为 11 天 (IQR 7-13)，每个集群中位数为 12 个人 (IQR 5-20)。大多数重要集群（n = 260；56.9%）中至少有一个人的病毒载量极高（> 10 亿拷贝/毫升）。这些簇（17 个感染个体的中位数，p < 0.001）比病毒载量低于 100 万拷贝/ml 的个体簇（3 个感染个体的中位数）大得多。在调查中考虑的平均年龄组最低的集群中发现了最高的病毒载量，而平均年龄最高的集群的病毒载量为低至中等。在20个重要的集群中，前三个病例的病毒载量低于100,000拷贝/毫升，这表明低于100,000拷贝/毫升的受试者可能仍然具有传染性。值得注意的是，传播集群的动态使得识别三个扩散区成为可能，这三个扩散区主要区分农村和城市地区，后者更容易持续和扩展，这可能导致附近出现新的集群。地理信息的使用对于公共卫生决策者减轻 SARS-CoV-2 病毒的传播至关重要。这项研究表明，集群的早期定位可能有助于实施有针对性的保护措施，限制病毒的传播。
To understand the geographical and temporal spread of SARS-CoV-2 during the first documented wave of infection in the state of Vaud, Switzerland, we analyzed clusters of positive cases using the precise residential location of 33,651 individuals tested (RT-PCR) between January 10 and June 30, 2020. We used a prospective Poisson space-time scan statistic (SaTScan) and a Modified Space–Time Density-Based Spatial Clustering of Application with Noise (MST-DBSCAN) to identify both space-time and transmission clusters, and estimated cluster duration, transmission behavior (emergence, growth, reduction, etc.) and relative risk. For each cluster, we computed the number of individuals, the median age of individuals and their viral load. Among the 1684 space-time clusters identified, 457 (27.1%) were significant (p ≤ 0.05), such that they harbored a higher relative risk of infection within the cluster than compared to regions outside the cluster. Clusters lasted a median of 11 days (IQR 7–13) and included a median of 12 individuals per cluster (IQR 5–20). The majority of significant clusters (n = 260; 56.9%) had at least one person with an extremely high viral load (>1 billion copies/ml). Those clusters were considerably larger (median of 17 infected individuals, p < 0.001) than clusters with individuals showing a viral load below 1 million copies/ml (median of three infected individuals). The highest viral loads were found in clusters with the lowest average age group considered in the investigation, while clusters with the highest average age had low to middle viral load. In 20 significant clusters, the viral load of the three first cases was below 100,000 copies/ml, suggesting that subjects with fewer than 100,000 copies/ml may still be contagious. Notably, the dynamics of transmission clusters made it possible to identify three diffusion zones, which predominantly differentiated between rural and urban areas, the latter being more prone to persistence and expansion, which may result in the emergence of new clusters nearby. The use of geographic information is key for public health decision makers in mitigating the spread of the SARS-CoV-2 virus. This study suggests that early localization of clusters may help implement targeted protective measures limiting the spread of the virus.
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