Rapid Emergence of SARS-CoV-2 in the Greater New York Metropolitan Area: Geolocation, Demographics, Positivity Rates, and Hospitalization for 46 793 Persons Tested by Northwell Health
Rapid Emergence of SARS-CoV-2 in the Greater New York Metropolitan Area: Geolocation, Demographics, Positivity Rates, and Hospitalization for 46 793 Persons Tested by Northwell Health
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DOI：
10.1093/cid/ciaa922
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发表时间：
2020-12-15
影响因子：
11.8
通讯作者：
Ziemba, Yonah C.
中科院分区：
文献类型：
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作者：
Reichberg, Samuel B.;Mitra, Partha P.;Ziemba, Yonah C.
背景资料。2020年3月，大纽约大都市区成为严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染的震中。病例发病率的初步演变还没有得到很好的描述。从3月4日到4月10日，诺斯韦尔卫生实验室对46793人进行了SARS-CoV-2检测。主要结果是SARS-CoV-2的逆转录-聚合酶链式反应呈阳性。次要结果包括患者的年龄、性别和种族(如果有说明)；获得标本的日期和测试结果；临床实践地点来源；患者居住地的地理位置；以及住院时间。从3月8日至4月10日，46793人中共有26735人(57.1%)的SARS-CoV-2检测呈阳性。25岁以上的男性比女性受到的影响更大，随着年龄的增长，男性逐渐占优势。在阳性患者中，7292人在就诊时直接住院；另有882人在随后住院前在门诊环境中检测为阳性，中位数为4.8天后。因此，总住院率为8174人(占阳性者的30.6%)。在有记录的第一例发病后，各个邮政编码的阳性病例累积数量范围很大(>；10倍)。居住在邮政编码且家庭年收入较低的人群，检测阳性率更高。我们的数据显示，SARS-CoV-2的发病率在该地区广泛的人口中迅速且几乎同时出现。这些发现支持这样一个前提，即SARS-CoV-2感染在病毒检测之前是广泛分布的。
Background. In March 2020, the greater New York metropolitan area became an epicenter for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The initial evolution of case incidence has not been well characterized.Methods. Northwell Health Laboratories tested 46793 persons for SARS-CoV-2 from 4 March through 10 April. The primary outcome measure was a positive reverse transcription-polymerase chain reaction test for SARS-CoV-2. The secondary outcomes included patient age, sex, and race, if stated; dates the specimen was obtained and the test result; clinical practice site sources; geolocation of patient residence; and hospitalization.Results. From 8 March through 10 April, a total of 26735 of 46793 persons (57.1%) tested positive for SARS-CoV-2. Males of each race were disproportionally more affected than females above age 25, with a progressive male predominance as age increased. Of the positive persons, 7292 were hospitalized directly upon presentation; an additional 882 persons tested positive in an ambulatory setting before subsequent hospitalization, a median of 4.8 days later. Total hospitalization rate was thus 8174 persons (30.6% of positive persons). There was a broad range (>10-fold) in the cumulative number of positive cases across individual zip codes following documented first caseincidence. Test positivity was greater for persons living in zip codes with lower annual household income.Conclusions. Our data reveal that SARS-CoV-2 incidence emerged rapidly and almost simultaneously across a broad demographic population in the region. These findings support the premise that SARS-CoV-2 infection was widely distributed prior to virus testing availability.