Community and Close Contact Exposures Associated with COVID-19 Among Symptomatic Adults ≥18 Years in 11 Outpatient Health Care Facilities — United States, July 2020
Community and Close Contact Exposures Associated with COVID-19 Among Symptomatic Adults ≥18 Years in 11 Outpatient Health Care Facilities — United States, July 2020
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11 个门诊医疗机构中 18 岁及以上有症状成年人中与 COVID-19 相关的社区和密切接触接触情况——美国，2020 年 7 月
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
W. Self
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作者：
Kiva A Fisher;M. Tenforde;Leora R. Feldstein;C. Lindsell;N. Shapiro;D. Files;K. Gibbs;H. Erickson;M. Prekker;J. Steingrub;M. Exline;D. Henning;Jennifer G. Wilson;Samuel M. Brown;I. Peltan;T. Rice;D. Hager;A. Ginde;H. Talbot;J. Casey;Carlos G. Grijalva;B. Flannery;Manish M Patel;W. Self
社区和密切接触者暴露继续推动2019冠状病毒病（COVID-19）大流行。CDC和其他公共卫生当局建议采取社区缓解策略，以减少导致COVID-19的SARS-CoV-2的传播（1，2）。当发生广泛传播时，特别是从内在相互联系的社区内的无症状者传播时，社区暴露的特征可能难以评估。主要在COVID-19病例中评估了潜在暴露，例如与确诊COVID-19患者的密切接触，没有非COVID-19对照组（3，4）。为了评估与COVID-19相关的社区和密切接触者暴露，将病例患者（154）报告的暴露与对照参与者（160）报告的暴露进行了比较。病例-患者为经逆转录-聚合酶链反应（RT-PCR）检测证实的SARS-CoV-2感染的有症状成年人（年龄≥18岁）。对照组参与者是来自同一卫生保健机构的有症状的门诊成人，他们的SARS-CoV-2检测结果为阴性。与已知COVID-19患者的密切接触在病例患者（42%）中比对照参与者（14%）更常见。与对照组相比，病例组患者在发病前2周内更有可能报告在餐馆（餐馆指定的任何区域，包括室内、露台和室外座位）用餐（调整后的比值比[aOR] = 2.4; 95%置信区间[CI] = 1.5-3.8）。将分析限制在与确诊的COVID-19患者没有已知密切接触的参与者中，病例患者比对照参与者更有可能报告在餐馆用餐（aOR = 2.8，95%CI = 1.9-4.3）或去酒吧/咖啡店（aOR = 3.9，95%CI = 1.5-10.1）。难以保持口罩使用和社交距离的暴露和活动，包括前往提供现场饮食的场所，可能是感染COVID-19的重要风险因素。随着社区重新开放，应考虑在提供现场饮食选择的地点减少可能的暴露，以保护客户、员工和社区。
Community and close contact exposures continue to drive the coronavirus disease 2019 (COVID-19) pandemic. CDC and other public health authorities recommend community mitigation strategies to reduce transmission of SARS-CoV-2, the virus that causes COVID-19 (1,2). Characterization of community exposures can be difficult to assess when widespread transmission is occurring, especially from asymptomatic persons within inherently interconnected communities. Potential exposures, such as close contact with a person with confirmed COVID-19, have primarily been assessed among COVID-19 cases, without a non-COVID-19 comparison group (3,4). To assess community and close contact exposures associated with COVID-19, exposures reported by case-patients (154) were compared with exposures reported by control-participants (160). Case-patients were symptomatic adults (persons aged ≥18 years) with SARS-CoV-2 infection confirmed by reverse transcription-polymerase chain reaction (RT-PCR) testing. Control-participants were symptomatic outpatient adults from the same health care facilities who had negative SARS-CoV-2 test results. Close contact with a person with known COVID-19 was more commonly reported among case-patients (42%) than among control-participants (14%). Case-patients were more likely to have reported dining at a restaurant (any area designated by the restaurant, including indoor, patio, and outdoor seating) in the 2 weeks preceding illness onset than were control-participants (adjusted odds ratio [aOR] = 2.4; 95% confidence interval [CI] = 1.5-3.8). Restricting the analysis to participants without known close contact with a person with confirmed COVID-19, case-patients were more likely to report dining at a restaurant (aOR = 2.8, 95% CI = 1.9-4.3) or going to a bar/coffee shop (aOR = 3.9, 95% CI = 1.5-10.1) than were control-participants. Exposures and activities where mask use and social distancing are difficult to maintain, including going to places that offer on-site eating or drinking, might be important risk factors for acquiring COVID-19. As communities reopen, efforts to reduce possible exposures at locations that offer on-site eating and drinking options should be considered to protect customers, employees, and communities.