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Front Med (Lausanne) . Epidemiological, Clinical, and Phylogenetic Characteristics of the First SARS-CoV-2 Transmission in a Nursing Home of Singap

tetano

Editor, Senior Moderator
Front Med (Lausanne)


. 2022 Jan 28;8:790177.
doi: 10.3389/fmed.2021.790177. eCollection 2021.
Epidemiological, Clinical, and Phylogenetic Characteristics of the First SARS-CoV-2 Transmission in a Nursing Home of Singapore: A Prospective Observational Investigation


Junxiong Pang[SUP] 1 2 [/SUP], Huei Nuo Tan[SUP] 3 [/SUP], Tze Minn Mak[SUP] 4 [/SUP], Sophie Octavia[SUP] 4 [/SUP], Sebastian Maurer-Stroh[SUP] 4 5 6 [/SUP], Fernanda L Sirota[SUP] 5 7 [/SUP], Mark Peng Chew Chan[SUP] 3 [/SUP], Ian Yi Onn Leong[SUP] 8 [/SUP], Valerie T J Koh[SUP] 1 [/SUP], Peng Lim Ooi[SUP] 2 9 [/SUP], Shawn Vasoo[SUP] 9 [/SUP], Dale Fisher[SUP] 10 [/SUP], Lin Cui[SUP] 4 [/SUP], Heidi Rafman[SUP] 11 [/SUP], Jeffery Cutter[SUP] 1 9 [/SUP], Vernon J Lee[SUP] 1 2 [/SUP]



Affiliations

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission has resulted in a significant burden among nursing home facilities globally. This prospective observational cohort study aims to define the potential sources of introduction and characteristics of SARS-CoV-2 transmission of the first nursing home facility in Singapore. An epidemiological serial point-prevalence survey of SARS-CoV-2 was conducted among 108 residents and 56 healthcare staff (HCS). In the current study, 14 (13%) residents and two (3.6%) HCS were diagnosed with coronavirus disease 2019 (COVID-19), with a case fatality rate (CFR) of 28.6% (4/14) among the residents. The median age of the infected residents was 86.5 [interquartile range (IQR) 78.5-88] and 85.7% were women. Five residents were symptomatic (35.7%) and the others were asymptomatic (64.3%). A higher proportion of residents who succumbed to COVID-19 had hypertension than those who recovered. The SARS-CoV-2 whole-genome sequencing showed lineage B.6 which is rare globally but common regionally during the early phase of the pandemic. Household transmission is a potential source of introduction into the nursing home, with at least six epidemiologically linked secondary cases. Male residents were less implicated due to the staff segregation plan by block. Among residents, a higher proportion of the non-survivors were asymptomatic and had hypertension compared with survivors.

Keywords: epidemiology; genomic epidemiology; infection prevention and control; nursing home; public health.
 
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