Frontiers in Public Health (Mar 2022)

Risk-Factors for Exposure Associated With SARS-CoV-2 Detection After Recent Known or Potential COVID-19 Exposures Among Patients Seeking Medical Care at a Large Urban, Public Hospital in Fulton County, Georgia — A Cross-Sectional Investigation

  • Sarah E. Smith-Jeffcoat,
  • Sadia Sleweon,
  • Mitsuki Koh,
  • George M. Khalil,
  • Marcos C. Schechter,
  • Marcos C. Schechter,
  • Paulina A. Rebolledo,
  • Paulina A. Rebolledo,
  • Vyjayanti Kasinathan,
  • Vyjayanti Kasinathan,
  • Adam Hoffman,
  • Adam Hoffman,
  • Rebecca Rossetti,
  • Talya Shragai,
  • Kevin O'Laughlin,
  • Catherine C. Espinosa,
  • Bettina Bankamp,
  • Michael D. Bowen,
  • Ashley Paulick,
  • Amy S. Gargis,
  • Jennifer M. Folster,
  • Juliana da Silva,
  • Caitlin Biedron,
  • Rebekah J. Stewart,
  • Yun F. Wang,
  • Yun F. Wang,
  • Hannah L. Kirking,
  • Jacqueline E. Tate,
  • CDC COVID-19 Emergency Response GA-10 Field,
  • Halie K. Miller,
  • AdeSubomi O. Adeyemo,
  • Anne C. Moorman,
  • Brenda L. Bauman,
  • Kahaliah Joseph,
  • Michelle O'Hegarty,
  • Nazia Kamal,
  • Mila Cohen,
  • Amadea Britton,
  • Courtney T. Callahan,
  • Jamila Fonseka,
  • Elfriede Agyemang,
  • Miriam J. Lawson,
  • Molly Deutsch-Feldman,
  • Tejpratap S. P. Tiwari,
  • Samira Sami,
  • Hong Tao

DOI
https://doi.org/10.3389/fpubh.2022.809356
Journal volume & issue
Vol. 10

Abstract

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We aimed to describe frequency of COVID-19 exposure risk factors among patients presenting for medical care at an urban, public hospital serving mostly uninsured/Medicare/Medicaid clients and risk factors associated with SARS-CoV-2 infection. Consenting, adult patients seeking care at a public hospital from August to November 2020 were enrolled in this cross-sectional investigation. Saliva, anterior nasal and nasopharyngeal swabs were collected and tested for SARS-CoV-2 using RT-PCR. Participant demographics, close contact, and activities ≤14 days prior to enrollment were collected through interview. Logistic regression was used to identify risk factors associated with testing positive for SARS-CoV-2. Among 1,078 participants, 51.8% were male, 57.0% were aged ≥50 years, 81.3% were non-Hispanic Black, and 7.6% had positive SARS-CoV-2 tests. Only 2.7% reported COVID-19 close contact ≤14 days before enrollment; this group had 6.79 adjusted odds of testing positive (95%CI = 2.78–16.62) than those without a reported exposure. Among participants who did not report COVID-19 close contact, working in proximity to ≥10 people (adjusted OR = 2.17; 95%CI = 1.03–4.55), choir practice (adjusted OR = 11.85; 95%CI = 1.44–97.91), traveling on a plane (adjusted OR = 5.78; 95%CI = 1.70–19.68), and not participating in an essential indoor activity (i.e., grocery shopping, public transit use, or visiting a healthcare facility; adjusted OR = 2.15; 95%CI = 1.07–4.30) were associated with increased odds of testing positive. Among this population of mostly Black, non-Hispanic participants seeking care at a public hospital, we found several activities associated with testing positive for SARS-CoV-2 infection in addition to close contact with a case. Understanding high-risk activities for SARS-CoV-2 infection among different communities is important for issuing awareness and prevention strategies.

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