Risk Factors, Epidemiological and Clinical
Outcome of Close Contacts of COVID-19
Cases in a Tertiary Hospital in Southern India
Published: March 1, 2021 | DOI: https://doi.org/10.7860/JCDR/2021/48059.14664
Binu Areekal, Sajna Mathumkunnath Vijayan, Mini Sreedharan Suseela, MA Andrews, Rajesh Koothupalakkal Ravi, Sudhiraj Thiruthara Sukumaran, Rajany Jose, Fathima Thasleema Thoombath Edappanatt
1. Additional Professor, Department of Community Medicine, Government Medical College, Thrissur, Kerala, India.
2. Associate Professor, Department of Community Medicine, Government Medical College, Thrissur, Kerala, India.
3. Professor and Head, Department of Community Medicine, Government Medical College, Thrissur, Kerala, India.
4. Principal, Department of Medicine, Government Medical College, Thrissur, Kerala, India.
5. Assistant Professor, Department of Medicine, Government Medical College, Thrissur, Kerala, India.
6. Assistant Professor, Department of Community Medicine, Government Medical College, Thrissur, Kerala, India.
7. Assistant Professor, Department of Community Medicine, Government Medical College, Thrissur, Kerala, India.
8. Junior Resident, Department of Community Medicine, Government Medical College, Thrissur, Kerala, India.
Correspondence
Binu Areekal,
Additional Professor, Department of Community Medicine Government Medical College,
Thrissur, Kerala, India.
E-mail: drbinu840@rediffmail.com
Introduction: The knowledge of epidemiologic characteristics and transmission dynamics of a novel pathogen, such as Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) among close contacts can help in planning and development of effective control policies in different parts of the world.
Aim: To assess the epidemiological and clinical outcome of close contacts of Coronavirus Disease (COVID-2019) cases admitted in a tertiary COVID hospital and to assess the role of risk factors in predicting the epidemiological outcome of these contacts.
Materials and Methods: The current retrospective cohort study was conducted among 1286 close contacts of COVID-19 patients admitted to Government Medical College, Thrissur, Kerala. The data collection was done by a semi-structured telephonic interview by the contact tracing team. The questions included the type of exposure to the index case, symptoms if any, date of last exposure with COVID-19 positive patients, and final COVID-19 status of the contact at the end of 14 days. The association of risk factors of COVID-19 positivity was done using binary logistic regression.
Results: Proportion of close contacts of COVID-19 who developed the disease was 24.2% (21.87-26.52%). The mean incubation period was found to be 4.22 days (C.I-3.71-4.65). The serial interval mean was found to be 5.24 days (C.I 4.764-5.716). The proportion of household contacts of COVID-19 cases who developed the disease was found to be 26% (C.I-23%-29%). The majority (52.4%) of infections among contacts were asymptomatic. Most common symptom among the COVID-19 positive was fever (32.8%) followed by cough (16.1%). The most common risk factors of infection among primary close contacts were sharing the same room (adjusted odds ratio-2.394) and common use of fomites (adjusted odds ratio-1.953) while use of a mask was found to be protective (adjusted odds ratio-0.570). Significant factors associated with the type of contact with infection were workplace-related contact (adjusted odds ratio-6.629), household contact (adjusted odds ratio-4.856), and travel-related contact (adjusted odds ratio-2.899).
Conclusion: The study concludes important risk factors of transmission among close contacts of COVID-19 as being in a household, workplace and travel related contact where the use of mask was found to be protective. The study also concludes that most of the COVID-19 infections in close contacts are asymptomatic.
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