COVID-19 Scan for Jun 18, 2020

Genetic role in severe COVID-19?
COVID-19 in nursing homes
New York SARS-CoV-2 antibody levels

Study links 2 gene clusters with increased risk for severe COVID-19 illness

A genomic analysis of hundreds of European patients who had severe cases of COVID-19 pointed to two gene clusters—one of them related to blood type—that seemed to be associated with severe disease, according to a report published yesterday in the New England Journal of Medicine.

The study initially involved 1,980 patients from seven hospitals in Italy and Spain whose COVID-19 cases resulted in respiratory failure. After applying quality control criteria and excluding population outliers, the researchers ended up with 835 patients and 1,255 control participants from Italy and 775 patients and 950 control participants from Spain. The control groups consisted of healthy volunteers, blood donors, and outpatients of hospital gastroenterology departments.

The team analyzed 8,582,968 single-nucleotide polymorphisms and conducted a meta-analysis of the two case-control panels.

"We detected a novel susceptibility locus at a chromosome 3p21.31 gene cluster and confirmed a potential involvement of the ABO blood-group system in Covid-19," the team wrote. Both genomic sites had associations with increased risk that were significant at the genome-wide level.

The 3p21.31 cluster involved six genes, including several that have functions relevant to COVID-19, such as interaction with angiotensin-converting enzyme 2, the SARS-CoV-2 cell-surface receptor. The findings do not "reliably implicate" a single causative gene, the authors said.

The other genomic site that was linked with increased risk is called locus 9q34.2, which "coincided with the ABO blood group locus," the report says. The team did an analysis by specific blood group and found that group A was linked to a significantly higher risk than other groups (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.20 to 1.75; P = 1.48×10−4), while blood group O had a lower risk than other blood groups (OR, 0.65; 95% CI, 0.53 to 0.79; P = 1.06×10−5).
Jun 17 N Engl J Med report


Reduced staffing levels associated with COVID-19 nursing home cases

A study today in the Journal of the American Geriatrics Society shows that increased staffing of registered nurses (RNs) in nursing homes and long-term care facilities in Connecticut was associated with fewer cases of COVID-19.

To conduct the study, researchers used data collected from the Connecticut Department of Health and Human Services website. They then compared information to data on the Center for Medicare & Medicaid Service's Nursing Home Compare website, which tracks nursing staff levels.

The authors found that, among facilities with at least one confirmed COVID-19 case, every 20-minute (per resident day) increase in RN staffing was associated with 22% less confirmed cases (incidence rate ratio [IRR], 0.78; 95% CI, 0.68 to 0.89, P < 0.001).

In facilities with at least one COVID-19 death, every 20 minutes (per resident day) increase in RN staffing significantly predicted 26% less COVID‐19 deaths (IRR, 0.74; 95% CI, 0.55‐1.00, P = 0.047).

"Our findings of the strong negative association between RN staffing and the number of COVID-19 cases and deaths in nursing homes are consistent with research that has demonstrated that increased nursing levels are key to an institution's ability to respond to outbreaks of emerging infections," said Yue Li, PhD, a professor in the University of Rochester Medical Center (URMC) Department of Public Health Sciences and lead author of the study, in a press release.

Nursing homes have hosted some of the largest COVID-19 outbreaks in the country and likely account for at least 40% of the nation's death toll. People older than 65 and those with chronic underlying health conditions are the most vulnerable to severe complications, including death, from the novel coronavirus.
Jun 18 J Am Geriatr Soc study
Jun 18 URMC
press release


Antibody study suggests 2.1 million New Yorkers infected with COVID-19 by late March

The largest US serosurvey to date to detect the presence of SARS-CoV-2 antibodies showed that more than 2 million residents of New York state had likely contracted COVID-19 by late March. The study is published in Annals of Epidemiology.

The statewide seroprevalence study was conducted among 15,101 shoppers selected at 99 grocery stores in 26 counties throughout New York State from Apr 19 and 28. A total of 1,887 of 15,101 people showed reactive antibodies to SARS-CoV-2, the virus that causes COVID-19. Based on those results, the authors estimated the cumulative incidence through Mar 29 was 14.0% (95% CI, 13.3% to 14.7%), corresponding to 2,139,300 infected adults (95% CI, 2,035,800 to 2,242,800).

The highest cumulative incidence of the antibodies was seen in New York City (22%). Hispanics had the highest incidence of positive antibody tests (29.2%), followed by black residents (20.2%), and non-Hispanic Asians (12.4%).

"Despite large numbers of persons acquiring SARS-CoV-2, this represents only 14.0% of adult residents, suggesting that, even in this COVID-19 epicenter, the epidemic is substantially below the estimated ∼70% US herd immunity threshold," the authors said.

New York has been the epicenter of COVID-19 activity in the United States, with residents accounting for accounting for roughly 25% of US diagnoses.
Jun 17 Ann Epidemiol study

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