Factors preventing SARS-CoV-2 transmission during unintentional exposure in a GP practice: a cohort study of patient contacts; Germany, 2020
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Abstract
Two general practitioners (GPs) a with SARS-CoV-2 infection provided in-person patient care to patients of their joint medical practice before and after symptom onset, up until SARS-CoV-2 laboratory confirmation. In a retrospective cohort study of patient contacts, we assessed the risk (frequency and determinants) of SARS-CoV-2 transmission from the GPs to their patients. Our findings support the use of facemasks for GPs, and short consultation time, to minimize the risk of transmission.
Summary
Two general practitioners (GPs) with SARS-CoV-2 infection provided in-person patient care to patients of their joint medical practice before and after symptom onset, up until SARS-CoV-2 laboratory confirmation. Through active contact tracing, the local public health authorities recruited the cohort of patients that had contact with either GP in their putative infectious period. In this cohort of patient contacts, we assess the frequency and determinants of SARS-CoV-2-transmission from GPs to patients. We calculated incidence rate ratios (IRR) to explore the type of contact as explanatory variable for COVID-19 cases. Among the cohort of 83 patient contacts, we identified 22 (27%) COVID-19 cases including 17 (21%) possible, 3 (4%) probable, and 2 (2%) confirmed cases. All 22 cases had contact with a GP when the GP did not wear a mask, and/or when contact was ≥10 minutes. Importantly, patients who had contact <10 minutes with a GP wearing a facemask were at reduced risk (IRR 0.21; 95%CI 0.01-0.99) of COVID-19. This outbreak investigation adds to the body of evidence in supporting current guidelines on measures at preventing transmission of SARS-CoV-2 in an outpatient setting.
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SciScore for 10.1101/2021.03.17.21251046: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study has a few limitations. First, and due to the observational nature of our study, case definitions rely on self-reported symptoms and the availability of PCR test results (64/83 were tested), and are therefore an …
SciScore for 10.1101/2021.03.17.21251046: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study has a few limitations. First, and due to the observational nature of our study, case definitions rely on self-reported symptoms and the availability of PCR test results (64/83 were tested), and are therefore an estimation of the true number of cases. Also, not all potentially confounding factors could be considered in the statistical analysis, because of the limited sample size. Second, we cannot exclude that the patients were exposed to another source for SARS-CoV-2 infection, even though community transmission in Germany at the time was limited (3, 4). Last, case definition for possible cases included symptoms that could also have been caused by others such as seasonal influenza which was still circulating by the time the patients were exposed to the infectious GPs.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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