Longitudinal SARS-CoV-2 infection study in a German medical school

  1. Michael Schön
  2. Clemens Lindenau
  3. Anja Böckers
  4. Claire-Marie Altrock
  5. David A. C. Messerer
  6. Lydia Krys
  7. Anastasia Nosanova
  8. Nicole Lang
  9. Andrea Renz
  10. Joris Kroschel
  11. Alexandra Beil
  12. Elke Pensel
  13. Claudia Grab
  14. Benjamin Mayer
  15. Ulrich Fassnacht
  16. Jan Philipp Delling
  17. Magdalena Engelmann
  18. Astrid Horneffer
  19. Maria Zernickel
  20. Klaus-Michael Debatin
  21. Jan Münch
  22. Frank Kirchhoff
  23. Thomas Wirth
  24. Tobias M. Boeckers

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Abstract

In light of the COVID-19 pandemic, universities around the world were challenged by the difficult decision whether classes could be held face-to-face in the winter semester 20/21. The gross anatomy course is considered an essential practical element of medical school. In order to protect the participants and teaching staff and to gain more knowledge about SARS-CoV-2 infections among students during a semester with face-to-face teaching a longitudinal test study was conducted. Medical students from the first three years of medical school were also invited. Out of a total of almost 1,000 swabs, only two active asymptomatic infections were detected at the start of the semester, none during the semester. At semester start, approximately 6% of the students had antibodies. At the end of the semester, only nine seroconversions after infection in 671 individuals occurred. This was surprisingly low because a massive second wave of infections hit Germany during the same period. The conclusion therefore is that face-to-face teaching under these measures was not infection-promoting even with high incidence rates in the overall population with the SARS-CoV-2 variants present at that time period. Moreover, the results are indicative of a preventive effect of hygiene concepts together with repetitive testings before and during a semester.

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  1. Version published to 10.1101/2021.05.04.21256382v3 on medRxiv
  2. Version published to 10.1101/2021.05.04.21256382v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2021.05.04.21256382: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot 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:
    A limitation of the study is the lack of comparison with a cohort of students who had only online classes during the winter semester. Interpretation of data in national and international comparison: Few studies have investigated the incidence of SARS-CoV-2 infections in students. In most cases, only seroprevalence at a specific time point was determined (Tilley et al., 2020, Tuells et al., 2021). Another study examined antibodies to SARS-CoV-2 in a cohort of students at the beginning of the fall term in the United States. The students had high infection status, with over 30% seropositive findings. The study does not report the antibody status of students at the end of the semester (Arnold et al., 2021). In the USA, there was a large increase in local COVID-19 incidence in the vicinity of universities that may be associated with the onset of fall term (Leidner et al., 2020). To our knowledge, a longitudinal study with direct SARS-CoV-2 pathogen and antibody detection during the second wave of infection of the pandemic is unique. The winter term and study largely coincided with the second severe wave of the pandemic in Germany. At the start of the semester (testing times from mid-November to early December), 6.4% (46 of 720) of all cohorts were seropositive. This value is difficult to rank in comparison to cohorts of the same age or in an overall population comparison. A survey of students in Los Angeles in May 2020 came up with a value of 4% (Tilley et al., 2020), and at a Spa...

    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.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2021.05.04.21256382v1 on medRxiv