On the increasing incidence of SARS-CoV- 2 in older adolescents and younger adults during the epidemic in Mexico

  1. Dalia Stern
  2. Martin Lajous
  3. Blanca De la Rosa
  4. Edward Goldstein

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Abstract

Objective. To estimate temporary changes in the inciden­ce of SARS-CoV-2-confirmed hospitalizations (by date of symptom onset) by age group during and after the national lockdown. Materials and methods. For each age group g, we computed the proportion E(g) of individuals in that age group among all cases aged 10-59y during the early lock­down period (April 20-May 3, 2020), and the corresponding proportion L(g) during the late lockdown (May 18-31, 2020) and post-lockdown (June 15-28, 2020) periods and computed the prevalence ratio: PR(g)=L(g)/E(g). Results. For the late lockdown and post-lockdown periods, the highest PR values were found in age groups 15-19y (late: PR=1.69, 95%CI 1.05,2.72; post-lockdown: PR=2.05, 1.30,3.24) and 20-24y (late: PR=1.43, 1.10,1.86; post-lockdown: PR=1.49, 1.15,1.93). These estimates were higher in individuals 15-24y compared to those ≥30y. Conclusions. Adolescents and younger adults had an increased relative incidence of SARS-CoV-2 during late lockdown and post-lockdown periods. The role of these age groups should be considered when implementing future pandemic response efforts.

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  1. Version published to 10.21149/11817
  2. Version published to 10.1101/2020.06.10.20127795v2 on medRxiv
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    SciScore for 10.1101/2020.06.10.20127795: (What is this?)

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

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    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:
    However, our study is not without limitations. Our findings could be affected by age-differential changes in case ascertainment, over time or across regions. However, we restricted the analysis to hospitalized cases rather than all confirmed COVID-19 cases in the community because changes in healthcare seeking behavior (e.g., for ambulatory visits), and changes in testing in the outpatient setting might affect the relation between the incidence of SARS-CoV-2 infection and the rates of detected COVID-19 cases. However, such temporal changes are less likely for hospitalized cases, with uniform guidelines for testing hospitalized cases applied in Mexico, and low likelihood of mild cases resulting in hospitalization during certain time periods. Second, the perception of the potential severity of the disease may have changed over time and clinicians, even with an existing case definition, may have preferentially tested certain age groups. We explored whether testing for hospitalized patients in all age groups changed over time and did not find evidence for this (Supplemental Figure). Third, we used date of symptom onset to temporally classify cases from an administrative database. Thus the possibility of error in registration is present. However, this error is probably random and unlikely to affect results. Alternatively, there might be differences across age groups in their recall of the date of onset, yet this seems unlikely. Fourth, it is important to notice that the database f...

    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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  4. Version published to 10.1101/2020.06.10.20127795v1 on medRxiv