Case-control study to evaluate risk factors associated with a positive RT-PCR for SARS-CoV-2 in a population tested at the Mexican Consulate of Atlanta, GA Open Access

Chung, E. Lisa (Spring 2021)

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Background: The COVID-19 pandemic in the United States exposed existing health inequities and health disparities among racial and ethnic minority groups. The Emory COVID-19 Outbreak Response Team (ORT), in partnership with the Mexican Consulate of Atlanta, provided voluntary COVID-19 testing opportunities to predominantly Hispanic/Latinx individuals as a part of disease surveillance efforts.

Methods: A matched case-control study was designed to evaluate the risk factors associated with having a positive SARS-CoV-2 RT-PCR result among the population who received a free diagnostic test at the Mexican Consulate of Atlanta between September 2020 and February 2021.

Results: This study included 37 cases and 74 controls after matching on age and the date of specimen collection. The median age of cases was 39.0 (IQR: 25.2-46.9) and controls was 39.1 (IQR: 24.5-46.8). Sex was evenly distributed; 49% of cases and 54% of controls were women. The majority of the study population self-identified as Hispanic/Latino (93%). Among cases, 30% were asymptomatic. After controlling for age, having a known exposure within the past 14 days (OR=2.98, 95% CI: 0.88, 10.15) and reporting two or more symptoms (OR=8.15, 95% CI: 1.74, 38.17) were associated with resulting a positive SARS-CoV-2 RT-PCR. Alternatively, this study found that working in essential industries such as healthcare environments, the food industry, or the airport was less likely to be associated with a positive COVID-19 test (OR = 0.153; 95% CI: 0.02, 1.05).

Conclusion: In this almost exclusively Hispanic/Latino testing population, we found that a known exposure and two or more symptoms was associated with testing positive during the fall and winter of 2020-2021. Asymptomatic cases were less common than estimates that are closer to 40%. Essential worker status was protective, likely reflecting that this far into the pandemic, the risk differential by work status has been mitigated. While this population had fewer asymptomatic cases, easily accessible testing remains a critical public health effort to curb the COVID-19 pandemic.

Table of Contents

Introduction   ------------------------------------------------------------------------                       1

Methods         ------------------------------------------------------------------------                        3

           Study Participants     ------------------------------------------------------                        3

           Data Collection         ------------------------------------------------------                        3

           Specimen Collection and Analysis    ------------------------------------                        4

           Statistical Analysis    ------------------------------------------------------                        4

Results           ------------------------------------------------------------------------                         5

           Descriptive Epidemiology     ---------------------------------------------                        5

           Risk Factors in the Study Population            ---------------------------                        5

Discussion     ------------------------------------------------------------------------                        7

Tables            ------------------------------------------------------------------------                        10

Figures           ------------------------------------------------------------------------                        12

References     ------------------------------------------------------------------------                        14

Appendix       ------------------------------------------------------------------------                        20

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