Study Protocol: Understanding SARS-Cov-2 infection, immunity and its duration in care home residents and staff in England (VIVALDI)

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Global infection and mortality rates from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are disproportionately high in certain populations, including amongst older people. Care home residents are frequently exposed to infection due to contact with staff and other residents, and are highly susceptible to infection due to their age and co-morbidity. In England, official statistics suggest that at least 25% of all deaths in care home residents since the start of pandemic are linked to coronavirus disease 2019 (COVID-19), but limited testing for SARS-CoV-2 early in the pandemic means estimates of the true burden of disease are lacking. Additionally, little is known about patterns of transmission between care homes, the community and hospitals, or the relationship between infection and immunity in care home staff and residents. The VIVALDI study plans to address these questions.

VIVALDI is a prospective cohort study aiming to recruit 6,500 staff and 5000 residents from 105 care homes across England. Successive rounds of testing for infection will be performed over a period of 12 months. Nasopharyngeal swabs will detect evidence of viral RNA and therefore active infection (accompanied by collection of data on symptoms), whereas blood tests will detect antibodies and evidence of cellular immunity to SARS-CoV-2. Whole genome sequencing of viral isolates to investigate pathways of transmission of infection is planned in collaboration with the COVID-19 Genomics UK Consortium. Qualitative interviews with care home staff will investigate the impact of the pandemic on ways of working and how test results influence infection control practices and behaviours. Data from residents and staff will be linked to national datasets on hospital admissions, antibody and PCR test results, mortality and care home characteristics.

Data generated will support national public health efforts to prevent transmission of COVID-19 and protect care home staff and residents from infection.

Protocol registration: ISRCTN14447421 05/06/2020

Related collections

Most cited references 10

Record: found
Abstract: found
Article: not found

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Fei Zhou, Ting Yu, Ronghui Du … (2020)

Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

0 comments Cited 13459 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington

Temet M. McMichael, Dustin W Currie, Shauna Clark … (2020)

Abstract Background Long-term care facilities are high-risk settings for severe outcomes from outbreaks of Covid-19, owing to both the advanced age and frequent chronic underlying health conditions of the residents and the movement of health care personnel among facilities in a region. Methods After identification on February 28, 2020, of a confirmed case of Covid-19 in a skilled nursing facility in King County, Washington, Public Health–Seattle and King County, aided by the Centers for Disease Control and Prevention, launched a case investigation, contact tracing, quarantine of exposed persons, isolation of confirmed and suspected cases, and on-site enhancement of infection prevention and control. Results As of March 18, a total of 167 confirmed cases of Covid-19 affecting 101 residents, 50 health care personnel, and 16 visitors were found to be epidemiologically linked to the facility. Most cases among residents included respiratory illness consistent with Covid-19; however, in 7 residents no symptoms were documented. Hospitalization rates for facility residents, visitors, and staff were 54.5%, 50.0%, and 6.0%, respectively. The case fatality rate for residents was 33.7% (34 of 101). As of March 18, a total of 30 long-term care facilities with at least one confirmed case of Covid-19 had been identified in King County. Conclusions In the context of rapidly escalating Covid-19 outbreaks, proactive steps by long-term care facilities to identify and exclude potentially infected staff and visitors, actively monitor for potentially infected patients, and implement appropriate infection prevention and control measures are needed to prevent the introduction of Covid-19.

0 comments Cited 638 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Applying principles of behaviour change to reduce SARS-CoV-2 transmission

Robert G. West, Susan Michie, G James Rubin … (2020)

Human behaviour is central to transmission of SARS-Cov-2, the virus that causes COVID-19, and changing behaviour is crucial to preventing transmission in the absence of pharmaceutical interventions. Isolation and social distancing measures, including edicts to stay at home, have been brought into place across the globe to reduce transmission of the virus, but at a huge cost to individuals and society. In addition to these measures, we urgently need effective interventions to increase adherence to behaviours that individuals in communities can enact to protect themselves and others: use of tissues to catch expelled droplets from coughs or sneezes, use of face masks as appropriate, hand-washing on all occasions when required, disinfecting objects and surfaces, physical distancing, and not touching one's eyes, nose or mouth. There is an urgent need for direct evidence to inform development of such interventions, but it is possible to make a start by applying behavioural science methods and models.

0 comments Cited 262 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Maria Krutikov: Role: InvestigationRole: MethodologyRole: Project AdministrationRole: Writing – Original Draft Preparation

ORCID: https://orcid.org/0000-0002-3982-642X

Tom Palmer: Role: Data CurationRole: MethodologyRole: Writing – Original Draft PreparationRole: Writing – Review & Editing

ORCID: https://orcid.org/0000-0002-9526-0045

Alasdair Donaldson: Role: ConceptualizationRole: Funding Acquisition

Fabiana Lorencatto: Role: ConceptualizationRole: InvestigationRole: MethodologyRole: Writing – Review & Editing

Gill Forbes: Role: ConceptualizationRole: InvestigationRole: Methodology

ORCID: https://orcid.org/0000-0003-3816-6383

Andrew Copas: Role: Data CurationRole: MethodologyRole: Writing – Review & Editing

James Robson: Role: Project Administration

Susan Hopkins: Role: ConceptualizationRole: Funding Acquisition

Paul Moss: Role: ConceptualizationRole: Funding AcquisitionRole: InvestigationRole: MethodologyRole: Supervision

ORCID: https://orcid.org/0000-0002-6895-1967

Jeremy Farrar: Role: ConceptualizationRole: Funding AcquisitionRole: Supervision

Andrew Hayward: Role: ConceptualizationRole: Funding AcquisitionRole: InvestigationRole: MethodologyRole: Supervision

ORCID: https://orcid.org/0000-0002-3549-6232

Laura Shallcross: Role: ConceptualizationRole: Funding AcquisitionRole: InvestigationRole: MethodologyRole: SupervisionRole: Writing – Original Draft PreparationRole: Writing – Review & Editing

ORCID: https://orcid.org/0000-0003-1713-2555

Journal

Journal ID (nlm-ta): Wellcome Open Res

Journal ID (iso-abbrev): Wellcome Open Res

Journal ID (pmc): Wellcome Open Res

Title: Wellcome Open Research

Publisher: F1000 Research Limited (London, UK )

ISSN (Electronic): 2398-502X

Publication date (Electronic): 29 January 2021

Publication date Collection: 2020

Publication date PMC-release: 29 January 2021

Volume: 5

Electronic Location Identifier: 232

Affiliations

[1 ]Institute of Health Informatics, University College London, London, NW1 2DA, UK

[2 ]Institute for Global Health, University College London, London, WC1N 1EH, UK

[3 ]Department of Health & Social Care, UK Government, London, SW1H 0EU, UK

[4 ]Centre for Behaviour Change, University College London, London, UK

[5 ]Four Seasons Health Care, Wilmslow, Cheshire, SK9 1BU, UK

[6 ]National Infection Service, Public Health England, London, NW9 5EQ, UK

[7 ]Institute of Immunology & Immunotherapy, University of Birmingham, Birmingham, UK

[8 ]The Wellcome Trust, London, UK

[9 ]Institute of Epidemiology & Health Care, University College London, London, WC1E 7HB, UK

[1 ]Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK

[1 ]National Institute of Psychology (NIP), Quaid-I-Azam University, Islamabad, Pakistan

[2 ]Foundation University Rawalpindi Campus, Newlalazar, Rawalpindi Cantt, Pakistan

[1 ]National Institute of Psychology (NIP), Quaid-I-Azam University, Islamabad, Pakistan

[2 ]Foundation University Rawalpindi Campus, Newlalazar, Rawalpindi Cantt, Pakistan

University College London, UK

[1 ]Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK

University College London, UK

Author notes

[a ] m.krutikov@ 123456ucl.ac.uk

No competing interests were disclosed.

Competing interests: No competing interests were disclosed.

Author information

Maria Krutikov https://orcid.org/0000-0002-3982-642X

Tom Palmer https://orcid.org/0000-0002-9526-0045

Gill Forbes https://orcid.org/0000-0003-3816-6383

Paul Moss https://orcid.org/0000-0002-6895-1967

Andrew Hayward https://orcid.org/0000-0002-3549-6232

Laura Shallcross https://orcid.org/0000-0003-1713-2555

Article

DOI: 10.12688/wellcomeopenres.16193.2

PMC ID: 7851710

PubMed ID: 33564722

SO-VID: c08c1096-5403-4003-becc-ed05a99bfff7

License:

This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date accepted : 26 January 2021

Funding

Funded by: Department of Health & Social Care

Funded by: National Institute for Health Research

Award ID: CS-2016-16-007

The study is supported by funding from the Department of Health & Social Care, UK government. LS holds a NIHR Grant [CS-2016-16-007]. JF is the Director of the Wellcome Trust.

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Study Protocol: Understanding SARS-Cov-2 infection, immunity and its duration in care home residents and staff in England (VIVALDI)

Read this article at

Abstract

Related collections

UCL: Covid-19 Research

Most cited references 10

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington

Applying principles of behaviour change to reduce SARS-CoV-2 transmission

Author and article information

Contributors

Journal

Affiliations

Author notes

Author information

Article

History

Funding

Categories

Comments

Comment on this article

Similar content 195

Cited by 15

Most referenced authors 343