Abstract
We describe the epidemiological characteristics and associated risk factors of those presenting at a large testing centre for SARS-CoV-2 infection. This is a retrospective record review of individuals who underwent SARS-CoV-2 testing by reverse transcription-polymerase chain reaction (RT-PCR) at a high-throughput national-level government facility located in the north of India. Samples collected from 6 April to 31 December 2020 are included in this work and represent four highly populous regions. Additionally, there was a prospective follow-up of 1729 cases through telephone interviews from 25 May 2020 to 20 June 2020. Descriptive analysis has been performed for profiling clinic-epidemiological aspects of suspect cases. Multivariable logistic regression analysis was undertaken to determine risk factors that are associated with SARS-CoV-2 test positivity and symptom status. A total of 125 600 participants' details have been included in this report. The mean (s.d.) age of the participants was 33.1 (±15.3) years and 66% were male. Among these tested, 9515 (7.6%) were positive for COVID-19. A large proportion of positive cases were asymptomatic. In symptomatic positive cases, the commonest symptoms were cough and fever. Increasing age (groups 20-59 and ≥60 years compared to age group less than 5 years), male sex, history of international travel, symptoms for SARS-CoV-2, and participants from Delhi and Madhya Pradesh were positively associated with SARS-CoV-2 test positivity. Having co-morbidity, risk behaviours and intra-familial positivity were associated with a positive odds ratio for exhibiting SARS-CoV-2 symptoms. Intensified testing and isolation of cases, identification of both asymptomatic and symptomatic individuals and additional care of those with co-morbidities and risk behaviours will all be collectively important for disease containment in India. Reasons for differentials in testing between men and women remain an important area for in-depth study. The increased deployment of vaccines is likely to impact the trajectory of COVID-19 in the coming time, and therefore our data will serve as a comparative resource as India experiences the second wave of infection in light of newer variants that are likely to accelerate disease spread.
Highlights
The first case of novel coronavirus disease in India was reported in a student from Thrissur, Kerala, who returned from Wuhan, China, on 30 January 2020 [1]
We report here clinic-epidemiological features along with the risk factors among the positive patients in one of the largest cohort of potential COVID-19 cases (n = 125 600) who were tested through reverse transcription-polymerase chain reaction (RT-PCR) for the detection of SARS-CoV-2 infection from the period of 6 April 2020 to 31 December 2020 at National Institute of Biologicals (NIB), an autonomous institute of Ministry of Health and Family Welfare situated in Noida, Uttar Pradesh, India
The individuals included in this study were people who were suspected to be exposed to a confirmed case of COVID-19, symptomatic frontline workers, symptomatic who had undertaken international travel, and those presented for laboratory testing from containment zones, or quarantine centres or self-isolation
Summary
The first case of novel coronavirus disease in India was reported in a student from Thrissur, Kerala, who returned from Wuhan, China, on 30 January 2020 [1]. India had reported the largest number of confirmed COVID-19 cases in Asia and ranked second worldwide after the United States during the first wave. As of 30 April 2021, India has confirmed a total of greater than 16.9 million cases with 192 311 deaths attributed to COVID19 [2]. India is dealing with an explosive second wave of SARS-CoV-2 infections and has the dubious distinction of largest daily cases worldwide. The brutal second wave of COVID-19 has hit the nation reporting more than 0.3 million cases daily since mid-April 2021. This study is restricted to the fast wave of the Indian epidemic, our analyses will enlighten data from the second and future waves of SARS-CoV-2 infections
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