Abstract
BackgroundOur main objectives were to estimate the incidence of illnesses presumably caused by SARS-CoV-2 infection during the lockdown period and to identify the associated risk factors.MethodsParticipants from 3 adult cohorts in the general population in France were invited to participate in a survey on COVID-19. The main outcome was COVID-19-Like Symptoms (CLS), defined as a sudden onset of cough, fever, dyspnea, ageusia and/or anosmia, that lasted more than 3 days and occurred during the 17 days before the survey. We used delayed-entry Cox models to identify associated factors.ResultsBetween April 2, 2020 and May 12, 2020, 279,478 participants were invited, 116,903 validated the questionnaire and 106,848 were included in the analysis. Three thousand thirty-five cases of CLS were reported during 62,099 person-months of follow-up. The cumulative incidences of CLS were 6.2% (95% Confidence Interval (95%CI): 5.7%; 6.6%) on day 15 and 8.8% (95%CI 8.3%; 9.2%) on day 45 of lockdown. The risk of CLS was lower in older age groups and higher in French regions with a high prevalence of SARS-CoV-2 infection, in participants living in cities > 100,000 inhabitants (vs rural areas), when at least one child or adolescent was living in the same household, in overweight or obese people, and in people with chronic respiratory diseases, anxiety or depression or chronic diseases other than diabetes, cancer, hypertension or cardiovascular diseases.ConclusionThe incidence of CLS in the general population remained high during the first 2 weeks of lockdown, and decreased significantly thereafter. Modifiable and non-modifiable risk factors were identified.
Highlights
Following the identification of a novel coronavirus (SARSCoV-2) in Wuhan, China in December 2019 and its worldwide spread [1], the first imported COVID-19 cases were initially reported in France on January 24, 2020 [2]
Twenty-six percent were residents of the Ile-de-France or GrandEst regions – the two regions with the highest rate of SARS-CoV-2 in metropolitan France, while 23% lived in rural areas and 44% lived in cities of more than 100,000 inhabitants
On multivariable analysis (Table 3), the risk of COVID-19 was lower in older age groups and was higher in the Ile-de-France and GrandEst regions, in those living in cities > 100,000 inhabitants, when at least one child or adolescent was living in the same household, in overweight or obese participants, and in people with chronic respiratory diseases, anxiety or depression and chronic diseases other than diabetes, cancer, hypertension or other cardiovascular diseases
Summary
Following the identification of a novel coronavirus (SARSCoV-2) in Wuhan, China in December 2019 and its worldwide spread [1], the first imported COVID-19 cases were initially reported in France on January 24, 2020 [2]. Less than 2 months later, the French government declared a nationwide epidemic (phase 3) and a generalized lockdown procedure was set-up on March 17, 2020 [3]. The lockdown included banning of any non-essential public gatherings, closure of educational and public/cultural institutions, ordering people to stay home apart from exercise and essential tasks. Children and their parents were required to stay at home as much as possible [4]. Public health reports have shown that lockdown had a marked impact on the dynamics of the pandemic with a clear downward trend in new hospitalizations from April 1, 2020, and a consecutive decrease in the number of deaths from April 7, 2020 [4, 5]. Our main objectives were to estimate the incidence of illnesses presumably caused by SARS-CoV-2 infection during the lockdown period and to identify the associated risk factors
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