Incidence of SARS-CoV-2 over Four Epidemic Waves in a Low-resource Community in Rio De Janeiro, Brazil: A Prospective Cohort Study

Overview

Journal Lancet Reg Health Am

Date 2022 Jun 6

PMID 35663637

Authors

Marilia Sa Carvalho

Leonardo Soares Bastos

Trevon Fuller

Owaldo Goncalves Cruz

Luana Damasceno

Guilherme Calvet

Paola Cristina Resende

Chris Smith

Jimmy Whitworth

Marilda Siqueira

Patricia Brasil

Affiliations

Soon will be listed here.

Abstract

Background: Incidence rates of SARS-CoV-2 infections in low-resource communities can inform vaccination strategies and non-pharmaceutical interventions (NPIs). Our objective was to estimate incidence over four epidemic waves in a slum in Rio de Janeiro, a proxy for economically deprived areas in the Global South.

Methods: Prospective cohort of children and household contacts screened for SARS-CoV-2 by PCR and serology (IgG). The incidence density of PCR positive infections estimated for each wave - the first wave, Zeta, Gamma and Delta - was compared to an index combining NPIs and vaccination coverage.

Findings: 718 families and 2501 individuals were enrolled, from May 2020 to November 2021. The incidence density of SARS-CoV-2 infection due to the first wave was 2, 3 times that of the other waves. The incidence among children was lower than that of older participants, except in later waves, when vaccination of the elderly reached 90%. Household agglomeration was significantly associated with incidence only during the first wave.

Interpretation: The incidence of infection greatly exceeded rates reported in similar cohorts. The observed reduction in incidence in the elderly during the Delta variant wave, in spite of the rollback of NPIs, can be attributed to increased vaccine coverage. The high incidence in young people reinforces the importance of vaccination in this age group, a policy that has yet to receive the full support of some sectors of society.

Funding: UK Medical Research Council, Foundation for the Advancement of Science of the State of Rio de Janeiro, National Council for Scientific and Technological Development.

Citing Articles

SARS-CoV-2 Infection and Adverse Maternal and Perinatal Outcomes: Time-to-Event Analysis of a Hospital-Based Cohort Study of Pregnant Women in Rio de Janeiro, Brazil.

Brendolin M, Wakimoto M, Oliveira R, Mageste L, Nielsen-Saines K, Brasil P Viruses. 2025; 17(2).

PMID: 40006963 PMC: 11860397. DOI: 10.3390/v17020207.

Cohort profile: follow-up of a household cohort throughout five epidemic waves of SARS-CoV-2 in Rio de Janeiro, Brazil.

Borges Da Silva M, Guaraldo L, Ferreira Pinto Santos H, Soares Bastos L, Pina-Costa A, Penetra S Cad Saude Publica. 2024; 40(7):e00152023.

PMID: 39194089 PMC: 11349275. DOI: 10.1590/0102-311XEN152023.

Seroprevalence trends of anti-SARS-CoV-2 antibodies in the adult population of the São Paulo Municipality, Brazil: Results from seven serosurveys from June 2020 to April 2022. The SoroEpi MSP Study.

Tess B, Turchi Martelli C, Goi Porto Alves M, Cortes F, Bernal R, Souza W PLoS One. 2024; 19(8):e0309441.

PMID: 39186722 PMC: 11346932. DOI: 10.1371/journal.pone.0309441.

SARS-CoV-2 Reinfection Cases in a Household-Based Prospective Cohort in Rio de Janeiro.

Penetra S, Santos H, Resende P, Soares Bastos L, da Silva M, Pina-Costa A J Infect Dis. 2023; 228(12):1680-1689.

PMID: 37571849 PMC: 11032242. DOI: 10.1093/infdis/jiad336.

The Role of Children in Household Transmission of SARS-CoV-2 Across Four Waves of the Pandemic.

Fuller T, Bastos L, Carvalho M, Resende P, Damasceno L, Cruz O J Pediatric Infect Dis Soc. 2023; 12(7):413-420.

PMID: 37327193 PMC: 10389060. DOI: 10.1093/jpids/piad044.

References

Pedro R, Carvalho M, Girianelli V, Damasceno L, Leal I, Cunha D . A populational-based birth cohort study in a low-income urban area in Rio de Janeiro, Brazil: implementation and description of the characteristics of the study. Cad Saude Publica. 2019; 35(5):e00023918. DOI: 10.1590/0102-311X00023918. View

Manfrinato C, Marino A, Conde V, Franco M, Stedefeldt E, Tomita L . High prevalence of food insecurity, the adverse impact of COVID-19 in Brazilian favela. Public Health Nutr. 2020; 24(6):1210-1215. PMC: 7870910. DOI: 10.1017/S1368980020005261. View

Koyama T, Platt D, Parida L . Variant analysis of SARS-CoV-2 genomes. Bull World Health Organ. 2020; 98(7):495-504. PMC: 7375210. DOI: 10.2471/BLT.20.253591. View

Vickers D, Baral S, Mishra S, Kwong J, Sundaram M, Katz A . Stringency of containment and closures on the growth of SARS-CoV-2 in Canada prior to accelerated vaccine roll-out. Int J Infect Dis. 2022; 118:73-82. PMC: 8863413. DOI: 10.1016/j.ijid.2022.02.030. View

Jorge D, Rodrigues M, Silva M, Cardim L, da Silva N, Silveira I . Assessing the nationwide impact of COVID-19 mitigation policies on the transmission rate of SARS-CoV-2 in Brazil. Epidemics. 2021; 35:100465. PMC: 8106524. DOI: 10.1016/j.epidem.2021.100465. View

Ellingson K, Gerald J, Sun X, Hollister J, Lutrick K, Parker J . Incidence of SARS-CoV-2 Infection Among Health Care Personnel, First Responders, and Other Essential Workers During a Prevaccination COVID-19 Surge in Arizona. JAMA Health Forum. 2022; 2(10):e213318. PMC: 8727035. DOI: 10.1001/jamahealthforum.2021.3318. View

Dawood F, Porucznik C, Veguilla V, Stanford J, Duque J, Rolfes M . Incidence Rates, Household Infection Risk, and Clinical Characteristics of SARS-CoV-2 Infection Among Children and Adults in Utah and New York City, New York. JAMA Pediatr. 2021; 176(1):59-67. PMC: 8501415. DOI: 10.1001/jamapediatrics.2021.4217. View

Lugon P, Fuller T, Damasceno L, Calvet G, Resende P, Matos A . SARS-CoV-2 Infection Dynamics in Children and Household Contacts in a Slum in Rio de Janeiro. Pediatrics. 2021; 148(1). PMC: 8276592. DOI: 10.1542/peds.2021-050182. View

Gudina E, Ali S, Girma E, Gize A, Tegene B, Hundie G . Seroepidemiology and model-based prediction of SARS-CoV-2 in Ethiopia: longitudinal cohort study among front-line hospital workers and communities. Lancet Glob Health. 2021; 9(11):e1517-e1527. PMC: 8525918. DOI: 10.1016/S2214-109X(21)00386-7. View

10.

Hale T, Angrist N, Hale A, Kira B, Majumdar S, Petherick A . Government responses and COVID-19 deaths: Global evidence across multiple pandemic waves. PLoS One. 2021; 16(7):e0253116. PMC: 8270409. DOI: 10.1371/journal.pone.0253116. View

11.

Mlcochova P, Kemp S, Dhar M, Papa G, Meng B, Ferreira I . SARS-CoV-2 B.1.617.2 Delta variant replication and immune evasion. Nature. 2021; 599(7883):114-119. PMC: 8566220. DOI: 10.1038/s41586-021-03944-y. View

12.

Letizia A, Ge Y, Goforth C, Weir D, Lizewski R, Lizewski S . SARS-CoV-2 Seropositivity among US Marine Recruits Attending Basic Training, United States, Spring-Fall 2020. Emerg Infect Dis. 2021; 27(4):1188-1192. PMC: 8007328. DOI: 10.3201/eid2704.204732. View

13.

Paschoalotto M, Costa E, Valente de Almeida S, Cima J, Gomes da Costa J, Santos J . Running away from the jab: factors associated with COVID-19 vaccine hesitancy in Brazil. Rev Saude Publica. 2021; 55:97. PMC: 8639140. DOI: 10.11606/s1518-8787.2021055003903. View

14.

Brasil P, Pereira Jr J, Moreira M, Ribeiro Nogueira R, Damasceno L, Wakimoto M . Zika Virus Infection in Pregnant Women in Rio de Janeiro. N Engl J Med. 2016; 375(24):2321-2334. PMC: 5323261. DOI: 10.1056/NEJMoa1602412. View

15.

Voloch C, da Silva Francisco Jr R, de Almeida L, Cardoso C, Brustolini O, Gerber A . Genomic characterization of a novel SARS-CoV-2 lineage from Rio de Janeiro, Brazil. J Virol. 2021; 95(10). PMC: 8139668. DOI: 10.1128/JVI.00119-21. View

16.

de Aguiar D, de Barros E, Ribeiro G, Brasil P, Gomes Mourao M, Luz K . A prospective, multicentre, cohort study to assess the incidence of dengue illness in households from selected communities in Brazil (2014-2018). Int J Infect Dis. 2021; 108:443-453. DOI: 10.1016/j.ijid.2021.04.062. View

17.

Konings F, Perkins M, Kuhn J, Pallen M, Alm E, Archer B . SARS-CoV-2 Variants of Interest and Concern naming scheme conducive for global discourse. Nat Microbiol. 2021; 6(7):821-823. DOI: 10.1038/s41564-021-00932-w. View

18.

Vancini R, Camargo-Neto L, de Lira C, Andrade M, Viana R, Nikolaidis P . Physical Activity and Sociodemographic Profile of Brazilian People during COVID-19 Outbreak: An Online and Cross-Sectional Survey. Int J Environ Res Public Health. 2020; 17(21). PMC: 7663508. DOI: 10.3390/ijerph17217964. View

19.

Damasceno L, Terzian A, Fuller T, Estofolete C, Andrade A, Kroon E . Why Did ZIKV Perinatal Outcomes Differ in Distinct Regions of Brazil? An Exploratory Study of Two Cohorts. Viruses. 2021; 13(5). PMC: 8146858. DOI: 10.3390/v13050736. View

20.

Dawood F, Varner M, Tita A, Newes-Adeyi G, Gyamfi-Bannerman C, Battarbee A . Incidence and Clinical Characteristics of and Risk Factors for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection Among Pregnant Individuals in the United States. Clin Infect Dis. 2021; 74(12):2218-2226. PMC: 8513407. DOI: 10.1093/cid/ciab713. View