Spectrum of COVID-19 Cases in Arkhangelsk, Northwest Russia: Findings from a Population-based Study Linking Serosurvey, Registry Data, and Self-reports of Symptoms

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2024 Oct 11

PMID 39392813

Authors

Ekaterina Krieger

Alexander V Kudryavtsev

Ekaterina Sharashova

Olga Samodova

Anna Kontsevaya

Vitaly A Postoev

Affiliations

Soon will be listed here.

Abstract

Introduction: The spectrum of COVID-19 manifestations makes it challenging to estimate the exact proportion of people who had the infection in a population, with the proportion of asymptomatic cases likely being underestimated. We aimed to assess and describe the spectrum of COVID-19 cases in a sample of adult population aged 40-74 years in Arkhangelsk, Northwest Russia, a year after the start of the pandemic.

Materials And Methods: A population-based survey conducted between February 24, 2021 and June 30, 2021 with an unvaccinated sample aged 40-74 years (N = 1089) combined a serological survey data, national COVID-19 case registry, and self-reported data on COVID-19 experience and symptoms. Based on the agreement between these sources, we classified the study participants as non-infected and previously infected (asymptomatic, non-hospitalized and hospitalized symptomatic) cases, and compared these groups regarding demographics, lifestyle and health characteristics.

Results: After a year of the pandemic in Arkhangelsk, 59.7% 95% confidence intervals (CI) (56.7; 62.6) of the surveyed population had had COVID-19. Among those who had been infected, symptomatic cases comprised 47.1% 95% CI (43.2; 51.0), with 8.6% 95% CI (6.6; 11.1) of them having been hospitalized. Of the asymptomatic cases, 96.2% were not captured by the healthcare system. Older age was positively associated, while smoking showed a negative association with symptomatic COVID-19. Individuals older than 65 years, and those with poor self-rated health were more likely to be hospitalized.

Conclusion: More than half of the infected individuals were not captured by the healthcare-based registry, mainly those with asymptomatic infections. COVID-19 severity was positively associated with older age and poor self-rated health, and inversely associated with smoking. Combining different sources of surveillance data could reduce the number of unidentified asymptomatic cases and enhance surveillance for emerging infections.

References

Kim G, Kim M, Ra S, Lee J, Bae S, Jung J . Clinical characteristics of asymptomatic and symptomatic patients with mild COVID-19. Clin Microbiol Infect. 2020; 26(7):948.e1-948.e3. PMC: 7252018. DOI: 10.1016/j.cmi.2020.04.040. View

Li G, Li W, He X, Cao Y . Asymptomatic and Presymptomatic Infectors: Hidden Sources of Coronavirus Disease 2019 (COVID-19). Clin Infect Dis. 2020; 71(8):2018. PMC: 7184467. DOI: 10.1093/cid/ciaa418. View

Barchuk A, Shirokov D, Sergeeva M, Tursun Zade R, Dudkina O, Tychkova V . Evaluation of the performance of SARS--CoV--2 antibody assays for a longitudinal population-based study of COVID--19 spread in St. Petersburg, Russia. J Med Virol. 2021; 93(10):5846-5852. PMC: 8242745. DOI: 10.1002/jmv.27126. View

Singhal S, Kumar P, Singh S, Saha S, Dey A . Clinical features and outcomes of COVID-19 in older adults: a systematic review and meta-analysis. BMC Geriatr. 2021; 21(1):321. PMC: 8133052. DOI: 10.1186/s12877-021-02261-3. View

Pinto Saravia V . Sociodemographic Differences in COVID-19 Self-Reported Symptoms by Ethnicity and Older Adults in Bolivia. J Popul Ageing. 2022; 15(3):811-841. PMC: 9358097. DOI: 10.1007/s12062-022-09383-5. View

Sannigrahi S, Pilla F, Basu B, Basu A, Molter A . Examining the association between socio-demographic composition and COVID-19 fatalities in the European region using spatial regression approach. Sustain Cities Soc. 2020; 62:102418. PMC: 7395296. DOI: 10.1016/j.scs.2020.102418. View

Naimeh M, Afsaneh A, Zahra A, Ali D, Abdullah B, Marzieh R . Smoking as a Risk or Protective Factor in Developing and Severity of COVID-19?. J Acute Med. 2023; 13(3):114-121. PMC: 10568632. DOI: 10.6705/j.jacme.202309_13(3).0003. View

Accorsi E, Qiu X, Rumpler E, Kennedy-Shaffer L, Kahn R, Joshi K . How to detect and reduce potential sources of biases in studies of SARS-CoV-2 and COVID-19. Eur J Epidemiol. 2021; 36(2):179-196. PMC: 7906244. DOI: 10.1007/s10654-021-00727-7. View

Gallus S, Scala M, Possenti I, Jarach C, Clancy L, Fernandez E . The role of smoking in COVID-19 progression: a comprehensive meta-analysis. Eur Respir Rev. 2023; 32(167). PMC: 10032583. DOI: 10.1183/16000617.0191-2022. View

10.

Popova A, Smirnov V, Andreeva E, Babura E, Balakhonov S, Bashketova N . SARS-CoV-2 Seroprevalence Structure of the Russian Population during the COVID-19 Pandemic. Viruses. 2021; 13(8). PMC: 8402751. DOI: 10.3390/v13081648. View

11.

Celik I, Ozturk R . From asymptomatic to critical illness: decoding various clinical stages of COVID-19. Turk J Med Sci. 2021; 51(SI-1):3284-3300. PMC: 8771010. DOI: 10.3906/sag-2107-137. View

12.

Conti P, Younes A . Coronavirus COV-19/SARS-CoV-2 affects women less than men: clinical response to viral infection. J Biol Regul Homeost Agents. 2020; 34(2):339-343. DOI: 10.23812/Editorial-Conti-3. View

13.

Bert N, Tan A, Kunasegaran K, Tham C, Hafezi M, Chia A . SARS-CoV-2-specific T cell immunity in cases of COVID-19 and SARS, and uninfected controls. Nature. 2020; 584(7821):457-462. DOI: 10.1038/s41586-020-2550-z. View

14.

Mubarik S, Liu X, Eshak E, Liu K, Liu Q, Wang F . The Association of Hypertension With the Severity of and Mortality From the COVID-19 in the Early Stage of the Epidemic in Wuhan, China: A Multicenter Retrospective Cohort Study. Front Med (Lausanne). 2021; 8:623608. PMC: 8149896. DOI: 10.3389/fmed.2021.623608. View

15.

Salerno S, Zhao Z, Prabhu Sankar S, Salvatore M, Gu T, Fritsche L . Patterns of repeated diagnostic testing for COVID-19 in relation to patient characteristics and outcomes. J Intern Med. 2020; 289(5):726-737. PMC: 7753604. DOI: 10.1111/joim.13213. View

16.

Menachemi N, Dixon B, Wools-Kaloustian K, Yiannoutsos C, Halverson P . How Many SARS-CoV-2-Infected People Require Hospitalization? Using Random Sample Testing to Better Inform Preparedness Efforts. J Public Health Manag Pract. 2021; 27(3):246-250. DOI: 10.1097/PHH.0000000000001331. View

17.

Zhang S, Guo M, Wu F, Xiong N, Ma Y, Wang Z . Factors associated with asymptomatic infection in health-care workers with severe acute respiratory syndrome coronavirus 2 infection in Wuhan, China: a multicentre retrospective cohort study. Clin Microbiol Infect. 2020; 26(12):1670-1675. PMC: 7476563. DOI: 10.1016/j.cmi.2020.08.038. View

18.

Schafer E, Scheer C, Salje K, Fritz A, Kohlmann T, Hubner N . Course of disease and risk factors for hospitalization in outpatients with a SARS-CoV-2 infection. Sci Rep. 2022; 12(1):7249. PMC: 9065670. DOI: 10.1038/s41598-022-11103-0. View

19.

Shubin M, Virtanen M, Toikkanen S, Lyytikainen O, Auranen K . Estimating the burden of A(H1N1)pdm09 influenza in Finland during two seasons. Epidemiol Infect. 2013; 142(5):964-74. PMC: 4097990. DOI: 10.1017/S0950268813002537. View

20.

Jackson S, Tattan-Birch H, Shahab L, Beard E, Brown J . Have there been sustained impacts of the COVID-19 pandemic on trends in smoking prevalence, uptake, quitting, use of treatment, and relapse? A monthly population study in England, 2017-2022. BMC Med. 2023; 21(1):474. PMC: 10720231. DOI: 10.1186/s12916-023-03157-2. View