Transmission of COVID-19 in 282 clusters in Catalonia, Spain: a cohort study.
Identifieur interne : 000064 ( Main/Exploration ); précédent : 000063; suivant : 000065Transmission of COVID-19 in 282 clusters in Catalonia, Spain: a cohort study.
Auteurs : Michael Marks [Royaume-Uni] ; Pere Millat-Martinez [Espagne] ; Dan Ouchi [Espagne] ; Chrissy H. Roberts [Royaume-Uni] ; Andrea Alemany [Espagne] ; Marc Corbacho-Monné [Espagne] ; Maria Ubals [Espagne] ; Aurelio Tobias [Espagne] ; Cristian Tebé [Espagne] ; Ester Ballana [Espagne] ; Quique Bassat [Espagne] ; Bàrbara Baro [Espagne] ; Martí Vall-Mayans [Espagne] ; Camila G-Beiras [Espagne] ; Nuria Prat [Espagne] ; Jordi Ara [Espagne] ; Bonaventura Clotet [Espagne] ; Oriol Mitjà [Papouasie-Nouvelle-Guinée]Source :
- The Lancet. Infectious diseases [ 1474-4457 ] ; 2021.
Descripteurs français
- KwdFr :
- MESH :
- épidémiologie : Espagne.
- Adulte, Adulte d'âge moyen, Charge virale, Femelle, Humains, Incidence, Mâle, Études de cohortes.
- Wicri :
- geographic : Espagne.
English descriptors
- KwdEn :
- MESH :
- geographic , epidemiology : Spain.
- epidemiology : COVID-19.
- transmission : COVID-19.
- Adult, Cohort Studies, Female, Humans, Incidence, Male, Middle Aged, SARS-CoV-2, Viral Load.
Abstract
BACKGROUND
Scarce data are available on what variables affect the risk of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the development of symptomatic COVID-19, and, particularly, the relationship with viral load. We aimed to analyse data from linked index cases of COVID-19 and their contacts to explore factors associated with transmission of SARS-CoV-2.
METHODS
In this cohort study, patients were recruited as part of a randomised controlled trial done between March 17 and April 28, 2020, that aimed to assess if hydroxychloroquine reduced transmission of SARS-CoV-2. Patients with COVID-19 and their contacts were identified by use of the electronic registry of the Epidemiological Surveillance Emergency Service of Catalonia (Spain). Patients with COVID-19 included in our analysis were aged 18 years or older, not hospitalised, had quantitative PCR results available at baseline, had mild symptom onset within 5 days before enrolment, and had no reported symptoms of SARS-CoV-2 infections in their accommodation or workplace within the 14 days before enrolment. Contacts included were adults with a recent history of exposure and absence of COVID-19-like symptoms within the 7 days preceding enrolment. Viral load of contacts, measured by quantitative PCR from a nasopharyngeal swab, was assessed at enrolment, at day 14, and whenever the participant reported COVID-19-like symptoms. We assessed risk of transmission and developing symptomatic disease and incubation dynamics using regression analysis. We assessed the relationship of viral load and characteristics of cases (age, sex, number of days from reported symptom onset, and presence or absence of fever, cough, dyspnoea, rhinitis, and anosmia) and associations between risk of transmission and characteristics of the index case and contacts.
FINDINGS
We identified 314 patients with COVID-19, with 282 (90%) having at least one contact (753 contacts in total), resulting in 282 clusters. 90 (32%) of 282 clusters had at least one transmission event. The secondary attack rate was 17% (125 of 753 contacts), with a variation from 12% when the index case had a viral load lower than 1 × 10
INTERPRETATION
In our study, the viral load of index cases was a leading driver of SARS-CoV-2 transmission. The risk of symptomatic COVID-19 was strongly associated with the viral load of contacts at baseline and shortened the incubation time of COVID-19 in a dose-dependent manner.
FUNDING
YoMeCorono, Generalitat de Catalunya.
TRANSLATIONS
For the Catalan translation of the abstract see Supplementary Materials section.
DOI: 10.1016/S1473-3099(20)30985-3
PubMed: 33545090
PubMed Central: PMC7906723
Affiliations:
- Espagne, Papouasie-Nouvelle-Guinée, Royaume-Uni
- Angleterre, Catalogne, Grand Londres
- Barcelone, Londres
Links toward previous steps (curation, corpus...)
Le document en format XML
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Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell</wicri:regionArea><wicri:noRegion>Sabadell</wicri:noRegion></affiliation></author><author><name sortKey="Ubals, Maria" sort="Ubals, Maria" uniqKey="Ubals M" first="Maria" last="Ubals">Maria Ubals</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona</wicri:regionArea><wicri:noRegion>Badalona</wicri:noRegion></affiliation></author><author><name sortKey="Tobias, Aurelio" sort="Tobias, Aurelio" uniqKey="Tobias A" first="Aurelio" last="Tobias">Aurelio Tobias</name><affiliation wicri:level="3"><nlm:affiliation>Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Tebe, Cristian" sort="Tebe, Cristian" uniqKey="Tebe C" first="Cristian" last="Tebé">Cristian Tebé</name><affiliation wicri:level="3"><nlm:affiliation>Biostatistics Unit, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Biostatistics Unit, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Ballana, Ester" sort="Ballana, Ester" uniqKey="Ballana E" first="Ester" last="Ballana">Ester Ballana</name><affiliation wicri:level="1"><nlm:affiliation>IrsiCaixa AIDS Research Institute, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>IrsiCaixa AIDS Research Institute, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona</wicri:regionArea><wicri:noRegion>Badalona</wicri:noRegion></affiliation></author><author><name sortKey="Bassat, Quique" sort="Bassat, Quique" uniqKey="Bassat Q" first="Quique" last="Bassat">Quique Bassat</name><affiliation wicri:level="3"><nlm:affiliation>Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona, Spain; Catalan Institution for Research and Advanced Studies, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona, Spain; Catalan Institution for Research and Advanced Studies, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Baro, Barbara" sort="Baro, Barbara" uniqKey="Baro B" first="Bàrbara" last="Baro">Bàrbara Baro</name><affiliation wicri:level="3"><nlm:affiliation>Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Vall Mayans, Marti" sort="Vall Mayans, Marti" uniqKey="Vall Mayans M" first="Martí" last="Vall-Mayans">Martí Vall-Mayans</name><affiliation wicri:level="1"><nlm:affiliation>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona</wicri:regionArea><wicri:noRegion>Badalona</wicri:noRegion></affiliation></author><author><name sortKey="G Beiras, Camila" sort="G Beiras, Camila" uniqKey="G Beiras C" first="Camila" last="G-Beiras">Camila G-Beiras</name><affiliation wicri:level="1"><nlm:affiliation>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Fight AIDS and Infectious Diseases Foundation, Badalona</wicri:regionArea><wicri:noRegion>Badalona</wicri:noRegion></affiliation></author><author><name sortKey="Prat, Nuria" sort="Prat, Nuria" uniqKey="Prat N" first="Nuria" last="Prat">Nuria Prat</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona</wicri:regionArea><wicri:noRegion>Badalona</wicri:noRegion></affiliation></author><author><name sortKey="Ara, Jordi" sort="Ara, Jordi" uniqKey="Ara J" first="Jordi" last="Ara">Jordi Ara</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona</wicri:regionArea><wicri:noRegion>Badalona</wicri:noRegion></affiliation></author><author><name sortKey="Clotet, Bonaventura" sort="Clotet, Bonaventura" uniqKey="Clotet B" first="Bonaventura" last="Clotet">Bonaventura Clotet</name><affiliation wicri:level="1"><nlm:affiliation>IrsiCaixa AIDS Research Institute, Badalona, Spain; Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Càtedra de Malalties Infeccioses i Immunitat, Universitat de Vic, Universtiat Central de Catalunya, Vic, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>IrsiCaixa AIDS Research Institute, Badalona, Spain; Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Càtedra de Malalties Infeccioses i Immunitat, Universitat de Vic, Universtiat Central de Catalunya, Vic</wicri:regionArea><wicri:noRegion>Vic</wicri:noRegion></affiliation></author><author><name sortKey="Mitja, Oriol" sort="Mitja, Oriol" uniqKey="Mitja O" first="Oriol" last="Mitjà">Oriol Mitjà</name><affiliation wicri:level="1"><nlm:affiliation>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Càtedra de Malalties Infeccioses i Immunitat, Universitat de Vic, Universtiat Central de Catalunya, Vic, Spain; Lihir Medical Centre, International SOS, Lihir Island, Papua New Guinea.</nlm:affiliation><country xml:lang="fr">Papouasie-Nouvelle-Guinée</country><wicri:regionArea>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Càtedra de Malalties Infeccioses i Immunitat, Universitat de Vic, Universtiat Central de Catalunya, Vic, Spain; Lihir Medical Centre, International SOS, Lihir Island</wicri:regionArea><wicri:noRegion>Lihir Island</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:33545090</idno><idno type="pmid">33545090</idno><idno type="doi">10.1016/S1473-3099(20)30985-3</idno><idno type="pmc">PMC7906723</idno><idno type="wicri:Area/Main/Corpus">000386</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000386</idno><idno type="wicri:Area/Main/Curation">000386</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000386</idno><idno type="wicri:Area/Main/Exploration">000386</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Transmission of COVID-19 in 282 clusters in Catalonia, Spain: a cohort study.</title><author><name sortKey="Marks, Michael" sort="Marks, Michael" uniqKey="Marks M" first="Michael" last="Marks">Michael Marks</name><affiliation wicri:level="3"><nlm:affiliation>Clinical Research Department, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Hospital for Tropical Diseases, University College London Hospital, London, UK. Electronic address: michael.marks@lshtm.ac.uk.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Clinical Research Department, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Hospital for Tropical Diseases, University College London Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Millat Martinez, Pere" sort="Millat Martinez, Pere" uniqKey="Millat Martinez P" first="Pere" last="Millat-Martinez">Pere Millat-Martinez</name><affiliation wicri:level="3"><nlm:affiliation>Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Ouchi, Dan" sort="Ouchi, Dan" uniqKey="Ouchi D" first="Dan" last="Ouchi">Dan Ouchi</name><affiliation wicri:level="1"><nlm:affiliation>IrsiCaixa AIDS Research Institute, Badalona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>IrsiCaixa AIDS Research Institute, Badalona</wicri:regionArea><wicri:noRegion>Badalona</wicri:noRegion></affiliation></author><author><name sortKey="Roberts, Chrissy H" sort="Roberts, Chrissy H" uniqKey="Roberts C" first="Chrissy H" last="Roberts">Chrissy H. Roberts</name><affiliation wicri:level="3"><nlm:affiliation>Clinical Research Department, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Clinical Research Department, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Alemany, Andrea" sort="Alemany, Andrea" uniqKey="Alemany A" first="Andrea" last="Alemany">Andrea Alemany</name><affiliation wicri:level="1"><nlm:affiliation>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Fight AIDS and Infectious Diseases Foundation, Badalona</wicri:regionArea><wicri:noRegion>Badalona</wicri:noRegion></affiliation></author><author><name sortKey="Corbacho Monne, Marc" sort="Corbacho Monne, Marc" uniqKey="Corbacho Monne M" first="Marc" last="Corbacho-Monné">Marc Corbacho-Monné</name><affiliation wicri:level="1"><nlm:affiliation>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell</wicri:regionArea><wicri:noRegion>Sabadell</wicri:noRegion></affiliation></author><author><name sortKey="Ubals, Maria" sort="Ubals, Maria" uniqKey="Ubals M" first="Maria" last="Ubals">Maria Ubals</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona</wicri:regionArea><wicri:noRegion>Badalona</wicri:noRegion></affiliation></author><author><name sortKey="Tobias, Aurelio" sort="Tobias, Aurelio" uniqKey="Tobias A" first="Aurelio" last="Tobias">Aurelio Tobias</name><affiliation wicri:level="3"><nlm:affiliation>Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Tebe, Cristian" sort="Tebe, Cristian" uniqKey="Tebe C" first="Cristian" last="Tebé">Cristian Tebé</name><affiliation wicri:level="3"><nlm:affiliation>Biostatistics Unit, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Biostatistics Unit, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Ballana, Ester" sort="Ballana, Ester" uniqKey="Ballana E" first="Ester" last="Ballana">Ester Ballana</name><affiliation wicri:level="1"><nlm:affiliation>IrsiCaixa AIDS Research Institute, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>IrsiCaixa AIDS Research Institute, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona</wicri:regionArea><wicri:noRegion>Badalona</wicri:noRegion></affiliation></author><author><name sortKey="Bassat, Quique" sort="Bassat, Quique" uniqKey="Bassat Q" first="Quique" last="Bassat">Quique Bassat</name><affiliation wicri:level="3"><nlm:affiliation>Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona, Spain; Catalan Institution for Research and Advanced Studies, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona, Spain; Catalan Institution for Research and Advanced Studies, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Baro, Barbara" sort="Baro, Barbara" uniqKey="Baro B" first="Bàrbara" last="Baro">Bàrbara Baro</name><affiliation wicri:level="3"><nlm:affiliation>Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Vall Mayans, Marti" sort="Vall Mayans, Marti" uniqKey="Vall Mayans M" first="Martí" last="Vall-Mayans">Martí Vall-Mayans</name><affiliation wicri:level="1"><nlm:affiliation>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona</wicri:regionArea><wicri:noRegion>Badalona</wicri:noRegion></affiliation></author><author><name sortKey="G Beiras, Camila" sort="G Beiras, Camila" uniqKey="G Beiras C" first="Camila" last="G-Beiras">Camila G-Beiras</name><affiliation wicri:level="1"><nlm:affiliation>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Fight AIDS and Infectious Diseases Foundation, Badalona</wicri:regionArea><wicri:noRegion>Badalona</wicri:noRegion></affiliation></author><author><name sortKey="Prat, Nuria" sort="Prat, Nuria" uniqKey="Prat N" first="Nuria" last="Prat">Nuria Prat</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona</wicri:regionArea><wicri:noRegion>Badalona</wicri:noRegion></affiliation></author><author><name sortKey="Ara, Jordi" sort="Ara, Jordi" uniqKey="Ara J" first="Jordi" last="Ara">Jordi Ara</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona</wicri:regionArea><wicri:noRegion>Badalona</wicri:noRegion></affiliation></author><author><name sortKey="Clotet, Bonaventura" sort="Clotet, Bonaventura" uniqKey="Clotet B" first="Bonaventura" last="Clotet">Bonaventura Clotet</name><affiliation wicri:level="1"><nlm:affiliation>IrsiCaixa AIDS Research Institute, Badalona, Spain; Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Càtedra de Malalties Infeccioses i Immunitat, Universitat de Vic, Universtiat Central de Catalunya, Vic, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>IrsiCaixa AIDS Research Institute, Badalona, Spain; Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Càtedra de Malalties Infeccioses i Immunitat, Universitat de Vic, Universtiat Central de Catalunya, Vic</wicri:regionArea><wicri:noRegion>Vic</wicri:noRegion></affiliation></author><author><name sortKey="Mitja, Oriol" sort="Mitja, Oriol" uniqKey="Mitja O" first="Oriol" last="Mitjà">Oriol Mitjà</name><affiliation wicri:level="1"><nlm:affiliation>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Càtedra de Malalties Infeccioses i Immunitat, Universitat de Vic, Universtiat Central de Catalunya, Vic, Spain; Lihir Medical Centre, International SOS, Lihir Island, Papua New Guinea.</nlm:affiliation><country xml:lang="fr">Papouasie-Nouvelle-Guinée</country><wicri:regionArea>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Càtedra de Malalties Infeccioses i Immunitat, Universitat de Vic, Universtiat Central de Catalunya, Vic, Spain; Lihir Medical Centre, International SOS, Lihir Island</wicri:regionArea><wicri:noRegion>Lihir Island</wicri:noRegion></affiliation></author></analytic><series><title level="j">The Lancet. Infectious diseases</title><idno type="eISSN">1474-4457</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>COVID-19 (epidemiology)</term><term>COVID-19 (transmission)</term><term>Cohort Studies (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Incidence (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>SARS-CoV-2 (MeSH)</term><term>Spain (epidemiology)</term><term>Viral Load (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Charge virale (MeSH)</term><term>Espagne (épidémiologie)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Incidence (MeSH)</term><term>Mâle (MeSH)</term><term>Études de cohortes (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Spain</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="transmission" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Espagne</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Cohort Studies</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Male</term><term>Middle Aged</term><term>SARS-CoV-2</term><term>Viral Load</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Charge virale</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Mâle</term><term>Études de cohortes</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Espagne</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Scarce data are available on what variables affect the risk of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the development of symptomatic COVID-19, and, particularly, the relationship with viral load. We aimed to analyse data from linked index cases of COVID-19 and their contacts to explore factors associated with transmission of SARS-CoV-2.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>In this cohort study, patients were recruited as part of a randomised controlled trial done between March 17 and April 28, 2020, that aimed to assess if hydroxychloroquine reduced transmission of SARS-CoV-2. Patients with COVID-19 and their contacts were identified by use of the electronic registry of the Epidemiological Surveillance Emergency Service of Catalonia (Spain). Patients with COVID-19 included in our analysis were aged 18 years or older, not hospitalised, had quantitative PCR results available at baseline, had mild symptom onset within 5 days before enrolment, and had no reported symptoms of SARS-CoV-2 infections in their accommodation or workplace within the 14 days before enrolment. Contacts included were adults with a recent history of exposure and absence of COVID-19-like symptoms within the 7 days preceding enrolment. Viral load of contacts, measured by quantitative PCR from a nasopharyngeal swab, was assessed at enrolment, at day 14, and whenever the participant reported COVID-19-like symptoms. We assessed risk of transmission and developing symptomatic disease and incubation dynamics using regression analysis. We assessed the relationship of viral load and characteristics of cases (age, sex, number of days from reported symptom onset, and presence or absence of fever, cough, dyspnoea, rhinitis, and anosmia) and associations between risk of transmission and characteristics of the index case and contacts.</p></div><div type="abstract" xml:lang="en"><p><b>FINDINGS</b></p><p>We identified 314 patients with COVID-19, with 282 (90%) having at least one contact (753 contacts in total), resulting in 282 clusters. 90 (32%) of 282 clusters had at least one transmission event. The secondary attack rate was 17% (125 of 753 contacts), with a variation from 12% when the index case had a viral load lower than 1 × 10</p></div><div type="abstract" xml:lang="en"><p><b>INTERPRETATION</b></p><p>In our study, the viral load of index cases was a leading driver of SARS-CoV-2 transmission. The risk of symptomatic COVID-19 was strongly associated with the viral load of contacts at baseline and shortened the incubation time of COVID-19 in a dose-dependent manner.</p></div><div type="abstract" xml:lang="en"><p><b>FUNDING</b></p><p>YoMeCorono, Generalitat de Catalunya.</p></div><div type="abstract" xml:lang="en"><p><b>TRANSLATIONS</b></p><p>For the Catalan translation of the abstract see Supplementary Materials section.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">33545090</PMID><DateCompleted><Year>2021</Year><Month>05</Month><Day>03</Day></DateCompleted><DateRevised><Year>2021</Year><Month>05</Month><Day>08</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1474-4457</ISSN><JournalIssue CitedMedium="Internet"><Volume>21</Volume><Issue>5</Issue><PubDate><Year>2021</Year><Month>05</Month></PubDate></JournalIssue><Title>The Lancet. Infectious diseases</Title><ISOAbbreviation>Lancet Infect Dis</ISOAbbreviation></Journal><ArticleTitle>Transmission of COVID-19 in 282 clusters in Catalonia, Spain: a cohort study.</ArticleTitle><Pagination><MedlinePgn>629-636</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S1473-3099(20)30985-3</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/S1473-3099(20)30985-3</ELocationID><Abstract><AbstractText Label="BACKGROUND">Scarce data are available on what variables affect the risk of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the development of symptomatic COVID-19, and, particularly, the relationship with viral load. We aimed to analyse data from linked index cases of COVID-19 and their contacts to explore factors associated with transmission of SARS-CoV-2.</AbstractText><AbstractText Label="METHODS">In this cohort study, patients were recruited as part of a randomised controlled trial done between March 17 and April 28, 2020, that aimed to assess if hydroxychloroquine reduced transmission of SARS-CoV-2. Patients with COVID-19 and their contacts were identified by use of the electronic registry of the Epidemiological Surveillance Emergency Service of Catalonia (Spain). Patients with COVID-19 included in our analysis were aged 18 years or older, not hospitalised, had quantitative PCR results available at baseline, had mild symptom onset within 5 days before enrolment, and had no reported symptoms of SARS-CoV-2 infections in their accommodation or workplace within the 14 days before enrolment. Contacts included were adults with a recent history of exposure and absence of COVID-19-like symptoms within the 7 days preceding enrolment. Viral load of contacts, measured by quantitative PCR from a nasopharyngeal swab, was assessed at enrolment, at day 14, and whenever the participant reported COVID-19-like symptoms. We assessed risk of transmission and developing symptomatic disease and incubation dynamics using regression analysis. We assessed the relationship of viral load and characteristics of cases (age, sex, number of days from reported symptom onset, and presence or absence of fever, cough, dyspnoea, rhinitis, and anosmia) and associations between risk of transmission and characteristics of the index case and contacts.</AbstractText><AbstractText Label="FINDINGS">We identified 314 patients with COVID-19, with 282 (90%) having at least one contact (753 contacts in total), resulting in 282 clusters. 90 (32%) of 282 clusters had at least one transmission event. The secondary attack rate was 17% (125 of 753 contacts), with a variation from 12% when the index case had a viral load lower than 1 × 10<sup>6</sup> copies per mL to 24% when the index case had a viral load of 1 × 10<sup>10</sup> copies per mL or higher (adjusted odds ratio per log<sub>10</sub> increase in viral load 1·3, 95% CI 1·1-1·5). Increased risk of transmission was also associated with household contact (3·0, 1·59-5·65) and age of the contact (per year: 1·02, 1·01-1·04). 449 contacts had a positive PCR result at baseline. 28 (6%) of 449 contacts had symptoms at the first visit. Of 421 contacts who were asymptomatic at the first visit, 181 (43%) developed symptomatic COVID-19, with a variation from approximately 38% in contacts with an initial viral load lower than 1 × 10<sup>7</sup> copies per mL to greater than 66% for those with an initial viral load of 1 × 10<sup>10</sup> copies per mL or higher (hazard ratio per log<sub>10</sub> increase in viral load 1·12, 95% CI 1·05-1·20; p=0·0006). Time to onset of symptomatic disease decreased from a median of 7 days (IQR 5-10) for individuals with an initial viral load lower than 1 × 10<sup>7</sup> copies per mL to 6 days (4-8) for those with an initial viral load between 1 × 10<sup>7</sup> and 1 × 10<sup>9</sup> copies per mL, and 5 days (3-8) for those with an initial viral load higher than 1 × 10<sup>9</sup> copies per mL.</AbstractText><AbstractText Label="INTERPRETATION">In our study, the viral load of index cases was a leading driver of SARS-CoV-2 transmission. The risk of symptomatic COVID-19 was strongly associated with the viral load of contacts at baseline and shortened the incubation time of COVID-19 in a dose-dependent manner.</AbstractText><AbstractText Label="FUNDING">YoMeCorono, Generalitat de Catalunya.</AbstractText><AbstractText Label="TRANSLATIONS">For the Catalan translation of the abstract see Supplementary Materials section.</AbstractText><CopyrightInformation>Copyright © 2021 Elsevier Ltd. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Marks</LastName><ForeName>Michael</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Clinical Research Department, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Hospital for Tropical Diseases, University College London Hospital, London, UK. Electronic address: michael.marks@lshtm.ac.uk.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Millat-Martinez</LastName><ForeName>Pere</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ouchi</LastName><ForeName>Dan</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>IrsiCaixa AIDS Research Institute, Badalona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Roberts</LastName><ForeName>Chrissy H</ForeName><Initials>CH</Initials><AffiliationInfo><Affiliation>Clinical Research Department, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Alemany</LastName><ForeName>Andrea</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Corbacho-Monné</LastName><ForeName>Marc</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ubals</LastName><ForeName>Maria</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tobias</LastName><ForeName>Aurelio</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tebé</LastName><ForeName>Cristian</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Biostatistics Unit, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ballana</LastName><ForeName>Ester</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>IrsiCaixa AIDS Research Institute, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bassat</LastName><ForeName>Quique</ForeName><Initials>Q</Initials><AffiliationInfo><Affiliation>Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona, Spain; Catalan Institution for Research and Advanced Studies, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Baro</LastName><ForeName>Bàrbara</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vall-Mayans</LastName><ForeName>Martí</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>G-Beiras</LastName><ForeName>Camila</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Prat</LastName><ForeName>Nuria</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ara</LastName><ForeName>Jordi</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Clotet</LastName><ForeName>Bonaventura</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>IrsiCaixa AIDS Research Institute, Badalona, Spain; Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Càtedra de Malalties Infeccioses i Immunitat, Universitat de Vic, Universtiat Central de Catalunya, Vic, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mitjà</LastName><ForeName>Oriol</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Fight AIDS and Infectious Diseases Foundation, Badalona, Spain; Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Càtedra de Malalties Infeccioses i Immunitat, Universitat de Vic, Universtiat Central de Catalunya, Vic, Spain; Lihir Medical Centre, International SOS, Lihir Island, Papua New Guinea.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>02</Month><Day>02</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Lancet Infect Dis</MedlineTA><NlmUniqueID>101130150</NlmUniqueID><ISSNLinking>1473-3099</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Lancet Infect Dis. 2021 May;21(5):580-581</RefSource><PMID Version="1">33545091</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000635" MajorTopicYN="Y">transmission</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort 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IdType="pmc">PMC7906723</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Euro Surveill. 2020 Feb;25(5):</Citation><ArticleIdList><ArticleId IdType="pubmed">32046819</ArticleId></ArticleIdList></Reference><Reference><Citation>PLoS Med. 2020 Sep 22;17(9):e1003346</Citation><ArticleIdList><ArticleId IdType="pubmed">32960881</ArticleId></ArticleIdList></Reference><Reference><Citation>Lancet Infect Dis. 2020 Aug;20(8):911-919</Citation><ArticleIdList><ArticleId IdType="pubmed">32353347</ArticleId></ArticleIdList></Reference><Reference><Citation>Water Res. 2020 Jul 15;179:115899</Citation><ArticleIdList><ArticleId IdType="pubmed">32361598</ArticleId></ArticleIdList></Reference><Reference><Citation>Nature. 2020 May;581(7809):465-469</Citation><ArticleIdList><ArticleId IdType="pubmed">32235945</ArticleId></ArticleIdList></Reference><Reference><Citation>Wellcome Open Res. 2020 May 1;5:83</Citation><ArticleIdList><ArticleId IdType="pubmed">32656368</ArticleId></ArticleIdList></Reference><Reference><Citation>Emerg Infect Dis. 2020 Aug;26(8):1666-1670</Citation><ArticleIdList><ArticleId IdType="pubmed">32324530</ArticleId></ArticleIdList></Reference><Reference><Citation>Infect Control Hosp Epidemiol. 2020 May;41(5):594-596</Citation><ArticleIdList><ArticleId IdType="pubmed">32183920</ArticleId></ArticleIdList></Reference><Reference><Citation>J Infect. 2020 Jun;80(6):e1-e13</Citation><ArticleIdList><ArticleId IdType="pubmed">32283156</ArticleId></ArticleIdList></Reference><Reference><Citation>JAMA Intern Med. 2020 Sep 1;180(9):1156-1163</Citation><ArticleIdList><ArticleId IdType="pubmed">32356867</ArticleId></ArticleIdList></Reference><Reference><Citation>Indoor Air. 2021 May;31(3):639-645</Citation><ArticleIdList><ArticleId IdType="pubmed">33131151</ArticleId></ArticleIdList></Reference><Reference><Citation>N Engl J Med. 2021 Feb 4;384(5):417-427</Citation><ArticleIdList><ArticleId IdType="pubmed">33289973</ArticleId></ArticleIdList></Reference><Reference><Citation>Eur J Clin Microbiol Infect Dis. 2020 Jun;39(6):1059-1061</Citation><ArticleIdList><ArticleId IdType="pubmed">32342252</ArticleId></ArticleIdList></Reference><Reference><Citation>Postgrad Med J. 2020 Dec;96(1142):753-758</Citation><ArticleIdList><ArticleId IdType="pubmed">32563999</ArticleId></ArticleIdList></Reference><Reference><Citation>Eur J Gen Pract. 2020 Dec;26(1):106-107</Citation><ArticleIdList><ArticleId IdType="pubmed">32715802</ArticleId></ArticleIdList></Reference><Reference><Citation>Clin Infect Dis. 2020 Nov 19;71(16):2099-2108</Citation><ArticleIdList><ArticleId IdType="pubmed">32392331</ArticleId></ArticleIdList></Reference><Reference><Citation>N Engl J Med. 2020 Mar 26;382(13):1199-1207</Citation><ArticleIdList><ArticleId IdType="pubmed">31995857</ArticleId></ArticleIdList></Reference><Reference><Citation>Int J Infect Dis. 2020 Oct;99:374-380</Citation><ArticleIdList><ArticleId IdType="pubmed">32768702</ArticleId></ArticleIdList></Reference><Reference><Citation>MMWR Morb Mortal Wkly Rep. 2020 May 15;69(19):606-610</Citation><ArticleIdList><ArticleId IdType="pubmed">32407303</ArticleId></ArticleIdList></Reference><Reference><Citation>Lancet. 2020 Jun 27;395(10242):1973-1987</Citation><ArticleIdList><ArticleId IdType="pubmed">32497510</ArticleId></ArticleIdList></Reference><Reference><Citation>Lancet Infect Dis. 2020 Aug;20(8):920-928</Citation><ArticleIdList><ArticleId IdType="pubmed">32422201</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Espagne</li><li>Papouasie-Nouvelle-Guinée</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Catalogne</li><li>Grand Londres</li></region><settlement><li>Barcelone</li><li>Londres</li></settlement></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Marks, Michael" sort="Marks, Michael" uniqKey="Marks M" first="Michael" last="Marks">Michael Marks</name></region><name sortKey="Roberts, Chrissy H" sort="Roberts, Chrissy H" uniqKey="Roberts C" first="Chrissy H" last="Roberts">Chrissy H. Roberts</name></country><country name="Espagne"><region name="Catalogne"><name sortKey="Millat Martinez, Pere" sort="Millat Martinez, Pere" uniqKey="Millat Martinez P" first="Pere" last="Millat-Martinez">Pere Millat-Martinez</name></region><name sortKey="Alemany, Andrea" sort="Alemany, Andrea" uniqKey="Alemany A" first="Andrea" last="Alemany">Andrea Alemany</name><name sortKey="Ara, Jordi" sort="Ara, Jordi" uniqKey="Ara J" first="Jordi" last="Ara">Jordi Ara</name><name sortKey="Ballana, Ester" sort="Ballana, Ester" uniqKey="Ballana E" first="Ester" last="Ballana">Ester Ballana</name><name sortKey="Baro, Barbara" sort="Baro, Barbara" uniqKey="Baro B" first="Bàrbara" last="Baro">Bàrbara Baro</name><name sortKey="Bassat, Quique" sort="Bassat, Quique" uniqKey="Bassat Q" first="Quique" last="Bassat">Quique Bassat</name><name sortKey="Clotet, Bonaventura" sort="Clotet, Bonaventura" uniqKey="Clotet B" first="Bonaventura" last="Clotet">Bonaventura Clotet</name><name sortKey="Corbacho Monne, Marc" sort="Corbacho Monne, Marc" uniqKey="Corbacho Monne M" first="Marc" last="Corbacho-Monné">Marc Corbacho-Monné</name><name sortKey="G Beiras, Camila" sort="G Beiras, Camila" uniqKey="G Beiras C" first="Camila" last="G-Beiras">Camila G-Beiras</name><name sortKey="Ouchi, Dan" sort="Ouchi, Dan" uniqKey="Ouchi D" first="Dan" last="Ouchi">Dan Ouchi</name><name sortKey="Prat, Nuria" sort="Prat, Nuria" uniqKey="Prat N" first="Nuria" last="Prat">Nuria Prat</name><name sortKey="Tebe, Cristian" sort="Tebe, Cristian" uniqKey="Tebe C" first="Cristian" last="Tebé">Cristian Tebé</name><name sortKey="Tobias, Aurelio" sort="Tobias, Aurelio" uniqKey="Tobias A" first="Aurelio" last="Tobias">Aurelio Tobias</name><name sortKey="Ubals, Maria" sort="Ubals, Maria" uniqKey="Ubals M" first="Maria" last="Ubals">Maria Ubals</name><name sortKey="Vall Mayans, Marti" sort="Vall Mayans, Marti" uniqKey="Vall Mayans M" first="Martí" last="Vall-Mayans">Martí Vall-Mayans</name></country><country name="Papouasie-Nouvelle-Guinée"><noRegion><name sortKey="Mitja, Oriol" sort="Mitja, Oriol" uniqKey="Mitja O" first="Oriol" last="Mitjà">Oriol Mitjà</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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