Evidence map›Paper›PMID 32923993›Full record

ArticleEClinicalMedicine2020

Investigation of SARS-CoV-2 outbreaks in six care homes in London, April 2020.

Shamez N Ladhani, J Yimmy Chow, Roshni Janarthanan, Jonathan Fok, Emma Crawley-Boevey, Amoolya Vusirikala, Elena Fernandez, Marina Sanchez Perez, Suzanne Tang, Kate Dun-Campbell and 20 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EClinicalMedicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis.Proceedings of the National Academy of Sciences of the United States of America · 2021
    Pooled it
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  11. Analysis of Concentrated COVID-19 Outbreaks in Elderly Facilities in Suita City, Osaka Prefecture, Japan.International journal of environmental research and public health · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Shamez N LadhaniImmunisation and Countermeasures Division, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom.
J Yimmy ChowLondon Health Protection team, Public Health England, London, UK.
Roshni JanarthananLondon Health Protection team, Public Health England, London, UK.
Jonathan FokLondon Health Protection team, Public Health England, London, UK.
Emma Crawley-BoeveyLondon Health Protection team, Public Health England, London, UK.
Amoolya VusirikalaLondon Health Protection team, Public Health England, London, UK.
Elena FernandezLondon Health Protection team, Public Health England, London, UK.
Marina Sanchez PerezLondon Health Protection team, Public Health England, London, UK.
Suzanne TangLondon Health Protection team, Public Health England, London, UK.
Kate Dun-CampbellLondon Health Protection team, Public Health England, London, UK.
Edward Wynne- EvansLondon Health Protection team, Public Health England, London, UK.
Anita BellLondon Health Protection team, Public Health England, London, UK.
Bharat PatelLondon Health Protection team, Public Health England, London, UK.
Zahin Amin-ChowdhuryImmunisation and Countermeasures Division, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom.
Felicity AianoImmunisation and Countermeasures Division, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom.
Karthik ParanthamanField Service, National Infection Service, Public Health England, London, UK.
Thomas MaField Service, National Infection Service, Public Health England, London, UK.
Maria Saavedra-CamposField Service, National Infection Service, Public Health England, London, UK.
Richard MyersInfectious Disease Informatics, Public Health England, London, UK.
Joanna EllisVirus Reference Department, Public Health England, London, UK.
Angie LackenbyVirus Reference Department, Public Health England, London, UK.
Robin GopalVirus Reference Department, Public Health England, London, UK.
Monika PatelVirus Reference Department, Public Health England, London, UK.
Colin BrownAntimicrobial Resistance and Hospital Acquired Infection Department, Public Health England, London, UK.
Meera ChandAntimicrobial Resistance and Hospital Acquired Infection Department, Public Health England, London, UK.
Kevin BrownVirus Reference Department, Public Health England, London, UK.
Mary E RamsayImmunisation and Countermeasures Division, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom.
Susan HopkinsAntimicrobial Resistance and Hospital Acquired Infection Department, Public Health England, London, UK.
Nandini ShettyVirus Reference Department, Public Health England, London, UK.
Maria ZambonVirus Reference Department, Public Health England, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCare homes are experiencing large outbreaks of COVID-19 associated with high case-fatality rates. We conducted detailed investigations in six London care homes reporting suspected COVID-19 outbreaks during April 2020.

methodsResidents and staff had nasal swabs for SARS CoV-2 testing using RT-PCR and were followed-up for 14 days. They were categorized as symptomatic, post-symptomatic or pre-symptomatic if they had symptoms at the time of testing, in the two weeks before or two weeks after testing, respectively, or asymptomatic throughout. Virus isolation and whole genome sequencing (WGS) was also performed.

findingsAcross the six care homes, 105/264 (39.8%) residents were SARS CoV-2 positive, including 28 (26.7%) symptomatic, 10 (9.5%) post-symptomatic, 21 (20.0%) pre-symptomatic and 46 (43.8%) who remained asymptomatic. Case-fatality at 14-day follow-up was highest among symptomatic SARS-CoV-2 positive residents (10/28, 35.7%) compared to asymptomatic (2/46, 4.3%), post-symptomatic (2/10, 20.0%) or pre-symptomatic (3/21,14.3%) residents. Among staff, 53/254 (20.9%) were SARS-CoV-2 positive and 26/53 (49.1%) remained asymptomatic. RT-PCR cycle-thresholds and live-virus recovery were similar between symptomatic/asymptomatic residents/staff. Higher RT-PCR cycle threshold values (lower virus load) samples were associated with exponentially decreasing ability to recover infectious virus (

interpretationA high prevalence of SARS-CoV-2 positivity was found in care homes residents and staff, half of whom were asymptomatic and potential reservoirs for on-going transmission. A third of symptomatic SARS-CoV-2 residents died within 14 days. Symptom-based screening alone is not sufficient for outbreak control.

fundingNone.

Indexed as

Care homesCase-fatality rateCovid-19Symptoms

Identifiers

PMID32923993
PMCPMC7480335

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.