Case-control study to identify risk factors for SARS-CoV-2 infection among university students in the northeastern USA

Kevin J Cummings; Marin Clarkberg; Jefferson Busche; Alexander J Travis; Genevive R Meredith; Isaac Weisfuse; Casey L Cazer; Gary A Koretzky; Lorin D Warnick

doi:10.1111/tbed.14619

Case-control study to identify risk factors for SARS-CoV-2 infection among university students in the northeastern USA

Transbound Emerg Dis. 2022 Sep;69(5):e2688-e2693. doi: 10.1111/tbed.14619. Epub 2022 Jun 29.

Authors

Kevin J Cummings¹, Marin Clarkberg¹, Jefferson Busche¹, Alexander J Travis¹, Genevive R Meredith¹, Isaac Weisfuse¹, Casey L Cazer¹, Gary A Koretzky¹, Lorin D Warnick¹

Affiliation

¹ Cornell University, Ithaca, New York, USA.

Abstract

Curbing the coronavirus disease 2019 (COVID-19) pandemic requires a thorough understanding of risk factors for transmission of SARS-CoV-2, the etiologic agent. Institutions of higher education present unique challenges for controlling disease spread because of features inherent to these settings. Our objective was to determine risk factors for SARS-CoV-2 infection among a university student population in the northeastern USA during the spring and fall 2021 semesters, using the case-control study design. Cases were defined as students with a newly diagnosed SARS-CoV-2 infection detected either through the robust PCR-based surveillance testing program on campus or through healthcare testing if symptoms compatible with COVID-19 were present. Controls were defined as students with negative SARS-CoV-2 status, based on consistently negative PCR results at the time of selection. A comprehensive questionnaire was administered to each student enrolled in the study, covering a broad range of campus life activities. A total of 446 cases and 1,185 controls were included in this study. Multivariable logistic regression analysis showed that recent party attendance (adjusted OR = 2.3, p < .0001), recently visiting a bar (aOR = 1.6, p = .007), living in a campus residence hall (aOR = 1.6, p = .001), fraternity/sorority membership (aOR = 1.8, p = .002), and recent travel (aOR = 1.3, p = .04) were associated with being a COVID-19 case. Having an on-campus job was negatively associated with being a COVID-19 case (aOR = 0.6, p = .0003). Among cases, the most commonly reported symptoms were cough (43.9%), fatigue (38.1%) and sore throat (30.3%). These findings can be used to inform the development of COVID-19 mitigation strategies and public health outreach efforts in university settings, thus reducing SARS-CoV-2 transmission among students and helping to preserve the vital education and research missions of these institutions.

Keywords: COVID-19; SARS-CoV-2; case-control study; epidemiology; public health; risk factors.

MeSH terms

Animals
COVID-19* / epidemiology
COVID-19* / veterinary
Case-Control Studies
Humans
Risk Factors
SARS-CoV-2
Students
Universities