@Article{info:doi/10.2196/53837,
author="Major, Chelsea G
and Rodr{\'i}guez, Dania M
and S{\'a}nchez-Gonz{\'a}lez, Liliana
and Rodr{\'i}guez-Estrada, Vanessa
and Morales-Ort{\'i}z, Tatiana
and Torres, Carolina
and P{\'e}rez-Rodr{\'i}guez, Nicole M
and Medina-L{\'o}pes, Nicole A
and Alexander, Neal
and Mabey, David
and Ryff, Kyle
and Tosado-Acevedo, Rafael
and Mu{\~{n}}oz-Jord{\'a}n, Jorge
and Adams, Laura E
and Rivera-Amill, Vanessa
and Rolfes, Melissa
and Paz-Bailey, Gabriela",
title="Investigating SARS-CoV-2 Incidence and Morbidity in Ponce, Puerto Rico: Protocol and Baseline Results From a Community Cohort Study",
journal="JMIR Res Protoc",
year="2024",
month="Apr",
day="19",
volume="13",
pages="e53837",
keywords="cohort studies; COVID-19; epidemiologic studies; Hispanic or Latino; incidence; prospective studies; research methodology; SARS-CoV-2; seroprevalence",
abstract="Background: A better understanding of SARS-CoV-2 infection risk among Hispanic and Latino populations and in low-resource settings in the United States is needed to inform control efforts and strategies to improve health equity. Puerto Rico has a high poverty rate and other population characteristics associated with increased vulnerability to COVID-19, and there are limited data to date to determine community incidence. Objective: This study describes the protocol and baseline seroprevalence of SARS-CoV-2 in a prospective community-based cohort study (COPA COVID-19 [COCOVID] study) to investigate SARS-CoV-2 infection incidence and morbidity in Ponce, Puerto Rico. Methods: In June 2020, we implemented the COCOVID study within the Communities Organized to Prevent Arboviruses project platform among residents of 15 communities in Ponce, Puerto Rico, aged 1 year or older. Weekly, participants answered questionnaires on acute symptoms and preventive behaviors and provided anterior nasal swab samples for SARS-CoV-2 polymerase chain reaction testing; additional anterior nasal swabs were collected for expedited polymerase chain reaction testing from participants that reported 1 or more COVID-19--like symptoms. At enrollment and every 6 months during follow-up, participants answered more comprehensive questionnaires and provided venous blood samples for multiantigen SARS-CoV-2 immunoglobulin G antibody testing (an indicator of seroprevalence). Weekly follow-up activities concluded in April 2022 and 6-month follow-up visits concluded in August 2022. Primary study outcome measures include SARS-CoV-2 infection incidence and seroprevalence, relative risk of SARS-CoV-2 infection by participant characteristics, SARS-CoV-2 household attack rate, and COVID-19 illness characteristics and outcomes. In this study, we describe the characteristics of COCOVID participants overall and by SARS-CoV-2 seroprevalence status at baseline. Results: We enrolled a total of 1030 participants from 388 households. Relative to the general populations of Ponce and Puerto Rico, our cohort overrepresented middle-income households, employed and middle-aged adults, and older children (P<.001). Almost all participants (1021/1025, 99.61{\%}) identified as Latino/a, 17.07{\%} (175/1025) had annual household incomes less than US {\$}10,000, and 45.66{\%} (463/1014) reported 1 or more chronic medical conditions. Baseline SARS-CoV-2 seroprevalence was low (16/1030, 1.55{\%}) overall and increased significantly with later study enrollment time (P=.003). Conclusions: The COCOVID study will provide a valuable opportunity to better estimate the burden of SARS-CoV-2 and associated risk factors in a primarily Hispanic or Latino population, assess the limitations of surveillance, and inform mitigation measures in Puerto Rico and other similar populations. International Registered Report Identifier (IRRID): RR1-10.2196/53837 ",
issn="1929-0748",
doi="10.2196/53837",
url="https://www.researchprotocols.org/2024/1/e53837",
url="https://doi.org/10.2196/53837",
url="http://www.ncbi.nlm.nih.gov/pubmed/38640475"
}