%0 Journal Article
%@ 1929-0748
%I JMIR Publications
%V 13
%N 
%P e53837
%T Investigating SARS-CoV-2 Incidence and Morbidity in Ponce, Puerto Rico: Protocol and Baseline Results From a Community Cohort Study
%A Major,Chelsea G
%A Rodríguez,Dania M
%A Sánchez-González,Liliana
%A Rodríguez-Estrada,Vanessa
%A Morales-Ortíz,Tatiana
%A Torres,Carolina
%A Pérez-Rodríguez,Nicole M
%A Medina-Lópes,Nicole A
%A Alexander,Neal
%A Mabey,David
%A Ryff,Kyle
%A Tosado-Acevedo,Rafael
%A Muñoz-Jordán,Jorge
%A Adams,Laura E
%A Rivera-Amill,Vanessa
%A Rolfes,Melissa
%A Paz-Bailey,Gabriela
%+ Division of Vector Borne Diseases, Centers for Disease Control and Prevention, 1324 Calle Cañada, San Juan, 00920, Puerto Rico, 1 787 706 2254, lhi5@cdc.gov
%K cohort studies
%K COVID-19
%K epidemiologic studies
%K Hispanic or Latino
%K incidence
%K prospective studies
%K research methodology
%K SARS-CoV-2
%K seroprevalence
%D 2024
%7 19.4.2024
%9 Protocol
%J JMIR Res Protoc
%G English
%X 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 
%M 38640475
%R 10.2196/53837
%U https://www.researchprotocols.org/2024/1/e53837
%U https://doi.org/10.2196/53837
%U http://www.ncbi.nlm.nih.gov/pubmed/38640475