Predictors of SARS-CoV-2 Infection in University Students: A Case-Control Study

Abstract

Closure of Higher Education Institutions in the early phase of the SARS-CoV-2 pandemic was largely diffused. With their reopening, numerous preventive measures have been enacted, but limited evidence exists on students’ behavior that could influence their infection risk. We conducted a case-control study at the Sapienza University of Rome to identify protective and risk factors for SARS-CoV-2 infection. Students attending the campus within 48 h of SARS-CoV-2 infection were considered cases. Controls were students who come in contact with a confirmed case within the campus. Demographic features and activities carried out before positivity or contact were investigated. Multivariable logistic regression models were built to identify factors associated with SARS-CoV-2 infection, estimating adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). The analysis showed an increased risk of SARS-CoV-2 infection for attending the second year or above of university (aOR 17.7, 95% CI 2.21–142.82) and participating in private parties or ceremonies (aOR 15.9, 95% CI 2.30–109.67) while living outside the family (aOR 0.08, 95% CI 0.01–0.54) and attending practical activities or libraries on campus (aOR 0.29, 95% CI 0.08–0.97) reduced the risk. Data strongly suggests that it may be safe to participate in activities organized under strict infection prevention guidelines. Tailored preventmeasuressure might reduce the risk of infection in university students.

Keeping university open did not increase the risk of SARS-CoV-2 acquisition: A test negative case-control study among students

“…Our results clearly indicate that students who attended lectures on the university campus were less likely to become infected. This findings, in line with other previous analytic studies performed at Sapienza during the second and third waves of the pandemic in Italy [ 17 , 19 ], could be explained by the numerous preventive measures implemented within the university to encourage safe reopening: 50% reduction in classroom capacity; hybrid face-to-face/at-distance lectures; low occupancy of all indoor spaces (libraries, laboratories, refreshment areas) and enforcement of face-mask wearing within all campus premises. A widespread campaign was enacted by Sapienza University to encourage students to focus on a combined four-part strategy: washing hands, staying at home in case of signs or symptoms suggestive of COVID-19, physical distancing, and continuous mask use [ 46 ].…”

“…More in line with the existing literature is the lack of an association with other social activities, such as shopping [ 4 , 5 , 7 – 9 , 12 ], attending indoor sports activities [ 5 , 7 , 8 , 12 ], and using public transport [ 4 , 5 , 7 ]. Overall these data seem to indicate a minimal risk when visiting places that implement strict preventive measures such as mandatory use of face masks and physical distancing, reduction of maximum capacity, and regulation of access by means of the EU digital COVID certificate [ 4 , 8 , 12 , 15 , 17 , 19 ].…”

“…After the release of the anti-COVID-19 vaccine, the campaign was modified to include active promotion of vaccination adherence by students and university staff [47]. Additionally, a free SARS-CoV-2 testing program for all asymptomatic students and a surveillance system for SARS-CoV-2 cases among students and university staff were instituted during the early stages of the COVID-19 response [17][18][19], to facilitate the test-trace-isolate-quarantine strategy, activities that may have been particularly useful in contrasting the virus spread in those scenarios with a high virus circulation such as the winter of 2022, during which we registered the highest number of positive cases. Overall, these measures seem contributed to maintaining a safe environment on the campus and may have induced a less risky behavior also outside the university.…”

“…In this context, the identification of risk factors for the transmission of SARS-CoV-2 infection is crucial to guide health policy decisions aimed at limiting virus transmission and, at the same time, preserving the normal activities of everyday life as far as possible [2,3]. However, few analytical epidemiological studies have been conducted worldwide to investigate the risk factors for SARS-CoV-2 acquisition [4][5][6][7][8][9][10][11][12][13], particularly in healthy individuals attending community settings and areas posing unique challenges for transmission control, such as schools [14][15][16] and higher education institutions (HEIs) [17][18][19][20].…”

Serological Survey in a university community after the fourth wave of COVID-19 in Senegal

“…This information is helpful in identifying the epidemic phases and can help the authorities make decisions and even anticipate appropriate measures to contain the pandemic's spread [24]. Seroepidemiological studies have been conducted in academic institutions such as universities in many countries [25][26][27][28]. However, more studies are highly relevant because university communities (faculty, staff and students) could be among the most exposed to SARS-CoV-2.…”