Test-to-Stay After SARS-CoV-2 Exposure: A Mitigation Strategy for Optionally Masked K-12 Schools.

2022

08/2022

1098-4275

OBJECTIVES: We evaluated the impact of a test-to-stay (TTS) program on within-school transmission and missed school days in optionally masked kindergarten through 12th grade schools during a period of high community severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission.

METHODS: Close contacts of those with confirmed SARS-CoV-2 infection were eligible for enrollment in the TTS program if exposure to a non-household contact occurred between 11/29/2021 and 01/28/2022. Consented participants avoided school exclusion if they remained asymptomatic and rapid antigen testing at pre-specified intervals remained negative. Primary outcomes included within-school tertiary attack rate (test positivity among close contacts of positive TTS participants) and school days saved among TTS participants. We estimated the number of additional school-acquired cases resulting from TTS and eliminating school exclusion.

RESULTS: A total of 1675 participants tested positive or received at least one negative test between days 5 and 7, and completed follow-up; 92% were students and 91% were exposed to an unmasked primary case. We identified 201 positive cases. We observed a tertiary attack rate of 10% (95% CI 6-19%) and 7,272 (89%) of potentially missed days were saved through TTS implementation. We estimated one additional school-acquired case for every 21 TTS participants remaining in school buildings during the entire study period.

CONCLUSIONS: Even in the setting of high community transmission, a TTS strategy resulted in substantial reduction in missed school days in optionally masked schools.

10.1542/peds.2022-058200

Pediatrics

35971240

Outcomes associated with surfactant in more mature and larger premature infants with respiratory distress syndrome.

2020

2020 Feb 20

1476-5543

<p><strong>OBJECTIVE: </strong>Examine the effect of off-label surfactant on mortality and morbidity in more mature and larger premature infants diagnosed with respiratory distress syndrome (RDS).</p>

<p><strong>STUDY DESIGN: </strong>Cohort study of premature infants born at 30-36 weeks, birth weight &gt; 2 kg, and a diagnosis of RDS. We compared the odds of mortality and morbidity between infants who were exposed vs unexposed to surfactant. We used a treatment effects model to balance covariates between groups.</p>

<p><strong>RESULTS: </strong>Of 54,964 included infants, 25,278 (46%) were exposed to surfactant. The frequency of mortality and morbidities were higher in the exposed group in unadjusted analyses. Following adjustment with a doubly robust treatment effects model, we found no significant treatment effect of surfactant on mortality or morbidity.</p>

<p><strong>CONCLUSION: </strong>Surfactant exposure is not associated with reduced or increased mortality or morbidity in more mature premature infants with RDS.</p>

10.1038/s41372-020-0625-1

J Perinatol

32080333