SARS-CoV-2 Transmission: A Portugal Analysis Question and Answers

Introduction: Evaluating Risk Factors of Virus Transmission in Lisbon

The study of the case control of the specific issue has been chosen here for further analysis and allows to accomplish the checklist of CASP. The case control study of the finding of the responsible factors of the transmission of SARS-Cov-2 to the human body helps to fulfill the various requirements obtained by the checklist and emphasizes on the proper evaluation of the study.

Discussion:

Q1. Addressing the issue of the study

Yes, this case study can address the issue of the case. The focus of this study is obvious from the title of the review paper which demonstrates the potential factors of the transmission of SARS-CoV-2. The group of people who were under investigation is most likely to include those who have been adversely affected by the virus's spread, probably comprising both types of cases (those who have COVID-19 infections) and controls (people who have not been infected by the virus). The research desires to know the variables that either promote or inhibit the viruses spread in particular surroundings (Andreescu et al. 2024). The factors of the study help to imply that the study intended to search for the behavioral and environmental which can influence the dynamics of the transmission of SARS-Cov-2. The authors of the study can reveal the potential risk factors that are responsible for the transmission of the individuals who are affected by the virus versus the persons who are not contaminated (control) by the virus. So this study can concentrate clearly on the contextual issues that are related to the transmission of the SARS-CoV-2 having the proper objective to recognize the risk factors within the specific population for managing the issue of covid 19.

Q2. Use of the appropriate method in this study

Yes, the authors of the case study have employed a suitable method for answering the research question on which the study is focused. This case study is appropriate for determining the relationships between the outcome and the exposure to recognize the risk factors for this disease (Duval et al. 2023). So the authors of the case study have aimed to grasp the elements that can affect the transmission of SARS-Cov in specific regions d Lisbon and Tagus Valley. With the employment of the suitable control design of the case study the authors were capable of distinguishing the people with infection by SARS-CoV or without infections. So this type of study design permits the authors to determine the risk factors responsible for the contamination. This case study has included both types of areas having large densities of population so it will help in the collection of the data. So this type of study design is very helpful for gathering the various data and medical records of the participant.

Q3. The recruitment of ways in the case study

The cases of the study were assembled by the system of national surveillance which makes the possibility of incident cases (Omer et al. 2023). Here is the method of recruitment that can be achieved by the national surveillance is appropriate in the study. The method of recruitment is very essential for considering the appropriate method. At first, the cases were shortly precise who were infected and got positive results from the chosen population. It is unidentified if these cases were geographically and chronologically typical of Portugal's total people. The capability to generalize the findings could be impacted by limitations in case recognition or reporting. The necessity of the system of national surveillance may result in biases concerning the behavior of those seeking healthcare, the availability of testing, or deviations in testing procedures between locations or periods. So this can give the result of the presentation of the demographic groups within the chosen people in those areas. Apprehensions concerning whether the number of samples of cases was acceptable to find significant relationships can be exposed that are relevant are further raised by the lack of power control. So the method of this study via the system of national surveillance offers a systematic approach to determining the cases.

Figure 1: The design of the study

Q 4. The Selection of Control

Yes, the controls were selected in a satisfactory way in the study. The controls of this study were chosen by employing random digit dialing; in which the procedure was utilized to recruit the controls of the chosen case study. In the study, there were responsible concerns about the representativeness of the section of the control in this study (Monaghesh, and Hajizadeh, 2020). The method of random digit dialing assists in the choice of contestants from the specific population so it can have boundaries in its application. The process depends on the telephone directories that cannot take the whole population similarly so it instructs to the underrepresentation of the specific demographic population in which some of them were without the landline phones and the others were not likely to attend the calls from the unidentified numbers. Also, this study has not offered precise information on the rate of the response as the control. If there is a conventional distinction between non-respondents and respondents in characteristics related to the research results, then it could be high failure-to-respond rates could suggest selection predisposition (Chatzilena et al. 2023). So there are no presentations of the control if these matched with the cases in the chosen population. So comparing the controls to the cases on the specific standards including the age, location which can help in the improvement of the distinguishing of the cases and the controls for the development of the outcomes of the study, from the number of analyzed cases of 1088, the controls were identified as 787.

Q 5. Measurement of exposure

Yes, the measurement of the exposure was correctly evaluated to reduce the discrimination. This study has effectively depicted the measurement of the exposures by consisting of going to restaurants, and cafes and joining in any type of gathering, uses of public transportation, working in remote areas along participating in varied social activities (Liljas et al. 2022). So these exposures can be measured with the help of telephone interviews for both the groups of control and cases which help to measure the consistency of this evaluation. The authors of this article have employed the measurements including the pattern of the questioning about the detailed information of activities and the settings. The relationship between the results and exposures was accurately identified to provide the measurements of the exposure. So this study has successfully acquired information on exposure via the process of interviews and matching between the cases and the controls from the same location which helps to reduce the equality in the study of recognizing the risk factors of the SARS-CoV-2 virus.

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Q 6. Evaluation of Group Treatment and Confounding Factors

a) The treatment of the groups aside from the intervention

The authors have not equally treated both groups according to the factors of environmental and socio-economic and these factors can create an impact on the results of the intervention chosen by the authors.

b) The potential factors of the analysis

Yes, the authors have employed the potential factors of the study in the analysis and the design of the study (McCarthy et al. 2023). The authors conducted the study according to the pattern of the case-control study which permits the deliberation of the factors with the help of the techniques including the regression analysis. In this type of analysis, the authors of this study accommodated the responsible factors including education, age, gender, and citizenship; these all factors are responsible for the transmission of the covid. So by adjusting these factors, the analysis assists in controlling the impacts on the desired outcome which can also permit for getting the accurate results by comparing between the rate of infection and exposures. In the investigation of the study of how the relationships between exposure and the possibility of infection differed among various demographic groups, the authors used stratified analyses to achieve the results. A more wide-ranging comprehension of the possible influence of confounding variables on the results is made possible by this technique (Skelton et al. 2020). The researcher of this study has evaluated the necessary provisions to account for any confounding variables and guarantee the reliability of their findings by executing these strategies into the study's design and investigation.

Q 7. The effect of the treatment

The study has evaluated the odds ratio or ORs in the effect of the treatment which can vary among various types of exposures. The risk of infection by the virus can be higher among people who belong to the lower level of education group than the people having a tertiary level of education. Here the range of ORs observed is 1.79 to 3.85 for having different levels of education. The risk of infection is also higher among the people of Portuguese without citizenship than the citizens of Portuguese. The value of OR was observed as higher values as 24.76 in the cases of contact with the infected case of SARS-Cov-2. On the other hand, it has been observed that some of the protective variables are associated with the lower values of the infection in this transmission of the viruses (Dillen et al. 2023). The workers of the remote area offer the value of OR of 0.30 which indicates a lower risk of infection than the workers who have worked in the offices. Here the regression models are employed as the study design to estimate the relationship between exposures and results while maintaining potential confounding factors consisting of sex, age, level of schooling, citizenship, and documented contact within the case.

Q 8. The estimation of the treatment effect

The accuracy of the treatment effect of this study here is to be high to moderate based on the different factors. Here are the effects of the treatment observed to provide the values of p with the confidence intervals which are acquired from the result of the study obtained by the authors in this study (Mellado et al. 2024). The measurement of p values demonstrates the importance of statistical analysis by providing values of less than 0.001. Observing the values of p it has indicated the important association between two factors of exposure and the risk factors of the infection of SARS-Cov-2. So the values of the p suggest a high level of effect in the treatment. The measurement of the confidence intervals offers the estimation of the accuracy. The reported values of confidence intervals of the study were observed as comparatively small in the prevalence of the estimations. So this suggested the accuracy of the therapy effects within the study. The values of ORs for the factors of citizenship and level of education. It can be portrayed by the example of the confidence intervals like the values of 95% shows the lack of the null values. This type of lack demonstrates the impact of the small level of CLs. the values of CLs are observed for the other types of exposures like the service of public transit or visiting the gym (Leite, et al. 2021). The higher result of CLs indicates a greater level of irregularities in the estimated values. The authors have used various factors including age, citizenship, and the contact between the people.

Q 9. Reliability of the results

Yes, I believe in the result of the study. There are various factors are responsible for this result in this study. First of all the factors of the big effect size of the result can be considered here which demonstrates the important relationship between the several factors of the study and the rate of the infection including the effect of the protectively of the remorse culture of work along with the elevating of the risk factors in the crowded place (Khodadadi et al. 2022). So these are responsible effects that can make an impact on the result and are hard to ignore. The employment of the study offers a process for reducing unfairness. To minimize in choice of the bias, controls of the study were chosen from communities with high incidence rates. The procedure also accounts for confounding variables like citizenship, age, sex, and education level. Although remaining confounding has been approved, the results' robustness indicates that it is difficult to entirely nullify the decisions. The design of the study has utilized the cases and the controls from the specific communities to offer the estimation of the risk factors. The thorough information of the study is collected based on the variety of characteristics of the people and their activities at the time of the investigation (Zohoori et al. 2021). The study has also found the various criteria structured by Bradford Hill consisting of the allowance of remote work for declining the rate of the infection, and a gradient of the response of the dose which can be demonstrated by the higher risk of living in the condition of a crowded place.

Q 10. The application of the results in the local population

Yes the application of the results can be applied successfully in the local population. This study has been directed in the region of Lisbon and Tegus Valley of Portuguese; these places have shared resemblances with the other places of the country with the characteristics of cultural preferences, socio-demographics, and the infrastructure of the public health sector. So the results of the study are relevant to the wide-ranging population of Portuguese (Lane et al. 2021). This study has concentrated on the particular period of the year 2020 in September and October; where it has been compared to other areas or places, the epidemiological state and initiatives of public health might have been varied. The differences in the factors within the study population and the communities are the variables that are context-related and can influence the implementation and interpretation of the outcomes of the study. So determining these differences is very crucial to implement in the other population in the other places. The authority of local public health must be evaluated to establish the actions to control the transmission rate of the virus. So observing the results is very necessary in the implementation of the objective in other countries or other areas for large populations.

Q 11. The result of the study fits with other evidence

Yes, the outcomes of the study can be fitted with the other evidence in the cases of the other implementation. The results about the risk factors of the SARS-Cov-2 transmission among people who have a lower level of education and without citizenship of the country of Portuguese supported the study of indicating the relationship between the factors of the results of the diseases and the socio-economic factors of the areas (Mazzochi et al. 2023). Various studies have shown that various populations having a lower financial status are observed as a higher risk of infection because of factors including the crowded condition of the population, limited functions of healthcare and the incapability's of remote work. The elevated rate of risk factors of the infection of COVID-19 in the large population resulted in the cases of the covid which is reliable to the other studies to emphasize the significance of the closeness to the infected persons can result in the transmission process. So the outcomes of the study signify the measurement of isolation and contact and how can it be processed in the managing of the transmission among the individual. This can be fitted with other evidence of the case-control studies, the evidence of the randomized controlled trials can also be fitted with these types of results for understanding the impacts of the study. The systematic reviews of the studies related to this type of study might be related to the outcomes of the results and are significant for analysis of the different implications of this evidence.

Conclusion

The study of the evaluation of the case control of SARS-CoV-2 evaluates the assessment with the help of the provided checklist to concentrate on the various perspective of the study. This helps to focus if the study adds more valuable information or not in the field of research of this type of study.

References

Journals

• Andreescu, M., Moldovan, C., Lespezeanu, D.A., Mocanu, A.I., Schipor, M.A. and Mocanu, H., 2024. COVID-19-Associated Rhinocerebral Mucormycosis, an Incidental Finding or a Matter of Concern–Mixed-Method Systematic Review. Infection and Drug Resistance, pp.387-402.
• Chatzilena, A., Hyams, C., Challen, R., Marlow, R., King, J., Adegbite, D., Kinney, J., Clout, M., Maskell, N., Oliver, J. and Danon, L., 2023. Effectiveness of BNT162b2 COVID-19 vaccination in prevention of hospitalisations and severe disease in adults with SARS-CoV-2 Delta (B. 1.617. 2) and Omicron (B. 1.1. 529) variant between June 2021 and July 2022: a prospective test negative case–control study. The Lancet Regional Health–Europe, 25.
• Dillen, H., Bekkering, G., Gijsbers, S., Vande Weygaerde, Y., Van Herck, M., Haesevoets, S., Bos, D.A., Li, A., Janssens, W., Gosselink, R. and Troosters, T., 2023. Clinical effectiveness of rehabilitation in ambulatory care for patients with persisting symptoms after COVID-19: a systematic review. BMC Infectious Diseases, 23(1), pp.1-13.
• Duval, D., Pearce-Smith, N., Palmer, J.C., Sarfo-Annin, J.K., Rudd, P. and Clark, R., 2023. Critical appraisal in rapid systematic reviews of COVID-19 studies: implementation of the Quality Criteria Checklist (QCC). Systematic Reviews, 12(1), pp.1-4.
• Khodadadi, H., Ahmadpour, E., Nami, S., Mohammadi, R., Hosseini, H., Behravan, M. and Morovati, H., 2022. Global prevalence, mortality, and main risk factors for COVID-19 associated pneumocystosis: A systematic review and meta-analysis. Asian Pacific Journal of Tropical Medicine, 15(10), pp.431-441.
• Lane, S., Yeomans, A. and Shakir, S., 2021. Reports of myocarditis and pericarditis following mRNA COVID-19 vaccines: A systematic review of spontaneously reported data from the UK, Europe, and the US and of the literature. MedRxiv, pp.2021-09.
• Leite, A., Leão, T., Soares, P., Severo, M., Moniz, M., Lucas, R., Aguiar, P., Meireles, P., Lunet, N., Nunes, C. and Barros, H., 2021. A case-control study of contextual factors for SARS-CoV-2 transmission. Frontiers in public health, 9, p.772782.
• Liljas, A.E.M., Morath, L.P., Burström, B., Schön, P. and Agerholm, J., 2022. The impact of organisational characteristics of staff and facility on infectious disease outbreaks in care homes: a systematic review. BMC Health Services Research, 22(1), p.339.
• Mazzochi, A.T., Dennis, M. and Chun, H.Y.Y., 2023. Electronic informed consent: effects on enrolment, practical and economic benefits, challenges, and drawbacks-a systematic review of studies within randomized controlled trials. Trials, 24(1), p.127.
• McCarthy, A., Galvin, R., Dockery, F., McLoughlin, K., O'Connor, M., Corey, G., Whiston, A., Carey, L., Steed, F., Tierney, A. and Robinson, K., 2023. Multidisciplinary inpatient rehabilitation for older adults with COVID-19: a systematic review and meta-analysis of clinical and process outcomes. BMC geriatrics, 23(1), p.391.
• Mellado-García, E., Díaz-Rodríguez, L., Cortés-Martín, J., Sánchez-García, J.C., Piqueras-Sola, B., Higuero Macías, J.C. and Rodríguez-Blanque, R., 2024, February. Systematic Reviews and Synthesis without Meta-Analysis on Hydrotherapy for Pain Control in Labor. In Healthcare (Vol. 12, No. 3, p. 373). MDPI.
• Monaghesh, E. and Hajizadeh, A., 2020. The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence. BMC public health, 20, pp.1-9.
• Omer, I., Abuthiyab, N., Al Zaid, N., Alkanani, R., Abualnaja, R. and Khan, G., 2023. Procalcitonin as a tool to antimicrobial stewardship in COVID-19 patients with superimposed bacterial infections: a systematic review. Journal of Inflammation Research, pp.6055-6064.
• Skelton, E., Drey, N., Rutherford, M., Ayers, S. and Malamateniou, C., 2020. Electronic consenting for conducting research remotely: A review of current practice and key recommendations for using e-consenting. International journal of medical informatics, 143, p.104271.
• Wang, C., Xiao, S., Sun, Y., Wang, J. and Xu, T., 2020. Psychosocial impact of respiratory infectious disease pandemics on children: a systematic review.
• Zohoori, V., England, R. and Nnyanzi, L., 2021. How do pandemics affect oral health? A systematic review protocol.