Cited by 1,248COVID-19 epidemiological studiesSARS-CoV-2 and COVID-19 ResearchSARS-CoV-2 detection and testing

Spread of SARS-CoV-2 in the Icelandic population

Open access
Gudbjartsson, Daniel F., Helgason, Agnar, Jonsson, Hakon, Magnusson, Olafur T., Melsted, Pall, Norddahl, Gudmundur L., Saemundsdottir, Jona, Sigurdsson, Asgeir +32 more·2020·New England Journal of Medicine

Published version of a preprint

Abstract

BACKGROUND: During the current worldwide pandemic, coronavirus disease 2019 (Covid-19) was first diagnosed in Iceland at the end of February. However, data are limited on how SARS-CoV-2, the virus that causes Covid-19, enters and spreads in a population. METHODS: We targeted testing to persons living in Iceland who were at high risk for infection (mainly those who were symptomatic, had recently traveled to high-risk countries, or had contact with infected persons). We also carried out population screening using two strategies: issuing an open invitation to 10,797 persons and sending random invitations to 2283 persons. We sequenced SARS-CoV-2 from 643 samples. RESULTS: As of April 4, a total of 1221 of 9199 persons (13.3%) who were recruited for targeted testing had positive results for infection with SARS-CoV-2. Of those tested in the general population, 87 (0.8%) in the open-invitation screening and 13 (0.6%) in the random-population screening tested positive for the virus. In total, 6% of the population was screened. Most persons in the targeted-testing group who received positive tests early in the study had recently traveled internationally, in contrast to those who tested positive later in the study. Children under 10 years of age were less likely to receive a positive result than were persons 10 years of age or older, with percentages of 6.7% and 13.7%, respectively, for targeted testing; in the population screening, no child under 10 years of age had a positive result, as compared with 0.8% of those 10 years of age or older. Fewer females than males received positive results both in targeted testing (11.0% vs. 16.7%) and in population screening (0.6% vs. 0.9%). The haplotypes of the sequenced SARS-CoV-2 viruses were diverse and changed over time. The percentage of infected participants that was determined through population screening remained stable for the 20-day duration of screening. CONCLUSIONS: In a population-based study in Iceland, children under 10 years of age and females had a lower incidence of SARS-CoV-2 infection than adolescents or adults and males. The proportion of infected persons identified through population screening did not change substantially during the screening period, which was consistent with a beneficial effect of containment efforts. (Funded by deCODE Genetics-Amgen.).

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Authors
Gudbjartsson, D. F., Helgason, A., Jonsson, H., Magnusson, O. T., Melsted, P., Norddahl, G. L., Saemundsdottir, J., Sigurdsson, A., Sulem, P., Agustsdottir, A. B., Eiriksdottir, B., Fridriksdottir, R., Gardarsdottir, E. E., Georgsson, G., Gretarsdottir, O. S., Gudmundsson, K. R., Gunnarsdottir, T. R., Gylfason, A., Holm, H., Jensson, B. O., Jonasdottir, A., Jonsson, F., Josefsdottir, K. S., Kristjansson, T., Magnusdottir, D. N., le Roux, L., Sigmundsdottir, G., Sveinbjornsson, G., Sveinsdottir, K. E., Sveinsdottir, M., Thorarensen, E. A., Thorbjornsson, B., Löve, A., Masson, G., Jonsdottir, I., Möller, A. D., Gudnason, T., Kristinsson, K. G., Thorsteinsdottir, U., & Stefansson, K.
Affiliations
From deCODE Genetics–Amgen (D.F.G., A.H., H.J., O.T.M., P.M., G.L.N., J.S., A.S., P.S., A.B.A., B.E., R.F., E.E.G., G.G., K.R.G., A.G., H.H., B.O.J., A.J., F.J., T.K., D.N.M., L.R., G. Sveinbjornsson, K.E.S., E.A.T., B.T., G.M., I.J., U.T., K.S.), the School of Engineering and Natural Sciences (D.F.G., P.M.), the Department of Anthropology (A.H.), the Faculty of Medicine, School of Health Sciences (A.L., I.J., K.G.K., U.T., K.S.), and the BioMedical Center of the University of Iceland (K.G.K.),...
Venue
New England Journal of Medicine
Published
2020-06-11
Volume
382
Issue
24
Pages
2302-2315
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W3015281372
Cited by
1,248
References
20
Citations by year
2026: 6 · 2025: 17 · 2024: 36 · 2023: 69 · 2022: 130 · 2021: 404 · 2020: 585 · 2019: 1
FWCI
47.26
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • New England Journal of Medicine (publishedVersion)
  • medRxiv (acceptedVersion, cc-by-nc)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Hirsla (Landspítali University Hospital) (submittedVersion)
Topics
  • Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 detection and testing
Keywords
SARS-CoV-2, COVID-19 pandemic, epidemic spread, mass screening, targeted testing, seroprevalence, children under 10, sex differences in infection, international travel, viral haplotypes, viral evolution, containment measures, Iceland, SARS-CoV-2 genomics, informed consent for children
MeSH terms
Betacoronavirus, COVID-19, SARS-CoV-2, Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Haplotypes, Humans, Iceland, Infant, Male, Mass Screening, Middle Aged, Pneumonia, Viral, Travel, Contact Tracing, Coronavirus Infections, Young Adult, Pandemics, Epidemiological Monitoring

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