TY  - JOUR
AU  - Fantin, Romain
AU  - Porras, Carolina
AU  - Aparicio, Amada
AU  - Vanegas, Juan Carlos
AU  - Loria, Viviana
AU  - Morera, Melvin
AU  - Abdelnour, Arturo
AU  - Waterboer, Tim
AU  - Butt, Julia Anna
AU  - Pfeiffer, Ruth M
AU  - Prevots, D Rebecca
AU  - Gail, Mitchell H
AU  - Hildesheim, Allan
AU  - Herrero, Rolando
TI  - A population-based case-control study of COVID-19: methodological considerations on the role of testing bias.
JO  - Journal of public health
VL  - 47
IS  - 3
SN  - 1741-3842
CY  - Oxford
PB  - Oxford Univ. Press
M1  - DKFZ-2025-01033
SP  - e250–e261
PY  - 2025
N1  - Volume 47, Issue 3, September 2025, Pages e250–e261
AB  - Targeting people at risk of COVID-19 infection has been critical to containing the pandemic. Using only differences in cumulative incidence by sociodemographic groups can be misleading, as it reflects both factors related to infection risk and those related to testing for infection. The aim of this analysis was to disentangle the determinants of both mechanisms.We compared the demographic, socioeconomic, and health characteristics of 813 PCR-confirmed COVID-19 cases over age 20 years with 1630 age- sex- and geography-matched population-based controls, both recruited in 2020-2021 in the RESPIRA study. We used antibody results and previous diagnosis to detect infections in population-based controls.High socioeconomic status and being older than 60 years old were negatively associated with seropositivity. Obesity and number of people living in the household were positively associated with seropositivity. Among infected (seropositive) people, diagnosis by PCR was more frequent in employees, and in people with asthma or hypertension, and was negatively associated with the number of people living in the household.Differences between PCR-confirmed cases and non-infected controls reflected differences both in risk of infection, and in PCR-testing in infected people. The possibility of PCR-testing bias in case-control studies of COVID should be considered in future research.
KW  - COVID-19 serological testing (Other)
KW  - COVID-19 testing (Other)
KW  - Costa Rica (Other)
KW  - Latin America (Other)
KW  - middle-income country (Other)
KW  - social determinants of health (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:40377264
DO  - DOI:10.1093/pubmed/fdaf055
UR  - https://inrepo02.dkfz.de/record/301491
ER  -