Factors associated with SARS-CoV-2 symptomatic infection in university
students: a school-wide web-based survey during the Omicron variant
outbreak
Abstract
Background: The Omicron outbreak is characterized by breakthrough
infection and reinfection. If no strategic solution can be found,
vaccination-rate-based risk compensation may prolong the COVID-19
crisis. Infection control in university students may have an indirect
impact on the COVID-19 burden for other age groups Methods: To reveal
the association between related factors and a symptomatic episode of
COVID-19, a school-wide web-based questionnaire survey was conducted
among university students as a part of the annual health check-up in
April, 2023. The positive outcome was confined to the first symptomatic
onset during the Omicron variant outbreak. Results: In this
self-administered and non-observational survey, risk or protective
associations were merely estimated statistically in university students
(n = 5,406). In measured factors, karaoke and club/group activities
could maintain the statistical significance in adjusted odds ratios
(ORs) as (relative) risk factors, and science course, measles/rubella
(MR) vaccination, and COVID-19 vaccination remained as (relative)
protective factors in adjusted OR analyses. Club/group activities (with
member gathering) and karaoke sing-along sessions in university students
may frequently have WHO’s three Cs. These risk factors are still
important topics for the infection control of COVID-19 in university
students. Together with some recent reports from other researchers, the
significant protective role of MR vaccine in our survey warrants further
clinical investigation. Conclusions: If the breakthrough infection
continuously constitutes the majority of infection, real data in
test-negative case-control or web-based questionnaire design continue to
be important for statistical analysis to determine the minimal
requirement of our strategies which may replace COVID-19 vaccines.