Secondary SARS-CoV-2 transmission by type of exposure setting among university students

<b>Objective:</b> We aimed to investigate the association between exposure settings and secondary SARS-CoV-2 transmission among university students. <b>Participants:</b> Students diagnosed with COVID-19 (<i>N</i> = 139) and randomly selected controls (<i>N</i> = 262) identified between April 4-December 5, 2021. <b>Methods:</b> This was a 1:2 case-control study. Exposure setting was categorized as academic/occupational, household, social/athletics, and multiple settings. Transmission was assessed by record of positive SARS-CoV-2 test among contacts within 14 days after most recent exposure. <b>Results:</b> Compared to exposure in the academic/occupational setting, all other settings had significantly higher odds of secondary SARS-CoV-2 transmission, adjusting for contact vaccination status, index case vaccination status, and contact sex (p-values ≤ 0.05). In the adjusted model, contact sex was found to be significantly associated with SARS-CoV-2 transmission. <b>Conclusion:</b> Among university students, academic/occupational settings had the lowest odds of SARS-CoV-2 transmission given safety measures in place. Future studies should analyze SARS-CoV-2 genomic sequence data to verify sources of infection.