Predictors of Influenza-Associated Absenteeism and Impact of Vaccination in a Cohort of Guatemalan Agricultural Workers

This is an Administrative Supplement Application to carry out SARS-CoV-2 PCR testing in an existing NIAID-funded study (1K23AI143967) evaluating the clinical and economic impacts of influenza in Guatemalanagricultural workers. The Parent Study includes the enrollment of an existing cohort (n=2,706) of Guatemalanagricultural workers with high rates of chronic medical conditions (CMCs) into a prospective active surveillancesystem for cough and fever (severe acute respiratory illness [SARI]). Workers meeting the case definition aretested for influenza A/B and RSV (Roche cobas® Liat RT-PCR Assay) and then clinical and economicoutcomes are assessed using follow up surveys and company reported absenteeism and productivity data. This Administrative Supplement will allow us to maintain our cough/fever surveillance system, given anincrease in expected cases due to SARS-CoV-2, and to perform RT-PCR testing for SARS-CoV-2. Wehypothesize that, similar to influenza, COVID-19 will place a significant clinical and economic burden onagricultural workers, especially the large proportion with CMCs, such as chronic kidney disease of unknownorigin (CKDu, aka "Mesoamerican nephropathy"), given existing data showing a significantly increased risk ofsevere disease. Evaluating these outcomes in an existing prospective cohort will allow us to measure theseburdens on a population-level, which will provide critical data in understanding the true impact of disease. Weaim to implement our SARS-CoV-2 testing immediately, analyze and disseminate our results quickly, andmake samples from our specimen biobank (annual blood and urine, acute illness respiratory and blood)available for additional research.