Practice of COVID-19 preventive measures and risk of acute respiratory infections: a longitudinal study in students from 95 countries

Abstract

\n Objectives\n We aimed to investigate whether the implementation of personal protective measures against coronavirus disease 2019 reduced the transmission of influenza-like illnesses.\n \n Methods\n We followed 758 international students from 95 countries located in five continents from October 2020 to March 2021. Their frequency of wearing masks, social distancing, washing hands, and avoiding crowded places as well as their reported cases of influenza-like illnesses were examined. We used Kaplan-Meier analysis to compare the occurrence of symptoms of influenza-like illnesses among participants who adhered with those who did not adhere to the personal protective measures.\n \n Results\n From October 2020 to March 2021, 139 (18%) students reported symptoms of influenza-like illnesses. The survival analysis showed that students who frequently wore face masks, exercised physical distancing, and disinfected their hands had a reduced risk of influenza-like illnesses. We found a two-fold increased risk of influenza-like illnesses among participants who did not implement all the personal protective measures as compared with those who adhered to the measures (Hazard ratio=2.16, 95%CI=1.53-3.05, P<0.001).\n \n Conclusions\n Our findings suggest that personal protective measures with high feasibility and high acceptability could be implemented during influenza epidemics to reduce transmission.\n