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Baigu Lee 1 Article
Identifying risk factors for COVID-19 cluster infections in schools in the Republic of Korea: a case-control study
Jihyun Choi, Seongju Choi, Baigu Lee, Young-Joon Park, Sang Eun Lee
Osong Public Health Res Perspect. 2024;15(4):375-382.   Published online July 11, 2024
DOI: https://doi.org/10.24171/j.phrp.2023.0351
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Objectives
No study has yet analyzed risk factors to determine whether students with confirmed coronavirus disease 2019 (COVID-19) infections may affect students at neighboring schools. Therefore, this study aimed to determine risk factors for COVID-19 transmission among schools within a community in the Republic of Korea.
Methods
An epidemiological investigation was conducted among 696 students and school staff members at 3 schools where COVID-19 clusters began on October 15, 2021. Interviews, visit history surveys, a facility risk assessment, and closed-circuit television were used to identify risk factors. The statistical significance of risk factors was also evaluated.
Results
We confirmed 129 cases (18.5%) among the individuals exposed to COVID-19 at the 3 schools, many of whom had a history of visiting the same multi-use facilities. The odds ratio of having visited multi-use facilities such as karaoke rooms was 1.90 (95% confidence interval, 1.03–3.50); the number of visits to a karaoke room and the visit durations were significantly higher among confirmed cases than non-confirmed cases (p=0.02 and p=0.03, respectively).
Conclusion
Having a history of visiting karaoke rooms often and spending a long time there were risk factors for COVID-19 infection and inter-school transmission. Thus, it is necessary to investigate the status of multi-use facilities frequently visited by adolescents and consider incorporating them into the scope of school quarantine to prevent infectious diseases at schools in a community.

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