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In an infectious disease cohort study, individuals who have been infected with a pathogen are often recruited for follow up. The period between infection and the onset of symptomatic disease, referred to as the incubation period, is of interest because of its importance on disease surveillance and control. However, the incubation period is often difficult to ascertain due to the uncertainty associated with asymptomatic infection onset time. An additional complication is that the observed infected subjects are likely to have longer incubation periods due to the prevalent sampling. In this article, we demonstrate how to estimate the distribution of the incubation period with the uncertain infection onset, subject to left-truncation and right-censoring. We employ a family of sufficiently general parametric models, the generalized odds-rate class of regression models, for the underlying incubation period and its correlation with covariates. In simulation studies, we assess the finite sample performance of the model fitting and hazard function estimation. The proposed method is illustrated on data from the HIV/AIDS study on injection drug users admitted to a detoxification program in Badalona, Spain. [ABSTRACT FROM AUTHOR]

Background: The incubation period of an infectious disease is defined as the elapsed time between the exposure to the pathogen and the onset of symptoms. Although both the mRNA-based and the adenoviral vector-based vaccines have shown to be effective, there have been raising concerns regarding possible decreases in vaccine effectiveness for new variants and variations in the incubation period., Methods: We conducted a unicentric observational study at the Hospital Universitari de Bellvitge, Barcelona, using a structured telephone survey performed by trained interviewers to estimate the incubation period of the SARS-CoV-2 Delta variant in a cohort of Spanish hospitalized patients. The distribution of the incubation period was estimated using the generalized odds-rate class of regression models., Results: From 406 surveyed patients, 242 provided adequate information to be included in the analysis. The median incubation period was 2.8 days (95%CI: 2.5-3.1) and no differences between vaccinated and unvaccinated patients were found. Sex and age are neither shown not to be significantly related to the COVID-19 incubation time., Conclusions: Knowing the incubation period is crucial for controlling the spread of an infectious disease: decisions on the duration of the quarantine or on the periods of active monitoring of people who have been at high risk of exposure depend on the length of the incubation period. Furthermore, its probability distribution is a key element for predicting the prevalence and the incidence of the disease., (© 2022. The Author(s).)