Household Transmission and Clinical Features of SARS-CoV-2 Infections.

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  • Additional Information
    • Source:
      Publisher: American Academy of Pediatrics Country of Publication: United States NLM ID: 0376422 Publication Model: Print Cited Medium: Internet ISSN: 1098-4275 (Electronic) Linking ISSN: 00314005 NLM ISO Abbreviation: Pediatrics Subsets: MEDLINE
    • Publication Information:
      Publication: Elk Grove Village Il : American Academy of Pediatrics
      Original Publication: Springfield, Ill., Thomas.
    • Subject Terms:
      Contact Tracing* ; Family Characteristics*; COVID-19/*transmission; Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Asymptomatic Infections ; COVID-19/diagnosis ; COVID-19/epidemiology ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; Tennessee/epidemiology ; Wisconsin/epidemiology ; Young Adult
    • Abstract:
      Objectives: Examine age differences in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission risk from primary cases and infection risk among household contacts and symptoms among those with SARS-CoV-2 infection.
      Methods: People with SARS-CoV-2 infection in Nashville, Tennessee and central and western Wisconsin and their household contacts were followed daily for 14 days to ascertain symptoms and secondary transmission events. Households were enrolled between April 2020 and April 2021. Secondary infection risks (SIR) by age of the primary case and contacts were estimated using generalized estimating equations.
      Results: The 226 primary cases were followed by 198 (49%) secondary SARS-CoV-2 infections among 404 household contacts. Age group-specific SIR among contacts ranged from 36% to 53%, with no differences by age. SIR was lower in primary cases age 12 to 17 years than from primary cases 18 to 49 years (risk ratio [RR] 0.42; 95% confidence interval [CI] 0.19-0.91). SIR was 55% and 45%, respectively, among primary case-contact pairs in the same versus different age group (RR 1.47; 95% CI 0.98-2.22). SIR was highest among primary case-contact pairs age ≥65 years (76%) and 5 to 11 years (69%). Among secondary SARS-CoV-2 infections, 19% were asymptomatic; there was no difference in the frequency of asymptomatic infections by age group.
      Conclusions: Both children and adults can transmit and are susceptible to SARS-CoV-2 infection. SIR did not vary by age, but further research is needed to understand age-related differences in probability of transmission from primary cases by age.
      Competing Interests: CONFLICT OF INTEREST DISCLOSURES: Dr Halasa reports grants from Sanofi and Quidel. Dr Grijalva reports grants from Campbell Alliance/Syneos, the National Institutes of Health, the Food and Drug Administration, the Agency for Health Care Research and Quality and Sanofi-Pasteur, and consultation fees from Pfizer, Merck, and Sanofi-Pasteur. Other authors have no conflicts of interest relevant to this article to disclose.
      (Copyright © 2022 by the American Academy of Pediatrics.)
    • Comments:
      Update of: medRxiv. 2021 Aug 20:2021.08.16.21262121. doi: 10.1101/2021.08.16.21262121. (PMID: 34426817)
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    • Grant Information:
      K24 AI148459 United States AI NIAID NIH HHS; U01 IP001078 United States IP NCIRD CDC HHS; U01 IP001083 United States IP NCIRD CDC HHS; UL1 TR002243 United States TR NCATS NIH HHS
    • Publication Date:
      Date Created: 20220223 Date Completed: 20220309 Latest Revision: 20240923
    • Publication Date:
      20240923
    • Accession Number:
      PMC9097956
    • Accession Number:
      10.1542/peds.2021-054178
    • Accession Number:
      35194642