A Meta-analysis on the Role of Children in Severe Acute Respiratory Syndrome Coronavirus 2 in Household Transmission Clusters

Yanshan Zhu; Conor J Bloxham; Katina D Hulme; Jane E Sinclair; Zhen Wei Marcus Tong; Lauren E Steele; Ellesandra C Noye; Jiahai Lu; Yao Xia; Keng Yih Chew; Janessa Pickering; Charles Gilks; Asha C Bowen; Kirsty R Short

doi:10.1093/cid/ciaa1825

A Meta-analysis on the Role of Children in Severe Acute Respiratory Syndrome Coronavirus 2 in Household Transmission Clusters

Clin Infect Dis. 2021 Jun 15;72(12):e1146-e1153. doi: 10.1093/cid/ciaa1825.

Authors

Yanshan Zhu¹, Conor J Bloxham², Katina D Hulme¹, Jane E Sinclair¹, Zhen Wei Marcus Tong¹, Lauren E Steele¹, Ellesandra C Noye¹, Jiahai Lu³, Yao Xia⁴, Keng Yih Chew¹, Janessa Pickering⁵, Charles Gilks^{6

7}, Asha C Bowen^{5

8}, Kirsty R Short^{1

7}

Affiliations

¹ School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia.
² School of Biomedical Science, The University of Queensland, Brisbane, Australia.
³ One Health Center of Excellence for Research and Training, Department of epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
⁴ School of Science, Edith Cowan University, Australia; School of Biomedical Science, The University of Western Australia, Perth, Australia.
⁵ Wesfarmer's Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Perth, Western Australia.
⁶ School of Public Health, The University of Queensland, Brisbane, Australia.
⁷ Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia.
⁸ Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Perth, Western Australia.

Abstract

The role of children in the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains highly controversial. To address this issue, we performed a meta-analysis of the published literature on household SARS-CoV-2 transmission clusters (n = 213 from 12 countries). Only 8 (3.8%) transmission clusters were identified as having a pediatric index case. Asymptomatic index cases were associated with a lower secondary attack in contacts than symptomatic index cases (estimate risk ratio [RR], 0.17; 95% confidence interval [CI], 0.09-0.29). To determine the susceptibility of children to household infections the secondary attack rate in pediatric household contacts was assessed. The secondary attack rate in pediatric household contacts was lower than in adult household contacts (RR, 0.62; 95% CI, 0.42-0.91). These data have important implications for the ongoing management of the COVID-19 pandemic, including potential vaccine prioritization strategies.

Keywords: COVID-19; SARS-CoV-2; children; household; transmission.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Adult
COVID-19*
Child
Family Characteristics
Humans
Incidence
Pandemics
SARS-CoV-2*

Grants and funding

1175509/DH_/Department of Health/United Kingdom