Child transmission of SARS-CoV-2: a systematic review and meta-analysis

Silverberg, Sarah L.; Zhang, Bei Yuan; Li, Shu Nan Jessica; Burgert, Conrad; Shulha, Hennady P.; Kitchin, Vanessa; Sauvé, Laura; Sadarangani, Manish

doi:10.1186/s12887-022-03175-8

Cited by 51 publications

(37 citation statements)

References 80 publications

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“…Of the 59 households with confirmed cases, the child care case was the household index in 39 instances. This contrasts with studies that suggest no secondary transmission from school aged children (16) and reduced transmission from children to their households (17). Our findings of increased cases in children when a child is the index case is in contrast to another Silverberg et al finding (17) that children transmit to other children less readily, although another study suggested that children aged 0-3 were the most at risk for transmitting to their households (18).…”

Section: Discussioncontrasting

confidence: 99%

COVID-19 outbreaks in child care facilities Alberta from March 2020 to December 31, 2021

Geary¹,

Rudko²,

Scott³

2022

Preprint

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Background: Children attending child care are vulnerable to SARS CoV-2 infection, and mitigationmeasures like masking, distancing, enhanced hygiene are not feasible for this population. Describingoutbreak growth during the COVID-19 pandemic in child care centres may provide insight in how to bestmitigate the risks of COVID-19 and other infectious diseases in these settings.Objective: To describe the characteristics of child care outbreaks and associated cases in Alberta.Methods: Our observational study used data on outbreaks and associated cases tracked through theAlberta Health Services Communicable Disease Outbreak Management database. We included allCOVID-19 outbreaks opened in child care facilities in the province (March 2020 to December 31, 2021).We compared the characteristics of outbreaks and cases during each wave of the pandemic.Outcome: 841 outbreaks were opened in Alberta, including 4613 cases (70.2% in children and 29.8%adults). Outbreaks averaged 5.5 cases per outbreak, and the average duration of time betweensymptoms starting in the first and last case was 9.7 days. The likely index was a child in 55.1% ofoutbreaks.Conclusions: Adults are a high proportion of cases compared to their proportion of the population atchild care facilities, and have consistently higher attack rates than children. Children have the highestattack rates when other children are the index case. Measures shown to be effective in other settings toreduce spread among adults can be implemented here, such as vaccination, strictly enforcing exclusionof those symptomatic, and facilitating rapid testing.

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Section: Discussioncontrasting

confidence: 99%

COVID-19 outbreaks in child care facilities Alberta from March 2020 to December 31, 2021

Geary¹,

Rudko²,

Scott³

2022

Preprint

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“…Thus, the increased likelihood of asymptomatic presentation of children infected with SARS-CoV-2 does not account for the differences in infectiousness between adults and children. [29] The overall estimated household SAR of 13.0% is comparable with estimates from studies in China that also used a statistical transmission model with similar parameters (10.4% and 12.4% for incubation period of 5 days and a 13-day infectious period). [14,30] However, studies that used estimates from primarily binomial models before and after the emergence of the omicron variant estimated a higher household SAR across settings; [2,28,31] while many factors may explain this difference, the use of binomial models rather than statistical transmission models likely bias the estimated SAR upwards.…”

Section: Discussionsupporting

confidence: 67%

Infection-induced immunity is associated with protection against SARS-CoV-2 infection, but not decreased infectivity during household transmission

Frutos

Kuan

López

et al. 2022

Preprint

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Background Understanding the impact of infection-induced immunity on SARS-CoV-2 transmission will provide insight into the transition of SARS-CoV-2 to endemicity. Here we estimate the effects of prior infection induced immunity and children on SARS-CoV-2 transmission in households. Methods We conducted a household cohort study between March 2020-June 2022 in Managua, Nicaragua where when one household member tests positive for SARS-CoV-2, household members are closely monitored for SARS-CoV-2 infection. Using a pairwise survival model, we estimate the association of infection period, age, symptoms, and infection-induced immunity with secondary attack risk. Results Overall transmission occurred in 72.4% of households, 42% of household contacts were infected and the secondary attack risk was 13.0% (95% CI: 11.7, 14.6). Prior immunity did not impact the probability of transmitting SARS-CoV-2. However, participants with pre-existing infection-induced immunity were half as likely to be infected compared to naive individuals (RR 0.53, 95% CI: 0.39, 0.72), but this reduction was not observed in children. Likewise, symptomatic infected individuals were more likely to transmit (RR 24.4, 95% CI: 7.8, 76.1); however, symptom presentation was not associated with infectivity of young children. Young children were less likely to transmit SARS-CoV-2 than adults. During the omicron era, infection-induced immunity remained protective against infection. Conclusions Infection-induced immunity is associated with protection against infection for adults and adolescents. While young children are less infectious, prior infection and asymptomatic presentation did not reduce their infectivity as was seen in adults. As SARS-CoV-2 transitions to endemicity, children may become more important in transmission dynamics.

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“…In the context of ongoing public health measures and vaccination programs, it is crucial to keep monitoring humoral immunity. Children have not been equally represented in immunosurveillance, while they do play a role in the transmission of SARS-CoV-2 (1). Surveillance of immunity in children is important to establish effective public health measures for this group.…”

Section: Introductionmentioning

confidence: 99%

Differences in systemic and mucosal SARS-CoV-2 antibody prevalence in a prospective cohort of Dutch children

et al. 2022

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BackgroundAs SARS-CoV-2 will likely continue to circulate, low-impact methods become more relevant to monitor antibody-mediated immunity. Saliva sampling could provide a non-invasive method with reduced impact on children. Studies reporting on the differences between systemic and mucosal humoral immunity to SARS-CoV-2 are inconsistent in adults and scarce in children. These differences may be further unraveled by exploring associations to demographic and clinical variables.MethodsTo evaluate the use of saliva antibody assays, we performed a cross-sectional cohort study by collecting serum and saliva of 223 children attending medical services in the Netherlands (irrespective of SARS-CoV-2 exposure, symptoms or vaccination) from May to October 2021. With a Luminex and a Wantai assay, we measured prevalence of SARS-CoV-2 spike (S), receptor binding domain (RBD) and nucleocapsid-specific IgG and IgA in serum and saliva and explored associations with demographic variables.FindingsThe S-specific IgG prevalence was higher in serum 39% (95% CI 32 – 45%) than in saliva 30% (95% CI 24 – 36%) (P ≤ 0.003). Twenty-seven percent (55/205) of children were S-specific IgG positive in serum and saliva, 12% (25/205) were only positive in serum and 3% (6/205) only in saliva. Vaccinated children showed a higher concordance between serum and saliva than infected children. Odds for saliva S-specific IgG positivity were higher in girls compared to boys (aOR 2.63, P = 0.012). Moreover, immunocompromised children showed lower odds for S- and RBD-specific IgG in both serum and saliva compared to healthy children (aOR 0.23 – 0.25, P ≤ 0.050).ConclusionsWe showed that saliva-based antibody assays can be useful for identifying SARS-CoV-2 humoral immunity in a non-invasive manner, and that IgG prevalence may be affected by sex and immunocompromisation. Differences between infection and vaccination, between sexes and between immunocompromised and healthy children should be further investigated and considered when choosing systemic or mucosal antibody measurement.

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Child transmission of SARS-CoV-2: a systematic review and meta-analysis

Cited by 51 publications

References 80 publications

COVID-19 outbreaks in child care facilities Alberta from March 2020 to December 31, 2021

COVID-19 outbreaks in child care facilities Alberta from March 2020 to December 31, 2021

Infection-induced immunity is associated with protection against SARS-CoV-2 infection, but not decreased infectivity during household transmission

Differences in systemic and mucosal SARS-CoV-2 antibody prevalence in a prospective cohort of Dutch children

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