Lower SARS-CoV-2 household transmission in children and adolescents compared to adults

Schumm, Leonie; Blankenburg, Judith; Kahre, Elisabeth; Armann, Jakob; Dalpke, Alexander H.; Lück, Christian; Berner, Reinhard; Czyborra, Paula

doi:10.1038/s41598-022-24643-2

Cited by 10 publications

(3 citation statements)

References 42 publications

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“…These findings were echoed in studies outside of households where the infection rate of SARS-CoV-2 among children younger than 10 years was significantly lower than that of adults [2]. However, since August 2020, the continuous emergence of new variants of SARS-CoV-2 has raised questions as to whether there has been a fundamental shift in the epidemiology of SARS-CoV-2 [3,4].…”

Section: Introductionmentioning

confidence: 99%

The role of children in transmission of SARS-CoV-2 variants of concern within households: an updated systematic review and meta-analysis, as at 30 June 2022

et al. 2023

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Background Meta-analyses and single-site studies have established that children are less infectious than adults within a household when positive for ancestral SARS-CoV-2. In addition, children appear less susceptible to infection when exposed to ancestral SARS-CoV-2 within a household. The emergence of SARS-CoV-2 variants of concern (VOC) has been associated with an increased number of paediatric infections worldwide. However, the role of children in the household transmission of VOC, relative to the ancestral virus, remains unclear. Aim We aimed to evaluate children's role in household transmission of SARS-CoV-2 VOC. Methods We perform a meta-analysis of the role of children in household transmission of both ancestral SARS-CoV-2 and SARS-CoV-2 VOC. Results Unlike with the ancestral virus, children infected with VOC spread SARS-CoV-2 to an equivalent number of household contacts as infected adults and were equally as likely to acquire SARS-CoV-2 VOC from an infected family member. Interestingly, the same was observed when unvaccinated children exposed to VOC were compared with unvaccinated adults exposed to VOC. Conclusions These data suggest that the emergence of VOC was associated with a fundamental shift in the epidemiology of SARS-CoV-2. It is unlikely that this is solely the result of age-dependent differences in vaccination during the VOC period and may instead reflect virus evolution over the course of the pandemic.

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Section: Introductionmentioning

confidence: 99%

The role of children in transmission of SARS-CoV-2 variants of concern within households: an updated systematic review and meta-analysis, as at 30 June 2022

et al. 2023

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“…Due to the associated risks of anesthesia complications and exposure for perioperative staff and patients, many elective surgeries have been postponed or canceled. Compared to adults, a higher proportion of pediatric patients infected with the novel coronavirus exhibit asymptomatic infections, and their infectivity is significantly lower than that of adult patients [ 1 ]. Omicron rapidly replaced Delta as the dominant variant worldwide since November/December 2021 [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Timing of general anesthesia for pediatric patients recovering from COVID-19: a prospective cohort study

Zhao,

Liu,

Zhang

et al. 2024

BMC Anesthesiol

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Objective To explore the timing of general anesthesia for pediatric patients who have recovered from novel coronavirus infection and summarize anesthesia-related complications. Methods We summarized the perioperative management of children under 14 years of age who underwent general anesthesia in our hospital according to national epidemic prevention and control requirements. We compared the incidence of postoperative pulmonary complications within 2 weeks (Group A), 3–4 weeks (Group B), and 5–6 weeks (Group C) after COVID-19 recovery. Results There were differences among the three groups in terms of decreased blood oxygen saturation (< 94%), secretions, and coughing during the PACU period. The risk of low blood oxygen saturation during PACU decreased as the time of COVID-19 recovery extended in the three groups. Compared to Group A, the risk of low blood oxygen saturation was lower in Group B. The presence of respiratory symptoms and a body temperature above 40℃ increased the risk of decreased blood oxygen saturation. The proportion of children aged 11–14 years and children with high fever experiencing decreased blood oxygen saturation during PACU was higher in Groups A and B. Among the three groups, children with respiratory symptoms and longer illness duration had a higher proportion of decreased blood oxygen saturation during PACU. Conclusion Pediatric patients who have recovered from COVID-19 for more than 2 weeks have a lower risk of postoperative complications after general anesthesia. For children with respiratory system symptoms or high fever, there is a higher risk of transient blood oxygen saturation decrease during PACU. For older children, those with high fever, respiratory system symptoms, or longer illness duration, it is recommended to appropriately extend the time from COVID-19 recovery to surgery.

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“…However, less is known about whether the role of children in familial clusters has changed with the rollout of vaccination and the emergence of variants of concern (VOC). A study during the VOC Beta wave in Germany found that household transmission from adults was more frequent than from children [4]. Furthermore, as most studies evaluating the direction of transmission took place in high-income countries, little is known about the direction of transmission between age groups in lower resource settings.…”

mentioning

confidence: 99%

The Role of Children in Household Transmission of SARS-CoV-2 Across Four Waves of the Pandemic

Fuller

Bastos

Carvalho

et al. 2023

Journal of the Pediatric Infectious Diseases Society

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Background It is important to understand the dynamics of SARS-CoV-2 transmission in close-contact settings such as households. We hypothesized that children would most often acquire SARS-CoV-2 from a symptomatic adult caregiver. Methods This prospective cohort study was conducted from April 2020 to July 2022 in a low-resource, urban settlement in Brazil. We recruited families who brought their children to a public clinic. We collected nasopharyngeal and oral swabs from household members and tracked symptoms and vaccination. Results In total, 1,256 participants in 298 households were tested for SARS-CoV-2. A total of 4073 RT-PCR tests were run with 893 SARS-CoV-2 positive results (21.9%). SARS-CoV-2 cases were defined as isolated cases (n=158) or well-defined transmission events (n=175). The risk of household transmission was lower if the index case was a child (OR: 0.3 [95% CI: 0.16-0.55], p<0.001) or was vaccinated (OR: 0.29 [95%CI: 0.1-0.85], p=0.024), and higher if the index was symptomatic (OR: 2.53 [95% CI: 1.51-4.26], p<0.001). The secondary attack rate for child index cases to child contacts was 0.29, whereas the secondary attack rate from adult index cases to child contacts was 0.47 (p=0.08). Conclusions In this community, children were significantly less infectious to their household contacts than adolescents or adults. Most children were infected by a symptomatic adult, usually their mother. There was a double benefit of vaccination as it protected the vaccinee from severe illness and prevented onward transmission to household contacts. Our findings may also be valid for similar populations throughout Latin America.

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Lower SARS-CoV-2 household transmission in children and adolescents compared to adults

Cited by 10 publications

References 42 publications

The role of children in transmission of SARS-CoV-2 variants of concern within households: an updated systematic review and meta-analysis, as at 30 June 2022

The role of children in transmission of SARS-CoV-2 variants of concern within households: an updated systematic review and meta-analysis, as at 30 June 2022

Timing of general anesthesia for pediatric patients recovering from COVID-19: a prospective cohort study

The Role of Children in Household Transmission of SARS-CoV-2 Across Four Waves of the Pandemic

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