No SARS-CoV-2 carriage observed in children attending daycare centers during the first weeks of the epidemic in Belgium

Desmet, Stefanie; Ekinci, Esra; Wouters, Ine; Decru, Bram; Beuselinck, Kurt; Malhotra-Kumar, Surbhi; Theeten, Heidi

doi:10.1101/2020.05.13.20095190

Cited by 5 publications

(9 citation statements)

References 17 publications

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“…The initial search retrieved 2,178 articles. After screening, 11 studies were eligible for inclusion ( Figure 1), including five cohort studies [13][14][15][16][17] and six cross-sectional studies [18][19][20][21][22][23]. We did not identify viral genotyping studies.…”

Section: Resultsmentioning

confidence: 99%

“…A study in Belgium measured the prevalence of SARS-CoV-2 in randomly sampled 84 children attending eight daycare centres during the period 2-12 March, and found all analyzed samples were negative for SARS-CoV-2 [21].…”

Section: Resultsmentioning

confidence: 99%

“…Cross-sectional studies estimated the proportion of SARS-CoV-2 positive cases, to give an insight into how many people have been infected in schools. As described above, the positivity results in the general study population under school environment varied from 0.00 (lowest in eight daycare centers in Belgium) to 25.87% (highest in one high school in France), which is likely to reflect the community positivity rate at the time the study was conducted [18][19][20][21][22][23]. The lower positivity rate in students suggested that students are less susceptible to infection and/or less frequently infected than adult school staff, which indicated that students are not at higher risk of causing super-spreading events in schools.…”

Section: Discussionmentioning

confidence: 99%

“…We also meta-analyzed SARS-CoV-2 positivity rates in schools (Table 4) from a total of six cross-sectional studies which included 639 SARS-CoV-2 positive cases in 6,682 participants tested [18][19][20][21][22][23]. The result of the random effect meta-analysis showed that the pooled SARS-CoV-2 positivity rate of total study participants was 8.00% (95% CI: 2.17%-16.95%) with substantial heterogeneity (I 2 = 99.2%) ( Figure 5A), but no evidence of publication bias ( Figure 5B, 5C).…”

Section: Sars-cov-2 Positivity Ratementioning

confidence: 99%

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What is the evidence for transmission of COVID-19 by children in schools? A living systematic review

Dozier

et al. 2020

Preprint

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Background: It is of paramount importance to understand the transmission of SARS-CoV-2 in schools, which could support the decision-making about educational facilities closure or re-opening with effective prevention and control measures in place. Methods: We conducted a systematic review and meta-analysis to investigate the extent of SARS-CoV-2 transmission in schools. We performed risk of bias evaluation of all included studies using the Newcastle- Ottawa Scale (NOS). Results: 2,178 articles were retrieved and 11 studies were included. Five cohort studies reported a combined 22 student and 21 staff index cases that exposed 3,345 contacts with 18 transmissions [overall infection attack rate (IAR): 0.08% (95% CI: 0.00%-0.86%)]. IARs for students and school staff were 0.15% (95% CI: 0.00%-0.93%) and 0.70% (95% CI: 0.00%-3.56%) respectively. Six cross-sectional studies reported 639 SARS-CoV-2 positive cases in 6,682 study participants tested [overall SARS-CoV-2 positivity rate: 8.00% (95% CI: 2.17%-16.95%)]. SARS-CoV-2 positivity rate was estimated to be 8.74% (95% CI: 2.34%-18.53%) among students, compared to 13.68% (95% CI: 1.68%-33.89%) among school staff. Gender differences were not found for secondary infection (OR: 1.44, 95% CI: 0.50-4.14, P= 0.49) and SARS-CoV-2 positivity (OR: 0.90, 95% CI: 0.72-1.13, P= 0.36) in schools. Fever, cough, dyspnea, ageusia, anosmia, rhinitis, sore throat, headache, myalgia, asthenia, and diarrhoea were all associated with the detection of SARS-CoV-2 antibodies (based on two studies). Overall, study quality was judged to be poor with risk of performance and attrition bias, limiting the confidence in the results. Conclusions: There is limited high-quality evidence available to quantify the extent of SARS-CoV-2 transmission in schools or to compare it to community transmission. Emerging evidence suggests lower IAR and SARS-CoV-2 positivity rate in students compared to school staff. Future prospective and adequately controlled cohort studies are necessary to confirm this finding.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Sars-cov-2 Positivity Ratementioning

confidence: 99%

See 2 more Smart Citations

What is the evidence for transmission of COVID-19 by children in schools? A living systematic review

Dozier

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…The initial search retrieved 2178 articles. After screening, 11 studies were eligible for inclusion (Figure 1), including five cohort studies [17][18][19][20][21] and six cross-sectional studies [11,12,[22][23][24][25]. We did not identify viral genotyping studies.…”

Section: Resultsmentioning

confidence: 99%

What Is the Evidence for Transmission of COVID-19 by Children in Schools? A Living Systematic Review

Dozier

et al. 2020

SSRN Journal

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What is the evidence for transmission of COVID-19 by children in schools? A living systematic review Background It is of paramount importance to understand the transmission of SARS-CoV-2 in schools, which could support the decision-making about educational facilities closure or re-opening with effective prevention and control measures in place. MethodsWe conducted a systematic review and meta-analysis to investigate the extent of SARS-CoV-2 transmission in schools. We performed risk of bias evaluation of all included studies using the Newcastle-Ottawa Scale (NOS).Results 2178 articles were retrieved and 11 studies were included. Five cohort studies reported a combined 22 student and 21 staff index cases that exposed 3345 contacts with 18 transmissions (overall infection attack rate (IAR): 0.08%, 95% confidence interval (CI) = 0.00%-0.86%). IARs for students and school staff were 0.15% (95% CI = 0.00%-0.93%) and 0.70% (95% CI = 0.00%-3.56%) respectively. Six cross-sectional studies reported 639 SARS-CoV-2 positive cases in 6682 study participants tested [overall SARS-CoV-2 positivity rate: 8.00% (95% CI = 2.17%-16.95%). SARS-CoV-2 positivity rate was estimated to be 8.74% (95% CI = 2.34%-18.53%) among students, compared to 13.68% (95% CI = 1.68%-33.89%) among school staff. Gender differences were not found for secondary infection (OR = 1.44, 95% CI = 0.50-4.14, P = 0.49) and SARS-CoV-2 positivity (OR = 0.90, 95% CI = 0.72-1.13, P = 0.36) in schools. Fever, cough, dyspnea, ageusia, anosmia, rhinitis, sore throat, headache, myalgia, asthenia, and diarrhoea were all associated with the detection of SARS-CoV-2 antibodies (based on two studies). Overall, study quality was judged to be poor with risk of performance and attrition bias, limiting the confidence in the results. ConclusionsThere is limited high-quality evidence available to quantify the extent of SARS-CoV-2 transmission in schools or to compare it to community transmission. Emerging evidence suggests lower IAR and SARS-CoV-2 positivity rate in students compared to school staff. Future prospective and adequately controlled cohort studies are necessary to confirm this finding.

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Factors affecting the transmission of SARS-CoV-2 in school settings

Reynolds

Yang

2021

Preprint

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Background Several studies have reported SARS-CoV-2 outbreaks in schools, with a wide range of secondary attack rate (SAR; range: 0-100%). We aimed to examine the key risk factors to better understand transmission in school settings. Methods We collected records of SARS-CoV-2 school outbreaks globally published from January 2020 to January 2021 and compiled information on hypothesized risk factors. We utilized the directed acyclic graph (DAG) to conceptualize the risk mechanisms, used logistic regression to examine each risk-factor group, and further built multiple variable models based on the marginal analysis. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated. Results From 17 relevant articles, 26 school clusters were included for analysis. The best-fit model showed that the intensity of community transmission (aOR: 1.26; 95% CI: 1.22 - 1.30, for each increase of 10 cases per 100,000 persons per week), social distancing (aOR: 0.26; 95% CI: 0.18 - 0.37), mask-wearing (aOR: 0.52; 95% CI: 0.35 - 0.78) were associated the risk of SARS-CoV-2 infection in schools. Compared to students in pre-schools, the aOR was 0.12 (95% CI: 0.07 - 0.19) for students in primary schools and 1.31 (95% CI: 0.93 - 1.87) for students in high schools. Conclusions Preventive measures in both schools (e.g. social distancing and mask-wearing) and communities (additionally, vaccination) should be taken to collectively reduce transmission and protect children in schools. Flexible reopening policies may be considered for different levels of schools given their risk differences.

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No SARS-CoV-2 carriage observed in children attending daycare centers during the first weeks of the epidemic in Belgium

Cited by 5 publications

References 17 publications

What is the evidence for transmission of COVID-19 by children in schools? A living systematic review

What is the evidence for transmission of COVID-19 by children in schools? A living systematic review

What Is the Evidence for Transmission of COVID-19 by Children in Schools? A Living Systematic Review

Factors affecting the transmission of SARS-CoV-2 in school settings

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