Risk factors associated with household transmission of SARS‐CoV‐2 in Negeri Sembilan, Malaysia

Abstract

Aim Households are a significant venue for the transmission of SARS‐CoV‐2. We conducted a study to characterise the transmission dynamics and identify risk factors for household transmission of SARS‐CoV‐2 in Negeri Sembilan, Malaysia. Methods This retrospective observational study included 185 families of paediatric COVID‐19 cases from 1 February 2020 to 31 December 2020. We identified the index case for each household and gathered the socio‐demographic, epidemiological investigation results and risk factors for household transmission from medical case records. The secondary attack rate was calculated, and logistic regression analyses were used to identify risk factors associated with secondary household transmission of SARS‐CoV‐2. Results Of the 848 household contacts, 466 acquired secondary infections, resulting in a secondary attack rate of 55%. The median age of the secondary cases was 12 years. Female household contacts and household contacts who slept in the same room with the index case were significantly associated with increased risk for COVID‐19. Other independent risk factors associated with higher transmission risk in the household included an index case who was symptomatic, a household index case aged greater than 18 years and a male household index case. Conclusions High rates of household transmission of COVID‐19 were found, indicating households were a major setting of transmission of SARS‐CoV‐2. Our data provide insight into the risk factors for household transmission of SARS‐CoV‐2 in Malaysia.

Comparison of Severe Viral Pneumonia Caused by SARS-CoV-2 and Other Respiratory Viruses Among Malaysian Children During the COVID-19 Pandemic

“…This is understandable as HRV/EV was the predominant circulating virus during the study period, and children are important reservoirs of these viruses. On the other hand, adults were the primary source of household transmission of SARS-CoV-2 as shown in a local study ( 30 ), and sick contact with an adult was a predictor for SARS-CoV-2.…”

Household Secondary Attack Rates of SARS-CoV-2 by Variant and Vaccination Status

“…We identified 2097 records (1791 from PubMed, 306 from medRxiv, and 2 from reference lists of eligible articles) published between June 18, 2021, and March 8, 2022 (eFigure 1 in the Supplement ). Fifty-eight new studies 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 (eTable 2 in the Supplement ) were combined with 77 studies from ou...…”

“…We identified 2097 records (1791 from PubMed, 306 from medRxiv, and 2 from reference lists of eligible articles) published between June 18, 2021, and March 8, 2022 (eFigure 1 in the Supplement). Fifty-eight new studies (eTable 2 in the Supplement) were combined with 77 studies from our previous review (see eTable 3 in the Supplement for references included from our previous review), with Figure 1 showing household SAR by study period, resulting in 135 total studies representing 1 375 806 contacts from 36 countries. Four of the new studies were preprints in our previous review that were subsequently published.…”

Clinical characteristics of COVID‐19 in hospitalized young infants and risk factors for disease severity

“…9,10 We observed that most of the accompanying mothers had concurrent COVID-19 infection, compatible with our previous findings that adults were the primary source of household transmission of SARS-CoV-2. 11 Family screening from infected household members detected some neonates with asymptomatic infection who were hospitalized due to their young age. The proportion of patients who received empirical iv antibiotics was significantly higher in the neonatal group, despite 20% of the neonates being asymptomatic.…”