Journal
CLINICAL INFECTIOUS DISEASES
Volume 72, Issue 12, Pages E1146-E1153Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciaa1825
Keywords
children; SARS-CoV-2; COVID-19; transmission; household
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The role of children in the spread of SARS-CoV-2 remains controversial, with studies showing lower transmission rates when children are index cases and lower secondary attack rates in pediatric household contacts compared to adults. These findings have implications for COVID-19 management and potential vaccine prioritization strategies.
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.
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