A Meta-analysis on the Role of Children in Severe Acute Respiratory Syndrome Coronavirus 2 in Household Transmission Clusters

Yanshan Zhu, Conor J. Bloxham, Katina D. Hulme, Jane E. Sinclair, Zhen Wei Marcus Tong, Lauren E. Steele, Ellesandra C. Noye, Jiahai Lu, Yao Xia, Keng Yih Chew, Janessa Pickering, Charles Gilks, Asha C. Bowen, Kirsty R. Short

Research output: Contribution to journalReview articlepeer-review

107 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)E1146-E1153
JournalClinical Infectious Diseases
Volume72
Issue number12
DOIs
Publication statusPublished - 15 Jun 2021

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