Review article

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

Yanshan ZhuSchool of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, AustraliaConor J. BloxhamSchool of Biomedical Science, The University of Queensland, Brisbane, AustraliaKatina D. HulmeSchool of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, AustraliaJane E. SinclairSchool of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, AustraliaZhen TongSchool of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, AustraliaLauren E. SteeleSchool of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, AustraliaEllesandra C. NoyeSchool of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, AustraliaJiahai LuOne Health Center of Excellence for Research and Training, Department of epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, ChinaYao XiaSchool of Science, Edith Cowan University, Australia; School of Biomedical Science, The University of Western Australia, Perth, AustraliaKeng Yih ChewSchool of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, AustraliaJanessa PickeringWesfarmer’s Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Perth, Western AustraliaCharles F. GilksAustralian Infectious Diseases Research Centre, The University of Queensland, Brisbane, AustraliaAsha C BowenDepartment of Infectious Diseases, Perth Children’s Hospital, Nedlands, Perth, Western AustraliaKirsty R. ShortAustralian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia

2020en

ABI

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.

Identifiers

DOI: 10.1093/cid/ciaa1825

Citations and references

Cited by 20 references

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