Reconstruction of Transmission Pairs for Novel Coronavirus Disease 2019 (COVID-19) in Mainland China: Estimation of Superspreading Events, Serial Interval, and Hazard of Infection
Reconstruction of Transmission Pairs for Novel Coronavirus Disease 2019 (COVID-19) in Mainland China: Estimation of Superspreading Events, Serial Interval, and Hazard of Infection
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中国大陆2019新型冠状病毒病（COVID-19）传播对重建：超级传播事件、序列间隔和感染风险的估计
DOI：
10.1093/cid/ciaa790
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发表时间：
2020-12-15
影响因子：
11.8
通讯作者：
Wang, Lin
中科院分区：
文献类型：
--
作者：
Xu, Xiao-Ke;Liu, Xiao Fan;Wang, Lin
背景关于新型冠状病毒病（COVID-19）的流行病学特征和传播模式的认识正在不断积累。家庭环境下的详细线路清单数据可以促进对COVID-19传播动态的理解。方法从2020年1月15日至2月29日报告的9120例COVID-19确诊病例中重建中国大陆形成643个传播聚集的1407对传播对的详细人口统计学特征、旅行史、社会关系和流行病学时间线的独特数据库。统计模型拟合用于识别超扩散事件和估计序列区间分布。对家庭与非家庭传播的年龄和性别分层感染危险进行了估计。结果原发性超传播病例34例，其中5例发生在家庭内。家庭传播的序列间隔均值和标准差估计分别为5.0（95%可信区间[CrI]， 4.4-5.5）天和5.2（95%可信区间[CrI]， 4.9-5.7）天和5.2（95%可信区间[CrI]， 4.6-5.8）天和5.3（95%可信区间[CrI]， 4.9-5.7）天。18-64岁的人在家庭外感染的危险更高，而在家庭内感染的危险对年轻人和老年人来说更高。结论：在工作年龄男性人群中，超传播事件的频率不可忽视、连续时间间隔短、家庭外感染风险较高，这表明COVID-19病例的识别和管理存在重大障碍，需要加强非药物干预措施，以减轻这次大流行。
Abstract Background Knowledge on the epidemiological features and transmission patterns of novel coronavirus disease (COVID-19) is accumulating. Detailed line-list data with household settings can advance the understanding of COVID-19 transmission dynamics. Methods A unique database with detailed demographic characteristics, travel history, social relationships, and epidemiological timelines for 1407 transmission pairs that formed 643 transmission clusters in mainland China was reconstructed from 9120 COVID-19 confirmed cases reported during 15 January–29 February 2020. Statistical model fittings were used to identify the superspreading events and estimate serial interval distributions. Age- and sex-stratified hazards of infection were estimated for household vs nonhousehold transmissions. Results There were 34 primary cases identified as superspreaders, with 5 superspreading events occurred within households. Mean and standard deviation of serial intervals were estimated as 5.0 (95% credible interval [CrI], 4.4–5.5) days and 5.2 (95% CrI, 4.9–5.7) days for household transmissions and 5.2 (95% CrI, 4.6–5.8) and 5.3 (95% CrI, 4.9–5.7) days for nonhousehold transmissions, respectively. The hazard of being infected outside of households is higher for people aged 18–64 years, whereas hazard of being infected within households is higher for young and old people. Conclusions Nonnegligible frequency of superspreading events, short serial intervals, and a higher risk of being infected outside of households for male people of working age indicate a significant barrier to the identification and management of COVID-19 cases, which requires enhanced nonpharmaceutical interventions to mitigate this pandemic.