Transmission of SARS-CoV-2 by children and young people in households and schools: A meta-analysis of population-based and contact-tracing studies.
Transmission of SARS-CoV-2 by children and young people in households and schools: A meta-analysis of population-based and contact-tracing studies.
复制标题
DOI：
10.1016/j.jinf.2021.12.026
复制
发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Melendez-Torres GJ
中科院分区：
文献类型：
--
作者：
Viner R;Waddington C;Mytton O;Booy R;Cruz J;Ward J;Ladhani S;Panovska-Griffiths J;Bonell C;Melendez-Torres GJ
儿童和年轻人（CYP）在家庭和教育环境中传播SARS-CoV-2的作用仍不清楚。我们对低偏倚风险的接触者追踪和基于人群的研究进行了系统回顾和荟萃分析。我们于2021年7月28日检索了4个电子数据库，以获取接触者追踪研究和基于人群的研究，这些研究提供了关于SARS-CoV-2在家庭或教育环境中从0至19岁人群传播的信息。我们排除了高偏倚风险的研究，包括未充分确定无症状感染的研究。我们对继发发病率（SAR：接触者追踪研究）和学校感染流行率进行了多水平随机效应荟萃分析，并使用荟萃回归研究社区SARS-CoV-2发病率对学校感染流行率的影响。综述了4529篇摘要，纳入了37项研究（16项接触者追踪研究，19项人口研究，2项混合研究）。在调整后的家庭研究中，CYP与成人的总相对传播率为0.92（0.68,1.26）。在学校研究中，CYP的综合SAR （p = 0.002）比家庭研究(7.6%（3.6,15.9）低0.7%（0.2,2.7）。CYP与儿童或成人接触者的SAR无差异。学校人口研究显示了学校内部班级聚集的一些证据。学校感染流行率与当代社区14天发病率相关（OR 1.003 (1.001, 1.004), p<0.001）。我们发现，与家庭环境中的成年人相比，CYP的SARS-CoV-2传播没有差异。与家庭环境相比，学校环境中的SAR明显较低，这表明在本次大流行中，家庭传播比学校传播更为重要。学校感染流行率与社区感染发生率相关，支持了学校感染广泛反映社区感染的假设。这些发现对于在大流行期间指导有关屏蔽、疫苗接种学校和业务的政策决定具有重要意义。
The role of children and young people (CYP) in transmission of SARS-CoV-2 in household and educational settings remains unclear. We undertook a systematic review and meta-analysis of contact-tracing and population-based studies at low risk of bias. We searched 4 electronic databases on 28 July 2021 for contact-tracing studies and population-based studies informative about transmission of SARS-CoV-2 from 0 to 19 year olds in household or educational settings. We excluded studies at high risk of bias, including from under-ascertainment of asymptomatic infections. We undertook multilevel random effects meta-analyses of secondary attack rates (SAR: contact-tracing studies) and school infection prevalence, and used meta-regression to examine the impact of community SARS-CoV-2 incidence on school infection prevalence. 4529 abstracts were reviewed, resulting in 37 included studies (16 contact-tracing; 19 population studies; 2 mixed studies). The pooled relative transmissibility of CYP compared with adults was 0.92 (0.68, 1.26) in adjusted household studies. The pooled SAR from CYP was lower (p = 0.002) in school studies 0.7% (0.2, 2.7) than household studies (7.6% (3.6, 15.9) . There was no difference in SAR from CYP to child or adult contacts. School population studies showed some evidence of clustering in classes within schools. School infection prevalence was associated with contemporary community 14-day incidence (OR 1.003 (1.001, 1.004), p<0.001). We found no difference in transmission of SARS-CoV-2 from CYP compared with adults within household settings. SAR were markedly lower in school compared with household settings, suggesting that household transmission is more important than school transmission in this pandemic. School infection prevalence was associated with community infection incidence, supporting hypotheses that school infections broadly reflect community infections. These findings are important for guiding policy decisions on shielding, vaccination school and operations during the pandemic.
登录
查看更多内容
影响因子：
11.8
作者：
Hoch M;Vogel S;Kolberg L;Dick E;Fingerle V;Eberle U;Ackermann N;Sing A;Huebner J;Rack-Hoch A;Schober T;von Both U
通讯作者：
von Both U
影响因子：
33.9
作者：
Blaisdell, Laura L.;Cohn, Wendy;Vergales, Jeffrey E.
通讯作者：
Vergales, Jeffrey E.
DOI：
10.2807/1560-7917.es.2020.25.49.2001911
发表时间：
2020-12
期刊：
Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin
影响因子：
--
作者：
Larosa E;Djuric O;Cassinadri M;Cilloni S;Bisaccia E;Vicentini M;Venturelli F;Giorgi Rossi P;Pezzotti P;Bedeschi E;Reggio Emilia Covid-19 Working Group
通讯作者：
Reggio Emilia Covid-19 Working Group
影响因子：
16.6
作者：
Hu S;Wang W;Wang Y;Litvinova M;Luo K;Ren L;Sun Q;Chen X;Zeng G;Li J;Liang L;Deng Z;Zheng W;Li M;Yang H;Guo J;Wang K;Chen X;Liu Z;Yan H;Shi H;Chen Z;Zhou Y;Sun K;Vespignani A;Viboud C;Gao L;Ajelli M;Yu H
通讯作者：
Yu H
影响因子：
5.2
作者：
Kim, Jieun;Choe, Young June;Choi, Eun Hwa
通讯作者：
Choi, Eun Hwa