Secondary household transmission of SARS-CoV-2 among children and adolescents: Clinical and epidemiological aspects
Secondary household transmission of SARS-CoV-2 among children and adolescents: Clinical and epidemiological aspects
复制标题
DOI：
10.1002/ppul.25711
复制
发表时间：
2021-10-13
影响因子：
3.1
通讯作者：
Guimaraes, Rafael A.
中科院分区：
文献类型：
--
作者：
Afonso, Eliane T.;Marques, Solomar M.;Guimaraes, Rafael A.
目的 评估儿童和青少年、基本活动工作人员的接触者感染 SARS-CoV-2 的二次发病率（SAR）；并描述相关的临床和流行病学数据。方法 对 2020 年 3 月至 10 月在巴西中部戈亚尼亚市 5 至 19 岁的儿童和青少年进行了一项横断面研究，这些儿童和青少年是感染 SARS-CoV-2 的父母和其他亲属的家庭接触者。收集了所有参与者的社会人口学和临床数据。收集鼻咽和口咽拭子，并使用实时逆转录聚合酶链反应 (RT-PCR) 检测 SARS-CoV-2 RNA。使用泊松回归分析与 SARS-CoV-2 感染和 SAR 相关的因素。结果共调查267名儿童青少年。通过实时 RT-PCR 检测得出的 SARS-CoV-2 RNA 患病率和/或存在 COVID-19 相关症状（嗅觉丧失/味觉缺失和流感综合征）的患病率为 25.1%（95.0% 置信区间 [95.0% CI] = 20.3-30.6）。超过一半（55.1%）的参与者有体征和症状。阳性个体中最常见的体征和症状是鼻塞（62.7%）、头痛（55.2%）、咳嗽（50.8%）、肌痛（47.8%）、流鼻涕（47.8%）和嗅觉丧失（47.8%）。泊松模型显示以下体征或症状与 SARS-CoV-2 感染相关：发烧、鼻塞、食欲下降、恶心、嗅觉丧失和味觉缺失。除了指示病例之外，有超过一名成人感染的家庭对儿童和青少年的传染性也更大。结论 我们的研究结果支持这样的假设：在保持社交距离和学校关闭期间，儿童和青少年并不是家庭环境中 SARS-CoV-2 的重要传播源；尽管他们在家庭中容易受到感染（约占我们研究人口的 1/4）。
Objective To evaluate the secondary attack rate (SAR) in children and adolescents, contacts of essential activities workers who were infected by SARS-CoV-2; and to describe associated clinical and epidemiological data. Methods A cross-sectional study conducted in children and adolescents aged 5 to 19 years of age, that were household contacts of parents and other relatives who were infected by SARS-CoV-2 in the city of Goiania, Central Brazil, from March to October 2020. Sociodemographic and clinical data were collected from all participants. Nasopharyngeal and oropharyngeal swabs were collected and tested for SARS-CoV-2 RNA using real-time reverse transcription polymerase chain reaction (RT-PCR). Factors associated with SARS-CoV-2 infection and SAR were analyzed using Poisson regression. Results A total of 267 children and adolescents were investigated. The prevalence of SARS-CoV-2 RNA by the real-time RT-PCR test and/or the presence of COVID-19 associated symptoms (anosmia/ageusia and flu syndrome) was 25.1% (95.0% Confidence Interval [95.0% CI] = 20.3-30.6). More than half (55.1%) of the participants had sygns and symptoms. The most prevalent signs and symptoms in positive individuals were nasal congestion (62.7%), headache (55.2%), cough (50.8%), myalgia (47.8%), runny nose (47.8%), and anosmia (47.8%). The Poisson model showed that the following signs or symptoms were associated with SARS-CoV-2 infection: fever, nasal congestion, decreased appetite, nausea, anosmia, and ageusia. Families that had more than one infected adult, in addition to the index case, presented greater transmissibility to children and adolescents. Conclusions Our results contribute to the hypothesis that children and adolescents are not important sources of transmission of SARS-CoV-2 in the home environment during a period of social distancing and school closure; even though they are susceptible to infection in the household (around 1/4 of our study population).