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. 2022 Jan;57(1):162-175.
doi: 10.1002/ppul.25711. Epub 2021 Oct 13.

Secondary household transmission of SARS-CoV-2 among children and adolescents: Clinical and epidemiological aspects

Eliane T Afonso  1 , Solomar M Marques  1 , Lusmaia D C Costa  1 , Patrícia M Fortes  1 , Fernanda Peixoto  1 , Danielli C Bichuetti-Silva  1 , Natália D A Aredes  2 , Claci F W Rosso  2 , Faétila Dos S Oliveira  2 , Fabíola S Fiaccadori  3 , Menira B de L D E Souza  3 , Elisângela de P Silveira-Lacerda  4 , Gabriela S Bazilio  5 , Clayton L Borges  6 , Juliana A P Rocha  6 , Alessandra V Naghettini  1 , Paulo S S da Costa  1 , Rafael A Guimarães  2
Affiliations

Secondary household transmission of SARS-CoV-2 among children and adolescents: Clinical and epidemiological aspects

Eliane T Afonso et al. Pediatr Pulmonol. 2022 Jan.

Abstract

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 Goiânia, 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 ¼ of our study population).

Keywords: COVID-19; SARS-CoV-2; adolescents; children; epidemiology; household infections.

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Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
Comparative analysis of the signs and symptoms presented by children and adolescents (household contacts of index cases) between positive and negative for SARS‐CoV‐2
See this image and copyright information in PMC

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