Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Sep:122:266-275.
doi: 10.1016/j.ijid.2022.05.016. Epub 2022 May 11.

The role of children in household transmission of COVID-19: a systematic review and meta-analysis

Feifan Chen  1 , Yan Tian  1 , Lixin Zhang  1 , Yuan Shi  2
Affiliations
Meta-Analysis

The role of children in household transmission of COVID-19: a systematic review and meta-analysis

Feifan Chen et al. Int J Infect Dis. 2022 Sep.

Abstract

Objectives: To explore household transmissibility of SARS-CoV-2 in children in new-variants dominating periods.

Methods: Through retrieval in PubMed and Embase, studies were included in two parts: meta-analysis of the household secondary attack rate (SAR) and case analysis of household pediatric infections.

Results: A total of 95 articles were included: 48 for meta-analysis and 47 for case analysis. Pediatric COVID-19 only comprised a minority of the household transmission. The total pooled household SAR of child index cases and contacts were 0.20 (95% confidence interval [CI]: 0.15-0.26) and 0.24 (95% CI: 0.18-0.30). Lower household transmissibility was reported in both child index cases and contacts than in adults (relative risk [RR] = 0.64, 95% CI: 0.50-0.81; RR = 0.74, 95% CI: 0.64-0.85). Younger children were as susceptible as the older children (RR = 0.89, 95% CI: 0.72-1.10). Through subgroup analyses of different variants and periods, increased household SAR was observed in children (Wild: 0.20; Alpha: 0.42; Delta: 0.35; Omicron: 0.56), and no significant difference was found in household SAR between children and adults when new variants dominated.

Conclusion: Although children were found not to be dominant in the household transmission, their transmissibility of SARS-CoV-2 appeared to be on the rise as new variants emerged.

Keywords: COVID-19; Child; Household transmission; SARS-CoV-2.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Pooled household SAR of child contacts. CI, confidence interval; SAR, secondary attack rate.
Figure 2
Figure 2
Subgroup analyses on household SAR of child contacts in different age groups. CI, confidence interval; RR, risk ratio; SAR, secondary attack rate.
Figure 3
Figure 3
Household SAR comparison between child and adult contacts. CI, confidence interval; RR, risk ratio; SAR, secondary attack rate.
Figure 4
Figure 4
Comparison on household SAR between child and adult index cases. CI, confidence interval; RR, risk ratio; SAR, secondary attack rate.
See this image and copyright information in PMC

References

    1. Afonso ET, Marques SM, Costa LDC, et al. Secondary household transmission of SARS-CoV-2 among children and adolescents: clinical and epidemiological aspects. Pediatr Pulmonol. 2022;57:162–175. - PMC - PubMed
    1. Allen H, Vusirikala A, Flannagan J, et al. Household transmission of COVID-19 cases associated with SARS-CoV-2 delta variant (B.1.617.2): national case-control study. Lancet Reg Health Eur. 2022;12 - PMC - PubMed
    1. Baker JM, Nakayama JY, O'Hegarty M, et al. SARS-CoV-2 B.1.1.529 (Omicron) variant transmission within households - four U.S. jurisdictions, November 2021-February 2022. MMWR Morb Mortal Wkly Rep. 2022;71:341–346. - PMC - PubMed
    1. Bhatt M, Plint AC, Tang K, et al. Household transmission of SARS-CoV-2 from unvaccinated asymptomatic and symptomatic household members with confirmed SARS-CoV-2 infection: an antibody-surveillance study. CMAJ Open. 2022;10:E357–E366. - PMC - PubMed
    1. Bi Q, Lessler J, Eckerle I, et al. Insights into household transmission of SARS-CoV-2 from a population-based serological survey. Nat Commun. 2021;12:3643. - PMC - PubMed