家庭传播 COVID-19 的特征。
Characteristics of Household Transmission of COVID-19.
机构信息
Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Thyroid and Breast Surgery, Union Hospital Affiliated With Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
Clin Infect Dis. 2020 Nov 5;71(8):1943-1946. doi: 10.1093/cid/ciaa450.
BACKGROUND
Since December 2019, SARS-CoV-2 has extended to most parts of China with >80 000 cases and to at least 100 countries with >60 000 international cases as of 15 March 2020. Here we used a household cohort study to determine the features of household transmission of COVID-19.
METHODS
A total of 105 index patients and 392 household contacts were enrolled. Both index patients and household members were tested by SARS-CoV-2 RT-PCR. Information on all recruited individuals was extracted from medical records and confirmed or supplemented by telephone interviews. The baseline characteristics of index cases and contact patients were described. Secondary attack rates of SARS-CoV-2 to contact members were computed and the risk factors for transmission within the household were estimated.
RESULTS
Secondary transmission of SARS-CoV-2 developed in 64 of 392 household contacts (16.3%). The secondary attack rate to children was 4% compared with 17.1% for adults. The secondary attack rate to the contacts within the households with index patients quarantined by themselves since onset of symptoms was 0% compared with 16.9% for contacts without quarantined index patients. The secondary attack rate to contacts who were spouses of index cases was 27.8% compared with 17.3% for other adult members in the households.
CONCLUSIONS
The secondary attack rate of SARS-CoV-2 in household is 16.3%. Age of household contacts and spousal relationship to the index case are risk factors for transmission of SARS-CoV-2 within a household. Quarantine of index patients at home since onset of symptoms is useful to prevent the transmission of SARS-Co-2 within a household.
背景
自 2019 年 12 月以来，SARS-CoV-2 已蔓延至中国大部分地区，确诊病例超过 8 万例，并传播至至少 100 个国家，国际确诊病例超过 6 万例。截至 2020 年 3 月 15 日，我们采用家庭队列研究来确定 COVID-19 家庭传播的特征。
方法
共纳入 105 例确诊患者和 392 名家庭接触者。对所有确诊患者和家庭成员均采用 SARS-CoV-2 RT-PCR 检测。所有纳入患者的信息均从病历中提取，并通过电话访谈进行确认或补充。描述了确诊患者和接触者的基线特征。计算了 SARS-CoV-2 对接触者的二代发病率，并估计了家庭内传播的危险因素。
结果
392 名家庭接触者中，有 64 例（16.3%）发生 SARS-CoV-2 二代传播。儿童的二代发病率为 4%，成人的二代发病率为 17.1%。从发病开始，对自行隔离的确诊患者的家庭接触者的二代发病率为 0%，对未隔离的确诊患者的家庭接触者的二代发病率为 16.9%。确诊患者的配偶作为接触者的二代发病率为 27.8%，而家庭中其他成年成员的二代发病率为 17.3%。
结论
SARS-CoV-2 在家庭中的二代发病率为 16.3%。家庭接触者的年龄和与确诊患者的配偶关系是家庭内 SARS-CoV-2 传播的危险因素。确诊患者从发病开始在家中隔离对于预防 SARS-CoV-2 在家内传播是有效的。
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