Swansea University Medical School, Swansea University, Swansea, UK.
BMJ Paediatr Open. 2021 May 10;5(1):e001049. doi: 10.1136/bmjpo-2021-001049. eCollection 2021.
Better understanding of the role that children and school staff play in the transmission of SARS-CoV-2 is essential to guide policy development on controlling infection while minimising disruption to children's education and well-being.
Our national e-cohort (n=464531) study used anonymised linked data for pupils, staff and associated households linked via educational settings in Wales. We estimated the odds of testing positive for SARS-CoV-2 infection for staff and pupils over the period August- December 2020, dependent on measures of recent exposure to known cases linked to their educational settings.
The total number of cases in a school was not associated with a subsequent increase in the odds of testing positive (staff OR per case: 0.92, 95% CI 0.85 to 1.00; pupil OR per case: 0.98, 95% CI 0.93 to 1.02). Among pupils, the number of recent cases within the same year group was significantly associated with subsequent increased odds of testing positive (OR per case: 1.12, 95% CI 1.08 to 1.15). These effects were adjusted for a range of demographic covariates, and in particular any known cases within the same household, which had the strongest association with testing positive (staff OR: 39.86, 95% CI 35.01 to 45.38; pupil OR: 9.39, 95% CI 8.94 to 9.88).
In a national school cohort, the odds of staff testing positive for SARS-CoV-2 infection were not significantly increased in the 14-day period after case detection in the school. However, pupils were found to be at increased odds, following cases appearing within their own year group, where most of their contacts occur. Strong mitigation measures over the whole of the study period may have reduced wider spread within the school environment.
更好地了解儿童和学校工作人员在 SARS-CoV-2 传播中所扮演的角色，对于制定控制感染的政策至关重要，同时尽量减少对儿童教育和福祉的干扰。
我们的全国电子队列（n=464531）研究使用了威尔士通过教育机构链接的学生、工作人员和相关家庭的匿名链接数据。我们估计了 2020 年 8 月至 12 月期间工作人员和学生 SARS-CoV-2 感染检测呈阳性的几率，这取决于与他们教育环境相关的已知病例的近期接触措施。
学校中的总病例数与随后检测呈阳性的几率增加无关（工作人员每例病例的比值比：0.92，95%CI 0.85 至 1.00；学生每例病例的比值比：0.98，95%CI 0.93 至 1.02）。在学生中，同年组内最近的病例数与随后检测呈阳性的几率增加显著相关（每例病例的比值比：1.12，95%CI 1.08 至 1.15）。这些效应调整了一系列人口统计学协变量，特别是同一家庭中的任何已知病例，这与检测呈阳性的关联性最强（工作人员比值比：39.86，95%CI 35.01 至 45.38；学生比值比：9.39，95%CI 8.94 至 9.88）。
在全国性的学校队列中，在学校中发现病例后的 14 天内，工作人员 SARS-CoV-2 感染检测呈阳性的几率没有显著增加。然而，在他们的大多数接触发生的同年组中出现病例后，学生被发现感染的几率增加。在整个研究期间采取的强有力的缓解措施可能减少了学校环境中的广泛传播。
