Department of Neonatology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.
Department of Neonatology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.
Int J Infect Dis. 2022 Sep;122:266-275. doi: 10.1016/j.ijid.2022.05.016. Epub 2022 May 11.
To explore household transmissibility of SARS-CoV-2 in children in new-variants dominating periods.
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.
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.
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.
探讨新变异株流行时期儿童 SARS-CoV-2 的家庭传播性。
通过检索 PubMed 和 Embase，纳入两部分研究：家庭二代发病率（SAR）的荟萃分析和家庭儿科感染的病例分析。
共纳入 95 篇文献：48 篇用于荟萃分析，47 篇用于病例分析。儿童 COVID-19 仅占家庭传播的一小部分。儿童指数病例和接触者的家庭总 SAR 分别为 0.20（95%置信区间[CI]：0.15-0.26）和 0.24（95%CI：0.18-0.30）。与成人相比，儿童指数病例和接触者的家庭传播率均较低（相对风险[RR] = 0.64，95%CI：0.50-0.81；RR = 0.74，95%CI：0.64-0.85）。年龄较小的儿童与年龄较大的儿童一样易感（RR = 0.89，95%CI：0.72-1.10）。通过不同变异株和时期的亚组分析，儿童的家庭 SAR 增加（野生型：0.20；Alpha 型：0.42；Delta 型：0.35；Omicron 型：0.56），而当新变异株占主导地位时，儿童和成人的家庭 SAR 无显著差异。
尽管儿童在家庭传播中并不占主导地位，但随着新变异株的出现，儿童 SARS-CoV-2 的传播能力似乎有所上升。
