Infection and disease spectrum in individuals with household exposure to SARS‐CoV‐2: A family cluster cohort study. Issue 5 (12th February 2021)

• Record Type: Journal Article
• Authors: Xie, Wen; Chen, Zhihai; Wang, Qi; Song, Meihua; Cao, Ying; Wang, Lin; Pan, Calvin Q.
• Other Names: Luo Guangxiang (George) guestEditor.; Ly Hinh guestEditor.; Gao Shou‐Jiang guestEditor.
• Is Part Of: Journal of medical virology. Volume 93:Issue 5(2021)
• Page Start: 3033
• Page End: 3046
• Publication Date: 2021-02-12
• Subjects: coronavirus disease 2019 -- COVID‐19 -- handwashing -- infectious disease transmission -- quarantine -- SARS‐CoV‐2 -- severe acute respiratory syndrome coronavirus 2; Virology -- Periodicals; 616
• DOI: 10.1002/jmv.26847
• Languages: English
• ISSNs: 0146-6615

Abstract

Abstract: We primarily quantified exposure patterns, transmission characteristics, and the clinical spectrum of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection among household contacts of individuals with severe coronavirus disease‐2019 (COVID‐19). We conducted a retrospective cohort study of 20 index patients hospitalized with severe COVID‐19 and 79 of their household contacts. We determined the transmission frequency, range of manifestations of SARS‐CoV‐2 infection, and factors associated with infection in household settings. Of the 79 household contacts, 53 (67%) developed SARS‐CoV‐2 infection (49 [62%] symptomatic, 4 [5%] asymptomatic). Eight patients (10%) developed severe COVID‐19, and one died of COVID‐19 pneumonia (case‐fatality rate: 1.9%). The probability of SARS‐CoV‐2 infection was similar in children and adults (55% vs. 72%, p = .14), with children being less likely to develop the symptomatic disease (46% vs. 68%, p = .06). Handwashing ≥ 5 times/day was associated with reduced infection risk (52.8% vs. 76.9%, p = .04). SARS‐CoV‐2 has a high frequency of transmission among household contacts. Nonhospitalized individuals with SARS‐CoV‐2 infection should be quarantined in patient care facilities rather than at home to minimize spread, if possible, and frequent handwashing should be practiced to prevent transmission. Highlights: The new coronavirus, SARS‐CoV‐2, is the cause of the COVID‐19 pandemic. It is readily transmitted and may cause severe pneumonia, but information on its infectivity and the full disease spectrum of the infection is limited because many infections are undiagnosed. The study followed a cohort of 79 household contacts of 20 unrelated index patients with severe COVID‐19 pneumonia. All household contacts had exposure to infection, and the complete cohort was followed‐up; thus, it was possible to determine the rates of transmission and the severity and complete clinical course of all infections. We were also able to determine the risk factors for transmission and severe disease and to compare the susceptibility of children and adults to infection and disease.