What do we know about SARS-CoV-2 transmission? A systematic review and meta-analysis of the secondary attack rate and associated risk factors

Autor: Roberta Pastore, Lin Naing, Mohammad Fathi Alikhan, Sirajul Adli Jamaludin, Muhammad Ali Rosledzana, Wee Chian Koh, Matthew M. Griffith, Faezah Amin, Asiah Omar, Alia Shazli, Justin Wong, Liling Chaw
Rok vydání: 2020
Předmět:
RNA viruses
0301 basic medicine
Epidemiology
Coronaviruses
Geographical Locations
Mathematical and Statistical Techniques
0302 clinical medicine
Risk Factors
United States
COVID-19
Medical risk factors
SARS CoV 2
Virus testing
China
Metaanalysis
Medical personnel
Retrospective studies
Medicine and Health Sciences
Medicine
Medical Personnel
030212 general & internal medicine
Transmission risks and rates
Child
Index case
Pathology and laboratory medicine
Virus Testing
Multidisciplinary
Statistics
Medical microbiology
Random effects model
Professions
Research Design
Meta-analysis
Quarantine
Viruses
Physical Sciences
Disease Susceptibility
Pathogens
Coronavirus Infections
Research Article
Adult
Funnel plot
Asia
SARS coronavirus
Health Personnel
Science
Pneumonia
Viral
030106 microbiology
Research and Analysis Methods
Microbiology
Betacoronavirus
03 medical and health sciences
Diagnostic Medicine
Humans
Family
Statistical Methods
Pandemics
Retrospective Studies
Biology and life sciences
SARS-CoV-2
business.industry
Organisms
Viral pathogens
Publication bias
Confidence interval
Microbial pathogens
Medical Risk Factors
People and Places
North America
Population Groupings
business
Mathematics
Contact tracing
Demography
Zdroj: PLOS ONE, 15(10):e0240205
PLoS ONE, Vol 15, Iss 10, p e0240205 (2020)
PLoS ONE
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0240205
Popis: IntroductionCurrent SARS-CoV-2 containment measures rely on controlling viral transmission. Effective prioritization can be determined by understanding SARS-CoV-2 transmission dynamics. We conducted a systematic review and meta-analyses of the secondary attack rate (SAR) in household and healthcare settings. We also examined whether household transmission differed by symptom status of index case, adult and children, and relationship to index case.MethodsWe searched PubMed, medRxiv, and bioRxiv databases between January 1 and July 25, 2020. High-quality studies presenting original data for calculating point estimates and 95% confidence intervals (CI) were included. Random effects models were constructed to pool SAR in household and healthcare settings. Publication bias was assessed by funnel plots and Egger's meta-regression test.Results43 studies met the inclusion criteria for household SAR, 18 for healthcare SAR, and 17 for other settings. The pooled household SAR was 18.1% (95% CI: 15.7%, 20.6%), with significant heterogeneity across studies ranging from 3.9% to 54.9%. SAR of symptomatic index cases was higher than asymptomatic cases (RR: 3.23; 95% CI: 1.46, 7.14). Adults showed higher susceptibility to infection than children (RR: 1.71; 95% CI: 1.35, 2.17). Spouses of index cases were more likely to be infected compared to other household contacts (RR: 2.39; 95% CI: 1.79, 3.19). In healthcare settings, SAR was estimated at 0.7% (95% CI: 0.4%, 1.0%).DiscussionWhile aggressive contact tracing strategies may be appropriate early in an outbreak, as it progresses, measures should transition to account for setting-specific transmission risk. Quarantine may need to cover entire communities while tracing shifts to identifying transmission hotspots and vulnerable populations. Where possible, confirmed cases should be isolated away from the household.
Databáze: OpenAIRE
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