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Household secondary attack rate of COVID-19 and associated determinants in Guangzhou, China: a retrospective cohort study.
Jing, Qin-Long; Liu, Ming-Jin; Zhang, Zhou-Bin; Fang, Li-Qun; Yuan, Jun; Zhang, An-Ran; Dean, Natalie E; Luo, Lei; Ma, Meng-Meng; Longini, Ira; Kenah, Eben; Lu, Ying; Ma, Yu; Jalali, Neda; Yang, Zhi-Cong; Yang, Yang.
  • Jing QL; Guangzhou Center for Disease Control and Prevention, Guangzhou, China.
  • Liu MJ; Department of Biostatistics, College of Public Health and Health Professions, Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.
  • Zhang ZB; Guangzhou Center for Disease Control and Prevention, Guangzhou, China.
  • Fang LQ; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China.
  • Yuan J; Guangzhou Center for Disease Control and Prevention, Guangzhou, China.
  • Zhang AR; Department of Biostatistics, College of Public Health and Health Professions, Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China; Department of Epidemiology, S
  • Dean NE; Department of Biostatistics, College of Public Health and Health Professions, Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.
  • Luo L; Guangzhou Center for Disease Control and Prevention, Guangzhou, China.
  • Ma MM; Guangzhou Center for Disease Control and Prevention, Guangzhou, China.
  • Longini I; Department of Biostatistics, College of Public Health and Health Professions, Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.
  • Kenah E; Division of Biostatistics, College of Public Health, Ohio State University, Columbus, OH, USA.
  • Lu Y; Guangzhou Center for Disease Control and Prevention, Guangzhou, China.
  • Ma Y; Guangzhou Center for Disease Control and Prevention, Guangzhou, China.
  • Jalali N; Department of Biostatistics, College of Public Health and Health Professions, Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.
  • Yang ZC; Guangzhou Center for Disease Control and Prevention, Guangzhou, China. Electronic address: yangzc@gzcdc.org.cn.
  • Yang Y; Department of Biostatistics, College of Public Health and Health Professions, Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA. Electronic address: yangyang@ufl.edu.
Lancet Infect Dis ; 20(10): 1141-1150, 2020 10.
Artigo em Inglês | MEDLINE | ID: covidwho-601834
Informação semântica de SemMedBD (por NLM)
1. 2019 novel coronavirus PROCESS_OF Households
Sujeito
2019 novel coronavirus
Predicado
PROCESS_OF
Objeto
Households
2. Infected PROCESS_OF Persons
Sujeito
Infected
Predicado
PROCESS_OF
Objeto
Persons
3. COVID-19 PROCESS_OF Households
Sujeito
COVID-19
Predicado
PROCESS_OF
Objeto
Households
4. 2019 novel coronavirus PROCESS_OF Households
Sujeito
2019 novel coronavirus
Predicado
PROCESS_OF
Objeto
Households
5. Infected PROCESS_OF Persons
Sujeito
Infected
Predicado
PROCESS_OF
Objeto
Persons
6. COVID-19 PROCESS_OF Households
Sujeito
COVID-19
Predicado
PROCESS_OF
Objeto
Households
ABSTRACT

BACKGROUND:

As of June 8, 2020, the global reported number of COVID-19 cases had reached more than 7 million with over 400 000 deaths. The household transmissibility of the causative pathogen, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains unclear. We aimed to estimate the secondary attack rate of SARS-CoV-2 among household and non-household close contacts in Guangzhou, China, using a statistical transmission model.

METHODS:

In this retrospective cohort study, we used a comprehensive contact tracing dataset from the Guangzhou Center for Disease Control and Prevention to estimate the secondary attack rate of COVID-19 (defined as the probability that an infected individual will transmit the disease to a susceptible individual) among household and non-household contacts, using a statistical transmission model. We considered two alternative definitions of household contacts in the

analysis:

individuals who were either family members or close relatives, such as parents and parents-in-law, regardless of residential address, and individuals living at the same address regardless of relationship. We assessed the demographic determinants of transmissibility and the infectivity of COVID-19 cases during their incubation period.

FINDINGS:

Between Jan 7, 2020, and Feb 18, 2020, we traced 195 unrelated close contact groups (215 primary cases, 134 secondary or tertiary cases, and 1964 uninfected close contacts). By identifying households from these groups, assuming a mean incubation period of 5 days, a maximum infectious period of 13 days, and no case isolation, the estimated secondary attack rate among household contacts was 12·4% (95% CI 9·8-15·4) when household contacts were defined on the basis of close relatives and 17·1% (13·3-21·8) when household contacts were defined on the basis of residential address. Compared with the oldest age group (≥60 years), the risk of household infection was lower in the youngest age group (<20 years; odds ratio [OR] 0·23 [95% CI 0·11-0·46]) and among adults aged 20-59 years (OR 0·64 [95% CI 0·43-0·97]). Our results suggest greater infectivity during the incubation period than during the symptomatic period, although differences were not statistically significant (OR 0·61 [95% CI 0·27-1·38]). The estimated local reproductive number (R) based on observed contact frequencies of primary cases was 0·5 (95% CI 0·41-0·62) in Guangzhou. The projected local R, had there been no isolation of cases or quarantine of their contacts, was 0·6 (95% CI 0·49-0·74) when household was defined on the basis of close relatives.

INTERPRETATION:

SARS-CoV-2 is more transmissible in households than SARS-CoV and Middle East respiratory syndrome coronavirus. Older individuals (aged ≥60 years) are the most susceptible to household transmission of SARS-CoV-2. In addition to case finding and isolation, timely tracing and quarantine of close contacts should be implemented to prevent onward transmission during the viral incubation period.

FUNDING:

US National Institutes of Health, Science and Technology Plan Project of Guangzhou, Project for Key Medicine Discipline Construction of Guangzhou Municipality, Key Research and Development Program of China.
Assuntos

Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Pneumonia Viral / Características da Família / Busca de Comunicante / Infecções por Coronavirus Tipo de estudo: Estudo de etiologia / Estudo de incidência / Estudo observacional / Estudo prognóstico / Ensaios controlados aleatórios / Fatores de risco Limite: Adulto / Feminino / Humanos / Masculino / Meia-Idade / Jovem adulto País/Região como assunto: Ásia Idioma: Inglês Revista: Lancet Infect Dis Assunto da revista: Doenças Transmissíveis Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: S1473-3099(20)30471-0

Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Pneumonia Viral / Características da Família / Busca de Comunicante / Infecções por Coronavirus Tipo de estudo: Estudo de etiologia / Estudo de incidência / Estudo observacional / Estudo prognóstico / Ensaios controlados aleatórios / Fatores de risco Limite: Adulto / Feminino / Humanos / Masculino / Meia-Idade / Jovem adulto País/Região como assunto: Ásia Idioma: Inglês Revista: Lancet Infect Dis Assunto da revista: Doenças Transmissíveis Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: S1473-3099(20)30471-0