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Lower SARS-CoV-2 household transmission in children and adolescents compared to adults

L Schumm1, J Blankenburg2, E Kahre2

  • 1Department of Paediatrics, University Hospital and Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. leonie.schumm@uniklinikum-dresden.de.

Scientific Reports
|December 27, 2022
PubMed

Insights

Children and adolescents show lower susceptibility and infectivity for SARS-CoV-2 compared to adults. This study found a significantly lower secondary attack rate in households with a child or adolescent index case.

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Public Health

Background:

  • Children were initially thought to be major SARS-CoV-2 transmitters, similar to influenza.
  • Mitigation measures disproportionately impacted children's lives due to this assumption.
  • The precise role of children and adolescents in SARS-CoV-2 transmission remained unclear.

Purpose of the Study:

  • To evaluate SARS-CoV-2 transmission dynamics within households, focusing on children and adolescents.
  • To compare the infectivity of pediatric versus adult index cases.
  • To assess the susceptibility and disease course in minors during the pandemic.

Main Methods:

  • A household serology study (FamilyCoviDD19) was conducted between January and July 2021.
  • 300 households with a confirmed SARS-CoV-2 index case were enrolled, including 341 minors and 650 adults.
  • Data collection involved serological assessment for SARS-CoV-2 antibodies and questionnaires on symptoms, demographics, and comorbidities.

Main Results:

  • Pediatric index cases (<18 years) accounted for 16.3% of all index cases.
  • Symptomatic COVID-19 associated illness was reported by 55.6% of pediatric index cases versus 94.8% of adult index cases.
  • The secondary attack rate was significantly lower when the index case was a child or adolescent (0.29) compared to an adult (0.54).

Conclusions:

  • Children and adolescents exhibit reduced susceptibility to SARS-CoV-2 infection.
  • Asymptomatic or mild disease courses are more frequent in younger populations.
  • Children and adolescents appear to be less infective than adults, challenging initial pandemic assumptions.

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