Tags

Type your tag names separated by a space and hit enter

What do we know about SARS-CoV-2 transmission? A systematic review and meta-analysis of the secondary attack rate and associated risk factors.
PLoS One. 2020; 15(10):e0240205.Plos

Abstract

INTRODUCTION

Current 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.

METHODS

We 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.

RESULTS

43 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%).

DISCUSSION

While 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.

Authors+Show Affiliations

Centre for Strategic and Policy Studies, Brunei Darussalam, Bandar Seri Begawan, Brunei.PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei.PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei.Disease Control Division, Ministry of Health, Brunei Darussalam, Bandar Seri Begawan, Brunei.Disease Control Division, Ministry of Health, Brunei Darussalam, Bandar Seri Begawan, Brunei.Disease Control Division, Ministry of Health, Brunei Darussalam, Bandar Seri Begawan, Brunei.Disease Control Division, Ministry of Health, Brunei Darussalam, Bandar Seri Begawan, Brunei.Disease Control Division, Ministry of Health, Brunei Darussalam, Bandar Seri Begawan, Brunei.Disease Control Division, Ministry of Health, Brunei Darussalam, Bandar Seri Begawan, Brunei.Western Pacific Regional Office (Manila), World Health Organization, Manila, Philippines.Western Pacific Regional Office (Manila), World Health Organization, Manila, Philippines.Disease Control Division, Ministry of Health, Brunei Darussalam, Bandar Seri Begawan, Brunei.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

33031427

Citation

Koh, Wee Chian, et al. "What Do We Know About SARS-CoV-2 Transmission? a Systematic Review and Meta-analysis of the Secondary Attack Rate and Associated Risk Factors." PloS One, vol. 15, no. 10, 2020, pp. e0240205.
Koh WC, Naing L, Chaw L, et al. What do we know about SARS-CoV-2 transmission? A systematic review and meta-analysis of the secondary attack rate and associated risk factors. PLoS One. 2020;15(10):e0240205.
Koh, W. C., Naing, L., Chaw, L., Rosledzana, M. A., Alikhan, M. F., Jamaludin, S. A., Amin, F., Omar, A., Shazli, A., Griffith, M., Pastore, R., & Wong, J. (2020). What do we know about SARS-CoV-2 transmission? A systematic review and meta-analysis of the secondary attack rate and associated risk factors. PloS One, 15(10), e0240205. https://doi.org/10.1371/journal.pone.0240205
Koh WC, et al. What Do We Know About SARS-CoV-2 Transmission? a Systematic Review and Meta-analysis of the Secondary Attack Rate and Associated Risk Factors. PLoS One. 2020;15(10):e0240205. PubMed PMID: 33031427.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - What do we know about SARS-CoV-2 transmission? A systematic review and meta-analysis of the secondary attack rate and associated risk factors. AU - Koh,Wee Chian, AU - Naing,Lin, AU - Chaw,Liling, AU - Rosledzana,Muhammad Ali, AU - Alikhan,Mohammad Fathi, AU - Jamaludin,Sirajul Adli, AU - Amin,Faezah, AU - Omar,Asiah, AU - Shazli,Alia, AU - Griffith,Matthew, AU - Pastore,Roberta, AU - Wong,Justin, Y1 - 2020/10/08/ PY - 2020/05/25/received PY - 2020/09/23/accepted PY - 2020/10/8/entrez PY - 2020/10/9/pubmed PY - 2020/10/21/medline SP - e0240205 EP - e0240205 JF - PloS one JO - PLoS One VL - 15 IS - 10 N2 - INTRODUCTION: Current 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. METHODS: We 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. RESULTS: 43 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%). DISCUSSION: While 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. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/33031427/What_do_we_know_about_SARS_CoV_2_transmission_A_systematic_review_and_meta_analysis_of_the_secondary_attack_rate_and_associated_risk_factors_ DB - PRIME DP - Unbound Medicine ER -