1/ Household transmission of #SARSCoV2 in children & adults
This new @PHE_uk study was pre-Alpha, pre-Delta & pre-vaccine but provides important insight into household infection & transmission risks in kids & adults
2/ The study followed up 452 household members of 181 PCR-confirmed adult & child cases in England during Mar-Nov 2020.
Nasal swabs taken for #SARSCoV2 PCR at baseline & Day 7.
#SARSCoV2 Antibodies tested at baseline & Day 35 to detect symptomatic + asymptomatic infection
3/ 91/431 (21%) contacts were PCR +ve & 180/383 (47%) were antibody +ve at day 35 👉 194/431 (45%) contacts had PCR +/- antibody evidence of infection
After excluding 55 households with prior/co-primary cases & PCR -ve asymptomatic contacts, 75/248 *(33%)* contacts were infected
4/ There was an inverse relationship between household size & transmission rate (bigger household ➡️ lower transmission)
Secondary Attack Rates in contacts was 16% for 0-10 yr-old children but doubled to 33% in 11-18 year-olds, 36% in 19-54 year-olds & 32% in 55+ year-olds
5/ Contacts in households where index cases reported that they were isolating from other members did not experience a lower attack rate
BUT attack rates from index cases with respiratory or systemic symptoms were significantly higher than in those without such symptoms.
6/ The proportion infected who developed symptoms (78%) was similar by age (p = 0.44) though 0-18 year-olds had fewer mean number of symptoms than adults (p = 0.001) and fewer reported loss of sense of taste or smell (p = 0.0001).
8/ Having at least 1 symptom needed for community testing (fever, cough, taste/smell loss) had sensitivity of 73% & captured 132/153 (86%) symptomatic infected contacts. But 32% (64/203) contacts without serological evidence of infection also reported at least 1 of these symptoms
7/ Conclusion: Risk if #SARSCoV2 transmission in the household is high, even when the infection is introduced by a child.
The risk of young children acquiring #SARSCoV2 infection was lower than that in adults and fewer kids developed typical symptoms of Covid-19 infection
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2/ We assessed all fatalities within 30 days of a positive #SARSCoV2 test in <20 year-olds during Jan-Mar 2022 when national testing was still available. We collected detailed clinical data from multiple sources to ascertain cause of death for each child
3/ During Jan-Mar 2022, there were 46 deaths within 30 days of a positive #SARSCoV2 test & 11 were due to COVID-19
👉All 11 #COVID19 deaths occurred after primary SARS-CoV-2 infection
👉 8/11 (73%) had underlying comorbidities, including 4 with severe neurodisabilities
1/ This is so mportant - thank you @kerpen for tagging me
The US with all its mitigations, vaccine & booster mandates has the same proportion of kids already exposed to #sarscov2 as the UK, which as been accused of “letting the virus rip”
2/ Methods: We used residual samples from kids aged 1–17 years having a blood test as part of their clinical management in 44 hospital trusts in England. Samples were processed using Roche Elecsys assays for i) nucleocapsid (N) antibodies and ii) spike RBD (S) antibodies
3/ The overall national prevalence estimate of #SARSCoV2 antibody seropositivity in 1-17y, weighted by age & NHS region, based on Spike protein (vaccine or infection) increased from
➡️ 48.5% (95% CrI 40.8%–55.1%) during Sep-Oct 2021
to
➡️ 97.2% (95% CrI 93.7%–98.9%) by Sep 2022
1/ Our latest paper on longitudinal follow-up of teens with long covid (CLoCk) is a game changer:
Different teens report the same post-covid symptoms at 0, 6m & 12m after their #SARSCoV2 PCR , irrespective of whether they tested + or - for the virus
2/ Method: we followed up 11-17y with a PCR-positive #SARSCoV2 test compared with matched PCR-negative controls for 12 months after their test. The final cohort included 2,909 cases and 2,177 controls
3/ We found that teens reporting a symptom at baseline (PCR-testing) improved by 6m, with new teens reporting the same symptoms at 6m, who then improved by 12m, with new kids reporting the same symptoms at 12m and so on …. you catch the drift .. 👇
1/ It’s really sad that, when we report that a disease (eg. #covid19) is more severe or fatal in kids with underlying conditions (eg neurodisabilities, immunocompromised), this is taken to mean that such kids are less valued
The truth is exactly the opposite…🧵
2/ It is really important that we identify kids at increased risk of severe outcomes after any condition (eg #COVID19) so we can raise awareness among clinicians, parents & policymakers to be extra vigilant & implement additional strategies protect them 👉journals.plos.org/plosmedicine/a…
3/ When kids with severe neurodisabilities were identified as high-risk in the 1st pandemic wave, the UK recommended #COVID19 vaccines for 12+y kids with severe neurodisabilities as soon as vaccines were licensed in adults - way back in Jan 2021 👉 adc.bmj.com/content/106/12…
2/ We pointed out that there was very little difference in protection against omicron infection between vaccinated & previously infected 5-11y, while infection plus 2 vaccine doses might provide slightly better protection after 4 months (79.4% vs 62.9%)
3/ We then pointed out that #COVID19 hospitalizations were v low in 5-11y irrespective of vaccination status (0.3-0.5%), although we still aren’t sure how these were calculated because numerator/denominator in their table give lower percentages (0.1%)🤷🏻♂️