Longitudinal Household Assessment of Respiratory Illness in Children and Parents During the COVID-19 Pandemic

Importance In the early COVID-19 pandemic, SARS-CoV-2 testing was only accessible and recommended for symptomatic persons or adults. This restriction hampered assessment of the true incidence of SARS-CoV-2 infection in children as well as detailed characterization of the SARS-CoV-2 disease spectrum...

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Published in:JAMA network open 2022-10, Vol.5 (10), p.e2237522-e2237522
Main Authors: de Hoog, Marieke L. A., Sluiter-Post, Judith G. C., Westerhof, Ilse, Fourie, Elandri, Heuvelman, Valerie D., Boom, Trisja T., Euser, Sjoerd M., Badoux, Paul, Reusken, Chantal, Bont, Louis J., Sanders, Elisabeth A. M., Jaddoe, Vincent W. V., Herpers, Bjorn L., Eggink, Dirk, Wildenbeest, Joanne G., Duijts, Liesbeth, van Houten, Marlies A., Bruijning-Verhagen, Patricia C. J. L.
Format: Article
Language:English
Subjects:
Cohort analysis
Coronaviruses
COVID-19
Epidemics
Households
Illnesses
Pandemics
Respiratory diseases
Severe acute respiratory syndrome coronavirus 2
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Summary:Importance In the early COVID-19 pandemic, SARS-CoV-2 testing was only accessible and recommended for symptomatic persons or adults. This restriction hampered assessment of the true incidence of SARS-CoV-2 infection in children as well as detailed characterization of the SARS-CoV-2 disease spectrum and how this spectrum compared with that of other common respiratory illnesses. Objective To estimate the community incidence of SARS-CoV-2 infection in children and parents and to assess the symptoms and symptom severity of respiratory illness episodes involving SARS-CoV-2–positive test results relative to those with SARS-CoV-2–negative test results. Design, Setting, and Participants This cohort study randomly selected Dutch households with at least 1 child younger than 18 years. A total of 1209 children and adults from 307 households were prospectively followed up between August 25, 2020, and July 29, 2021, covering the second and third waves of the COVID-19 pandemic. Participation included SARS-CoV-2 screening at 4- to 6-week intervals during the first 23 weeks of participation (core study period; August 25, 2020, to July 29, 2021). Participants in all households finishing the core study before July 1, 2021, were invited to participate in the extended follow-up and to actively report respiratory symptoms using an interactive app until July 1, 2021. At new onset of respiratory symptoms or a SARS-CoV-2 positive test result, a household outbreak study was initiated, which included daily symptom recording, repeated polymerase chain reaction testing (nose-throat swabs and saliva and fecal samples), and SARS-CoV-2 antibody measurement (paired dried blood spots) in all household members. Outbreaks, households, and episodes of respiratory illness were described as positive or negative depending on SARS-CoV-2 test results. Data on participant race and ethnicity were not reported because they were not uniformly collected in the original cohorts and were therefore not representative or informative. Exposures SARS-CoV-2–positive and SARS-CoV-2–negative respiratory illness episodes. Main Outcomes and Measures Age-stratified incidence rates, symptoms, and symptom severity for SARS-CoV-2–positive and SARS-CoV-2–negative respiratory illness episodes. Results Among 307 households including 1209 participants (638 female [52.8%]; 403 [33.3%] aged <12 years, 179 [14.8%] aged 12-17 years, and 627 [51.9%] aged ≥18 years), 183 household outbreaks of respiratory illness were obse
ISSN:2574-3805
2574-3805
DOI:10.1001/jamanetworkopen.2022.37522