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Researchers working for NHS England have found no evidence that adults living with school-aged children are at an increased risk of severe outcomes following infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). , the agent that causes the coronavirus disease 2019 (COVID-19).
The large population-based study was conducted by researchers from the London School of Hygiene and Tropical Medicine (LSHTSM), the University of Oxford and the Phoenix Partnership, to investigate the growing concern that children may serve as a primary reservoir for spread of SARS. -CoV-2.
“This is the first population-based study to investigate whether the risk of recorded SARS-CoV-2 infection and serious COVID-19 outcomes differ between adults living in families with and without school-age children during the UK pandemic. United “, writes the team.
Among adults of working age (aged 65 years and younger), cohabitation with children aged 0 to 11 years was not associated with any increased risk of SARS-CoV-2 infection or COVID-related hospitalizations. -19, compared to working-age adults who did not live with children.
In this age group, cohabitation with children aged 12 to 18 years was associated with a small increased risk of infection, but not with COVID-19 outcomes. Additionally, living with children of any age reduced the risk of death from causes unrelated to COVID-19.
Among adults over the age of 65, no association was identified between coexistence with children and any SARS-CoV-2-related outcomes.
Laurie Tomlinson and colleagues say the findings have implications for determining the benefits versus harms of children attending school as the pandemic continues.
A pre-printed version of the document is available on the server medRxiv*, while the article is undergoing peer review.
The role children play in transmission is unclear
Modeling studies of other respiratory tract infections have pointed to children as a major source of spread during the early stage of an outbreak, partly due to their frequent engagement in social contacts.
However, a growing body of evidence suggests that in the case of SARS-CoV-2, children may be less susceptible, less infectious, and no more likely to transmit the virus than adults.
A suggested mechanism for lower susceptibility among children is cross-reactive immunity to SARS-CoV-2, acquired through seasonal human coronavirus (hCoV) infection. These infections, which cause the common cold, are more common among children than adults, with the highest rates of infection seen among young children.
“If recent hCoV infection is protective against SARS-CoV-2 or COVID-19 infection, then adults living with children may be at lower risk than those living without children,” Tomlinson said. team.
On the other hand, children can introduce SARS-CoV-2 into their families, and adults who live closely with children may be at greater risk of infection, they add.
“In the face of increasing transmission in many countries and the need for political decisions on school opening, it is important to quantify the overall impact of living with children on the risk of SARS-CoV-2 infections and severe COVID-19 outcomes. “writes the researchers.
What did the team do?
Tomlinson and colleagues used UK electronic health records linked to family member data to investigate whether the risk of SARS-CoV-2 infection and severe COVID-19 outcomes differed between adults living with children and those who they don’t.
The study used primary care data and related information on hospital and intensive care unit (ICU) admissions and patient death registers registered in general practices, which account for 40% of England.
The team used Cox’s multivariate regression to calculate the risk of results between February 1st and on August 3rd, 2020, after adjustment for gender, age, multiple deprivation index, body mass index, smoking habit, ethnicity and number of adults in the household.
The final cohort included 9,157,814 adults of working age (65 years and younger) and 2,567,671 adults over the age of 65.
What did the researchers find?
Among adults of working age, sharing a home with children aged 0-11 was not associated with any increased risk of registered SARS-CoV-2 infection or hospitalization or COVID-related ICU. -19. However, the team observed a 25% reduced risk of COVID-19-related death.
In the same age group, living with children between the ages of 12 and 18 was associated with an 8% increased risk of recorded SARS-CoV-2 infection, but not an increased risk of other COVID-related outcomes. 19. Living with children of any age was also associated with a reduced risk of death from causes unrelated to COVID-19.
Among adults over the age of 65, there was no evidence of an association between cohabitation with children and any SARS-CoV-2-related findings, regardless of the children’s age group.
In all analyzes, the additional adjustment for comorbidities did not significantly change the outcomes, and no consistent differences in risk of infection or severe outcomes were observed when comparing periods before and after school closes.
The findings have important implications
“Our results show no evidence of severe COVID-19 harm to adults in close contact with children, compared to those living in childless families,” the researchers write.
“These findings, taken together with other evidence, have implications for determining the benefit-harm balance of children attending school in the COVID-19 pandemic,” the team concludes.
*Important Notice
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be considered conclusive, guide clinical practice / health-related behaviors, or treated as consolidated information.
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