Changes in Transmission and Symptoms of SARS-CoV-2 in United States Households, April 2020–September 2022
Changes in Transmission and Symptoms of SARS-CoV-2 in United States Households, April 2020–September 2022
Abstract BackgroundThe natural history of SARS-CoV-2 infection and transmission dynamics may have changed as SARS-CoV-2 has evolved and population immunity has shifted. MethodsHousehold contacts, enrolled from two multi-site case-ascertained household transmission studies (April 2020–April 2021 and September 2021–September 2022), were followed for 10–14 days after enrollment with daily collection of nasal swabs and/or saliva for SARS-CoV-2 testing and symptom diaries. SARS-CoV-2 virus lineage was determined by whole genome sequencing, with multiple imputation where sequences could not be recovered. Adjusted infection risks were estimated using modified Poisson regression. Findings858 primary cases with 1473 household contacts were examined. Among unvaccinated household contacts, the infection risk adjusted for presence of prior infection and age was 58% (95% confidence interval [CI]: 49–68%) in households currently exposed to pre-Delta lineages and 90% (95% CI: 74–100%) among those exposed to Omicron BA.5 (detected May – September 2022). The fraction of infected household contacts reporting any symptom was similarly high between pre-Delta (86%, 95% CI: 81–91%) and Omicron lineages (77%, 70–85%). Among Omicron BA.5-infected contacts, 48% (41–56%) reported fever, 63% (56–71%) cough, 22% (17–28%) shortness of breath, and 20% (15–27%) loss of/change in taste/smell. InterpretationThe risk of infection among household contacts exposed to SARS-CoV-2 is high and increasing with more recent SARS-CoV-2 lineages. This high infection risk highlights the importance of vaccination to prevent severe disease. FundingFunded by the Centers for Disease Control and Prevention and the Food and Drug Administration. Key points-Monitoring the transmissibility and symptomatology of SARS-CoV-2 lineages is important for informing public health practice and understanding the epidemiology of COVID-19; household transmission studies contribute to our understanding of the natural history of SARS-CoV-2 infections and the transmissibility of SARS-CoV-2 variants.-The Omicron BA.5 sub-lineage is highly transmissible, similar to previous Omicron sub-lineages.-Over 80% of infected household contacts reported at least 1 symptom during their infection and the proportion of household contacts with asymptomatic infection did not differ by SARS-CoV-2 variant. The most common symptom was cough. Change in taste or smell was more common in Omicron BA.5 infections, compared to previous Omicron sub-lineages, but less common compared to pre-Delta lineages.-The high infection risk among household contacts supports the recommendations that individuals maintain up-to-date and lineage-specific vaccinations to mitigate further risks of severe disease.
Talbot H. Keipp、McLean Huong Q.、Morrissey Kerry Grace、Stockwell Melissa S.、Johnson Sheroi、Ogokeh Constance、Reed Carrie、Smith-Jeffcoat Sarah E.、Bowman Natalie M.、Ellingson Katherine D.、Grijalva Carlos G.、Hanson Kayla E.、Belongia Edward A.、Bendall Emily E.、Gilbert Julie、McLaren Son H.、Sano Ellen、Vargas Celibell Y.、Saiman Lisa、Silverio Francisco Raul A、Lin Jessica、Rolfes Melissa A.、Govindarajan Prasanthi、Ledezma Karla I.、Chappell James、Dominguez Samuel、Olson Daniel、Olivo Vanessa、Lauring Adam S.、Maldonado Yvonne、Lutrick Karen、Zhu Yuwei、Goodman Sarah H.、Lindsell Christopher、Halasa Natasha、Sarnquist Clea C.、Miiro Flavia N、Pryor Kathleen、Meece Jennifer K.、Salvatore Phillip P.、Biddle Jessica E.、Asturias Edwin、Schmitz Jonathan、Merrill Lori S.、Izurieta Hector S.、Ramadan Ferris A.、Bullock Ayla、Hart Kimberly、Mellis Alexandra M.、Rao Suchitra
Vanderbilt University Medical CenterMarshfield Clinic Research InstituteWestatColumbia UniversityInfluenza Division, Centers for Disease Control and PreventionInfluenza Division, Centers for Disease Control and PreventionInfluenza Division, Centers for Disease Control and PreventionDivision of Viral Diseases, Centers for Disease Control and PreventionUniversity of North CarolinaUniversity of ArizonaVanderbilt University Medical CenterMarshfield Clinic Research InstituteMarshfield Clinic Research InstituteUniversity of MichiganUniversity of MichiganColumbia UniversityColumbia UniversityColumbia UniversityUniversity of North CarolinaInfluenza Division, Centers for Disease Control and PreventionStanford UniversityUniversity of ArizonaVanderbilt University Medical CenterUniversity of ColoradoUniversity of ColoradoWestatUniversity of MichiganStanford UniversityUniversity of ArizonaVanderbilt University Medical CenterStanford UniversityVanderbilt University Medical CenterVanderbilt University Medical CenterStanford UniversityUniversity of ArizonaUniversity of ArizonaMarshfield Clinic Research InstituteDivision of Viral Diseases, Centers for Disease Control and PreventionInfluenza Division, Centers for Disease Control and PreventionUniversity of ColoradoVanderbilt University Medical CenterWestatFood and Drug AdministrationUniversity of ArizonaUniversity of North CarolinaVanderbilt University Medical CenterInfluenza Division, Centers for Disease Control and PreventionUniversity of Colorado
医学研究方法预防医学医药卫生理论
COVID-19secondary attack ratehouseholdsymptomstransmission
Talbot H. Keipp,McLean Huong Q.,Morrissey Kerry Grace,Stockwell Melissa S.,Johnson Sheroi,Ogokeh Constance,Reed Carrie,Smith-Jeffcoat Sarah E.,Bowman Natalie M.,Ellingson Katherine D.,Grijalva Carlos G.,Hanson Kayla E.,Belongia Edward A.,Bendall Emily E.,Gilbert Julie,McLaren Son H.,Sano Ellen,Vargas Celibell Y.,Saiman Lisa,Silverio Francisco Raul A,Lin Jessica,Rolfes Melissa A.,Govindarajan Prasanthi,Ledezma Karla I.,Chappell James,Dominguez Samuel,Olson Daniel,Olivo Vanessa,Lauring Adam S.,Maldonado Yvonne,Lutrick Karen,Zhu Yuwei,Goodman Sarah H.,Lindsell Christopher,Halasa Natasha,Sarnquist Clea C.,Miiro Flavia N,Pryor Kathleen,Meece Jennifer K.,Salvatore Phillip P.,Biddle Jessica E.,Asturias Edwin,Schmitz Jonathan,Merrill Lori S.,Izurieta Hector S.,Ramadan Ferris A.,Bullock Ayla,Hart Kimberly,Mellis Alexandra M.,Rao Suchitra.Changes in Transmission and Symptoms of SARS-CoV-2 in United States Households, April 2020–September 2022[EB/OL].(2025-03-28)[2025-04-26].https://www.medrxiv.org/content/10.1101/2023.05.18.23290185.点此复制
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