Einleitung To prevent the spread of SARS-CoV-2 in the community, schools and kindergartens were closed proactively almost worldwide during the first wave. Despite evidence that school closures and home confinement have psychological, physical, and socioeconomic consequences, children and adolescents associated with school outbreaks were home quarantined during subsequent waves. As the pandemic progressed, various scientific publications reported a lower SARS-CoV-2 incidence rate, a milder or asymptomatic course of the disease, faster recovery and fewer deaths in children and adolescents compared to adults. However, due to the heterogeneous findings and scarcity of data on disease transmission, it is still difficult to ascertain COVID-19 susceptibility and infectivity in the paediatric population.
Methoden The aim of this study was to learn more about the manifestation and transmission of COVID-19 in paediatric population in both household and non-household settings. For this purpose, surveillance data collected between September 20 th and November 30 th , 2020 by the local health office Hamburg-Eimsbüttel was used. The data were collected from the respective case files using the Hamburg Pandemic Manager and cleaned by means of a plausibility check. For the analysis and comparison of the different variables, cross tabulations were used, and a descriptive analysis was performed. For in-depth analysis of transmissions in a community setting, transmission clusters were reconstructed, showing onward transmission of disease from an infector to infected close contacts.
Ergebnisse Data from SARS-CoV-2 positive paediatric cases (n=225) and their infected (n=183) and uninfected close contacts (n=403) were analysed (test method: SARS-CoV-2 RT-PCR). The findings revealed that the majority of paediatric (0–17y) and adult cases (>17y) were infected at home. As compared to adults, paediatric cases had asymptomatic or milder disease manifestations. Based on the estimation of secondary attack rate and relative risk of infection for secondary cases in household (p = 0.000, 95% CI: [1.195, 1.824]) and non-household settings (p = 0.002, 95% CI: [1.323, 8.682]), children and adolescents were found to be more susceptible to SARS-CoV-2 than adults. Additionally, children and adolescents were mostly not the primary source of infection in household and non-household settings.
Schlussfolgerung The findings of this study highlight the importance of surveillance data to understand the natural history of the disease and determine appropriate public health actions. Vaccination coverage should be expanded to include both children and adolescents, as well as areas of the population that are still reluctant to get vaccinated. Furthermore, the use of non-pharmaceutical measures (proper mask use, adherence to hygiene rules, and social distancing) in conjunction with increased testing is an important strategy for protecting all parts of the population from SARS-CoV-2 infections and its serious outcomes.
