Reduction of SARS-CoV-2 intra-household child-to-parent transmission associated with ventilation: results from a case–control study

Abstract

Abstract Purpose Our objective was to describe circumstances of SARS-CoV-2 household transmission and to identify factors associated with a lower risk of transmission in a nationwide case–control study in France. Methods In a descriptive analysis, we analysed cases reporting transmission from someone in the household (source case). Index cases could invite a non-infected household member to participate as a related control. In such situations, we compared the exposures of the index case and related control to the source case by conditional logistic regression matched for household, restricted to households in which the source case was a child, and the index case and related control were the infected child’s parents. Results From October 27, 2020 to May 16, 2022, we included 104 373 cases for the descriptive analysis with a documented infection from another household member. The source case was mostly the index case’s child (46.9%) or partner (45.7%). In total, 1026 index cases invited a related control to participate in the study. In the case–control analysis, we included 611 parental pairs of cases and controls exposed to the same infected child. COVID-19 vaccination with 3 + doses versus no vaccination (OR 0.1, 95%CI: 0.04–0.4), isolation from the source case (OR 0.6, 95%CI: 0.4–0.97) and the ventilation of indoor areas (OR 0.6, 95%CI: 0.4–0.9) were associated with lower risk of infection. Conclusion Household transmission was common during the SARS-CoV-2 pandemic in France. Mitigation strategies, including isolation and ventilation, decreased the risk of secondary transmission within the household. Trial registration ClinicalTrials.gov registration number: NCT04607941.

Keywords

• SARS-CoV-2
• Home environment
• Family
• Patient isolation
• Ventilation