Nosocomial transmission of SARS-CoV-2 from infected children to uninfected caregivers: A retrospective cohort study in a Japanese tertiary children's hospital

Abstract

BackgroundThe transmission rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unclear when caregivers accompany pediatric COVID-19 patients in the same isolation room in a hospital setting. AimWe investigated SARS-CoV-2 transmission from infected children to caregivers at our hospital. MethodsThis retrospective cohort study included 34 discordant pairs of patients admitted between September 2020 and April 2022. FindingsThe median ages of the children and caregivers were 3.7 years (interquartile range [IQR]: 1.6–8.1) and 33.1 years (IQR: 28.3–43.4), respectively. Of the 34 caregivers, 31 were mothers, two were fathers, and one was a relative. Sixteen caregivers received at least two doses of the mRNA vaccine. The mean duration of the hospital stays was 7.7 ± 4.1 days (range: 3–19). Two unvaccinated caregivers developed COVID-19 after admission; the onset was within 48 h after admission. It is likely that they had been infected in their household prior to admission, since the incubation period for COVID-19 is usually >2 days. ConclusionsNosocomial SARS-CoV-2 transmission from infected children to caregivers was not confirmed in this study. The combination of negative-pressure rooms, vaccinations, and infection-control bundles appears to be effective at preventing SARS-CoV-2 transmission. It is acceptable to allow caregivers to accompany pediatric COVID-19 patients in a hospital ward if they can comply with basic infection control measures.