Abstract
BackgroundMost people with COVID-19 receive care at home, increasing the likelihood of exposure for household members.ObjectiveTo study the prevalence and characteristics of secondary cases in families after the appearance of a primary caseMethodologyAn observational and retrospective study of families with at least one polymerase chain reaction (PCR) confirmed COVID-19 primary case was conducted from March 15 to December 25, 2020, in a general medicine office in Toledo, Spain. Socio-demographic and clinical variables were compared between primary and secondary cases in the families. The outcome of interest was secondary attack rate of SARS-CoV-2 within the family.Results39 families with a primary case (average size 3.4 members) with a total of 132 cohabitants were included. There were 22 cohabitants with negative PCR (22/92 = 24%), 70 secondary cases with positive PCR (Secondary attack rate 76%), of which 25 were asymptomatic (25/70 = 36%), and a cohabiting new-born. A high frequency of people from ethnic minorities, low household income and complex families was found, both in primary and secondary cases. The secondary cases with respect to the primary ones were more women, younger, students and with a lower socio-occupational level, with more asymptomatic cases, and milder symptomatic cases.ConclusionsIn this context, the prevalence of secondary domestic contacts is very high, and it occur in young women, being asymptomatic or mild. The high secondary attack rate suggests the importance of the pre-symptomatic or early symptomatic period of COVID-19, as well as the possible failure to comply with isolation measures.
Highlights
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), emerged in December 2019 in Wuhan, China [1]
The secondary cases with respect to the primary ones were more women, younger, students and with a lower sociooccupational level, with more asymptomatic cases, and milder symptomatic cases. In this context the prevalence of secondary domestic contacts is very high, and it occur in young women, being asymptomatic or mild
The high secondary attack rate suggests the importance of the pre-symptomatic or early symptomatic period of COVID-19, as well as the possible failure to comply with isolation measures
Summary
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), emerged in December 2019 in Wuhan, China [1]. Contact within homes is believed to be responsible for approximately 70% of SARS-CoV-2 transmission when widespread community control measures are in place [22]. In a study in New York State, 38% of household contacts tested positive for SARS-Cov-2 [25], and similar rates of secondary infection have been reported in China [26]. In this context, most people with COVID-19 receive care at home, which increases the probability of exposure of household members, and the transmission of COVID-19 within families and close contacts accounts for most of the epidemic growth. Most people with COVID-19 receive care at home, increasing the likelihood of exposure for household members
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