Risk of SARS-CoV-2 infection among contacts of individuals with COVID-19 in Hangzhou, China

OBJECTIVES: This study determined the rate of secondary infection among contacts of individuals with confirmed coronavirus disease 2019 (COVID-19) in Hangzhou according to the type of contacts, the intensity of contacts, and their relationship with the index patient. STUDY DESIGN: This is a retrospective cohort study. METHODS: The analysis used the data of 2994 contacts of 144 individuals with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The contacts were categorized according to the information source, type of contact, location, intensity of contact, and relationship with the index patient. RESULTS: The incidence of infection differed significantly according to contact type. Of the contacts, 186 (6.2%) developed symptoms, and 71 (2.4%) had confirmed SARS-CoV-2 infection. The main symptoms were cough and fever. Compared with those who had brief contact with the index case, those who had dined with the index case had 2.6 times higher risk of acquiring infection; those who had shared transport with, had visited, or had contact with the index case in a medical institution had 3.6 times higher risk of acquiring infection; and household contacts had 41.7 times higher risk of acquiring infection. Family members had 31.6 times higher risk of acquiring infection than healthcare providers or other patients exposed to an index case. CONCLUSIONS: The form and frequency of contact are the main factors affecting the risk of infection among contacts of individuals with COVID-19. Centralized isolation and observation of close contacts of individuals with confirmed SARS-CoV-2 infection, in addition to population-based control measures, can reduce the risk of secondary infections and curb the spread of the infection.