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What is the evidence for transmission of COVID-19 by children in schools? A living systematic review
BACKGROUND: It is of paramount importance to understand the transmission of SARS-CoV-2 in schools, which could support the decision-making about educational facilities closure or re-opening with effective prevention and control measures in place. METHODS: We conducted a systematic review and meta-an...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Society of Global Health
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774027/ https://www.ncbi.nlm.nih.gov/pubmed/33437465 http://dx.doi.org/10.7189/jogh.10.021104 |
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author | Xu, Wei Li, Xue Dozier, Marshall He, Yazhou Kirolos, Amir Lang, Zhongyu Mathews, Catherine Siegfried, Nandi Theodoratou, Evropi |
author_facet | Xu, Wei Li, Xue Dozier, Marshall He, Yazhou Kirolos, Amir Lang, Zhongyu Mathews, Catherine Siegfried, Nandi Theodoratou, Evropi |
author_sort | Xu, Wei |
collection | PubMed |
description | BACKGROUND: It is of paramount importance to understand the transmission of SARS-CoV-2 in schools, which could support the decision-making about educational facilities closure or re-opening with effective prevention and control measures in place. METHODS: We conducted a systematic review and meta-analysis to investigate the extent of SARS-CoV-2 transmission in schools. We performed risk of bias evaluation of all included studies using the Newcastle-Ottawa Scale (NOS). RESULTS: 2178 articles were retrieved and 11 studies were included. Five cohort studies reported a combined 22 student and 21 staff index cases that exposed 3345 contacts with 18 transmissions (overall infection attack rate (IAR): 0.08%, 95% confidence interval (CI) = 0.00%-0.86%). IARs for students and school staff were 0.15% (95% CI = 0.00%-0.93%) and 0.70% (95% CI = 0.00%-3.56%) respectively. Six cross-sectional studies reported 639 SARS-CoV-2 positive cases in 6682 study participants tested [overall SARS-CoV-2 positivity rate: 8.00% (95% CI = 2.17%-16.95%). SARS-CoV-2 positivity rate was estimated to be 8.74% (95% CI = 2.34%-18.53%) among students, compared to 13.68% (95% CI = 1.68%-33.89%) among school staff. Gender differences were not found for secondary infection (OR = 1.44, 95% CI = 0.50-4.14, P = 0.49) and SARS-CoV-2 positivity (OR = 0.90, 95% CI = 0.72-1.13, P = 0.36) in schools. Fever, cough, dyspnea, ageusia, anosmia, rhinitis, sore throat, headache, myalgia, asthenia, and diarrhoea were all associated with the detection of SARS-CoV-2 antibodies (based on two studies). Overall, study quality was judged to be poor with risk of performance and attrition bias, limiting the confidence in the results. CONCLUSIONS: There is limited high-quality evidence available to quantify the extent of SARS-CoV-2 transmission in schools or to compare it to community transmission. Emerging evidence suggests lower IAR and SARS-CoV-2 positivity rate in students compared to school staff. Future prospective and adequately controlled cohort studies are necessary to confirm this finding. |
format | Online Article Text |
id | pubmed-7774027 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | International Society of Global Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-77740272021-01-11 What is the evidence for transmission of COVID-19 by children in schools? A living systematic review Xu, Wei Li, Xue Dozier, Marshall He, Yazhou Kirolos, Amir Lang, Zhongyu Mathews, Catherine Siegfried, Nandi Theodoratou, Evropi J Glob Health Research Theme 7: Rapid Reviews on COVID-19 Evidence BACKGROUND: It is of paramount importance to understand the transmission of SARS-CoV-2 in schools, which could support the decision-making about educational facilities closure or re-opening with effective prevention and control measures in place. METHODS: We conducted a systematic review and meta-analysis to investigate the extent of SARS-CoV-2 transmission in schools. We performed risk of bias evaluation of all included studies using the Newcastle-Ottawa Scale (NOS). RESULTS: 2178 articles were retrieved and 11 studies were included. Five cohort studies reported a combined 22 student and 21 staff index cases that exposed 3345 contacts with 18 transmissions (overall infection attack rate (IAR): 0.08%, 95% confidence interval (CI) = 0.00%-0.86%). IARs for students and school staff were 0.15% (95% CI = 0.00%-0.93%) and 0.70% (95% CI = 0.00%-3.56%) respectively. Six cross-sectional studies reported 639 SARS-CoV-2 positive cases in 6682 study participants tested [overall SARS-CoV-2 positivity rate: 8.00% (95% CI = 2.17%-16.95%). SARS-CoV-2 positivity rate was estimated to be 8.74% (95% CI = 2.34%-18.53%) among students, compared to 13.68% (95% CI = 1.68%-33.89%) among school staff. Gender differences were not found for secondary infection (OR = 1.44, 95% CI = 0.50-4.14, P = 0.49) and SARS-CoV-2 positivity (OR = 0.90, 95% CI = 0.72-1.13, P = 0.36) in schools. Fever, cough, dyspnea, ageusia, anosmia, rhinitis, sore throat, headache, myalgia, asthenia, and diarrhoea were all associated with the detection of SARS-CoV-2 antibodies (based on two studies). Overall, study quality was judged to be poor with risk of performance and attrition bias, limiting the confidence in the results. CONCLUSIONS: There is limited high-quality evidence available to quantify the extent of SARS-CoV-2 transmission in schools or to compare it to community transmission. Emerging evidence suggests lower IAR and SARS-CoV-2 positivity rate in students compared to school staff. Future prospective and adequately controlled cohort studies are necessary to confirm this finding. International Society of Global Health 2020-12 2020-12-19 /pmc/articles/PMC7774027/ /pubmed/33437465 http://dx.doi.org/10.7189/jogh.10.021104 Text en Copyright © 2020 by the Journal of Global Health. All rights reserved. http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. |
spellingShingle | Research Theme 7: Rapid Reviews on COVID-19 Evidence Xu, Wei Li, Xue Dozier, Marshall He, Yazhou Kirolos, Amir Lang, Zhongyu Mathews, Catherine Siegfried, Nandi Theodoratou, Evropi What is the evidence for transmission of COVID-19 by children in schools? A living systematic review |
title | What is the evidence for transmission of COVID-19 by children in schools? A living systematic review |
title_full | What is the evidence for transmission of COVID-19 by children in schools? A living systematic review |
title_fullStr | What is the evidence for transmission of COVID-19 by children in schools? A living systematic review |
title_full_unstemmed | What is the evidence for transmission of COVID-19 by children in schools? A living systematic review |
title_short | What is the evidence for transmission of COVID-19 by children in schools? A living systematic review |
title_sort | what is the evidence for transmission of covid-19 by children in schools? a living systematic review |
topic | Research Theme 7: Rapid Reviews on COVID-19 Evidence |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774027/ https://www.ncbi.nlm.nih.gov/pubmed/33437465 http://dx.doi.org/10.7189/jogh.10.021104 |
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