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

BACKGROUND: The 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. AIM: We investigated SARS-CoV-2 transmission from infected children to caregivers at our hospital. METHODS: This retrospective cohort study included 34 discordant pairs of patients admitted between September 2020 and April 2022. FINDINGS: The 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. CONCLUSIONS: Nosocomial 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.