Household Exposure to Severe Acute Respiratory Syndrome Coronavirus 2 and Association With Coronavirus Disease 2019 Severity: a Danish nationwide cohort study

Marcella Broccia; Victoria Elizabeth de Knegt; Elisabeth Helen Anna Mills; Amalie Lykkemark Møller; Filip Gnesin; Thea K Fischer; Nertila Zylyftari; Stig Nikolaj Blomberg; Mikkel Porsborg Andersen; Morten Schou; Emil Fosbøl; Kristian Kragholm; Helle Collatz Christensen; Laura Bech Polcwiartek; Matthew Phelps; Lars Køber; Christian Torp-Pedersen

doi:10.1093/cid/ciab340

Household Exposure to Severe Acute Respiratory Syndrome Coronavirus 2 and Association With Coronavirus Disease 2019 Severity: a Danish nationwide cohort study

Marcella Broccia^*, Victoria Elizabeth de Knegt, Elisabeth Helen Anna Mills, Amalie Lykkemark Møller, Filip Gnesin, Thea K Fischer, Nertila Zylyftari, Stig Nikolaj Blomberg, Mikkel Porsborg Andersen, Morten Schou, Emil Fosbøl, Kristian Kragholm, Helle Collatz Christensen, Laura Bech Polcwiartek, Matthew Phelps, Lars Køber, Christian Torp-Pedersen

^*Corresponding author for this work

Research output: Contribution to journal › Journal article › Research › peer-review

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Abstract

BACKGROUND: Households are high-risk settings for the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Severity of coronavirus disease 2019 (COVID-19) is likely associated with the infectious dose of SARS-CoV-2 exposure. We therefore aimed to assess the association between SARS-CoV-2 exposure within households and COVID-19 severity.

METHODS: We performed a Danish, nationwide, register-based, cohort study including laboratory-confirmed SARS-CoV-2-infected individuals from 22 February 2020 to 6 October 2020. Household exposure to SARS-CoV-2 was defined as having 1 individual test positive for SARS-CoV-2 within the household. Cox proportional hazards models were used to estimate the association between "critical COVID-19" within and between households with and without secondary cases.

RESULTS: From 15 063 multiperson households, 19 773 SARS-CoV-2-positive individuals were included; 11 632 were categorized as index cases without any secondary household cases; 3431 as index cases with secondary cases, that is, 22.8% of multiperson households; and 4710 as secondary cases. Critical COVID-19 occurred in 2.9% of index cases living with no secondary cases, 4.9% of index cases with secondary cases, and 1.3% of secondary cases. The adjusted hazard ratio for critical COVID-19 among index cases vs secondary cases within the same household was 2.50 (95% confidence interval [CI], 1.88-3.34), 2.27 (95% CI, 1.77-2.93) for index cases in households with no secondary cases vs secondary cases, and 1.1 (95% CI, .93-1.30) for index cases with secondary cases vs index cases without secondary cases.

CONCLUSIONS: We found no increased hazard ratio of critical COVID-19 among household members of infected SARS-CoV-2 index cases.

Original language	English
Journal	Clinical Infectious Diseases
Volume	74
Issue number	1
Pages (from-to)	1-7
Number of pages	7
ISSN	1058-4838
DOIs	https://doi.org/10.1093/cid/ciab340
Publication status	Published - 1 Jan 2022

Bibliographical note

Keywords

COVID-19
Cohort Studies
Denmark/epidemiology
Family Characteristics
Humans
SARS-CoV-2
transmission
viral load
death
corona
infectious dose

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8135460/pdf/ciab340.pdf

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Broccia, M., de Knegt, V. E., Mills, E. H. A., Møller, A. L., Gnesin, F., Fischer, T. K., Zylyftari, N., Blomberg, S. N., Andersen, M. P., Schou, M., Fosbøl, E., Kragholm, K., Christensen, H. C., Polcwiartek, L. B., Phelps, M., Køber, L., & Torp-Pedersen, C. (2022). Household Exposure to Severe Acute Respiratory Syndrome Coronavirus 2 and Association With Coronavirus Disease 2019 Severity: a Danish nationwide cohort study. Clinical Infectious Diseases, 74(1), 1-7. https://doi.org/10.1093/cid/ciab340

@article{4a8c3955b6f74d7387aa9d697b6c8e8d,

title = "Household Exposure to Severe Acute Respiratory Syndrome Coronavirus 2 and Association With Coronavirus Disease 2019 Severity: a Danish nationwide cohort study",

abstract = "BACKGROUND: Households are high-risk settings for the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Severity of coronavirus disease 2019 (COVID-19) is likely associated with the infectious dose of SARS-CoV-2 exposure. We therefore aimed to assess the association between SARS-CoV-2 exposure within households and COVID-19 severity.METHODS: We performed a Danish, nationwide, register-based, cohort study including laboratory-confirmed SARS-CoV-2-infected individuals from 22 February 2020 to 6 October 2020. Household exposure to SARS-CoV-2 was defined as having 1 individual test positive for SARS-CoV-2 within the household. Cox proportional hazards models were used to estimate the association between {"}critical COVID-19{"} within and between households with and without secondary cases.RESULTS: From 15 063 multiperson households, 19 773 SARS-CoV-2-positive individuals were included; 11 632 were categorized as index cases without any secondary household cases; 3431 as index cases with secondary cases, that is, 22.8% of multiperson households; and 4710 as secondary cases. Critical COVID-19 occurred in 2.9% of index cases living with no secondary cases, 4.9% of index cases with secondary cases, and 1.3% of secondary cases. The adjusted hazard ratio for critical COVID-19 among index cases vs secondary cases within the same household was 2.50 (95% confidence interval [CI], 1.88-3.34), 2.27 (95% CI, 1.77-2.93) for index cases in households with no secondary cases vs secondary cases, and 1.1 (95% CI, .93-1.30) for index cases with secondary cases vs index cases without secondary cases.CONCLUSIONS: We found no increased hazard ratio of critical COVID-19 among household members of infected SARS-CoV-2 index cases.",

keywords = "COVID-19, Cohort Studies, Denmark/epidemiology, Family Characteristics, Humans, SARS-CoV-2, transmission, viral load, death, corona, infectious dose",

author = "Marcella Broccia and {de Knegt}, {Victoria Elizabeth} and Mills, {Elisabeth Helen Anna} and M{\o}ller, {Amalie Lykkemark} and Filip Gnesin and Fischer, {Thea K} and Nertila Zylyftari and Blomberg, {Stig Nikolaj} and Andersen, {Mikkel Porsborg} and Morten Schou and Emil Fosb{\o}l and Kristian Kragholm and Christensen, {Helle Collatz} and Polcwiartek, {Laura Bech} and Matthew Phelps and Lars K{\o}ber and Christian Torp-Pedersen",

note = "{\textcopyright} The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.",

year = "2022",

month = jan,

day = "1",

doi = "10.1093/cid/ciab340",

language = "English",

volume = "74",

pages = "1--7",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

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Broccia, M, de Knegt, VE, Mills, EHA, Møller, AL, Gnesin, F, Fischer, TK, Zylyftari, N, Blomberg, SN, Andersen, MP, Schou, M, Fosbøl, E, Kragholm, K, Christensen, HC, Polcwiartek, LB, Phelps, M, Køber, L & Torp-Pedersen, C 2022, 'Household Exposure to Severe Acute Respiratory Syndrome Coronavirus 2 and Association With Coronavirus Disease 2019 Severity: a Danish nationwide cohort study', Clinical Infectious Diseases, vol. 74, no. 1, pp. 1-7. https://doi.org/10.1093/cid/ciab340

Household Exposure to Severe Acute Respiratory Syndrome Coronavirus 2 and Association With Coronavirus Disease 2019 Severity: a Danish nationwide cohort study. / Broccia, Marcella; de Knegt, Victoria Elizabeth; Mills, Elisabeth Helen Anna et al.
In: Clinical Infectious Diseases, Vol. 74, No. 1, 01.01.2022, p. 1-7.

Research output: Contribution to journal › Journal article › Research › peer-review

TY - JOUR

T1 - Household Exposure to Severe Acute Respiratory Syndrome Coronavirus 2 and Association With Coronavirus Disease 2019 Severity

T2 - a Danish nationwide cohort study

AU - Broccia, Marcella

AU - de Knegt, Victoria Elizabeth

AU - Mills, Elisabeth Helen Anna

AU - Møller, Amalie Lykkemark

AU - Gnesin, Filip

AU - Fischer, Thea K

AU - Zylyftari, Nertila

AU - Blomberg, Stig Nikolaj

AU - Andersen, Mikkel Porsborg

AU - Schou, Morten

AU - Fosbøl, Emil

AU - Kragholm, Kristian

AU - Christensen, Helle Collatz

AU - Polcwiartek, Laura Bech

AU - Phelps, Matthew

AU - Køber, Lars

AU - Torp-Pedersen, Christian

PY - 2022/1/1

Y1 - 2022/1/1

N2 - BACKGROUND: Households are high-risk settings for the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Severity of coronavirus disease 2019 (COVID-19) is likely associated with the infectious dose of SARS-CoV-2 exposure. We therefore aimed to assess the association between SARS-CoV-2 exposure within households and COVID-19 severity.METHODS: We performed a Danish, nationwide, register-based, cohort study including laboratory-confirmed SARS-CoV-2-infected individuals from 22 February 2020 to 6 October 2020. Household exposure to SARS-CoV-2 was defined as having 1 individual test positive for SARS-CoV-2 within the household. Cox proportional hazards models were used to estimate the association between "critical COVID-19" within and between households with and without secondary cases.RESULTS: From 15 063 multiperson households, 19 773 SARS-CoV-2-positive individuals were included; 11 632 were categorized as index cases without any secondary household cases; 3431 as index cases with secondary cases, that is, 22.8% of multiperson households; and 4710 as secondary cases. Critical COVID-19 occurred in 2.9% of index cases living with no secondary cases, 4.9% of index cases with secondary cases, and 1.3% of secondary cases. The adjusted hazard ratio for critical COVID-19 among index cases vs secondary cases within the same household was 2.50 (95% confidence interval [CI], 1.88-3.34), 2.27 (95% CI, 1.77-2.93) for index cases in households with no secondary cases vs secondary cases, and 1.1 (95% CI, .93-1.30) for index cases with secondary cases vs index cases without secondary cases.CONCLUSIONS: We found no increased hazard ratio of critical COVID-19 among household members of infected SARS-CoV-2 index cases.

AB - BACKGROUND: Households are high-risk settings for the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Severity of coronavirus disease 2019 (COVID-19) is likely associated with the infectious dose of SARS-CoV-2 exposure. We therefore aimed to assess the association between SARS-CoV-2 exposure within households and COVID-19 severity.METHODS: We performed a Danish, nationwide, register-based, cohort study including laboratory-confirmed SARS-CoV-2-infected individuals from 22 February 2020 to 6 October 2020. Household exposure to SARS-CoV-2 was defined as having 1 individual test positive for SARS-CoV-2 within the household. Cox proportional hazards models were used to estimate the association between "critical COVID-19" within and between households with and without secondary cases.RESULTS: From 15 063 multiperson households, 19 773 SARS-CoV-2-positive individuals were included; 11 632 were categorized as index cases without any secondary household cases; 3431 as index cases with secondary cases, that is, 22.8% of multiperson households; and 4710 as secondary cases. Critical COVID-19 occurred in 2.9% of index cases living with no secondary cases, 4.9% of index cases with secondary cases, and 1.3% of secondary cases. The adjusted hazard ratio for critical COVID-19 among index cases vs secondary cases within the same household was 2.50 (95% confidence interval [CI], 1.88-3.34), 2.27 (95% CI, 1.77-2.93) for index cases in households with no secondary cases vs secondary cases, and 1.1 (95% CI, .93-1.30) for index cases with secondary cases vs index cases without secondary cases.CONCLUSIONS: We found no increased hazard ratio of critical COVID-19 among household members of infected SARS-CoV-2 index cases.

KW - COVID-19

KW - Cohort Studies

KW - Denmark/epidemiology

KW - Family Characteristics

KW - Humans

KW - SARS-CoV-2

KW - transmission

KW - viral load

KW - death

KW - corona

KW - infectious dose

UR - http://www.scopus.com/inward/record.url?scp=85118639712&partnerID=8YFLogxK

U2 - 10.1093/cid/ciab340

DO - 10.1093/cid/ciab340

M3 - Journal article

C2 - 33893489

SN - 1058-4838

VL - 74

SP - 1

EP - 7

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 1

ER -

Household Exposure to Severe Acute Respiratory Syndrome Coronavirus 2 and Association With Coronavirus Disease 2019 Severity: a Danish nationwide cohort study

Abstract

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