TY - JOUR
T1 - Risk factors for SARS-CoV-2 infection and transmission in households with children with asthma and allergy
T2 - A prospective surveillance study
AU - HEROS study team
AU - Seibold, Max A.
AU - Moore, Camille M.
AU - Everman, Jamie L.
AU - Williams, Blake J.M.
AU - Nolin, James D.
AU - Fairbanks-Mahnke, Ana
AU - Plender, Elizabeth G.
AU - Patel, Bhavika B.
AU - Arbes, Samuel J.
AU - Bacharier, Leonard B.
AU - Bendixsen, Casper G.
AU - Calatroni, Agustin
AU - Camargo, Carlos A.
AU - Dupont, William D.
AU - Furuta, Glenn T.
AU - Gebretsadik, Tebeb
AU - Gruchalla, Rebecca S.
AU - Gupta, Ruchi S.
AU - Khurana Hershey, Gurjit K.
AU - Murrison, Liza Bronner
AU - Jackson, Daniel J.
AU - Johnson, Christine C.
AU - Kattan, Meyer
AU - Liu, Andrew H.
AU - Lussier, Stephanie J.
AU - O'Connor, George T.
AU - Rivera-Spoljaric, Katherine
AU - Phipatanakul, Wanda
AU - Rothenberg, Marc E.
AU - Seroogy, Christine M.
AU - Teach, Stephen J.
AU - Zoratti, Edward M.
AU - Togias, Alkis
AU - Fulkerson, Patricia C.
AU - Hartert, Tina V.
N1 - Publisher Copyright:
© 2022
PY - 2022/8
Y1 - 2022/8
N2 - Background: Whether children and people with asthma and allergic diseases are at increased risk for severe acute respiratory syndrome virus 2 (SARS-CoV-2) infection is unknown. Objective: Our aims were to determine the incidence of SARS-CoV-2 infection in households with children and to also determine whether self-reported asthma and/or other allergic diseases are associated with infection and household transmission. Methods: For 6 months, biweekly nasal swabs and weekly surveys were conducted within 1394 households (N = 4142 participants) to identify incident SARS-CoV-2 infections from May 2020 to February 2021, which was the pandemic period largely before a vaccine and before the emergence of SARS-CoV-2 variants. Participant and household infection and household transmission probabilities were calculated by using time-to-event analyses, and factors associated with infection and transmission risk were determined by using regression analyses. Results: In all, 147 households (261 participants) tested positive for SARS-CoV-2. The household SARS-CoV-2 infection probability was 25.8%; the participant infection probability was similar for children (14.0% [95% CI = 8.0%-19.6%]), teenagers (12.1% [95% CI = 8.2%-15.9%]), and adults (14.0% [95% CI = 9.5%-18.4%]). Infections were symptomatic in 24.5% of children, 41.2% of teenagers, and 62.5% of adults. Self-reported doctor-diagnosed asthma was not a risk factor for infection (adjusted hazard ratio [aHR] = 1.04 [95% CI = 0.73-1.46]), nor was upper respiratory allergy or eczema. Self-reported doctor-diagnosed food allergy was associated with lower infection risk (aHR = 0.50 [95% CI = 0.32-0.81]); higher body mass index was associated with increased infection risk (aHR per 10-point increase = 1.09 [95% CI = 1.03-1.15]). The household secondary attack rate was 57.7%. Asthma was not associated with household transmission, but transmission was lower in households with food allergy (adjusted odds ratio = 0.43 [95% CI = 0.19-0.96]; P =.04). Conclusion: Asthma does not increase the risk of SARS-CoV-2 infection. Food allergy is associated with lower infection risk, whereas body mass index is associated with increased infection risk. Understanding how these factors modify infection risk may offer new avenues for preventing infection.
AB - Background: Whether children and people with asthma and allergic diseases are at increased risk for severe acute respiratory syndrome virus 2 (SARS-CoV-2) infection is unknown. Objective: Our aims were to determine the incidence of SARS-CoV-2 infection in households with children and to also determine whether self-reported asthma and/or other allergic diseases are associated with infection and household transmission. Methods: For 6 months, biweekly nasal swabs and weekly surveys were conducted within 1394 households (N = 4142 participants) to identify incident SARS-CoV-2 infections from May 2020 to February 2021, which was the pandemic period largely before a vaccine and before the emergence of SARS-CoV-2 variants. Participant and household infection and household transmission probabilities were calculated by using time-to-event analyses, and factors associated with infection and transmission risk were determined by using regression analyses. Results: In all, 147 households (261 participants) tested positive for SARS-CoV-2. The household SARS-CoV-2 infection probability was 25.8%; the participant infection probability was similar for children (14.0% [95% CI = 8.0%-19.6%]), teenagers (12.1% [95% CI = 8.2%-15.9%]), and adults (14.0% [95% CI = 9.5%-18.4%]). Infections were symptomatic in 24.5% of children, 41.2% of teenagers, and 62.5% of adults. Self-reported doctor-diagnosed asthma was not a risk factor for infection (adjusted hazard ratio [aHR] = 1.04 [95% CI = 0.73-1.46]), nor was upper respiratory allergy or eczema. Self-reported doctor-diagnosed food allergy was associated with lower infection risk (aHR = 0.50 [95% CI = 0.32-0.81]); higher body mass index was associated with increased infection risk (aHR per 10-point increase = 1.09 [95% CI = 1.03-1.15]). The household secondary attack rate was 57.7%. Asthma was not associated with household transmission, but transmission was lower in households with food allergy (adjusted odds ratio = 0.43 [95% CI = 0.19-0.96]; P =.04). Conclusion: Asthma does not increase the risk of SARS-CoV-2 infection. Food allergy is associated with lower infection risk, whereas body mass index is associated with increased infection risk. Understanding how these factors modify infection risk may offer new avenues for preventing infection.
KW - COVID-19
KW - SARS-CoV-2
KW - asthma
KW - body mass index
KW - food allergy
KW - infection
KW - transmission
UR - http://www.scopus.com/inward/record.url?scp=85135599377&partnerID=8YFLogxK
U2 - 10.1016/j.jaci.2022.05.014
DO - 10.1016/j.jaci.2022.05.014
M3 - Article
C2 - 35660376
AN - SCOPUS:85135599377
SN - 0091-6749
VL - 150
SP - 302
EP - 311
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
IS - 2
ER -