ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2024
Household Transmission Dynamics of Asymptomatic SARS-CoV-2-Infected Children: A Multinational, Controlled Case-Ascertained Prospective Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 6 citations in OpenAlex.
- Increased respiratory pathogen positivity and diversity in hospitalized children following the COVID-19 pandemic in Malaysia.New microbes and new infections · 2026Article
- Influenza mitigation recommendations, symptoms, and viral RNA shedding durations-2023-24 and 2024-25 seasons.American journal of epidemiology · 2026Article
- Article
- Household Transmission of COVID-19 and Influenza During the Early Omicron Era: An Insurance Claims Database Study in Japan.Viruses · 2026Article
- Roles of children, isolation measures and socioeconomic status in SARS-CoV-2 household transmission: a retrospective cohort study in a southern US city.BMJ public health · 2026Article
- Vaccine efficacy of NVX-CoV2373 against SARS-CoV-2 infection in adolescents in the USA: an ancillary study to a phase 3, observer-blinded, randomised, placebo-controlled trial.The Lancet. Microbe · 2025Observational
- Canada needs a national COVID-19 inquiry now.BMC medicine · 2024Review
- Association of antenatal or neonatal SARS-COV-2 exposure with developmental and respiratory outcomes, and healthcare usage in early childhood: a national prospective cohort study.EClinicalMedicine · 2024Article
Corrections and comments
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Authors and funding
23 authors at 17 institutions in 3 countries.
Funding
Abstract
backgroundAsymptomatic SARS-CoV-2 infection in children is highly prevalent but its acute and chronic implications have been minimally described.
methodsIn this controlled case-ascertained household transmission study, we recruited asymptomatic children <18 years with SARS-CoV-2 nucleic acid testing performed at 12 tertiary care pediatric institutions in Canada and the United States. We attempted to recruit all test-positive children and 1 to 3 test-negative, site-matched controls. After 14 days' follow-up we assessed the clinical (ie, symptomatic) and combined (ie, test-positive, or symptomatic) secondary attack rates (SARs) among household contacts. Additionally, post-COVID-19 condition (PCC) was assessed in SARS-CoV-2-positive participating children after 90 days' follow-up.
resultsA total of 111 test-positive and 256 SARS-CoV-2 test-negative asymptomatic children were enrolled between January 2021 and April 2022. After 14 days, excluding households with co-primary cases, the clinical SAR among household contacts of SARS-CoV-2-positive and -negative index children was 10.6% (19/179; 95% CI: 6.5%-16.1%) and 2.0% (13/663; 95% CI: 1.0%-3.3%), respectively (relative risk = 5.4; 95% CI: 2.7-10.7). In households with a SARS-CoV-2-positive index child, age <5 years, being pre-symptomatic (ie, developed symptoms after test), and testing positive during Omicron and Delta circulation periods (vs earlier) were associated with increased clinical and combined SARs among household contacts. Among 77 asymptomatic SARS-CoV-2-infected children with 90-day follow-up, 6 (7.8%; 95% CI: 2.9%-16.2%) reported PCC.
conclusionsAsymptomatic SARS-CoV-2-infected children, especially those <5 years, are important contributors to household transmission, with 1 in 10 exposed household contacts developing symptomatic illness within 14 days. Asymptomatic SARS-CoV-2-infected children may develop PCC.
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