Risk factors and vectors for SARS-CoV-2 household transmission: a prospective, longitudinal cohort study

Derqui-Fernández, Nieves; Koycheva, Aleksandra; Zhou, Jie; Pillay, Timesh D; Crone, Michael; Hakki, Seran; Fenn, Joe; Kundu, Rhia; Varro, Robert; Conibear, Emily; Madon, Kieran J; Barnett, Jack L; Houston, Hamish; Narean, Janakan Sam; Tolosa-Wright, Mica; Mosscrop, Lucy; Rosadas, Carolina; Watber, Patricia; Anderson, Charlotte; Parker, Eleanor; Freemont, Paul S.; Ferguson, Neil; Zambon, Maria; McClure, Myra O.; Tedder, Richard S.; Barclay, Wendy S.; Dunning, Jake; Taylor, Graham P.; Lalvani, Ajit; Cutajar, Jessica; Quinn, Valerie; Hammett, Sarah; McDermott, Eimèar; Luca, Constanta; Timcang, Kristel; Samuel, Jonathon; Bremang, Samuel; Evetts, Samuel; Wang, Lulu; Nevin, Sean; Davies, Megan; Tejpal, Chitra; Essoussi, Mohammed; Ketkar, Anjeli V; Miserocchi, Giulia; Catchpole, Harriet; Badhan, Anjna; Dustan, Simon; Weber, Isaac J Day; Marchesin, Federica; Whitfield, Michael G.; Poh, John; Kondratiuk, Alexandra

doi:10.1016/s2666-5247(23)00069-1

Cited by 35 publications

(22 citation statements)

References 32 publications

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“…Although the lungs are considered the primary site of SARS-CoV-2 replication, several studies have reported the presence of virus in the gastrointestinal tract [2]. One study found SARS-CoV-2 RNA on the hands of primary cases and contact cases, as well as on frequentlytouched household surfaces associated with transmission, indicating these as potential vectors for spread within households [27]. We demonstrated that in K18-hACE2 transgenic mice infected with SARS-CoV-2 via intranasal administration, extensive necrosis and inflammation of the lamina propria of intestinal villi associated with cell damage and increased intestinal permeability are observed [24].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, it was reported that although the virus is inactivated by gastric pH of <2.5, it is much less affected by pH between 3.5 and 6.0 that fits gastric pH variations depending whether the individual is in fasting or feeding state, respectively [26]. Finally, a recent study provided evidence for the transmission of SARS-CoV-2 via people's hands through frequently-touched surfaces at home [27]. The present study, aimed at distinguishing the different possible routes of infection of intestinal cells and their sensitivities to polarised infection (apical and/or basal) by SARS-CoV-2, revealed a preferential tropism of SARS-CoV-2 for the apical surface of the human intestinal cells, as well as damage to the integrity of the epithelial cell monolayer.…”

Section: Introductionmentioning

confidence: 99%

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Preferential apical infection of intestinal cell monolayers by SARS-CoV-2 is associated with damage to cellular barrier integrity: Implications for the physiopathology of COVID-19

Garrec,

Arrindell,

Andrieu

et al. 2024

Preprint

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SARS-CoV-2 can infect different organs, including the intestine. In Caco-2 intestinal cell line, SARS-CoV-2 modulates the ACE2 receptor expression and affects the expression of molecules involved in intercellular junctions. To further explore the possibility that the intestinal epithelium serves as an alternative infection route for SARS-CoV-2, we used a model of polarised intestinal cell monolayers grown on the polycarbonate membrane of Transwell inserts, inoculated with the virus either in the upper or lower chamber of culture. In both polarised Caco-2 cell monolayers and co-culture Caco-2/HT29 cell monolayer, apical SARS-CoV-2 inoculation was found to be much more effective in establishing infection than basolateral inoculation. In addition, apical SARS-CoV-2 infection triggers monolayer degeneration, as shown by histological examination, measurement of trans-epithelial electronic resistance, and cell adhesion molecule expression. During this process, the infectious viruses reach the lower chamber, suggesting either a transcytosis mechanism from the apical side to the basolateral side of cells, a paracellular trafficking of the virus after damage to intercellular junctions in the epithelial barrier, or both. Taken together, these data highlight a preferential tropism of SARS-CoV-2 for the apical side of the human intestinal tract and suggests that infection via the intestinal lumen leads to a systemic infection.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Preferential apical infection of intestinal cell monolayers by SARS-CoV-2 is associated with damage to cellular barrier integrity: Implications for the physiopathology of COVID-19

Garrec,

Arrindell,

Andrieu

et al. 2024

Preprint

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“…Alternative study designs have also struggled to measure household attack rates, with for example household contact studies being labor-intensive and expensive, with relatively low yield and power. 6,31…”

Section: Discussionmentioning

confidence: 99%

The association between SARS-CoV-2 infections in English primary and secondary school children and staff, and infections in members of their household in the schoolyear 2020-2021: a self-controlled case-series analysis

McClenaghan,

Nguipdop-Djomo,

Lewin

et al. 2023

Preprint

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BackgroundThe role of children and staff in SARS-CoV-2 transmission outside and within households is still not fully understood when large numbers are in regular, frequent contact in schools.MethodsWe used the self-controlled case-series method during the alpha- and delta-dominant periods to explore the incidence of infection in periods around a household member infection, relative to periods without household infection, in a cohort of primary and secondary English school children and staff from November 2020 to July 2021.ResultsWe found the relative incidence of infection in students and staff was highest in the 1-7 days following household infection, remaining high up to 14 days after, with risk also elevated in the 6-12 days before household infection. Younger students had a higher relative incidence following household infection, suggesting household transmission may play a more prominent role compared with older students. The relative incidence was also higher amongst students in the alpha variant dominant period.ConclusionsThis analysis suggests SARS-CoV2 infection in children, young people and staff at English schools were more likely to be associated with within-household transmission than from outside the household, but that a small increased risk of seeding from outside is observed.Key messagesQuestion: With respect to incidence of SARS-CoV-2 infection before and after household member infection, is within-household transmission more likely than community transmission amongst school children and staff?Findings: In this self-controlled case-series analysis, the relative incidence of infection in students and staff was highest in the 1-7 days following household infection, remaining high up to 14 days after, with the highest relative incidence found in younger, primary school-aged children.Importance: Within-household transmission is more likely than from outside the household, but a small increased risk of seeding from outside the household is observed as well as variation by age and variant dominant period.

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“…Surface disinfection: Contamination of surfaces in houses or hospital wards housing individuals with COVID-19 suggests that fomite transmission may be possible [70][71][72]. Lin et al studied secondary transmission to HCWs that performed gastrointestinal endoscopy in 11 COVID-19 patients at a hospital in China, where enhanced disinfection strategies were in place both during and after the procedures.…”

Section: Ventilation and Air Filtrationmentioning

confidence: 99%

Non-pharmaceutical interventions for COVID-19: a systematic review on environmental control measures

Madhusudanan,

Iddon,

Cevik

et al. 2023

Phil. Trans. R. Soc. A.

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The purpose of this review was to identify the effectiveness of environmental control (EC) non-pharmaceutical interventions (NPIs) in reducing transmission of SARS-CoV-2 through conducting a systematic review. EC NPIs considered in this review are room ventilation, air filtration/cleaning, room occupancy, surface disinfection, barrier devices, CO 2 monitoring and one-way-systems. Systematic searches of databases from Web of Science, Medline, EMBASE, preprint servers MedRxiv and BioRxiv were conducted in order to identify studies reported between 1 January 2020 and 1 December 2022. All articles reporting on the effectiveness of ventilation, air filtration/cleaning, room occupancy, surface disinfection, barrier devices, CO 2 monitoring and one-way systems in reducing transmission of SARS-CoV-2 were retrieved and screened. In total, 13 971 articles were identified for screening. The initial title and abstract screening identified 1328 articles for full text review. Overall, 19 references provided evidence for the effectiveness of NPIs: 12 reported on ventilation, 4 on air cleaning devices, 5 on surface disinfection, 6 on room occupancy and 1 on screens/barriers. No studies were found that considered the effectiveness of CO 2 monitoring or the implementation of one-way systems. Many of these studies were assessed to have critical risk of bias in at least one domain, largely due to confounding factors that could have affected the measured outcomes. As a result, there is low confidence in the findings. Evidence suggests that EC NPIs of ventilation, air cleaning devices and reduction in room-occupancy may have a role in reducing transmission in certain settings. However, the evidence was usually of low or very low quality and certainty, and hence the level of confidence ascribed to this conclusion is low. Based on the evidence found, it was not possible to draw any specific conclusions regarding the effectiveness of surface disinfection and the use of barrier devices. From these results, we further conclude that community agreed standards for well-designed epidemiological studies with low risk of bias are needed. Implementation of such standards would enable more confident assessment in the future of the effectiveness of EC NPIs in reducing transmission of SARS-CoV-2 and other pathogens in real-world settings. This article is part of the theme issue ‘The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence’.

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Risk factors and vectors for SARS-CoV-2 household transmission: a prospective, longitudinal cohort study

Cited by 35 publications

References 32 publications

Preferential apical infection of intestinal cell monolayers by SARS-CoV-2 is associated with damage to cellular barrier integrity: Implications for the physiopathology of COVID-19

Preferential apical infection of intestinal cell monolayers by SARS-CoV-2 is associated with damage to cellular barrier integrity: Implications for the physiopathology of COVID-19

The association between SARS-CoV-2 infections in English primary and secondary school children and staff, and infections in members of their household in the schoolyear 2020-2021: a self-controlled case-series analysis

Non-pharmaceutical interventions for COVID-19: a systematic review on environmental control measures

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