Risk factors for SARS-CoV-2 infection and transmission in households with children with asthma and allergy: A prospective surveillance study - 04/08/22
, Camille M. Moore, PhD a, d, e, Jamie L. Everman, PhD a, Blake J.M. Williams, MS a, James D. Nolin, PhD a, Ana Fairbanks-Mahnke, BA a, Elizabeth G. Plender, BS a, Bhavika B. Patel, PhD a, Samuel J. Arbes, DDS, PhD f, Leonard B. Bacharier, MD g, Casper G. Bendixsen, PhD h, Agustin Calatroni, MS g, Carlos A. Camargo, MD, DrPH i, William D. Dupont, PhD j, Glenn T. Furuta, MD k, Tebeb Gebretsadik, MPH l, Rebecca S. Gruchalla, MD, PhD m, Ruchi S. Gupta, PhD n, Gurjit K. Khurana Hershey, MD, PhD o, Liza Bronner Murrison, PhD o, Daniel J. Jackson, MD p, Christine C. Johnson, PhD q, Meyer Kattan, MD r, Andrew H. Liu, MD k, s, Stephanie J. Lussier, MS f, George T. O’Connor, MD, MS t, Katherine Rivera-Spoljaric, MD u, Wanda Phipatanakul, MD, MS v, Marc E. Rothenberg, MD, PhD w, Christine M. Seroogy, MD p, Stephen J. Teach, MD, MPH x, Edward M. Zoratti, MD q, Alkis Togias, MD y, Patricia C. Fulkerson, MD, PhD y, Tina V. Hartert, MD, MPH g, jon behalf of the
HEROS study team
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Abstract |
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.
Il testo completo di questo articolo è disponibile in PDF.Key words : SARS-CoV-2, COVID-19, food allergy, body mass index, asthma, infection, transmission
Abbreviations used : ACE2, aHR, aOR, BMI, CDC, COVID-19, Cq, HEROS, OR, SAR, SARS-CoV-2
Mappa
| Please see the Supplementary Appendix in the Online Repository at www.jacionline.org for full cohort and funding information. Grant numbers: AI024156, AI051598, UG3OD023282, 3U19AI070235-14S1, 3U54AI117804-06S1, 3U54AI117804-07S1, R01AI127507, U19 AI104317, PO1HL70381, U01 AI 110397, R01 HL 137192, K24 AI 106822, U10 HL109172, 3R01AI130348-04S1, 1UL1TR001430, 5UM1AI114271, 3UM1AI114271-06S1, 3UM1AI114271-07S1, UM1AI114271, U19 AI 095227-S2, U19 AI 095227-S1, 3PO1AI089473-07S1, AI089473, NIH 3UM1AI151958-01S1, NIH 3UM1AI151958-02S1, 1UM2AI117870, AI050681, and UH3 OD023282. |
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| Disclaimer: The authorship of P.C.F. and A.T. does not constitute endorsement by the National Institute of Allergy and Infection Diseases (NIAID), the National Institutes of Health (NIH), or any other agency of the United States government. |
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| Disclosure of potential conflict of interest: L. B. Bacharier reports grants from NIH/NIAID and NHLBI, personal fees from GlaxoSmithKline Genentech/Novartis, DBV Technologies, Teva, Boehringer Ingelheim, AstraZeneca, WebMD/Medscape, Sanofi/Regeneron, Vectura, Circassia, Kinaset, and Vertex, as well as royalties from Elsevier outside the submitted work. R. S. Gupta reports research grant support from the NIH (R21 ID# AI135705, R01 ID# AI130348, U01 ID # AI138907), Allergy and Asthma Network, Food Allergy Research and Education, Melchiorre Family Foundation, Sunshine Charitable Foundation, Walder Foundation, Stanford Sean N. Parker Center for Allergy Research, UnitedHealth Group, Thermo Fisher Scientific, Genentech, and the National Confectioners Association; in addition, she has served as a medical consultant/advisor for Genentech, Novartis, and Food Allergy Research and Education; has ownership interest in YoBee Care Inc; and is currently employed by Ann and Robert H. Lurie Children's Hospital of Chicago. D. J. Jackson reports personal fees from Astra Zeneca, GlaxoSmithKline, Vifor Pharma, Sanofi, Regeneron, and Pfizer, as well as grant funding from GlaxoSmithKline outside the submitted work. S. J. Teach reports grant support from the NIH/NHLBI, NIH/NIAID, NIH/NICHD, EJF Philanthropies and Novartis, contract support from DC Health, and royalties from UptoDate, Inc. G. T. Furuta is the co-founder of EnteroTrack. L. B. Murrison is employed by and owns stock in AbbVie. M. A. Seibold reports grants from NIH/NIAID/NHLBI, and previous research funding from Genentech, Medimmune, and Pfizer. W. Phipatanakul reports NIH funding, consulting for Genentech, Novartis, Regeneron, Sanofi, GSK, and Teva, as well as asthma-related trial support from Genentech, Novartis, Regeneron, Sanofi, Merk, and Circassia. M. E. Rothenberg reports that he is a consultant for Pulm One, Spoon Guru, ClostraBio, Serpin Pharm, Allakos, Celldex, Bristol Myers Squibb, Astra Zeneca, Ellodi Pharma, GlaxoSmith Kline, Regeneron/Sanofi, Revolo Biotherapeutics, and Guidepoint and has an equity interest in the first 6 entities listed, and royalties from reslizumab (Teva Pharmaceuticals), PEESSv2 (Mapi Research Trust) and UpToDate. M. E. Rothenberg is an inventor of patents owned by Cincinnati Children’s Hospital. The remaining authors declare that they have no relevant conflicts of interest. |
Vol 150 - N° 2
P. 302-311 - Agosto 2022 Ritorno al numero
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