February 26, 2021
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Among the household contacts of patients diagnosed with COVID-19, around a tenth subsequently tested positive for the novel coronavirus, according to a study published in JAMA Network Open.
“With the electronic health record system of a large integrated health system, we were able to measure the risk of COVID-19 transmission in the home during the first half of the pandemic.” Joshua P. Metlay, MD, PhD, The director of general internal medicine at Massachusetts General Hospital told Healio Primary Care, “The risk of transmission of an infected index case to a household member during the study period was 10%. This underscores the need for preventive measures in households of patients with COVID- 19, especially in patients at higher risk. “
Reference: Metlay JP et al. JAMA Netw Open. 2021; doi: 10.1001 / jamanetworkopen.2021.0304.
Metlay and colleagues conducted a retrospective cohort study to assess the risk of COVID-19 infection in household contacts. The Index COVID-19 cases in the study were diagnosed in the Mass General Brigham healthcare system from March 4, 2020 to May 17, 2020.
The researchers identified index cases based on positive reverse transcriptase polymerase chain reaction test results and identified the risk cohort by finding all patients registered at the same address as the index case except those who had not visited the health system at least once in the last 60 months. They used electronic health records to collect information on the characteristics of household contacts in index cases.
A total of 7,262 index cases with 17,917 people at risk linked to the same addresses were included in the study.
Among the people at risk, 52.1% were female and 38.4% lived in households of six to ten people.
Metlay and colleagues found an overall incidence of 10.1% in people at risk of COVID-19 exposure through household contact.
They found that after the index case, the median time to diagnosis in people at risk who were later diagnosed with COVID-19 was 3 days (IRQ = 1-9 days).
Additionally, they found that independent factors associated with increased risk of transmission include those older than 18 years of age who have multiple comorbid conditions.
According to the results of sensitivity analyzes that limited the maximum household size to two people, the risk of transmission increased to 13.8%.
“Best practice to reduce budget carry-overs remains an area of significant uncertainty,” Metlay said. “However, based on data from hospital settings, we believe that social distancing, hand hygiene, and the wearing of masks all help reduce risk during the 10-day post-diagnosis window of suspected infectivity.”
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