tetano
Editor, Senior Moderator
Proc Natl Acad Sci U S A
. 2022 Aug 16;119(33):e2204141119.
doi: 10.1073/pnas.2204141119. Epub 2022 Jul 27.
Risk of severe COVID-19 infection among adults with prior exposure to children
Matthew D Solomon[SUP] 1 2 [/SUP], Gabriel J Escobar[SUP] 1 [/SUP], Yun Lu[SUP] 1 [/SUP], David Schlessinger[SUP] 1 [/SUP], Jonathan B Steinman[SUP] 3 [/SUP], Lawrence Steinman[SUP] 4 5 6 [/SUP], Catherine Lee[SUP] 1 [/SUP], Vincent X Liu[SUP] 1 [/SUP]
Affiliations
Abstract
Susceptibility and severity of COVID-19 infection vary widely. Prior exposure to endemic coronaviruses, common in young children, may protect against SARS-CoV-2. We evaluated risk of severe COVID-19 among adults with and without exposure to young children in a large, integrated healthcare system. Adults with children 0-5 years were matched 1:1 to adults with children 6-11 years, 12-18 years, and those without children based upon a COVID-19 propensity score and risk factors for severe COVID-19. COVID-19 infections, hospitalizations, and need for intensive care unit (ICU) were assessed in 3,126,427 adults, of whom 24% (N = 743,814) had children 18 years or younger, and 8.8% (N = 274,316) had a youngest child 0-5 years. After 1:1 matching, propensity for COVID-19 infection and risk factors for severe COVID-19 were well balanced between groups. Rates of COVID-19 infection were slightly higher for adults with exposure to older children (incident risk ratio, 1.09, 95% confidence interval, [1.05-1.12] and IRR 1.09 [1.05-1.13] for adults with children 6-11 and 12-18, respectively), compared to those with children 0-5 years, although no difference in rates of COVID-19 illness requiring hospitalization or ICU admission was observed. However, adults without exposure to children had lower rates of COVID-19 infection (IRR 0.85, [0.83-0.87]) but significantly higher rates of COVID-19 hospitalization (IRR 1.49, [1.29-1.73]) and hospitalization requiring ICU admission (IRR 1.76, [1.19-2.58]) compared to those with children aged 0-5. In a large, real-world population, exposure to young children was associated with less severe COVID-19 illness. Endemic coronavirus cross-immunity may play a role in protection against severe COVID-19.
Keywords: COVID-19; coronavirus; cross-immunity; infectious diseases; public health.
. 2022 Aug 16;119(33):e2204141119.
doi: 10.1073/pnas.2204141119. Epub 2022 Jul 27.
Risk of severe COVID-19 infection among adults with prior exposure to children
Matthew D Solomon[SUP] 1 2 [/SUP], Gabriel J Escobar[SUP] 1 [/SUP], Yun Lu[SUP] 1 [/SUP], David Schlessinger[SUP] 1 [/SUP], Jonathan B Steinman[SUP] 3 [/SUP], Lawrence Steinman[SUP] 4 5 6 [/SUP], Catherine Lee[SUP] 1 [/SUP], Vincent X Liu[SUP] 1 [/SUP]
Affiliations
- PMID: 35895714
- DOI: 10.1073/pnas.2204141119
Abstract
Susceptibility and severity of COVID-19 infection vary widely. Prior exposure to endemic coronaviruses, common in young children, may protect against SARS-CoV-2. We evaluated risk of severe COVID-19 among adults with and without exposure to young children in a large, integrated healthcare system. Adults with children 0-5 years were matched 1:1 to adults with children 6-11 years, 12-18 years, and those without children based upon a COVID-19 propensity score and risk factors for severe COVID-19. COVID-19 infections, hospitalizations, and need for intensive care unit (ICU) were assessed in 3,126,427 adults, of whom 24% (N = 743,814) had children 18 years or younger, and 8.8% (N = 274,316) had a youngest child 0-5 years. After 1:1 matching, propensity for COVID-19 infection and risk factors for severe COVID-19 were well balanced between groups. Rates of COVID-19 infection were slightly higher for adults with exposure to older children (incident risk ratio, 1.09, 95% confidence interval, [1.05-1.12] and IRR 1.09 [1.05-1.13] for adults with children 6-11 and 12-18, respectively), compared to those with children 0-5 years, although no difference in rates of COVID-19 illness requiring hospitalization or ICU admission was observed. However, adults without exposure to children had lower rates of COVID-19 infection (IRR 0.85, [0.83-0.87]) but significantly higher rates of COVID-19 hospitalization (IRR 1.49, [1.29-1.73]) and hospitalization requiring ICU admission (IRR 1.76, [1.19-2.58]) compared to those with children aged 0-5. In a large, real-world population, exposure to young children was associated with less severe COVID-19 illness. Endemic coronavirus cross-immunity may play a role in protection against severe COVID-19.
Keywords: COVID-19; coronavirus; cross-immunity; infectious diseases; public health.
