The goal of this project is to understand the household level transmission dynamics andfactors that predict transmission of SARS-COV-2 between pediatric and adults in thehousehold.The novel coronavirus SARS-CoV-2 has spread all around the world and testing has posed achallenge globally. Not much is known about who does and does not acquire SARS-CoV2. Itis also unknown who will show symptoms or progress severe disease or death from COVID-19.Children tend to have milder symptoms or none at all. Therefore, few children have everbeen tested, so it is unknown if they get the infection as much as anyone else. Healthcare providers are highly exposed, and they do not get tested unless they show severesymptoms. If groups like children and health workers are infected, they can unknowinglyspread SARS-CoV-2, unless they practice behaviors like self-isolation very strictly. Theinvestigators aim to measure the prevalence of SARS-CoV-2 in children and health careworkers at a large urban health center. The investigators will also measure how manypeople in the household of the positive children and health care workers also getSARS-CoV-2 infection. Lastly, the investigators will see what other risk factors affectwho acquires SARSCoV-2 from inside or outside of the household clusters.
The rapid spread of the novel coronavirus SARS-CoV-2 has resulted in pandemic levels and
a global challenge in diagnosing infection. Little is known about transmission and
disease presentation of COVID-19. Children tend to present with mild or no symptoms, and
only a minority seem to progress to severe disease. Therefore, fewer have been tested.
Health care providers who are highly exposed are under tested for their level of
exposure. Under diagnoses in these groups can result in onward transmission of SARS-CoV-2
if non-pharmaceutical interventions like self-isolation are not strictly practiced. The
investigators aim to assess the prevalence of SARS-CoV-2 in a pediatric, health care
worker and other individuals sample in a large urban health center; Estimate the
household secondary attack rate of SARS-COV-2 from the pediatric and adult index case
SARS-COV-2 identified through the prevalence survey; and identify risk factors that
affect transmission from within and outside of the household clusters.
This is an observational prospective cohort study of pediatric patients, New York
Presbyterian (and affiliates) health workers, and any individuals who have been exposed
to SARS-CoV-2 cases and their household contacts residing in New York City. Child index
and their household members who consent to participate will be enrolled and tested for
SARS-CoV-2. Households will be followed prospectively for a minimum of 15 days from the
date the last household member testing positive. Daily clinical symptom reporting, social
distancing behaviors within and outside of the household, emotional and mental health
factors such anxiety, stigma and disclosure (among SARS-CoV-2 diagnosed) will be reported
by adult household members and minors over the age of 7. Adults will report signs and
symptoms for minors under the age of 7. SARS-CoV-2 negative household members will be
re-tested around the day of onset of symptoms and baseline negative household members
will be tested at the end of the observation period. A proportion of SARS-CoV-2 positive
household members will be sampled serially for viral shedding and would be sampled on the
day of onset of exposure. Households where all members are positive at baseline visit
will be excluded from participation.
Inclusion Criteria:
- Index is a positive child AND at least one household member is negative
OR
- Index is a positive symptomatic / asymptomatic New York Presbyterian Hospital (NYP)
and affiliates worker or any individual AND at least one household member is
negative
OR
- Either Index case is negative, exposed to a confirmed positive SARS-CoV-2 case, AND
at least one household members is negative
Exclusion Criteria:
- Index case is positive and all household members are positive
Columbia University Irving Medical Center
New York, New York, United States
Investigator: Delivette Castor, Ph.D.
Contact: 347-770-2201
dc2022@cumc.columbia.edu
Delivette Castor, PhD
347-770-2201
covid19idresearch@cumc.columbia.edu
Delivette Castor, PhD, Principal Investigator
Columbia University