Evidence map›Paper›PMID 37031689›Full record

ArticleThe Lancet. Microbe2023

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

Nieves Derqui, Aleksandra Koycheva, Jie Zhou, Timesh D Pillay, Michael A Crone, Seran Hakki, Joe Fenn, Rhia Kundu, Robert Varro, Emily Conibear and 21 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Microbe, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 3 pooled it
11.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 61 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Non-pharmaceutical interventions for COVID-19: a systematic review on environmental control measures.Philosophical transactions. Series A, Mathematical, physical, and engineering sciences · 2023
    Pooled it
  4. Trial
  5. Genomic epidemiology ofOne health (Amsterdam, Netherlands) · 2026
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  15. Inferring transmission risk of respiratory viral infection from the viral load kinetics of SARS-CoV-2, England, 2020 to 2021 and influenza A virus, Hong Kong, 2008 to 2012.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025
    Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

31 authors at 3 institutions in 1 country.

Nieves DerquiNIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK.
Aleksandra KoychevaNIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK.
Jie ZhouSection of Virology, Department of Infectious Disease, Imperial College London, London, UK.
Timesh D PillayNIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK.
Michael A CroneSection of Virology, Department of Infectious Disease, Imperial College London, London, UK; UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, London, UK; London Biofoundry, Imperial College Translation and Innovation Hub, London, UK.
Seran HakkiNIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK.
Joe FennNIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK.
Rhia KunduNIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK.
Robert VarroNIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK.
Emily ConibearNIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK.
Kieran J MadonNIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK.
Jack L BarnettNIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK.
Hamish HoustonNIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK.
Anika SinganayagamNIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK; Section of Virology, Department of Infectious Disease, Imperial College London, London, UK; UK Health Security Agency, London, UK.
Janakan S NareanNIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK.
Mica R Tolosa-WrightNIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK.
Lucy MosscropSection of Virology, Department of Infectious Disease, Imperial College London, London, UK.
Carolina RosadasSection of Virology, Department of Infectious Disease, Imperial College London, London, UK.
Patricia WatberSection of Virology, Department of Infectious Disease, Imperial College London, London, UK.
Charlotte AndersonUK Health Security Agency, London, UK.
Eleanor ParkerSection of Virology, Department of Infectious Disease, Imperial College London, London, UK.
Paul S FreemontSection of Virology, Department of Infectious Disease, Imperial College London, London, UK; UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, London, UK; London Biofoundry, Imperial College Translation and Innovation Hub, London, UK.
Neil M FergusonNIHR Health Protection Research Unit in Modelling and Health Economics, MRC Centre for Global Infectious Disease Analysis, Jameel Institute, Imperial College London, London, UK.
Maria ZambonUK Health Security Agency, London, UK.
Myra O McClureSection of Virology, Department of Infectious Disease, Imperial College London, London, UK.
Richard TedderSection of Virology, Department of Infectious Disease, Imperial College London, London, UK.
Wendy S BarclaySection of Virology, Department of Infectious Disease, Imperial College London, London, UK.
Jake DunningUK Health Security Agency, London, UK; NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Oxford, Oxford, UK.
Graham P TaylorSection of Virology, Department of Infectious Disease, Imperial College London, London, UK.
Ajit LalvaniNIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK. Electronic address: a.lalvani@imperial.ac.uk.
INSTINCT and ATACCC study group
Imperial College London · GBNIHR Imperial Biomedical Research Centre · GBUK Health Security Agency

Funding

Department of Health NIHR200908Department of Health NIHR200927Medical Research Council MR/R015600/1Medical Research Council MR/V038109/1Medical Research Council MR/W005611/1
6 · The paper itself

Abstract

backgroundDespite circumstantial evidence for aerosol and fomite spread of SARS-CoV-2, empirical data linking either pathway with transmission are scarce. Here we aimed to assess whether the presence of SARS-CoV-2 on frequently-touched surfaces and residents' hands was a predictor of SARS-CoV-2 household transmission.

methodsIn this longitudinal cohort study, during the pre-alpha (September to December, 2020) and alpha (B.1.1.7; December, 2020, to April, 2021) SARS-CoV-2 variant waves, we prospectively recruited contacts from households exposed to newly diagnosed COVID-19 primary cases, in London, UK. To maximally capture transmission events, contacts were recruited regardless of symptom status and serially tested for SARS-CoV-2 infection by RT-PCR on upper respiratory tract (URT) samples and, in a subcohort, by serial serology. Contacts' hands, primary cases' hands, and frequently-touched surface-samples from communal areas were tested for SARS-CoV-2 RNA. SARS-CoV-2 URT isolates from 25 primary case-contact pairs underwent whole-genome sequencing (WGS).

findingsFrom Aug 1, 2020, until March 31, 2021, 620 contacts of PCR-confirmed SARS-CoV-2-infected primary cases were recruited. 414 household contacts (from 279 households) with available serial URT PCR results were analysed in the full household contacts' cohort, and of those, 134 contacts with available longitudinal serology data and not vaccinated pre-enrolment were analysed in the serology subcohort. Household infection rate was 28·4% (95% CI 20·8-37·5) for pre-alpha-exposed contacts and 51·8% (42·5-61·0) for alpha-exposed contacts (p=0·0047). Primary cases' URT RNA viral load did not correlate with transmission, but was associated with detection of SARS-CoV-2 RNA on their hands (p=0·031). SARS-CoV-2 detected on primary cases' hands, in turn, predicted contacts' risk of infection (adjusted relative risk [aRR]=1·70 [95% CI 1·24-2·31]), as did SARS-CoV-2 RNA presence on household surfaces (aRR=1·66 [1·09-2·55]) and contacts' hands (aRR=2·06 [1·57-2·69]). In six contacts with an initial negative URT PCR result, hand-swab (n=3) and household surface-swab (n=3) PCR positivity preceded URT PCR positivity. WGS corroborated household transmission.

interpretationPresence of SARS-CoV-2 RNA on primary cases' and contacts' hands and on frequently-touched household surfaces associates with transmission, identifying these as potential vectors for spread in households.

fundingNational Institute for Health Research Health Protection Research Unit in Respiratory Infections, Medical Research Council.

Indexed as

COVID-19SARS-CoV-2Cohort StudiesHumansLongitudinal StudiesProspective StudiesRisk FactorsRNA, ViralRNA, Viral

Identifiers

PMID37031689
PMCPMC10132910
OpenAlexW4362660795

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.