Transmission of SARS‐CoV‐2 in standardised first few X cases and household transmission investigations: A systematic review and meta‐analysis
This article has been Reviewed by the following groups
Listed in
- Evaluated articles (ScreenIT)
Abstract
We aimed to estimate the household secondary infection attack rate (hSAR) of SARS‐CoV‐2 in investigations aligned with the WHO Unity Studies Household Transmission Investigations (HHTI) protocol. We conducted a systematic review and meta‐analysis according to PRISMA 2020 guidelines. We searched Medline, Embase, Web of Science, Scopus and medRxiv/bioRxiv for “Unity‐aligned” First Few X cases (FFX) and HHTIs published 1 December 2019 to 26 July 2021. Standardised early results were shared by WHO Unity Studies collaborators (to 1 October 2021). We used a bespoke tool to assess investigation methodological quality. Values for hSAR and 95% confidence intervals (CIs) were extracted or calculated from crude data. Heterogeneity was assessed by visually inspecting overlap of CIs on forest plots and quantified in meta‐analyses. Of 9988 records retrieved, 80 articles (64 from databases; 16 provided by Unity Studies collaborators) were retained in the systematic review; 62 were included in the primary meta‐analysis. hSAR point estimates ranged from 2% to 90% (95% prediction interval: 3%–71%; I 2 = 99.7%); I 2 values remained >99% in subgroup analyses, indicating high, unexplained heterogeneity and leading to a decision not to report pooled hSAR estimates. FFX and HHTI remain critical epidemiological tools for early and ongoing characterisation of novel infectious pathogens. The large, unexplained variance in hSAR estimates emphasises the need to further support standardisation in planning, conduct and analysis, and for clear and comprehensive reporting of FFX and HHTIs in time and place, to guide evidence‐based pandemic preparedness and response efforts for SARS‐CoV‐2, influenza and future novel respiratory viruses.
Article activity feed
-
-
-
SciScore for 10.1101/2022.04.01.22273107: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable not detected. Randomization not detected. Blinding Screening was performed by at least two independent reviewers (AJM, NM, JPV-C, VS, JEF) who were blind to the other reviewer’s assessment. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources First, four databases – MEDLINE, Embase, Web of Science and Scopus, were explored to identify relevant investigations published between 1 December 2019 and 26 July 2021. MEDLINEsuggested: (MEDLINE, RRID:SCR_002185)Embasesuggested: (EMBASE, RRID:SCR_001650)Second, using the same search terms and dates, we screened unpublished investigations made available on the medRxiv and bioRxiv … SciScore for 10.1101/2022.04.01.22273107: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable not detected. Randomization not detected. Blinding Screening was performed by at least two independent reviewers (AJM, NM, JPV-C, VS, JEF) who were blind to the other reviewer’s assessment. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources First, four databases – MEDLINE, Embase, Web of Science and Scopus, were explored to identify relevant investigations published between 1 December 2019 and 26 July 2021. MEDLINEsuggested: (MEDLINE, RRID:SCR_002185)Embasesuggested: (EMBASE, RRID:SCR_001650)Second, using the same search terms and dates, we screened unpublished investigations made available on the medRxiv and bioRxiv preprint servers. bioRxivsuggested: (bioRxiv, RRID:SCR_003933)Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:We conducted a robust and thorough assessment of the methodological quality of investigations using a bespoke quality assessment tool for HHTIs which allowed for a more targeted critical appraisal and better understanding of strengths and limitations of HHTIs.(16) We only included investigations with a low or moderate risk of bias in our primary meta-analysis (n = 62) and subsequently only those aligned with the objectives of the WHO Unity Studies HHTI protocol. It also allowed us to carefully consider the appropriateness of pooling data across investigations that were conducted in different resource settings and environments, using different protocols and with differing internal and external validity. The use of a bespoke tool for methodological quality assessment does not guarantee that the intricacies of HHTI designs are fully captured, particularly where insufficient details are reported. We acknowledge that tailoring of the HHTI protocol according to cultural norms (e.g., household definition), capacity (e.g., laboratory testing, degree of follow up) and context (e.g., PHSM, local incidence, quarantine practices) may be required, increasing the true variance observed across investigations. As a result, unclear reporting may have inflated the heterogeneity in our review due to inappropriate inclusion or exclusion of some investigations. Of the 76 investigations that reported a hSAR, 13 were assessed to be at high risk of bias and subsequently excluded from the primary ana...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
-