H. Forbes, C. Morton, S. Bacon, H. McDonald, C. Minassian, J. Brown, C. Rentsch, R. Mathur, Anna Schultze, N. J. DeVito, B. MacKenna, W. Hulme, R. Croker, A. Walker, E. Williamson, C. Bates, A. Mehrkar, H. Curtis, D. Evans, K. Wing, P. Inglesby, H. Drysdale, A. Wong, J. Cockburn, R. Mcmanus, J. Parry, F. Hester, S. Harper, I. Douglas, L. Smeeth, S. Evans, K. Bhaskaran, R. Eggo, B. Goldacre, L. Tomlinson
medRxiv, 2020
Background: Close contact with children may provide cross-reactive immunity to SARs-CoV-2 due to more frequent prior coryzal infections from seasonal coronaviruses. Alternatively, close contact with children may increase risk of SARs-CoV-2 infection. We investigated whether risk of infection with SARs-CoV-2 and severe outcomes differed between adults living with and without children. Methods: Working on behalf of NHS England, we conducted a population-based cohort study using primary care data and pseudonymously-linked hospital and intensive care admissions, and death records, from patients registered in general practices representing 40% of England. Using multivariable Cox regression, we calculated fully-adjusted hazard ratios (HR) of outcomes from 1st February-3rd August 2020 comparing adults living with and without children in the household. Findings: Among 9,157,814 adults [≤]65 years, living with children 0-11 years was not associated with increased risks of recorded SARS-CoV-2 infection, COVID-19 related hospital or ICU admission but was associated with reduced risk of COVID-19 death (HR 0.75, 95%CI 0.62-0.92). Living with children aged 12-18 years was associated with a small increased risk of recorded SARS-CoV-2 infection (HR 1.08, 95%CI 1.03-1.13), but not associated with other COVID-19 outcomes. Living with children of any age was also associated with lower risk of dying from non-COVID-19 causes. Among 2,567,671 adults >65 years there was no association between living with children and outcomes related to SARS-CoV-2. We observed no consistent changes in risk following school closure. Interpretation: For adults living with children there is no evidence of an increased risk of severe COVID-19 outcomes. These findings have implications for determining the benefit-harm balance of children attending school in the COVID-19 pandemic. Funding This work was supported by the Medical Research Council MR/V015737/1.
Cited by 24 publications.
Field of study: Medicine