Epidemiological burden of parents being the index cases of COVID-19 infected children

World J Methodol. 2021 Jan 20;11(1):1-14. doi: 10.5662/wjm.v11.i1.1.

Abstract

Background: In the ongoing coronavirus disease 2019 (COVID-19) pandemic, when children remain home-confined secondary to the closure of schools, little is known of the burden of the parents being their index case.

Aim: To determine the prevalence of parents being the index case of COVID-19 infected children.

Methods: A database search in PubMed and Scopus ensued to recruit studies reporting the index case information of COVID-19 infected individuals aged ≤ 18. The reviewed articles' quality evaluation included the use of the National Heart, Lung, and Blood Institute's tool. A random-effect meta-analysis ensued to determine the prevalence of the parent being and not-being the index case. Heterogeneity was assessed by I 2 and Chi 2 statistics. The publication bias was evaluated by funnel plots and Egger's test.

Results: Overall, this review included 13 eligible studies sourcing data from 622 children of 33 nations. Study designs were heterogeneous and primarily included descriptive reports (38.4%). The prevalence of parent being the index case was 54% (95%CI: 0.29-0.79; I 2: 62.3%, Chi 2 P < 0.001). In > 70% of children, their index-case parent was symptomatic due to COVID-19 at the time of infection transmitting. Studies for which a risk of bias assessment was possible were of fair quality.

Conclusion: There is a substantial global burden of parents being the index case of COVID-19 infected children, and frequently these parents are symptomatic. Therefore, from a public health perspective, early detection of these parents is crucial.

Keywords: COVID-19; COVID-19 pandemic; Index case epidemiology; Patient zero epidemiology; Pediatrics.