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SARS-CoV-2 Circulation in the School Setting: A Systematic Review and Meta-Analysis

Author

Listed:
  • Saverio Caini

    (Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy)

  • Chiara Martinoli

    (Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy)

  • Carlo La Vecchia

    (Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, 20133 Milan, Italy)

  • Sara Raimondi

    (Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy)

  • Federica Bellerba

    (Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy)

  • Oriana D’Ecclesiis

    (Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy)

  • Clementina Sasso

    (The Italian National Institute for Astrophysics (INAF)-Osservatorio Astronomico di Capodimonte, Salita Moiariello 16, 80131 Naples, Italy)

  • Alessandra Basso

    (Centre for Philosophy of Social Science (TINT), Unit of Practical Philosophy, Department of Political and Economic Studies, University of Helsinki, P.O. Box 24, 00014 Helsinki, Finland)

  • Giulio Cammarata

    (Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy)

  • Sara Gandini

    (Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy)

Abstract

The contribution of children to viral spread in schools is still debated. We conducted a systematic review and meta-analysis of studies to investigate SARS-CoV-2 transmission in the school setting. Literature searches on 15 May 2021 yielded a total of 1088 publications, including screening, contact tracing, and seroprevalence studies. MOOSE guidelines were followed, and data were analyzed using random-effects models. From screening studies involving more than 120,000 subjects, we estimated 0.31% (95% confidence interval (CI) 0.05–0.81) SARS-CoV-2 point prevalence in schools. Contact tracing studies, involving a total of 112,622 contacts of children and adults, showed that onward viral transmission was limited (2.54%, 95% CI 0.76–5.31). Young index cases were found to be 74% significantly less likely than adults to favor viral spread (odds ratio (OR) 0.26, 95% CI 0.11–0.63) and less susceptible to infection (OR 0.60; 95% CI 0.25–1.47). Lastly, from seroprevalence studies, with a total of 17,879 subjects involved, we estimated that children were 43% significantly less likely than adults to test positive for antibodies (OR 0.57, 95% CI 0.49–0.68). These findings may not applied to the Omicron phase, we further planned a randomized controlled trial to verify these results.

Suggested Citation

  • Saverio Caini & Chiara Martinoli & Carlo La Vecchia & Sara Raimondi & Federica Bellerba & Oriana D’Ecclesiis & Clementina Sasso & Alessandra Basso & Giulio Cammarata & Sara Gandini, 2022. "SARS-CoV-2 Circulation in the School Setting: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 19(9), pages 1-13, April.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:9:p:5384-:d:804733
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    References listed on IDEAS

    as
    1. Per Engzell & Arun Frey & Mark D. Verhagen, 2021. "Learning loss due to school closures during the COVID-19 pandemic," Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, vol. 118(17), pages 2022376118-, April.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    3. Laura Di Domenico & Giulia Pullano & Chiara E. Sabbatini & Pierre-Yves Boëlle & Vittoria Colizza, 2021. "Modelling safe protocols for reopening schools during the COVID-19 pandemic in France," Nature Communications, Nature, vol. 12(1), pages 1-10, December.
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