Angeli, LeonardoCaetano, Constantino PereiraFranco, NicolasColetti, PietroFaes, ChristelMolenberghs, GeertBeutels, PhilippeAbrams, StevenWillem, LanderHens, Niel2026-01-222026-01-222025-03-05Nat Commun. 2025 Mar 5;16(1):2230. doi: 10.1038/s41467-025-57087-z2041-1723http://hdl.handle.net/10400.18/10749Constantino Pereira também afiliado ao Departamento de Epidemiologia do Instituto Nacional de Saúde Doutor Ricardo Jorge, Portugal. Afiliação não incluída devido a erro na submissão do artigo.Understanding the evolving role of different age groups in virus transmission is essential for effective pandemic management. We investigated SARS-CoV-2 transmission in Belgium from November 2020 to February 2022, focusing on age-specific patterns. Using a next generation matrix approach integrating social contact data and simulating population susceptibility evolution, we performed a longitudinal perturbation analysis of the effective reproduction number to unravel age-specific transmission dynamics. From November to December 2020, adults in the [18, 60) age group were the main transmission drivers, while children contributed marginally. This pattern shifted between January and March 2021, when in-person education resumed, and the Alpha variant emerged: children aged under 12 years old were crucial in transmission. Stringent social distancing measures in March 2021 helped diminish the noticeable contribution of the [18, 30) age group. By June 2021, as the Delta variant became the predominant strain, adults aged [18, 40) years emerged as main contributors to transmission, with a resurgence in children’s contribution during September-October 2021. This study highlights the effectiveness of our methodology in identifying age-specific transmission patterns.engCOVID-19Next Generation MatrixMathematical ModelESCAPEDeterminantes da Saúde e da Doençajournal article10.1038/s41467-025-57087-z40044649