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Asymptomatic SARS-CoV-2 infection in children linked to rural rates

 


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When the community is working on the decision to send children back to school or choose distance learning, a key issue is the number of children who may have subclinical SARS-CoV-2 infections. According to an analysis of data from 28 US children’s hospitals, the researchers found that the prevalence of asymptomatic infections in children correlated with the overall incidence of COVID-19 in local populations. discovered.

“A strong association with the prevalence of SARS-CoV-2 in children with co-morbidity of asymptomatic and concurrent COVID-19 in the general population… from Johns Hopkins, publicly available It provides an easy way to estimate asymptomatic prevalence in local children. A university database,” the researchers say in an article. Published online August 25 JAMA Pediatrics..

Ana Marija Sola, BS, researchers at the University of California, San Francisco, School of Medicine, and colleagues said SARS-CoV-2 infection in 33,041 children undergoing routine testing in April and May when the hospital resumed selective care We investigated the prevalence of. Surgical care. Hospitals performed a reverse transcription polymerase chain reaction test for SARS-CoV-2 RNA prior to surgery, clinic visits, or hospitalization. Pediatric otolaryngologists reported prevalence data through May 29 as part of a quality improvement project.

Overall, 250 patients were virus positive with an overall prevalence of 0.65%. Prevalence rates ranged from 0% to 2.2% across 25 geographical regions. By region, the prevalence was 0.90% in the northeast and 0.87% in the midwest. The prevalence was 0.59% lower in the west and 0.52% in the south.

To understand how those rates compare to the overall rates for the same geographic region, researchers used a case database identified at Johns Hopkins University to study all geographic regions. The average weekly incidence of COVID-19 in the population was calculated.

“The prevalence of asymptomatic children was significantly associated with the weekly incidence of COVID-19 in the general population during the 6-week period during which most tests in asymptomatic individuals were performed,” Sola. Report. Analysis using additional data from 11 geographical regions showed that this association persisted at a later point in time.

The study provides “another window on the question of how likely an asymptomatic child is likely to carry the coronavirus,” said Susan E. Coffin, MD, a physician in the Department of Infectious Diseases at the Philadelphia Children’s Hospital. Said the doctor. But important relevant questions remain, said Coffin, who was not involved in the study.

For one thing, it is unclear how many children will remain asymptomatic as compared to the children who were presymptomatic at the time of testing. And the important thing is “[w]”Is the proportion of these children contagious?” said, “Children with asymptomatic infections may be less contagious than children with symptomatic infections.” There are some data that suggests.”

Also, the patients seen in a pediatric hospital may differ from the general pediatric population. “What would this look like if we did the exact same study on a group of randomly selected children? Was the order lifted?”

Further studies are needed to establish that detection of COVID-19 in the general population predicts the prevalence of SARS-CoV-2 infection in asymptomatic children, Coffin said.

The author does not disclose the financial relationships involved.

JAMA Pediatrics.. Published online August 25, 2020. Full text

Jacob Remaly is a staff journalist at Medscape Medical News and MDedge. He has been in health care and medicine for over five years. You can contact him at [email protected].

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