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Are children more likely to have asymptomatic SARS-CoV-2 than adults?

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It has been suggested that children with asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are more frequent than adults. It has also been suggested that asymptomatic children promote the spread of the virus. Research letter published in the journal JAMA Pediatrics In September 2020, we will explore the truth of this common belief.

Study: Severe Acute Respiratory Syndrome Child vs. adult frequency of asymptomatic coronavirus 2.  Image Copyright: FamVeld / Shutterstock

Previous research

Previous studies have shown that both children and adults have a similar prevalence of COVID-19, as observed by antibody testing. According to a study conducted at SJD Barcelona Children’s Hospital, 17% of children who came into contact with cases of COVID-19 were infected. This is similar to up to 19% of adults infected after contact with a household. Unlike a high proportion of infected adults with moderate to severe symptoms, more than 99% of infected children were asymptomatic or mild.

Viral carriers in the throat one month after the first case of COVID-19 at home were detected in more than one-third and one-tenth of adults, but at very low levels.

Another paper published by the American Academy of Pediatrics shows that about 4% and 51% of infected children show asymptomatic and mild illness. “Asymptomatic shedding is likely to actually perpetuate the epidemic within the population,” said one researcher.

The child’s presumptive role in asymptomatic infections of COVID-19 has shaped public health decisions, including school closures.

Infrequent children

Carlo Agostoni of Fondazione IRCCS, MD, Ca’Granda Ospedale Maggiore Policlinico of Milan, Italy, and colleagues investigated how often this phenomenon occurs among children.

This study tested children and adults who were hospitalized in a non-infectious state but did not have the clinical features of SARS-CoV-2 infection, relative to asymptomatic infections in these two groups of inpatients. I understand the frequency.

All patients in this group immediately after admission Nasopharyngeal swab Tested regardless of symptoms. The first cotton swab led to the second cotton swab within 12-48 hours. Patients in the hospital had no history of COVID-19 signs or symptoms, or long-term or close contact with COVID-19 cases for at least 21 days.

The study has 83 children with a median age of 5 years. The study had 131 adult patients with a median age of 77 years. Only about 1% of children were positive, compared to about 9% of adults. In fact, of the 12 adults who tested positive for RT PCR, 11 required only one swab test. None of them showed any signs or signs of infection over the next 48 hours.

This means that children have an almost 90% lower risk of asymptomatic infections than adults.

It is noteworthy that in this study, conducted in Milan, where the viral load is the highest in the world, 9% of adults admitted to the hospital for reasons other than infection were positive for SARS-CoV-2. In contrast, only 1% of hospitalized children were positive.

Children are less infectious than adults

Overall, previous studies have shown that approximately 80% of adults have asymptomatic COVID-19 infection. Most reports of asymptomatic infections in children are from China and have been shown to account for about 15% of infected cases. Current studies support a significantly lower prevalence of asymptomatic infections in children than in adults. This means that they probably do not play an important role in the spread of the virus that caused them.

This was a retrospective study conducted in a single center. Only inpatient cases were analyzed. Therefore, these findings are only preliminary. However, they contribute to a better understanding of the epidemiology of the disease, showing that there is limited evidence that children are asymptomatic and have a higher infection rate than adults.

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