Study: Children, adults equally susceptible to COVID-19 infection in the home

A Survey Released today Pediatrics Children in two states are as likely to be infected with COVID-19 at home as adults, and children have spread the virus to one-fifth of their homes, but because they have no severe symptoms, they are infected. May not have been detected.

The study, led by researchers at the Centers for Disease Control and Prevention (CDC), enrolled 58 households in Milwaukee, Wisconsin and Salt Lake City, Utah, with contact between 120 adults and 68 children from March to May. I did. This study included the management of questionnaires and the collection of blood and respiratory samples.

Of the 68 pediatric contacts, 19 (28%) were tested positive for the virus that causes SARS-CoV-2, COVID-19, and 36 of the 120 adult contacts (36). 30%) are positive, 18 out of 65 (28%) are homes with children and 18 out of 55 (33%) without children.

Child-to-adult COVID-19 transmission can occur in 2 out of 10 (20%) households with vulnerable household members, with 1 in 6 households having children to other children. The virus may have spread (17%).

Children of the most endangered infected parents

Children with index COVID-19 patients were more likely to be infected by infected household members than non-parental children (odds ratio). [OR], 17.28). The probability of infection did not vary substantially depending on age, gender, race, underlying illness, household size, number of household members, or ratio of children to bedroom and bathroom.

The median time to secondary infection in pediatric probands was 5 days, with median symptoms lasting 10 days, compared to 16 days in adults. No child needed hospitalization or died.

All 19 children with COVID-19 reported at least one symptom, the most common of which were headache (79%), sore throat (68%), and runny nose (68%). Children are less likely to report cough (OR, 0.15), taste loss (OR, 0.21), and odor loss (OR, 0.29) than adults, and are more likely to report sore throat (OR, 3.4). it was high. Symptoms, with the exception of fever (100% PPV), had a low predictive value (PPV) (the probability that a patient with a positive diagnostic test would actually get the disease).

Of the 68 pediatric contacts, 37 (54%) are girls, 34 (50%) are 5-12 years old, and 9 (13%) have underlying illness, the most common of which. The typical one was asthma. Of the adult contacts, 74% were 18-49 years old and 49 (41%) had underlying illness.

Children lived in 33 households (57%), and 65 (54%) of the 120 adult contacts lived in homes with children. Of the pediatric contacts, 63% were children of the main patient and 21% were their siblings.

Underrecognition of the burden of illness in children

The authors underestimate children because early pandemic coronavirus surveillance data have no or only mild symptoms that are difficult to distinguish from other common childhood viral infections. He said he could be.

“In contrast to 8.3% of cases reported among children in the United States, 35% of household cases in our study population are children, testing contact with all households regardless of symptoms. Most of them have been identified because of this, “they write.

Researchers have found that because most COVID-19 symptoms and case definitions have low PPV, home and school-based screening strategies that use the symptoms are too broad or unnecessarily excluded from school or day care, or too narrow. To recognize an infection that said it could fail.

“Clinicians and schools maintain low laboratory thresholds in children when there is an epidemiological association with parents with suspected or confirmed COVID-19, especially in asymptomatic or mildly symptomatic children. We need to, “the authors said.

They called for future studies of childhood infection patterns in environments such as schools in areas where the incidence of coronavirus is higher than that studied. “In these studies, researchers should include an assessment of the effectiveness of mitigation efforts,” the author writes. “Finally, additional studies on previous exposure to other coronaviruses and duration of SARS-CoV-2 antibody will be conducted to shed light on protective factors for future SARS-CoV-2 infection in children. maybe.”

so Commentary In the same journal, Benjamin Lee, MD and William Raszka, Jr., MD of the University of Vermont, Burlington, found that the findings show that children can acquire and spread the coronavirus, and the importance of public health. Said to emphasize. Intervention in this group.

Lee and Raszka have no place guaranteed to be safe from COVID-19, but children still have important medical, academic, social and emotional needs that must be met. I said there is. “One day, I’m afraid to look back at this horrific pandemic and recognize how much failure children have made by fearing infection and the risk of infection, rather than disappointing them exactly when they need them. Mostly, “they wrote.