As schools in the United States are gearing up to open, anew study has come out stating that children are equally susceptible to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) but exhibit mild symptoms compared with adults. Though data is sparse on children, they do spread respiratory and gastrointestinal illnesses far wider than previously thought.
Early reports did not find strong evidence of children as major contributors to SARS-CoV-2 spread owing to school closures ahead of the pandemic and no large-scale investigations of schools in community transmission had been conducted, said the researchers. Now that public health systems ponder to reopen schools and day cares, the new study on children’s transmission potential has sent alarm bells to public health officials in the US and elsewhere.
The study conducted between March 23 and April 27, 2020 on replication of SARS-CoV-2 in older children found similar levels of viral nucleic acid as adults, but significantly greater amounts of viral nucleic acid among those younger than 5 years. The SARS-CoV-2 reverse transcriptase–polymerase chain reaction (PCR) was performed on nasopharyngeal swabs collected at various hospitals and clinics including drive-through testing sites at a pediatric tertiary medical center in Chicago, Illinois.
This cohort included all individuals aged younger than 1 month to 65 years who tested positive for SARS-CoV-2 or those with symptoms suggestive of a COVID-19–compatible illness and/or high-risk exposures. In all, 145 patients with mild to moderate illness within 1 week of symptom onset were tested.
Divided in 3 groups — young children younger than 5 years, older children aged 5 to 17 years, and adults aged 18 to 65 years — researchers found young children had significantly equivalent or more viral nucleic acid in their upper respiratory tract compared with older children and adults. Some had even 100-fold greater amount of SARS-CoV-2 in the upper respiratory tract.
Thus, the study suggests that young children can potentially be important drivers of SARS-CoV-2 spread in the general population, and are more likely to transmit. “Behavioral habits of young children and close quarters in school and day care settings raise concern for SARS-CoV-2 amplification in this population as public health restrictions are eased,” wrote authors in their paper published in the journal JAMA Pediatrics.