Loading...
As cases of COVID-19 increase worldwide, it has been interesting that children, particularly young children, seem relatively unaffected. Although there are reports of a systemic inflammatory syndrome (MIS-C) associated with SARS-CoV-2 infection (NEJM JW Pediatr Adolesc Medicine Jul 8 2020 and N Engl J Med Jun 29; [e-pub]), children account for a small proportion of SARS-CoV-2 infections.
To examine children's role in household transmission of COVID-19, researchers studied household clusters of 40 patients <16 years of age who received a diagnosis of SARS-CoV-2 infection at a single medical center in Switzerland during March/April 2020. These cases constituted 0.9% of all COVID-19 cases at the center during that period. All but one cluster was included in the analysis. Findings include:
Of the 39 children, 74% were previously healthy, 18% required hospitalization, and none required intensive care unit admission.
Median age was 11.1 years (range, 5.7–14.5 years).
Cough was the most common symptom (82%), followed by fever (67%) and nasal discharge (64%). Abdominal pain was reported by 28%.
In 79% of cases, at least one adult in the household had COVID-19 symptoms before the child.
Adult household contacts of the child were more frequently symptomatic than pediatric household contacts (85% vs. 43%).
Posfay-Barbe KM et al. COVID-19 in children and the dynamics of infection in families. Pediatrics 2020 May 26; 146:e20201576. (https://doi.org/10.1542/peds.2020-1576)
Comment
Although this study was small, the finding that the child likely was not the initial case in most households is important and adds to the growing body of evidence that SARS-CoV-2 is not transmitted like influenza and other respiratory viruses, where children are often the index case in the household and community spreaders of infection. These findings should be reassuring as we make decisions about reopening schools in the fall.