1
|
Pons-Tomàs G, Pino R, Soler-García A, Launes C, Martínez-de-Albeniz I, Ríos-Barnés M, Melé-Casas M, Hernández-García M, Monsonís M, Gené A, de-Sevilla MF, García-García JJ, Fortuny C, Fumadó V. Deciphering the Longevity and Levels of SARS-CoV-2 Antibodies in Children: A Year-Long Study Highlighting Clinical Phenotypes and Age-Related Variations. Pathogens 2024; 13:622. [PMID: 39204223 PMCID: PMC11357146 DOI: 10.3390/pathogens13080622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/19/2024] [Accepted: 07/23/2024] [Indexed: 09/03/2024] Open
Abstract
BACKGROUND Identifying potential factors correlated with the sustained presence of antibodies in plasma may facilitate improved retrospective diagnoses and aid in the appraisal of pertinent vaccination strategies for various demographic groups. The main objective was to describe the persistence of anti-spike IgG one year after diagnosis in children and analyse its levels in relation to epidemiological and clinical variables. METHODS A prospective, longitudinal, observational study was conducted in a university reference hospital in the Metropolitan Region of Barcelona (Spain) (March 2020-May 2021). This study included patients under 18 years of age with SARS-CoV-2 infection (positive PCR or antigen tests for SARS-CoV-2). Clinical and serological follow-up one year after infection was performed. RESULTS We included 102 patients with a median age of 8.8 years. Anti-spike IgG was positive in 98/102 (96%) 12 months after the infection. There were higher anti-spike IgG levels were noted in patients younger than 2 years (p = 0.034) and those with pneumonia (p < 0.001). A positive and significant correlation was observed between C-reactive protein at diagnosis and anti-spike IgG titre one-year after diagnosis (p = 0.027). CONCLUSION Anti-SARS-CoV-2 IgG antibodies were detected in almost all paediatric patients one year after infection. We also observed a positive correlation between virus-specific IgG antibody titres with SARS-CoV-2 clinical phenotype (pneumonia) and age (under 2 years old).
Collapse
Affiliation(s)
- Gemma Pons-Tomàs
- Paediatric Department, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain; (G.P.-T.); (R.P.); (A.S.-G.); (M.M.-C.); (M.H.-G.); (M.-F.d.-S.); (J.-J.G.-G.)
- Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (M.R.-B.); (C.F.); (V.F.)
| | - Rosa Pino
- Paediatric Department, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain; (G.P.-T.); (R.P.); (A.S.-G.); (M.M.-C.); (M.H.-G.); (M.-F.d.-S.); (J.-J.G.-G.)
| | - Aleix Soler-García
- Paediatric Department, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain; (G.P.-T.); (R.P.); (A.S.-G.); (M.M.-C.); (M.H.-G.); (M.-F.d.-S.); (J.-J.G.-G.)
- Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (M.R.-B.); (C.F.); (V.F.)
| | - Cristian Launes
- Paediatric Department, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain; (G.P.-T.); (R.P.); (A.S.-G.); (M.M.-C.); (M.H.-G.); (M.-F.d.-S.); (J.-J.G.-G.)
- Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (M.R.-B.); (C.F.); (V.F.)
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | | | - María Ríos-Barnés
- Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (M.R.-B.); (C.F.); (V.F.)
- Infectious and Imported Diseases Department, Hospital Sant Joan de Déu, 08950 Barcelona, Spain;
| | - Maria Melé-Casas
- Paediatric Department, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain; (G.P.-T.); (R.P.); (A.S.-G.); (M.M.-C.); (M.H.-G.); (M.-F.d.-S.); (J.-J.G.-G.)
- Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (M.R.-B.); (C.F.); (V.F.)
| | - María Hernández-García
- Paediatric Department, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain; (G.P.-T.); (R.P.); (A.S.-G.); (M.M.-C.); (M.H.-G.); (M.-F.d.-S.); (J.-J.G.-G.)
- Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (M.R.-B.); (C.F.); (V.F.)
| | - Manuel Monsonís
- Department of Microbiology, Hospital Sant Joan de Déu, 08950 Barcelona, Spain; (M.M.); (A.G.)
| | - Amadeu Gené
- Department of Microbiology, Hospital Sant Joan de Déu, 08950 Barcelona, Spain; (M.M.); (A.G.)
| | - Mariona-F. de-Sevilla
- Paediatric Department, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain; (G.P.-T.); (R.P.); (A.S.-G.); (M.M.-C.); (M.H.-G.); (M.-F.d.-S.); (J.-J.G.-G.)
- Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (M.R.-B.); (C.F.); (V.F.)
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Juan-José García-García
- Paediatric Department, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain; (G.P.-T.); (R.P.); (A.S.-G.); (M.M.-C.); (M.H.-G.); (M.-F.d.-S.); (J.-J.G.-G.)
- Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (M.R.-B.); (C.F.); (V.F.)
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Claudia Fortuny
- Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (M.R.-B.); (C.F.); (V.F.)
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Infectious and Imported Diseases Department, Hospital Sant Joan de Déu, 08950 Barcelona, Spain;
| | - Victoria Fumadó
- Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (M.R.-B.); (C.F.); (V.F.)
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Infectious and Imported Diseases Department, Hospital Sant Joan de Déu, 08950 Barcelona, Spain;
| |
Collapse
|
2
|
Zheng B, Chen H, Xia W, Jiang Y, Zhang J. Secondary infections of COVID-19 in schools and the effectiveness of school-based interventions: a systematic review and meta-analysis. Public Health 2024; 229:42-49. [PMID: 38394706 DOI: 10.1016/j.puhe.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/17/2023] [Accepted: 01/16/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVES This meta-analysis explored secondary infections of SARS-CoV-2 and the effectiveness of non-pharmaceutical interventions (NPIs) in school settings, with the aim of providing a reference to formulate scientific prevention and response strategies for similar major public health emergencies in specific settings. STUDY DESIGN This was a systematic review and meta-analysis. METHODS Systematic searches were conducted in PubMed, Web of Science and the Cochrane Library through to 1 August 2022 using the following key search terms: COVID-19, SARS-CoV-2, secondary attack rate, school, transmission, etc. The IVhet model was used for the meta-analysis, and the I2 index and Cochran's Q-test were used to assess heterogeneity. Publication bias was examined using Doi plot, Galbraith plots and Luis Furuya-Kanamori index. Prevalence Critical Appraisal Tool was used to assess the quality of the included articles, while Grading of Recommendations Assessment, Development, and Evaluation was used to rate the quality of the evidence. Subgroup analyses were conducted to explore the potential source of heterogeneity. RESULTS Thirty-four studies involving 226,727 school contacts and 2216 secondary cases were included in this study. The pooled secondary attack rates (SARs) of close contacts, staff contacts and student contacts were 0.67% (95% confidence interval [CI]: 0.11, 1.56), 0.79% (95% CI: 0.00, 6.72) and 0.50% (95% CI: 0.00, 4.48), respectively. Subgroup analysis suggested that multiple or specific combinations (e.g. the combination of contact restriction and hygiene action) of NPIs appeared to be associated with lower SARs. CONCLUSIONS The SAR of SARS-CoV-2 was low in schools. Multiple or specific combinations of prevention strategies appear to mitigate SARS-CoV-2 transmission in school settings. These findings provide a basis for continuous improvement of response strategies to major public health emergencies in the school environment.
Collapse
Affiliation(s)
- B Zheng
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment & Health (Huazhong University of Science and Technology), Ministry of Education, Wuhan, Hubei, China.
| | - H Chen
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment & Health (Huazhong University of Science and Technology), Ministry of Education, Wuhan, Hubei, China.
| | - W Xia
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment & Health (Huazhong University of Science and Technology), Ministry of Education, Wuhan, Hubei, China.
| | - Y Jiang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment & Health (Huazhong University of Science and Technology), Ministry of Education, Wuhan, Hubei, China.
| | - J Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment & Health (Huazhong University of Science and Technology), Ministry of Education, Wuhan, Hubei, China.
| |
Collapse
|
3
|
Funk T, Espenhain L, Møller FT, Ethelberg S. Factors associated with the formation of SARS-CoV-2 case-clusters in Danish schools: a nationwide register-based observational study. Epidemiol Infect 2023; 151:e168. [PMID: 37466091 PMCID: PMC10600729 DOI: 10.1017/s0950268823001188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/12/2023] [Accepted: 06/28/2023] [Indexed: 07/20/2023] Open
Abstract
A register-based retrospective observational study was conducted to describe SARS-CoV-2 cases and case-clusters in schoolchildren of Danish primary and lower secondary schools and identify which factors were associated with the occurrence of case-clusters in schools. The study period was the autumn school semester 2021. Clusters were defined as three or more cases in a school-class level within 14 days. Descriptive analysis was carried out and multivariable logistic regression analysis was performed to determine which factors were associated with case introductions (i.e., primary case) being linked to a cluster. More cases and clusters were identified in lower than in higher class levels. Out of 21,497 cases introduced into a school, 41.6% started a cluster. A higher assumed immunity level in a class level was significantly reducing the odds of a case introduction being linked to a cluster (e.g., assumed immunity of ≥80% vs <20%: OR: 0.28; 95%CI: 0.17-0.44). A previous infection (in the primary case) had a protective effect (OR: 0.58; 95%CI: 0.33-0.99). This study suggests that most cases appearing in schools did not induce clusters, but that once cluster occur sizes can be large. It further indicates that vaccination of children markedly reduces the risk of secondary infections.
Collapse
Affiliation(s)
- Tjede Funk
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
- ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Laura Espenhain
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Frederik Trier Møller
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Steen Ethelberg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
4
|
Callies M, Kabouche I, Desombere I, Merckx J, Roelants M, Vermeulen M, Duysburgh E. SARS-CoV-2 infection prevention and control measures in Belgian schools between December 2020 and June 2021 and their association with seroprevalence: a cross-sectional analysis of a prospective cohort study. BMC Public Health 2023; 23:898. [PMID: 37194008 DOI: 10.1186/s12889-023-15806-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 05/04/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND To protect school-aged children from the potential consequences of a new viral infection, public health authorities recommended to implement infection prevention and control (IPC) measures in school settings. Few studies evaluated the implementation of these measures and their effect on SARS-CoV-2 infection rates among pupils and staff. The aim of this study was to describe the implementation of infection prevention and control (IPC) measures in Belgian schools and assess its relation to the prevalence of anti-SARS-CoV-2 antibodies among pupils and staff. METHODS We conducted a prospective cohort study in a representative sample of primary and secondary schools in Belgium between December 2020 and June 2021. The implementation of IPC measures in schools was assessed using a questionnaire. Schools were classified according to their compliance with the implementation of IPC measures as 'poor', 'moderate' or 'thorough'. Saliva samples were collected from pupils and staff to determine the SARS-CoV-2 seroprevalence. To assess the association between the strength of implementation of IPC measures and SARS-CoV-2 seroprevalence among pupils and staff, we conducted a cross-sectional analysis using the data collected in December 2020/January 2021. RESULTS A variety of IPC measures (ventilation, hygiene and physical distancing) was implemented by more than 60% of schools, with most attention placed on hygiene measures. In January 2021, poor implementation of IPC measures was associated with an increase in anti-SARS-CoV-2 antibody prevalence among pupils from 8.6% (95%CI: 4.5 - 16.6) to 16.7% (95%CI: 10.2 - 27.4) and staff from 11.5% (95%CI: 8.1 - 16.4) to 17.6% (95%CI: 11.5 - 27.0). This association was only statistically significant for the assessment of all IPC measures together in the population comprised of pupils and staff. CONCLUSIONS Belgian schools were relatively compliant with recommended IPC measures at the school level. Higher SARS-CoV-2 seroprevalence among pupils and staff was found in schools with poor implementation of IPC measures, compared to schools with thorough implementation. TRIAL REGISTRATION This trial is registered under the NCT04613817 ClinicalTrials.gov Identifier on November 3, 2020.
Collapse
Affiliation(s)
- Milena Callies
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
| | - Ines Kabouche
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Isabelle Desombere
- Department of Infectious Diseases in Humans, Immune Response, Sciensano, Brussels, Belgium
| | - Joanna Merckx
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Mathieu Roelants
- Environment and Health, Department of Public Health and Primary Care, University of Leuven, Louvain, KU, Belgium
| | - Melissa Vermeulen
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Els Duysburgh
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| |
Collapse
|
5
|
Zhang P, Wei M, Jing P, Li Z, Li J, Zhu F. COVID-19 in children: epidemic issues and candidate vaccines. Chin Med J (Engl) 2022; 135:1314-1324. [PMID: 35830254 PMCID: PMC9433085 DOI: 10.1097/cm9.0000000000002169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT A large-scale vaccination of coronavirus disease-19 (COVID-19) in adults has been conducted for nearly a year, and there is a growing recognition that immunization for children is also essential. It has been months since emergency use of pediatric COVID-19 vaccine was approved, we reviewed the prevalence and transmission of COVID-19 in children. The prevalence of COVID-19 in children is reduced due to vaccination even in a Delta prevalent period, so an increase in the vaccination rate is needed in children. Although the precise role of children in the transmission requires more research to uncover, they likely played a significant role, according to the available literature. We also described four candidate COVID-19 vaccines for children on their safety and immunogenicity and the impact of severe acute respiratory syndrome coronavirus 2 variants on childhood vaccination. Safety issues on pediatric vaccines post-approval, like adverse events following immunization and adverse events of special interest require studies on long-term and effective regulatory mechanisms.
Collapse
Affiliation(s)
- Peng Zhang
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 210009, China
| | - Mingwei Wei
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China
| | - Pengfei Jing
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China
| | - Zhuopei Li
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 210009, China
| | - Jingxin Li
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China
| | - Fengcai Zhu
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 210009, China
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China
- Institute of Global Public Health and Emergency Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu 210009, China
| |
Collapse
|
6
|
SARS-CoV-2 Circulation in the School Setting: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095384. [PMID: 35564779 PMCID: PMC9099553 DOI: 10.3390/ijerph19095384] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/20/2022] [Accepted: 04/26/2022] [Indexed: 02/01/2023]
Abstract
The contribution of children to viral spread in schools is still debated. We conducted a systematic review and meta-analysis of studies to investigate SARS-CoV-2 transmission in the school setting. Literature searches on 15 May 2021 yielded a total of 1088 publications, including screening, contact tracing, and seroprevalence studies. MOOSE guidelines were followed, and data were analyzed using random-effects models. From screening studies involving more than 120,000 subjects, we estimated 0.31% (95% confidence interval (CI) 0.05–0.81) SARS-CoV-2 point prevalence in schools. Contact tracing studies, involving a total of 112,622 contacts of children and adults, showed that onward viral transmission was limited (2.54%, 95% CI 0.76–5.31). Young index cases were found to be 74% significantly less likely than adults to favor viral spread (odds ratio (OR) 0.26, 95% CI 0.11–0.63) and less susceptible to infection (OR 0.60; 95% CI 0.25–1.47). Lastly, from seroprevalence studies, with a total of 17,879 subjects involved, we estimated that children were 43% significantly less likely than adults to test positive for antibodies (OR 0.57, 95% CI 0.49–0.68). These findings may not applied to the Omicron phase, we further planned a randomized controlled trial to verify these results.
Collapse
|
7
|
Silverberg SL, Zhang BY, Li SNJ, Burgert C, Shulha HP, Kitchin V, Sauvé L, Sadarangani M. Child transmission of SARS-CoV-2: a systematic review and meta-analysis. BMC Pediatr 2022; 22:172. [PMID: 35365104 PMCID: PMC8975734 DOI: 10.1186/s12887-022-03175-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 02/15/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Understanding of the role of children in COVID-19 transmission has significant implications for school and childcare policies, as well as appropriate targeting of vaccine campaigns. The objective of this systematic review was to identify the role of children in SARS-CoV-2 transmission to other children and adults. METHODS MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and Web of Science were electronically searched for articles published before March 31, 2021. Studies of child-to-child and child-to-adult transmission and quantified the incidence of index and resulting secondary attack rates of children and adults in schools, households, and other congregate pediatric settings were identified. All articles describing confirmed transmission of SARS-CoV-2 from a child were included. PRISMA guidelines for data abstraction were followed, with each step conducted by two reviewers. RESULTS 40 of 6110 articles identified met inclusion criteria. Overall, there were 0.8 secondary cases per primary index case, with a secondary attack rate of 8.4% among known contacts. The secondary attack rate was 26.4% among adult contacts versus 5.7% amongst child contacts. The pooled estimate of a contact of a pediatric index case being infected as secondary case was 0.10 (95% CI 0.03-0.25). CONCLUSIONS Children transmit COVID-19 at a lower rate to children than to adults. Household adults are at highest risk of transmission from an infected child, more so than adults or children in other settings.
Collapse
Affiliation(s)
- Sarah L Silverberg
- Department of Pediatrics, BC Children's Hospital, 4500 Oak Street, V6H 3N1, Vancouver, BC, Canada.
| | - Bei Yuan Zhang
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | - Conrad Burgert
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Hennady P Shulha
- Department of Pediatrics, BC Children's Hospital, 4500 Oak Street, V6H 3N1, Vancouver, BC, Canada
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
- BC Centre for Disease Control, Vancouver, Canada
| | | | - Laura Sauvé
- Department of Pediatrics, BC Children's Hospital, 4500 Oak Street, V6H 3N1, Vancouver, BC, Canada
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
| | - Manish Sadarangani
- Department of Pediatrics, BC Children's Hospital, 4500 Oak Street, V6H 3N1, Vancouver, BC, Canada
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
| |
Collapse
|
8
|
Viner R, Waddington C, Mytton O, Booy R, Cruz J, Ward J, Ladhani S, Panovska-Griffiths J, Bonell C, Melendez-Torres GJ. Transmission of SARS-CoV-2 by children and young people in households and schools: A meta-analysis of population-based and contact-tracing studies. J Infect 2022; 84:361-382. [PMID: 34953911 PMCID: PMC8694793 DOI: 10.1016/j.jinf.2021.12.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 12/18/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND The role of children and young people (CYP) in transmission of SARS-CoV-2 in household and educational settings remains unclear. We undertook a systematic review and meta-analysis of contact-tracing and population-based studies at low risk of bias. METHODS We searched 4 electronic databases on 28 July 2021 for contact-tracing studies and population-based studies informative about transmission of SARS-CoV-2 from 0 to 19 year olds in household or educational settings. We excluded studies at high risk of bias, including from under-ascertainment of asymptomatic infections. We undertook multilevel random effects meta-analyses of secondary attack rates (SAR: contact-tracing studies) and school infection prevalence, and used meta-regression to examine the impact of community SARS-CoV-2 incidence on school infection prevalence. FINDINGS 4529 abstracts were reviewed, resulting in 37 included studies (16 contact-tracing; 19 population studies; 2 mixed studies). The pooled relative transmissibility of CYP compared with adults was 0.92 (0.68, 1.26) in adjusted household studies. The pooled SAR from CYP was lower (p = 0.002) in school studies 0.7% (0.2, 2.7) than household studies (7.6% (3.6, 15.9) . There was no difference in SAR from CYP to child or adult contacts. School population studies showed some evidence of clustering in classes within schools. School infection prevalence was associated with contemporary community 14-day incidence (OR 1.003 (1.001, 1.004), p<0.001). INTERPRETATION We found no difference in transmission of SARS-CoV-2 from CYP compared with adults within household settings. SAR were markedly lower in school compared with household settings, suggesting that household transmission is more important than school transmission in this pandemic. School infection prevalence was associated with community infection incidence, supporting hypotheses that school infections broadly reflect community infections. These findings are important for guiding policy decisions on shielding, vaccination school and operations during the pandemic.
Collapse
Affiliation(s)
- Russell Viner
- Population, Policy and Practice, UCL Great Ormond St. Institute of Child Health, London, United Kingdom.
| | | | | | | | - Joana Cruz
- Population, Policy and Practice, UCL Great Ormond St. Institute of Child Health, London, United Kingdom
| | - Joseph Ward
- Population, Policy and Practice, UCL Great Ormond St. Institute of Child Health, London, United Kingdom
| | | | | | - Chris Bonell
- London School of Hygiene and Tropical Medicine, United Kingdom
| | | |
Collapse
|
9
|
Dobaño C, Alonso S, Vidal M, Jiménez A, Rubio R, Santano R, Barrios D, Pons Tomas G, Melé Casas M, Hernández García M, Girona-Alarcón M, Puyol L, Baro B, Millat-Martínez P, Ajanovic S, Balanza N, Arias S, Rodrigo Melero N, Carolis C, García-Miquel A, Bonet-Carné E, Claverol J, Cubells M, Fortuny C, Fumadó V, Codina A, Bassat Q, Muñoz-Almagro C, Fernández de Sevilla M, Gratacós E, Izquierdo L, García-García JJ, Aguilar R, Jordan I, Moncunill G. Multiplex Antibody Analysis of IgM, IgA and IgG to SARS-CoV-2 in Saliva and Serum From Infected Children and Their Close Contacts. Front Immunol 2022; 13:751705. [PMID: 35154094 PMCID: PMC8828491 DOI: 10.3389/fimmu.2022.751705] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 01/06/2022] [Indexed: 12/12/2022] Open
Abstract
COVID-19 affects children to a lesser extent than adults but they can still get infected and transmit SARS-CoV-2 to their contacts. Field deployable non-invasive sensitive diagnostic techniques are needed to evaluate the infectivity dynamics of SARS-CoV-2 in pediatric populations and guide public health interventions, particularly if this population is not fully vaccinated. We evaluated the utility of high-throughput Luminex assays to quantify saliva IgM, IgA and IgG antibodies against five SARS-CoV-2 spike (S) and nucleocapsid (N) antigens in a contacts and infectivity longitudinal study in 122 individuals (52 children and 70 adults). We compared saliva versus serum/plasma samples in infected children and adults diagnosed by weekly RT-PCR over 35 days (n=62), and those who consistently tested negative over the same follow up period (n=60), in the Summer of 2020 in Barcelona, Spain. Saliva antibody levels in SARS-CoV-2 RT-PCR positive individuals were significantly higher than in negative individuals and correlated with those measured in sera/plasmas. Asymptomatic infected individuals had higher levels of anti-S IgG than symptomatic individuals, suggesting a protective anti-disease role for antibodies. Higher anti-S IgG and IgM levels in serum/plasma and saliva, respectively, in infected children compared to infected adults could also be related to stronger clinical immunity in them. Among infected children, males had higher levels of saliva IgG to N and RBD than females. Despite overall correlation, individual clustering analysis suggested that responses that may not be detected in blood could be patent in saliva, and vice versa. In conclusion, measurement of SARS-CoV-2-specific saliva antibodies should be considered as a complementary non-invasive assay to serum/plasma to determine COVID-19 prevalence and transmission in pediatric populations before and after vaccination campaigns.
Collapse
Affiliation(s)
- Carlota Dobaño
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red (CIBER) de Enfermedades Infecciosas, Madrid, Spain
| | - Selena Alonso
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Alfons Jiménez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Rocío Rubio
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Rebeca Santano
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Diana Barrios
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Gemma Pons Tomas
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Spain
| | - María Melé Casas
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Spain
| | - María Hernández García
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Spain
| | - Mònica Girona-Alarcón
- Institut de Recerca Sant Joan de Déu, Esplugues, Spain.,Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Laura Puyol
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Barbara Baro
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | | | - Sara Ajanovic
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Núria Balanza
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Sara Arias
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Natalia Rodrigo Melero
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Carlo Carolis
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Aleix García-Miquel
- Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
| | - Elisenda Bonet-Carné
- Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat Politècnica de Catalunya, BarcelonaTech, Barcelona, Spain
| | - Joana Claverol
- Institut de Recerca Sant Joan de Déu, Esplugues, Spain.,Fundació Sant Joan de Déu, Barcelona, Spain
| | - Marta Cubells
- Institut de Recerca Sant Joan de Déu, Esplugues, Spain.,Fundació Sant Joan de Déu, Barcelona, Spain
| | - Claudia Fortuny
- Institut de Recerca Sant Joan de Déu, Esplugues, Spain.,Infectious Diseases Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Victoria Fumadó
- Institut de Recerca Sant Joan de Déu, Esplugues, Spain.,Infectious Diseases Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Anna Codina
- Biobank Hospital Sant Joan de Déu, Barcelona, Spain
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Spain.,Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.,Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Carmen Muñoz-Almagro
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues, Spain.,Department of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain.,Molecular Microbiology Department, Hospital Sant Joan de Déu, Esplugues, Spain
| | - Mariona Fernández de Sevilla
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues, Spain
| | - Eduard Gratacós
- Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - Luis Izquierdo
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red (CIBER) de Enfermedades Infecciosas, Madrid, Spain
| | - Juan José García-García
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues, Spain
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Iolanda Jordan
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues, Spain.,Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red (CIBER) de Enfermedades Infecciosas, Madrid, Spain
| |
Collapse
|
10
|
Friedman N, Levy N, Kaplan O, Padeh G, Krupik D, Jacob R, Gamsu S, Weiser G, Cohen NK, Schnapp Z, Cohen N, Feldman O, Porat D, Gal M, Gleyzer A, Capua T, Klein A, Sharkansky L, Shilo S, Grotto I, Kozer E, Shavit I. Pediatric Hospitalizations after School Reopening during the SARS-CoV-2 Alpha (B.1.1.7) Variant Spread: A Multicenter Cross-sectional Study in Israel. Clin Infect Dis 2022; 75:e300-e302. [PMID: 35092684 PMCID: PMC8807310 DOI: 10.1093/cid/ciac065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Indexed: 12/31/2022] Open
Abstract
This multicenter, cross-sectional study provides evidence on SARS-CoV-2-associated ED visits and hospitalizations in pediatric wards and intensive care units, after school reopening during the SARS-CoV-2 Alpha (B.1.1.7) variant spread in Israel. Study findings suggest that school reopening was not followed by an increase in SARS-CoV-2-related pediatric morbidity.
Collapse
Affiliation(s)
- Nir Friedman
- Pediatric Emergency Department, Meir Medical Center, Kfar Saba, Israel
| | - Nitai Levy
- Pediatric Emergency Department, Rambam Health Care Campus, Haifa, Israel
| | - Or Kaplan
- Pediatric Emergency Department, Soroka Medical Center, Beer Sheva, Israel
| | - Gabi Padeh
- Emergency Department, Schneider Children's Medical Center, Petah Tikva, Israel
| | - Danna Krupik
- Pediatric Emergency Department, Ziv Medical Centre, Safed, Israel
| | - Ron Jacob
- Pediatric Emergency Department, Ha'Emek Medical Center, Afula, Israel
| | - Shirly Gamsu
- Pediatric Emergency Department, Shamir Medical Center, Beer Yaakov, Israel
| | - Giora Weiser
- Pediatric Emergency Department, Shaare Zedek Medical Center, Jerusalem, Israel
| | | | - Zeev Schnapp
- Pediatric Emergency Department, Carmel Medical Center, Haifa, Israel
| | - Noy Cohen
- Pediatric Emergency Department, Samson Assuta University Hospital, Ashdod, Israel
| | - Oren Feldman
- Pediatric Emergency Department, Sheba Medical Center, Tel Hashomer, Israel
| | - Danit Porat
- Pediatric Emergency Department, Wolfson Medical Center, Holon, Israel
| | - Moran Gal
- Pediatric Emergency Department, Kaplan Medical Center, Rehovot, Israel
| | - Alexandra Gleyzer
- Pediatric Emergency Department, Mayanei Hayeshua Medical Center, Bnei Brak, Israel
| | - Tali Capua
- Pediatric Emergency Department, Sourasky Medical Center, Tel Aviv, Israel
| | - Adi Klein
- Pediatric Emergency Department, Hillel Yaffe Medical Center, Hadera, Israel
| | - Livnat Sharkansky
- Pediatric Emergency Department, Bnai Zion Medical Center, Haifa, Israel
| | - Smadar Shilo
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel
| | - Itamar Grotto
- Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel
| | - Eran Kozer
- Pediatric Emergency Department, Shamir Medical Center, Beer Yaakov, Israel
| | - Itai Shavit
- Pediatric Emergency Department, Rambam Health Care Campus, Haifa, Israel
| |
Collapse
|
11
|
Ajanovic S, Garrido-Aguirre J, Baro B, Balanza N, Varo R, Millat-Martínez P, Arias S, Fonollosa J, Perera-Lluna A, Jordan I, Muñoz-Almagro C, Bonet-Carne E, Crosas-Soler A, Via E, Nafria B, García-García JJ, Bassat Q. How Did the COVID-19 Lockdown Affect Children and Adolescent's Well-Being: Spanish Parents, Children, and Adolescents Respond. Front Public Health 2021; 9:746052. [PMID: 34900898 PMCID: PMC8655116 DOI: 10.3389/fpubh.2021.746052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/05/2021] [Indexed: 12/23/2022] Open
Abstract
Background: During the COVID-19 pandemic, lockdown strategies have been widely used to contain SARS-CoV-2 virus spread. Children and adolescents are especially vulnerable to suffering psychological effects as result of such measures. In Spain, children were enforced to a strict home lockdown for 42 days during the first wave. Here, we studied the effects of lockdown in children and adolescents through an online questionnaire. Methods: A cross-sectional study was conducted in Spain using an open online survey from July (after the lockdown resulting from the first pandemic wave) to November 2020 (second wave). We included families with children under 16 years-old living in Spain. Parents answered a survey regarding the lockdown effects on their children and were instructed to invite their children from 7 to 16 years-old (mandatory scholar age in Spain) to respond a specific set of questions. Answers were collected through an application programming interface system, and data analysis was performed using R. Results: We included 1,957 families who completed the questionnaires, covering a total of 3,347 children. The specific children's questionnaire was completed by 167 kids (7–11 years-old), and 100 adolescents (12–16 years-old). Children, in general, showed high resilience and capability to adapt to new situations. Sleeping problems were reported in more than half of the children (54%) and adolescents (59%), and these were strongly associated with less time doing sports and spending more than 5 h per day using electronic devices. Parents perceived their children to gain weight (41%), be more irritable and anxious (63%) and sadder (46%). Parents and children differed significantly when evaluating children's sleeping disturbances. Conclusions: Enforced lockdown measures and isolation can have a negative impact on children and adolescent's mental health and well-being. In future waves of the current pandemic, or in the light of potential epidemics of new emerging infections, lockdown measures targeting children, and adolescents should be reconsidered taking into account their infectiousness potential and their age-specific needs, especially to facilitate physical activity and to limit time spent on electronic devices.
Collapse
Affiliation(s)
- Sara Ajanovic
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Jon Garrido-Aguirre
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Universitat Politècnica de Catalunya, BarcelonaTech, Barcelona, Spain.,B2SLab, Departament d'Enginyeria de Sistemes, Automàtica i Informàtica Industrial, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Bàrbara Baro
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Núria Balanza
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Rosauro Varo
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | | | - Sara Arias
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Jordi Fonollosa
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Universitat Politècnica de Catalunya, BarcelonaTech, Barcelona, Spain.,Networking Biomedical Research Centre in the Subject Area of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Alexandre Perera-Lluna
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Universitat Politècnica de Catalunya, BarcelonaTech, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Iolanda Jordan
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - Carmen Muñoz-Almagro
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.,Department of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain.,Molecular Microbiology Department, Hospital Sant Joan de Deu, Esplugues, Barcelona, Spain
| | - Elisenda Bonet-Carne
- Universitat Politècnica de Catalunya, BarcelonaTech, Barcelona, Spain.,BCNatal Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Aina Crosas-Soler
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Esther Via
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Begonya Nafria
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Juan José García-García
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Quique Bassat
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.,ICREA, Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| |
Collapse
|
12
|
Dobaño C, Alonso S, Fernández de Sevilla M, Vidal M, Jiménez A, Pons Tomas G, Jairoce C, Melé Casas M, Rubio R, Hernández García M, Ruiz-Olalla G, Girona-Alarcón M, Barrios D, Santano R, Mitchell RA, Puyol L, Mayer L, Chi J, Rodrigo Melero N, Carolis C, Garcia-Miquel A, Bonet-Carne E, Claverol J, Cubells M, Fortuny C, Fumadó V, Jou C, Muñoz-Almagro C, Izquierdo L, Bassat Q, Gratacós E, Aguilar R, García-García JJ, Moncunill G, Jordan I. Antibody conversion rates to SARS-CoV-2 in saliva from children attending summer schools in Barcelona, Spain. BMC Med 2021; 19:309. [PMID: 34809617 PMCID: PMC8608564 DOI: 10.1186/s12916-021-02184-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/09/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Surveillance tools to estimate viral transmission dynamics in young populations are essential to guide recommendations for school opening and management during viral epidemics. Ideally, sensitive techniques are required to detect low viral load exposures among asymptomatic children. We aimed to estimate SARS-CoV-2 infection rates in children and adult populations in a school-like environment during the initial COVID-19 pandemic waves using an antibody-based field-deployable and non-invasive approach. METHODS Saliva antibody conversion defined as ≥ 4-fold increase in IgM, IgA, and/or IgG levels to five SARS-CoV-2 antigens including spike and nucleocapsid constructs was evaluated in 1509 children and 396 adults by high-throughput Luminex assays in samples collected weekly in 22 summer schools and 2 pre-schools in 27 venues in Barcelona, Spain, from June 29th to July 31st, 2020. RESULTS Saliva antibody conversion between two visits over a 5-week period was 3.22% (49/1518) or 2.36% if accounting for potentially cross-reactive antibodies, six times higher than the cumulative infection rate (0.53%) assessed by weekly saliva RT-PCR screening. IgG conversion was higher in adults (2.94%, 11/374) than children (1.31%, 15/1144) (p=0.035), IgG and IgA levels moderately increased with age, and antibodies were higher in females. Most antibody converters increased both IgG and IgA antibodies but some augmented either IgG or IgA, with a faster decay over time for IgA than IgG. Nucleocapsid rather than spike was the main antigen target. Anti-spike antibodies were significantly higher in individuals not reporting symptoms than symptomatic individuals, suggesting a protective role against COVID-19. CONCLUSION Saliva antibody profiling including three isotypes and multiplexing antigens is a useful and user-friendlier tool for screening pediatric populations to detect low viral load exposures among children, particularly while they are not vaccinated and vulnerable to highly contagious variants, and to recommend public health policies during pandemics.
Collapse
Affiliation(s)
- Carlota Dobaño
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain. .,CIBER de Enfermedades Infecciosas, Madrid, Spain. .,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Selena Alonso
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Mariona Fernández de Sevilla
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Alfons Jiménez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gemma Pons Tomas
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Chenjerai Jairoce
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - María Melé Casas
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Rocío Rubio
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - María Hernández García
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Gemma Ruiz-Olalla
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Mònica Girona-Alarcón
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Diana Barrios
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Rebeca Santano
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Robert A Mitchell
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Laura Puyol
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Leonie Mayer
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Jordi Chi
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Natalia Rodrigo Melero
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Carlo Carolis
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Aleix Garcia-Miquel
- Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
| | - Elisenda Bonet-Carne
- Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat Politècnica de Catalunya, BarcelonaTech, Barcelona, Spain
| | - Joana Claverol
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Fundació Sant Joan de Déu, Barcelona, Spain
| | - Marta Cubells
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Fundació Sant Joan de Déu, Barcelona, Spain
| | - Claudia Fortuny
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Infectious Diseases Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Victoria Fumadó
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Infectious Diseases Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Cristina Jou
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Department of Pathology and Biobank Hospital Sant Joan de Déu, Barcelona, Spain.,CIBERER, Instituto de Salud Carlos III, Barcelona, Spain
| | - Carmen Muñoz-Almagro
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Department of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain.,Molecular Microbiology Department, Hospital Sant Joan de Déu, Esplugues, Barcelona, Spain
| | - Luis Izquierdo
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain.,CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.,ICREA, Pg. Lluís Companys 23, 08010, Barcelona, Spain
| | - Eduard Gratacós
- Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Juan José García-García
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain.,CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Iolanda Jordan
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. .,Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain. .,Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.
| |
Collapse
|
13
|
Calvo C, Tagarro A, Méndez Echevarría A, Fernández Colomer B, Albañil Ballesteros MR, Bassat Q, Mellado Peña MJ. COVID-19 pandemic. What have we learned? An Pediatr (Barc) 2021; 95:382.e1-382.e8. [PMID: 34728170 PMCID: PMC8529266 DOI: 10.1016/j.anpede.2021.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/20/2021] [Indexed: 02/05/2023] Open
Abstract
Since the COVID-19 pandemic was declared in March 2020, we have learned a lot about the SARS-CoV-2 coronavirus, and its role in pediatric pathology. Children are infected in a rate quite similar to adults, although in most cases they suffer mild or asymptomatic symptoms. Around 1% of those infected require hospitalization, less than 0.02% require intensive care, and mortality is very low and generally in children with comorbidities. The most common clinical diagnoses are upper or lower respiratory infections, gastrointestinal infection and, more seriously, multisystemic inflammatory syndrome (MIS-C). Most episodes do not require treatment, except for MIS-C. Remdesivir has been widely used as a compassionate treatment and its role has yet to be defined. The newborn can become infected, although vertical transmission is very low (<1%) and it has been shown that the baby can safely cohabit with its mother and be breastfed. In general, neonatal infections have been mild. Primary care has supported a very important part of the management of the pandemic in pediatrics. There has been numerous collateral damage derived from the difficulty of access to care and the isolation suffered by children. The mental health of the pediatric population has been seriously affected. Although it has been shown that schooling has not led to an increase in infections, but rather the opposite. It is essential to continue maintaining the security measures that make schools a safe place, so necessary not only for children's education, but for their health in general.
Collapse
Affiliation(s)
- Cristina Calvo
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz, Madrid, Spain; Red de Investigación traslacional en infectología Pediátrica (RITIP), Spain.
| | - Alfredo Tagarro
- Red de Investigación traslacional en infectología Pediátrica (RITIP), Spain; Unidad de Pediatría Investigación y Ensayos Clínicos (UPIC), Instituto de Investigación Sanitaria Hospital 12 de Octubre (IMAS12), Madrid; Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid; Servicio de Pediatría, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, Madrid, Spain
| | - Ana Méndez Echevarría
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz, Madrid, Spain; Red de Investigación traslacional en infectología Pediátrica (RITIP), Spain
| | | | - M Rosa Albañil Ballesteros
- Centro de Salud Cuzco, Fuenlabrada, Madrid; Grupo de Patología Infecciosa de la Asociación Española de Pediatría de Atención Primaria (AEPap), Spain
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; ICREA, Barcelona, Spain; Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - M José Mellado Peña
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz, Madrid, Spain; Red de Investigación traslacional en infectología Pediátrica (RITIP), Spain
| |
Collapse
|
14
|
Calvo C, Tagarro A, Méndez Echevarría A, Fernández Colomer B, Albañil Ballesteros MR, Bassat Q, Mellado Peña MJ. [COVID-19 pandemic. What have we learned?]. An Pediatr (Barc) 2021; 95:382.e1-382.e8. [PMID: 34580593 PMCID: PMC8457926 DOI: 10.1016/j.anpedi.2021.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/20/2021] [Indexed: 12/30/2022] Open
Abstract
Since the COVID-19 pandemic was declared in March 2020, we have learned a lot about the SARS-CoV-2 coronavirus, and its role in pediatric pathology.Children are infected in a rate quite similar to adults, although in most cases they suffer mild or asymptomatic symptoms. Around 1% of those infected require hospitalization, less than 0.02% require intensive care, and mortality is very low and generally in children with comorbidities. The most common clinical diagnoses are upper or lower respiratory infections, gastrointestinal infection and, more seriously, multisystemic inflammatory syndrome (MIS-C). Most episodes do not require treatment, except for MIS-C. Remdesivir has been widely used as a compassionate treatment and its role has yet to be defined.The newborn can become infected, although vertical transmission is very low (<1%) and it has been shown that the baby can safely cohabit with its mother and be breastfed. In general, neonatal infections have been mild.Primary care has supported a very important part of the management of the pandemic in pediatrics. There has been numerous collateral damage derived from the difficulty of access to care and the isolation suffered by children. The mental health of the pediatric population has been seriously affected. Although it has been shown that schooling has not led to an increase in infections, but rather the opposite. It is essential to continue maintaining the security measures that make schools a safe place, so necessary not only for children's education, but for their health in general.
Collapse
Affiliation(s)
- Cristina Calvo
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales. Hospital Universitario La Paz, Madrid, España
- Red de Investigación traslacional en infectología Pediátrica (RITIP), España
| | - Alfredo Tagarro
- Red de Investigación traslacional en infectología Pediátrica (RITIP), España
- Unidad de Pediatría Investigación y Ensayos Clínicos (UPIC), Instituto de Investigación Sanitaria Hospital 12 de Octubre (IMAS12), Madrid; Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid; Servicio de Pediatría, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, Madrid, España
| | - Ana Méndez Echevarría
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales. Hospital Universitario La Paz, Madrid, España
- Red de Investigación traslacional en infectología Pediátrica (RITIP), España
| | | | - María Rosa Albañil Ballesteros
- Centro de Salud Cuzco, Fuenlabrada, Madrid; Grupo de Patología Infecciosa de la Asociación Española de Pediatría de Atención Primaria (AEPap), España
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, España
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ICREA, Barcelona, España
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, España
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España
| | - Maria José Mellado Peña
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales. Hospital Universitario La Paz, Madrid, España
- Red de Investigación traslacional en infectología Pediátrica (RITIP), España
| |
Collapse
|
15
|
Yuan H, Reynolds C, Ng S, Yang W. Factors affecting the transmission of SARS-CoV-2 in school settings. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.06.18.21259156. [PMID: 34189533 PMCID: PMC8240688 DOI: 10.1101/2021.06.18.21259156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Several studies have reported SARS-CoV-2 outbreaks in schools, with a wide range of secondary attack rate (SAR; range: 0-100%). We aimed to examine key risk factors to better understand SARS-CoV-2 transmission in schools. METHODS We collected records of 39 SARS-CoV-2 school outbreaks globally published through July 2021 and compiled information on hypothesized risk factors. We utilized the directed acyclic graph (DAG) to conceptualize risk mechanisms, used logistic regression to examine each risk-factor group, and further built multi-risk models. RESULTS The best-fit model showed that the intensity of concurrent community transmission (adjusted odds ratio [aOR]: 1.2, 95% CI: 1.17 - 1.24, for each increase of 1 case per 10,000 persons per week), individualism (aOR: 1.72, 95% CI: 1.19 - 2.5, above vs. below the median) were associated higher risk, whereas preventive measures (aOR: 0.22, 95% CI: 0.17 - 0.29, distancing and masking vs. none) and higher population immunity (aOR: 0.28, 95% CI: 0.22 - 0.35) were associated with lower risk of SARS-CoV-2 transmission in schools. Compared to students in pre-schools, the aOR was 0.35 (95% CI: 0.23 - 0.54) for students in primary schools and 1.3 (95% CI: 0.9 - 1.88) for students in high schools. CONCLUSIONS Preventive measures in schools (e.g. social distancing and mask-wearing) and communal efforts to lower transmission and increase vaccination uptake (i.e. vaccine-induced population immunity) in the community should be taken to collectively reduce transmission and protect children in schools. Flexible reopening policies may be considered for different levels of schools given their risk differences.
Collapse
|
16
|
Tagliabue M, Ridolfo AL, Pina P, Rizzolo G, Belbusti S, Antinori S, Beltrami M, Cattaneo D, Gervasoni C. Preventing COVID-19 in assisted living facilities: An impossible task pending vaccination roll out. Prev Med Rep 2021; 23:101471. [PMID: 34221853 PMCID: PMC8233410 DOI: 10.1016/j.pmedr.2021.101471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 05/12/2021] [Accepted: 06/23/2021] [Indexed: 12/23/2022] Open
Abstract
Here, we aimed to describe the clinical outcomes of the residents of a long-term care facility during its closure to visitors and suppliers in response to the first COVID-19 pandemic from February 23 to June 22, 2020, and the results of the facility-wide SARS-CoV-2 testing of residents and staff in June 2020 before its partially reopening. Seventy-four residents and 53 members of staff were included in the present study. The staff underwent nasopharyngeal swab tests for SARS-CoV-2, and both the staff and residents underwent serological tests to detect IgG antibodies against SARS-CoV-2. The results of all of the tests were negative. Conversely, 94% of residents and 38% members of the staff were tested positive to the nasopharyngeal swab tests during the second COVID-19 pandemic wave (data collected from November 1 to November 30, 2020). Our experience suggests that, in the presence of a life-threatening pandemic such as SARS-CoV-2 infection, the prompt use of restrictive procedures can prevent the spread and progression of disease in assisted living facilities in the short term but may fail in the long term, especially when the prevalence of the COVID-19 greatly increased outside the facility enhancing the risk of import the disease from outside. SARS-CoV-2 vaccination of residents and staff members would contribute to control/limit the prevalence and the spread of the virus.
Collapse
Affiliation(s)
| | - Anna Lisa Ridolfo
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
| | - Paolo Pina
- Cesare e Emilio Prandoni ONLUS, Torno, Italy
| | | | | | - Spinello Antinori
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
| | - Martina Beltrami
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
| | - Dario Cattaneo
- Gestione Ambulatoriale Politerapie (GAP) Outpatient Clinic, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
- Unit of Clinical Pharmacology, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
| | - Cristina Gervasoni
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
- Gestione Ambulatoriale Politerapie (GAP) Outpatient Clinic, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
| |
Collapse
|
17
|
Costa R, Bueno F, Albert E, Torres I, Carbonell-Sahuquillo S, Barrés-Fernández A, Sánchez D, Padrón C, Colomina J, Lázaro Carreño MI, Bretón-Martínez JR, Martínez-Costa C, Navarro D. Upper respiratory tract SARS-CoV-2 RNA loads in symptomatic and asymptomatic children and adults. Clin Microbiol Infect 2021; 27:1858.e1-1858.e7. [PMID: 34384874 PMCID: PMC8349738 DOI: 10.1016/j.cmi.2021.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 07/14/2021] [Accepted: 08/01/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Studies comparing SARS-CoV-2 RNA load in the upper respiratory tract (URT) between children and adults, either presenting with COVID-19 or asymptomatic have yielded inconsistent results. Here, we conducted a retrospective, single center study to address this issue. PATIENTS AND METHODS 1,184 consecutive subjects (256 children and 928 adults) testing positive for SARS-COV-2 RNA in nasopharyngeal exudates (NP), of whom 424 (121 children and 303 adults) had COVID-19 and 760 (135 children and 625 adults) were asymptomatic close contacts of COVID-19 patients. SARS-CoV-2 RNA testing was carried out using the TaqPath COVID-19 Combo Kit (Thermo Fisher Scientific, MS, USA). The AMPLIRUN® TOTAL SARS-CoV-2 RNA Control (Vircell SA, Granada, Spain) was used for estimating SARS-CoV-2 RNA loads (in copies/mL). SARS-CoV-2 RNA loads at the time of laboratory diagnosis (single specimen/patient) were used for comparison purposes. RESULTS Median initial SARS-COV-2 RNA load was lower (P=0.094) in children (6.98 log10 copies/ml; range, 3.0-11.7) than in adults (7.14 log10 copies/ml; range, 2.2.-13.4) with COVID-19. As for asymptomatic individuals, median SARS-CoV-2 RNA load was comparable (P=0.97) in children (6.20 log10 copies/ml; range, 1.8-11.6) and adults (6.48 log10 copies/ml; range, 1.9-11.8). Children with COVID-19 symptoms displayed SARS-CoV-2 RNA loads (6.98 log10 copies/ml; range, 3.0-11.7) comparable to their asymptomatic counterparts (6.20 log10 copies/ml; range, 1.8-11.6) (P=0.61). Meanwhile in adults, median SARS-CoV-2 RNA load was significantly higher in symptomatic (7.14 log10 copies/ml; range, 2.2.-13.4) than in asymptomatic subjects (6.48 log10 copies/ml; range, 1.9-11.8) (P=<0.001). Overall, a faster URT SARS-CoV-2 RNA clearance rate was observed in children than in adults. CONCLUSIONS Based on viral load data at the time of diagnosis, our results suggested that SARS-CoV-2 infected children, with or without COVID-19, may display NP viral loads of comparable magnitude to that found in their adult counterparts; However, children may have shorter viral shedding as compared to adults.
Collapse
Affiliation(s)
- Rosa Costa
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - Felipe Bueno
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - Eliseo Albert
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - Ignacio Torres
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | | | | | - David Sánchez
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - Carmelo Padrón
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - Javier Colomina
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - María Isabel Lázaro Carreño
- Pediatric Department, Hospital Clínico Universitario, Valencia, Spain; Department of Pediatrics, University of Valencia, Valencia, Spain
| | - José Rafael Bretón-Martínez
- Pediatric Department, Hospital Clínico Universitario, Valencia, Spain; Department of Pediatrics, University of Valencia, Valencia, Spain
| | - Cecilia Martínez-Costa
- Pediatric Department, Hospital Clínico Universitario, Valencia, Spain; Department of Pediatrics, University of Valencia, Valencia, Spain
| | - David Navarro
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain; Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain.
| |
Collapse
|