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Transmission of SARS-CoV-2 by Children
Joanna Merckx1, Jeremy A Labrecque2, Jay S Kaufman1
1Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
Insights
Children appear less affected by COVID-19 but public health interventions impact them. Current evidence suggests children transmit SARS-CoV-2 less effectively, but more research is needed to confirm pediatric transmission dynamics.
Area of Science:
- Pediatric infectious diseases
- Epidemiology
- Public health
Background:
- Children are generally less affected by COVID-19, with age being a key factor in infection and severity.
- Public health interventions significantly impact children, necessitating an understanding of their role in disease transmission.
Purpose of the Study:
- To assess the components of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission.
- To identify study designs and considerations for valid assessment of pediatric transmission dynamics.
Main Methods:
- A narrative review methodology was employed.
- Searched for published evidence on SARS-CoV-2 transmission by children up to June 25, 2020.
Main Results:
- Evidence suggests a lower secondary attack rate in children compared to other age groups.
- Viral load estimates from representative pediatric samples are currently lacking.
- Further quantification and understanding of age-specific transmission patterns are needed.
Conclusions:
- A robust pediatric evidence base is crucial for informing policy decisions regarding COVID-19.
- This evidence is vital for managing current and future waves, and for addressing endemicity and vaccination strategies.
Background:
Six months into the COVID-19 pandemic, children appear largely spared from the direct effects of disease, suggesting age as an important predictor of infection and severity. They remain, however, impacted by far-reaching public health interventions. One crucial question often posed is whether children generally transmit SARS-CoV-2 effectively.
Methods:
We assessed the components of transmission and the different study designs and considerations necessary for valid assessment of transmission dynamics. We searched for published evidence about transmission of SARS-CoV-2 by children employing a narrative review methodology through 25 June, 2020.
Results:
Transmission dynamics must be studied in repre - sentative pediatric populations with a combination of study designs including rigorous epidemiological studies (e.g. in households, schools, daycares, clinical settings) and laboratory studies while taking into account the social and socio-economic contexts. Viral load (VL) estimates from representative pediatric samples of infected children are missing so far. Currently available evidence suggests that the secondary attack rate stratified by age of the infector is lower for children, however this age pattern needs to be better quantified and understood.
Conclusion:
A generalizable pediatric evidence base is urgently needed to inform policy making now, later when facing potential subsequent waves, and extending through a future in which endemicity alongside vaccination may become the enduring reality.
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