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Symptoms and Transmission of SARS-CoV-2 Among Children - Utah and Wisconsin, March-May 2020

Rebecca L Laws1,2, Rebecca J Chancey3,2, Elizabeth M Rabold3,4

  • 1COVID-19 Response Team, lxq2@cdc.gov.

Pediatrics
|October 9, 2020
PubMed

Insights

Children and adults show similar severe acute respiratory syndrome coronavirus 2 infection rates, but pediatric cases present with milder symptoms. Early pandemic data suggest possible child-to-adult and child-to-child transmission, highlighting the need for further research on pediatric COVID-19.

Area of Science:

  • Virology
  • Pediatric Infectious Diseases
  • Epidemiology

Background:

  • Limited data exist on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection dynamics in children.
  • Understanding pediatric household transmission and symptomology is crucial for public health strategies during the coronavirus disease 2019 (COVID-19) pandemic.

Purpose of the Study:

  • To describe SARS-CoV-2 infection rates and symptom profiles among pediatric household contacts of COVID-19 cases.
  • To assess risk factors for infection and compare transmission and symptoms between pediatric and adult contacts.

Main Methods:

  • Prospective enrollment of COVID-19 cases and household contacts, with daily symptom assessment for 14 days.
  • RT-PCR and serology testing for SARS-CoV-2.
  • Statistical comparison of secondary infection rates and symptoms between pediatric (<18 years) and adult contacts using generalized estimating equations.

Main Results:

  • Secondary infection rates were similar between adults (30%) and children (28%).
  • Possible child-to-adult transmission occurred in 20% and child-to-child in 17% of households with transmission potential.
  • Pediatric symptoms included headache, sore throat, and rhinorrhea; fever was the only symptom with a high positive predictive value. Children were less likely to report cough, loss of taste, or smell, but more likely to report sore throat compared to adults.

Conclusions:

  • Children and adults exhibit comparable SARS-CoV-2 secondary infection rates.
  • Pediatric COVID-19 cases generally present with less frequent and severe symptoms than adults.
  • Early pandemic observations suggest children can contribute to household transmission, necessitating continued surveillance and understanding of pediatric roles in SARS-CoV-2 spread.
Abstract

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