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Comparative Analysis of Symptomatic and Asymptomatic SARS-CoV-2 Infection in Children
Jiahui Li1, Koh Cheng Thoon, Chia Yin Chong
1Infectious Disease Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore.
Insights
A significant proportion of children infected with SARS-CoV-2 (COVID-19) were asymptomatic. Household transmission was the primary source, highlighting the need for early screening and isolation of children in affected households.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) can infect children, presenting with a range of clinical manifestations.
- Understanding the differences between symptomatic and asymptomatic pediatric SARS-CoV-2 infections is crucial for public health strategies.
Purpose of the Study:
- To compare clinical, epidemiological, and laboratory parameters in symptomatic versus asymptomatic children diagnosed with SARS-CoV-2 infection.
Main Methods:
- Retrospective analysis of data from children with confirmed SARS-CoV-2 infection admitted to KK Women's and Children's Hospital, Singapore.
- Data collection spanned from January to May 2020, including clinical presentation, ethnicity, and laboratory results.
Main Results:
- Out of 39 pediatric COVID-19 cases, 38.5% were asymptomatic.
- Household transmission was the predominant mode of infection (95%).
- Symptomatic children more frequently presented with fever, rhinorrhea, sore throat, diarrhea, and acute olfactory dysfunction, and showed higher rates of Chinese ethnicity, abnormal complete blood counts, and liver enzymes, though all cases had mild disease.
Conclusions:
- The high prevalence of asymptomatic pediatric SARS-CoV-2 infections and significant household transmission emphasize the need for prompt screening and isolation within families.
- While symptomatic children exhibited more laboratory abnormalities, their disease outcomes were comparable to asymptomatic cases, indicating generally mild illness severity.
Introduction:
In this study, a comparison of clinical, epidemiological and laboratory parameters between symptomatic and asymptomatic children with SARS-CoV-2 infection was performed.
Materials And Methods:
Data from all children with laboratory confirmed SARS-CoV-2 infection admitted to KK Women's and Children's Hospital (KKH), Singapore, from January to May 2020 were analysed.
Results:
Of the 39 COVID-19 children included, 38.5% were asymptomatic. Household transmission accounted for 95% of cases. The presenting symptoms of symptomatic children were low-grade fever (54.2%), rhinorrhoea (45.8%), sore throat (25%), diarrhoea (12.5%) and acute olfactory dysfunction (5.4%). Children of Chinese ethnicity (37.5% vs 6.7%), complete blood count (45.8% vs 6.7%) and liver enzyme abnormalities (25% vs 7.7%) were more common in symptomatic versus asymptomatic children. All children had a mild disease course and none required oxygen supplementation or intensive care.
Conclusions:
The high proportion of asymptomatic infected children coupled with household transmission as the main source of paediatric COVID-19 infection underscores the importance of early screening and isolation of children upon detection of an index case of COVID-19 in a household. Symptomatic children were more likely to have abnormal laboratory parameters but they did not have a poorer outcome compared to asymptomatic cases.
