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Results of Testing Children for Severe Acute Respiratory Syndrome Coronavirus-2 Through a Community-based Testing
Joelle N Simpson1, Monika K Goyal1, Joanna S Cohen1
1Children's National Hospital, Washington, DC; Department of Pediatrics, George Washington University, Washington, DC.
Insights
Nearly 30% of children and young adults tested for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in community settings were positive. Fever and cough were common symptoms in pediatric SARS-CoV-2 cases, highlighting the need for transmission assessment.
Area of Science:
- Pediatric infectious diseases
- Epidemiology of viral respiratory illnesses
- Public health surveillance
Background:
- Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emerged as a global pandemic in 2020.
- Understanding the prevalence and characteristics of SARS-CoV-2 infection in pediatric populations is crucial for public health strategies.
- Community-based testing sites play a vital role in assessing disease spread outside of hospital settings.
Purpose of the Study:
- To characterize the demographics, clinical presentations, and diagnostic test results of children and young adults tested for SARS-CoV-2.
- To describe the positivity rates and trends of SARS-CoV-2 infection in a pediatric cohort referred from primary care.
- To identify clinical features associated with a positive SARS-CoV-2 test in children and adolescents.
Main Methods:
- Retrospective cross-sectional study design.
- Inclusion of pediatric patients (≤22 years) tested at a community specimen collection site from March 21 to May 16, 2020.
- Analysis of demographic data, clinical symptoms (fever, cough), exposure history, and polymerase chain reaction (PCR) test results.
Main Results:
- Out of 1445 patients tested, 408 (28.2%) had a positive SARS-CoV-2 PCR test.
- The daily positivity rate increased significantly over the study period, from 5.4% to 47.4%.
- Fever, cough, and known contact with an infected individual were associated with higher odds of a positive test, though not highly discriminating.
Conclusions:
- Approximately one in four children and young adults tested in this community cohort were positive for SARS-CoV-2.
- Pediatric and young adult populations represent a significant reservoir of SARS-CoV-2 infection.
- Further research into the transmission dynamics of SARS-CoV-2 in pediatric populations is essential for effective control measures.
Objective:
To describe the demographics, clinical features, and test results of children referred from their primary provider for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in the community setting.
Study Design:
Retrospective cross-sectional study of children ≤22 years of age who were tested for SARS-CoV-2 at a community-based specimen collection site in Washington, DC, affiliated with a large children's hospital between March 21 and May 16, 2020.
Results:
Of the 1445 patients tested at the specimen collection site for SARS-CoV-2 virus, 408 (28.2%) had a positive polymerase chain reaction test. The daily positivity rate increased over the study period, from 5.4% during the first week to a peak of 47.4% (Ptrend < .001). Patients with fever (aOR, 1.7; 95% CI, 1.3-2.3) or cough (aOR, 1.4; 95% CI, 1.1-1.9) and those with known contact with someone with confirmed SARS-CoV-2 infection (aOR, 1.6; 95% CI, 1.0-2.4.) were more likely have a positive test, but these features were not highly discriminating.
Conclusions:
In this cohort of mildly symptomatic or well children and adolescents referred to a community drive-through/walk-up SARS-CoV-2 testing site because of risk of exposure or clinical illness, 1 in 4 patients had a positive test. Children and young adults represent a considerable burden of SARS-CoV-2 infection. Assessment of their role in transmission is essential to implementing appropriate control measures.
