Virological Characteristics of Hospitalized Children With SARS-CoV-2 Infection

Area of Science:

• Pediatric Infectious Diseases
• Virology
• Epidemiology

Background:

• Limited data exists on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virological characteristics in children.
• Understanding viral load (VL) correlation with disease severity is crucial for pediatric COVID-19 management.

Purpose of the Study:

• To determine the correlation between SARS-CoV-2 viral load (VL) and age, disease severity, and comorbidities in hospitalized children.
• To investigate virological characteristics of SARS-CoV-2 in pediatric patients.

Main Methods:

• Included 102 children under 21 years hospitalized and tested positive for SARS-CoV-2 via PCR.
• Measured SARS-CoV-2 VL at various sites and compared between groups based on symptoms, age, and comorbidities.

Main Results:

• Symptomatic children had significantly higher VL (3.0 × 10^5 copies/mL) than asymptomatic children (7.2 × 10^3 copies/mL).
• Infants under 1 year had higher respiratory tract VL (3.3 × 10^7 copies/mL) compared to older children (1.3 × 10^4 copies/mL).
• SARS-CoV-2 RNA was detected in respiratory tract, gastrointestinal tract (saliva, rectum), and blood; prolonged PCR positivity was observed.

Conclusions:

• Children with more than one comorbidity were at higher risk for severe SARS-CoV-2 disease.
• Higher respiratory tract SARS-CoV-2 VL is associated with symptomatic disease and younger age (<1 year) in children.