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Virological Characteristics of Hospitalized Children With SARS-CoV-2 Infection
Swetha G Pinninti1, Sunil Pati2, Claudette Poole2
1Departments of Pediatrics and spinninti@peds.uab.edu.
Insights
In children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), higher viral loads were observed in symptomatic cases and infants under one year old. Comorbidities increased the risk of severe disease in hospitalized children.
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.
Background And Objectives:
In children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, virological characteristics and correlation with disease severity have not been extensively studied. The primary objective in this study is to determine the correlation between SARS-CoV-2 viral load (VL) in infected children with age, disease severity, and underlying comorbidities.
Methods:
Children <21 years, screened for SARS-CoV-2 at the time of hospitalization, who tested positive by polymerase chain reaction were included in this study. VL at different sites was determined and compared between groups.
Results:
Of the 102 children included in this study, 44% of the cohort had asymptomatic infection, and children with >1 comorbidity were the most at risk for severe disease. VL in children with symptomatic infection was significantly higher than in children with asymptomatic infection (3.0 × 105 vs 7.2 × 103 copies per mL; P = .001). VL in the respiratory tract was significantly higher in children <1 year, compared with older children (3.3 × 107 vs 1.3 × 104 copies per mL respectively; P < .0001), despite most infants presenting with milder illness. Besides the respiratory tract, SARS-CoV-2 RNA was also detectable in samples from the gastrointestinal tract (saliva and rectum) and blood. In 13 children for whom data on duration of polymerase chain reaction positivity was available, 12 of 13 tested positive 2 weeks after initial diagnosis, and 6 of 13 continued to test positive 4 weeks after initial diagnosis.
Conclusions:
In hospitalized children with SARS-CoV-2, those with >1 comorbid condition experienced severe disease. SARS-CoV-2 VL in the respiratory tract is significantly higher in children with symptomatic disease and children <1 year of age.
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