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Assessment of SARS-CoV-2 testing in children during a low prevalence period (VIGIL study 1)

Eleonore Eskander1, Camille Jung2, Corinne Levy3

  • 1ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, 31, rue Le Corbusier, 94000 Créteil, France.

Infectious Diseases Now
|July 16, 2021
PubMed

Insights

In a study of children tested for SARS-CoV-2, only 1.4% were positive. Younger age and known contact were key predictors of a positive test result for COVID-19 in children.

Area of Science:

  • Pediatric infectious diseases
  • Virology
  • Epidemiology

Background:

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents with diverse symptoms in children, often overlapping with common childhood viral infections.
  • Distinguishing SARS-CoV-2 from other infections in pediatric populations can be challenging, necessitating accurate diagnostic approaches.

Purpose of the Study:

  • To determine the positivity rate of SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) tests in ambulatory pediatric patients, differentiating between symptomatic and asymptomatic children.
  • To identify predictive factors associated with a positive SARS-CoV-2 RT-PCR test in children.

Main Methods:

  • A prospective, multicenter, cross-sectional study was conducted in France from June 1 to July 31, 2020.
  • Nasopharyngeal SARS-CoV-2 RT-PCR tests were administered to children under 15 years of age presenting to emergency units or pediatricians.

Main Results:

  • Out of 1,553 RT-PCR tests performed, 22 yielded positive results, representing a positivity rate of 1.4% (95% CI [0.9; 2.1]).
  • Univariate and multivariate analyses identified two significant predictive factors for SARS-CoV-2 positivity: age under 2 years (Odds Ratio [OR]: 4.5 [1.6; 12.7]) and a history of contact with a confirmed case (OR: 12.3 [4.6; 32.8]).

Conclusions:

  • During periods of low SARS-CoV-2 circulation, the clinical utility of testing children with non-specific symptoms and no known contact history warrants consideration.
  • Targeted testing strategies may be more efficient in identifying pediatric COVID-19 cases during low epidemic phases.
Abstract

Keywords:
AmbulatoryChildrenClinical signsRT-PCRSARS-CoV-2

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