With the UK government stressing the importance of getting children back to school in September, a new study indicates that children may be a potential source of COVID-19 infection, despite of having either milder disease or a lack of symptoms.
The study by a team from Massachusetts General Hospital, included children aged 0 to 22 years with suspected severe COVID-19, presenting at urgent care clinics or even being hospitalised. A total of 192 enrolled children with a mean age of 10.2 years, of which 49 were diagnosed with COVID-19, 18 had multisystem inflammatory syndrome (MIS) and 125 were COVID-19 negative. Interestingly, there were no differences in the proportion of children who were either COVID-19 positive or negative, reporting a fever, cough, congestion or headache though anosmia was uncommon in COVID-19-negative children.
Further analysis revealed that children carried a high viral load in their upper airways yet displayed relatively mild or no symptoms and infected children had higher ACE2 expression.
The authors also noted that the symptoms of COVID-19 overlapped with non-COVID related illnesses which makes identifying those with the disease based on symptoms more complex.
The authors suggest that relying on symptoms and temperature checks, may be an ineffective method for identifying infection in children and express concern that infected children might easily pass on the virus to other, possibly vulnerable household members.
Yonker LM et al. Pediatric SARS-CoV-2: Clinical presentation, infectivity, and immune responses. Pediatrics, 2020; DOI: 10.1016/j.jpeds.2020.08.037