We evaluated the Panbio™ COVID‐19 Ag Rapid Test Device as a point‐of‐care diagnostic tool for COVID‐19 in 357 patients at a pediatric emergency department. Thirty‐four patients tested positive by reverse transcription polymerase chain reaction, of which 24 were positive by the antigen assay. The sensitivity and specificity of the assay were 70.5% and 100%, respectively.

Objectives Studies comparing SARS-CoV-2 RNA load in the upper respiratory tract (URT) between children and adults, either presenting with COVID-19 or asymptomatic have yielded inconsistent results. Here, we conducted a retrospective, single center study to address this issue. Patients and Methods 1,184 consecutive subjects (256 children and 928 adults) testing positive for SARS-COV-2 RNA in nasopharyngeal exudates (NP), of whom 424 (121 children and 303 adults) had COVID-19 and 760 (135 children and 625 adults) were asymptomatic close contacts of COVID-19 patients. SARS-CoV-2 RNA testing was carried out using the TaqPath COVID-19 Combo Kit (Thermo Fisher Scientific, MS, USA). The AMPLIRUN® TOTAL SARS-CoV-2 RNA Control (Vircell SA, Granada, Spain) was used for estimating SARS-CoV-2 RNA loads (in copies/mL). SARS-CoV-2 RNA loads at the time of laboratory diagnosis (single specimen/patient) were used for comparison purposes. Results Median initial SARS-COV-2 RNA load was lower ( P =0.094) in children (6.98 log 10 copies/ml; range, 3.0-11.7) than in adults (7.14 log 10 copies/ml; range, 2.2.-13.4) with COVID-19. As for asymptomatic individuals, median SARS-CoV-2 RNA load was comparable ( P =0.97) in children (6.20 log 10 copies/ml; range, 1.8-11.6) and adults (6.48 log 10 copies/ml; range, 1.9-11.8). Children with COVID-19 symptoms displayed SARS-CoV-2 RNA loads (6.98 log 10 copies/ml; range, 3.0-11.7) comparable to their asymptomatic counterparts (6.20 log 10 copies/ml; range, 1.8-11.6) ( P =0.61). Meanwhile in adults, median SARS-CoV-2 RNA load was significantly higher in symptomatic (7.14 log 10 copies/ml; range, 2.2.-13.4) than in asymptomatic subjects (6.48 log 10 copies/ml; range, 1.9-11.8) ( P =<0.001). Overall, a faster URT SARS-CoV-2 RNA clearance rate was observed in children than in adults. Conclusions Based on viral load data at the time of diagnosis, our results suggested that SARS-CoV-2 infected children, with or without COVID-19, may display NP viral loads of comparable magnitude to that found in their adult counterparts; However, children may have shorter viral shedding as compared to adults.

ObjectivesThere is limited information comparing SARS-CoV-2 RNA load in the upper respiratory tract (URT) between children and adults, either presenting with COVID-19 or asymptomatic. Here we conducted a retrospective, single center study involving a large cohort of SARS-CoV-2 infected individuals to address this issue.Patients and MethodsA total of 1,184 consecutive subjects (256 children and 928 adults) testing positive for SARS-COV-2 RNA in nasopharyngeal exudates (NP) were included, of whom 424 (121 children and 303 adults) had COVID-19 not requiring hospitalization and 760 (135 children and 625 adults) were asymptomatic close contacts of COVID-19 patients. SARS-CoV-2 RNA testing was carried out using the TaqPath COVID-19 Combo Kit (Thermo Fisher Scientific, MS, USA). The AMPLIRUN® TOTAL SARS-CoV-2 RNA Control (Vircell SA, Granada, Spain) was used for estimating SARS-CoV-2 RNA loads (in copies/mL).ResultsMedian SARS-COV-2 RNA loads were comparable between adults and children with COVID-19 (7.14 log10 copies/ml vs. 6.98 log10 copies/ml; P=0.094). Median SARS-CoV-2 RNA load in asymptomatic children and adults was similar (6.20 log10 copies/ml vs. 6.48 log10 copies/ml; P=0.97). Children with COVID-19 symptoms displayed SARS-CoV-2 RNA loads comparable to their asymptomatic counterparts (P=0.61). Meanwhile in adults, median SARS-CoV-2 RNA load was significantly higher in symptomatic than in asymptomatic subjects (P=<0.001), yet comparable (P=0.61) when the analysis excluded patients sampled within 48 h after symptoms onset.ConclusionsThe data suggest that children may be drivers of SARS-CoV-2 transmission in the general population at the same level as adults.

The state of alarm decreed by the Spanish Government, due to the Coronavirus Disease-19 (COVID-19) pandemic, has demanded the lockdown of children and has conditioned a new organization of the Emergency Departments (ED). A pre-triage station and 2 independent circuits were established: suspected COVID-19 and not suspected COVID-19. The ED visits decreased 84,5% from pre-alarm with no increase in the level of urgencies. During the alarm state, 40.97% of the children were classified as suspected COVID-19. Fever and respiratory symptoms, used as discriminators, generated 2 groups of patients with different characteristics. Although the interruption of sports activities and isolation of children at home contributed to the decrease in emergencies, it was also probably conditioned by adults’ fear of contagion, who avoided going to the hospital in situations that would never have really required ED and resolved themselves in primary care or spontaneously.

Mediastinitis after surgery for congenital heart disease has a great impact on morbidity and mortality. However, there are scarce studies focused on the epidemiology of postsurgical mediastinitis in pediatric patients. In this 18-year period retrospective study, the cumulative incidence of mediastinitis was low: 0.64%, (95% confidence interval: 0.36–1.1). Gram-negative bacilli were common (35%). The mortality rate was 7.1%, associated with fungal infection.