Culture-Competent SARS-CoV-2 in Nasopharynx of Symptomatic Neonates, Children, and Adolescents

L'Huillier, Arnaud G; Torriani, Giulia; Pigny, Fiona; Kaiser, Laurent; Eckerle, Isabella

doi:10.3201/eid2610.202403

Cited by 125 publications

(166 citation statements)

References 6 publications

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“…However, 90% of all the pediatric cases in our analysis were infected through close contact with family members with COVID-19, which was the main route of transmission when schools and daycares were closed, indicating that children are as vulnerable as adults to SARS-CoV-2 infection. Furthermore, the shedding of SARS-CoV-2 in the upper respiratory tract of pediatric patients lasted 11.43 days, which is comparable with adults (13). A Chicago study showed that children with COVID-19 younger than 5 years old had 10-100 times viral load compared with children more than 5 years old and adults with COVID-19 (14).…”

Section: Discussionmentioning

confidence: 84%

Epidemiological and Clinical Characteristics of COVID-19 in Children: A Systematic Review and Meta-Analysis

et al. 2020

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Given the relatively low rate and limited publicly available data regarding children with SARS-CoV-2 infection, this knowledge gap should be addressed with urgency. This systematic review with meta-analysis aimed to evaluate the epidemiological spectrum and clinical characteristics of children infected with SARS-CoV-2. Relevant international and Chinese public databases were systematically searched to identify all case studies from January 1, 2020 to May 7, 2020. This study consisted of 96 studies involving 7004 cases. The mean age of pediatric cases was 6.48 years (95% CI 52.0-77.5), 90% had household contact, and 66% presented with mild to moderate clinical syndromes. The main symptoms were fever (47%, 95% CI 41-53%) and cough (42%, 95% CI 36-48%). About 23% of children were asymptomatic, 27% had comorbidity, and 29% had a co-infection. The pooled mean incubation period was 9.57 days (95% CI 7.70-11.44). The shedding of SARS-CoV-2 in the upper respiratory tract lasted 11.43 days, and 75% of patients had virus particles in their stool. A total of 34% of the children had neutropenia and 26% had lymphocytosis. Interferon-alpha (81%) was the most commonly used antiviral drug in the children. The discharge and death rates were 79 and 1%. In conclusion, the transmissibility of pediatric COVID-19 should be not ignored because of the relatively long incubation period, shedding duration, and mild clinical syndromes.

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Section: Discussionmentioning

confidence: 84%

Epidemiological and Clinical Characteristics of COVID-19 in Children: A Systematic Review and Meta-Analysis

et al. 2020

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“…Clinical features of neonatal SARS-CoV-2 infections. Ninetyseven neonates presented with clinical features related to COVID-19: 18,20,[26][27][28]30,32,[34][35][36][38][39][40][41]44,45,[50][51][52]55,56,58,60,61,[65][66][67][70][71][72]77,78,80,81,[85][86][87][88]90 their distribution is shown in Table 3. Respiratory manifestations mainly consisted of signs of respiratory failure, such as tachypnoea, intercostal retractions, and rhinitis; neonatal ARDS was not diagnosed in any case.…”

Section: Resultsmentioning

confidence: 99%

Synthesis and systematic review of reported neonatal SARS-CoV-2 infections

et al. 2020

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A number of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections have been reported in neonates. Here, we aim to clarify the transmission route, clinical features and outcomes of these infections. We present a meta-analysis of 176 published cases of neonatal SARS-CoV-2 infections that were defined by at least one positive nasopharyngeal swab and/or the presence of specific IgM. We report that 70% and 30% of infections are due to environmental and vertical transmission, respectively. Our analysis shows that 55% of infected neonates developed COVID-19; the most common symptoms were fever (44%), gastrointestinal (36%), respiratory (52%) and neurological manifestations (18%), and lung imaging was abnormal in 64% of cases. A lack of mother–neonate separation from birth is associated with late SARS-CoV-2 infection (OR 4.94 (95% CI: 1.98–13.08), p = 0.0002; adjusted OR 6.6 (95% CI: 2.6–16), p < 0.0001), while breastfeeding is not (OR 0.35 (95% CI: 0.09–1.18), p = 0.10; adjusted OR 2.2 (95% CI: 0.7–6.5), p = 0.148). Our findings add to the literature on neonatal SARS-CoV-2 infections.

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“…Only 1 study provided information on SARS-CoV-2 culture specifically in children. 29 However, as virus culture was only attempted once per patient, to a maximum of 5 days post symptom onset, this study provides insufficient information to inform policy decisions surrounding isolation requirements specifically for children testing positive for SARS-CoV-2 RNA. Children have generally been under-represented in COVID-19 studies to-date, although this may be a function of testing practices which initially typically prioritised those with more severe symptoms, healthcare workers and those residing in long term care settings.…”

Section: Discussionmentioning

confidence: 99%

“…Two studies each were conducted in the United States (US), 21 , 28 Taiwan, 24 , 30 the United Kingdom (UK) 31 , 34 and Germany; 25 , 33 while 1 study each was conducted in Switzerland, 29 Australia, 22 Canada, 23 Spain, 26 South Korea, 27 Hong Kong, 14 and the Netherlands. 32 Of the 13 SARS-CoV-2 virus culture studies, 11 were case series 14 , 21 -23 , 26 -29 , 31 -33 and 2 were case reports.…”

Section: Population Characteristics Of Included Studiesmentioning

confidence: 99%

The duration of infectiousness of individuals infected with SARS-CoV-2

Walsh

Spillane

Comber

et al. 2020

Journal of Infection

137

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Objectives: To summarise the evidence on the duration of infectiousness of individuals in whom SARS-CoV-2 ribonucleic acid is detected. Methods: A rapid review was undertaken in PubMed, Europe PubMed Central and EMBASE from 1 January 2020 to 26 August 2020. Results: We identified 15 relevant studies, including 13 virus culture and 2 contact tracing studies. For 5 virus culture studies, the last day on which SARS-CoV-2 was isolated occurred within 10 days of symptom onset. For another 5 studies, SARS-CoV-2 was isolated beyond day 10 for approximately 3% of included patients. The remaining 3 virus culture studies included patients with severe or critical disease; SARS-CoV-2 was isolated up to day 32 in one study. Two studies identified immunocompromised patients from whom SARS-CoV-2 was isolated for up to 20 days. Both contact tracing studies, when close contacts were first exposed greater than 5 days after symptom onset in the index case, found no evidence of laboratoryconfirmed onward transmission of SARS-CoV-2. Conclusion: COVID-19 patients with mild-to-moderate illness are highly unlikely to be infectious beyond 10 days of symptoms. However, evidence from a limited number of studies indicates that patients with severe-to-critical illness or who are immunocompromised, may shed infectious virus for longer .

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Culture-Competent SARS-CoV-2 in Nasopharynx of Symptomatic Neonates, Children, and Adolescents

Cited by 125 publications

References 6 publications

Epidemiological and Clinical Characteristics of COVID-19 in Children: A Systematic Review and Meta-Analysis

Epidemiological and Clinical Characteristics of COVID-19 in Children: A Systematic Review and Meta-Analysis

Synthesis and systematic review of reported neonatal SARS-CoV-2 infections

The duration of infectiousness of individuals infected with SARS-CoV-2

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