Frequency of Children vs Adults Carrying Severe Acute Respiratory Syndrome Coronavirus 2 Asymptomatically

Milani, Gregorio P.; Bottino, Ilaria; Rocchi, Alessia; Marchisio, Paola; Elli, Silvia; Agostoni, Carlo; Costantino, Giorgio

doi:10.1001/jamapediatrics.2020.3595

Cited by 53 publications

(52 citation statements)

References 6 publications

(12 reference statements)

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“…9 However, more recent studies report that children are less likely to get infected after contact with a SARS-CoV-2-positive individual. [10][11][12][13][14] It has been suggested that children and adolescents have similar viral loads 15 16 and may therefore be as likely to transmit SARS-CoV-2 as adults. 17 18 In addition, the viral load may be similar in asymptomatic and symptomatic individuals.…”

Section: Introductionmentioning

confidence: 99%

Why is COVID-19 less severe in children? A review of the proposed mechanisms underlying the age-related difference in severity of SARS-CoV-2 infections

2020

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In contrast to other respiratory viruses, children have less severe symptoms when infected with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this review, we discuss proposed hypotheses for the age-related difference in severity of coronavirus disease 2019 (COVID-19).Factors proposed to explain the difference in severity of COVID-19 in children and adults include those that put adults at higher risk and those that protect children. The former include: (1) age-related increase in endothelial damage and changes in clotting function; (2) higher density, increased affinity and different distribution of angiotensin converting enzyme 2 receptors and transmembrane serine protease 2; (3) pre-existing coronavirus antibodies (including antibody-dependent enhancement) and T cells; (4) immunosenescence and inflammaging, including the effects of chronic cytomegalovirus infection; (5) a higher prevalence of comorbidities associated with severe COVID-19 and (6) lower levels of vitamin D. Factors that might protect children include: (1) differences in innate and adaptive immunity; (2) more frequent recurrent and concurrent infections; (3) pre-existing immunity to coronaviruses; (4) differences in microbiota; (5) higher levels of melatonin; (6) protective off-target effects of live vaccines and (7) lower intensity of exposure to SARS-CoV-2.

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Section: Introductionmentioning

confidence: 99%

Why is COVID-19 less severe in children? A review of the proposed mechanisms underlying the age-related difference in severity of SARS-CoV-2 infections

2020

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“…Some estimates suggest that 80% of adults with the virus are aymptomatic. 82 Similarly, we do not know the testing protocol for US politicians and other attendees of the Rose Garden event. While it seems that transmission from children is rare, the difficulty in maintenance of social distancing between children in schools can permit SSEs to arise; it seems the same applies to adults in the Rose Garden.…”

mentioning

confidence: 99%

SARS-CoV-2 (COVID-19) superspreader events

Majra

Benson

Pitts

et al. 2021

Journal of Infection

141

121

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Background & objectives: A significant number of reported COVID-19 cases can be traced back to superspreader events (SSEs), where a disproportionally large number of secondary cases relative to the standard reproductive rate, R0, are initiated. Although a superspreader is an individual who undergoes more viral shedding and transmission than others, it appears likely that environmental factors have a substantial role in SSEs. We categorise SSEs into two distinct groups: 'societal' and 'isolated' SSEs. Methods: We summarise SSEs that have occurred using multiple databases that have been cross referenced to ensure numbers are as reliable as we can ascertain. This enables more focussed and productive control of the current pandemic and future pandemics, especially as countries and regions ease lockdown restrictions. Results and discussion: 'Societal' SSEs pose a significant threat as members of the event are free to mingle and can infect individuals in the outside community. On the other hand, 'isolated' SSEs can be effectively quarantined as only a few individuals can transmit the virus from the isolated community to the outside community, therefore lowering further societal infection.

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“…The few available data from other parts of Italy have suggested a non-negligible risk of transmission of SARS-CoV-2 in the schools [4], while other studies conducted in other European Countries such as Germany [5] and Ireland [6] have reported a very low risk of secondary infection from children attending schools. In a previous study conducted during the school closure for the first SARS-CoV-2 outbreak in Italy, we observed a lower frequency of asymptomatic carriers among children as compared to adults (1.2% vs 9.2%, respectively) in hospital settings [7]. However, no comparable data are available after the school reopening.…”

Section: Introductionmentioning

confidence: 67%

“…In particular, two clinical pathways were established in the Ca' Granda Ospedale Maggiore Policlinico for non-suspected and suspected cases of SARS-CoV-2 infection, to avoid any potential contact (and infection spread) between these two groups of patients [8]. A nasopharyngeal swab specimen was collected for the detection of SARS-CoV-2 in all patients admitted in the short stay observation of the ED, irrespective of their clinical presentation [7]. The swab was sampled by a trained nurse according to a standardized procedure [9].…”

Section: Methodsmentioning

confidence: 99%

Frequency of asymptomatic carriers of SARS-CoV-2 among children and adults after school reopening

et al. 2021

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Background Children often develop an asymptomatic form of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), but it is debated if children are at higher risk than adults to be asymptomatic carriers of SARS-CoV-2, especially during the school reopening. The main aim of this study was to investigate the frequency of SARS-CoV-2 asymptomatic carriers in children and adults during the reopening of the schools in Milan, Italy. Methods We conducted a cross-sectional study at the pediatric and adult Emergency Department (ED) of the Ca' Granda Ospedale Maggiore Policlinico (Milan) between October 1 and 31, 2020, i.e. 3 weeks after the reopening of schools. Patients admitted to the ED short stay observation and without any sign or symptom consistent with a SARS-CoV-2 were eligible. These patients underwent a nasopharyngeal swab specimen for the detection of SARS-CoV-2. The odds ratio and its 95% confidence interval (CI) was calculated to assess the risk of asymptomatically carrying the SARS-CoV-2 infection in children and adults. Results A total of 69 (27 females, median age 8.7 years) children and 251 (107 females, median age 71 years) adults were enrolled. Pediatric and adult subjects tested positive for SARS-CoV-2 with a similar frequency (1/69 [1.4%] vs 4/251 [1.6%]). Children had an odds ratio to be a carrier of 0.91 (CI 0.02– 9.38) compared to adults. Conclusions The frequency of asymptomatic SARS-CoV-2 carriers was similar among children and adults. Considering the emerging diffusion of new SARS-CoV-2 variants, the asymptomatic spread of SARS-CoV-2 infection among children and adults should be monitored.

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Frequency of Children vs Adults Carrying Severe Acute Respiratory Syndrome Coronavirus 2 Asymptomatically

Cited by 53 publications

References 6 publications

Why is COVID-19 less severe in children? A review of the proposed mechanisms underlying the age-related difference in severity of SARS-CoV-2 infections

Why is COVID-19 less severe in children? A review of the proposed mechanisms underlying the age-related difference in severity of SARS-CoV-2 infections

SARS-CoV-2 (COVID-19) superspreader events

Frequency of asymptomatic carriers of SARS-CoV-2 among children and adults after school reopening

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