SARS-CoV-2 Acquisition and Immune Pathogenesis Among School-Aged Learners in Four Diverse Schools

Abstract

Objectives. To directly measure SARS-CoV-2 infection in diverse schools with either remote or onsite learning. Methods. 4 schools participated. Schools A and B served low-income Hispanic learners, school C special needs, and all three provided predominantly remote instruction. School D served middle and upper-middle income, White learners, with predominantly onsite instruction. 320 learners [10.5+/-2.1(SD); 7-17 y.o.]; 86% had phlebotomy. Testing occurred early in the fall (2020), at lower levels of COVID-19, and 6-8 weeks later during the fall-winter surge (tenfold increase in COVID-19 cases). Results: Nasal RT-qPCR for SARS-CoV-2 and 21 respiratory pathogens was performed. Phlebotomy was obtained for circulating immunity. Face covering and physical distancing fidelity was measured by direct observation. 17 learners were SARS-CoV-2 positive during the surge. School A (97% remote) had the highest infection rate (9/70, 12.9%, p<0.01) and IgG positivity rate (13/70, 18.6%). School D had the lowest infection and IgG positive rate (1/86, 1.2%). Mitigation compliance [physical distancing (mean 87.4%) and face covering (91.3%)] was high at all schools. Learners with documented SARS-CoV-2 infection had neutralizing antibodies (94.7%), broad and robust interferon-gamma T cell responses, reduced frequencies of monocytes, and lower levels of circulating inflammatory mediators. Conclusions: Infection in the schools reflected regional rates rather than remote or onsite learning modalities. Schools can implement successful mitigation strategies across a wide range of income, school-type, and student diversity. Reduced monocyte and immune mediator concentrations coupled with robust humoral and cellular immunity may explain the generally milder symptoms in school-aged children.

Few Canadian children and youth were meeting the 24-hour movement behaviour guidelines 6-months into the COVID-19 pandemic: Follow-up from a national study

“…Concerns for child and youth health across the pandemic There are rising pediatric cases of COVID-19 globally, though proportionately the virus tends to infect children and youth at relatively lower rates compared with adults (Song et al, 2020;Cooper et al, 2021). For many, it is the collateral mental and physical health consequences on children and youth that are of prime concern (Golberstein et al, 2020;Guan et al, 2020).…”

Development of the systematic observation of COVID-19 mitigation (SOCOM): Assessing face covering and distancing in schools

“…In the private and public schools providing formal PE classes, 34% of students were sedentary. Additional preliminary data on mitigation using SOCOM linked to SARS-CoV-2 infection in the four schools are also available [35].…”

SARS-CoV-2 circulation in the school setting: A systematic review and meta-analysis

“…Fifteen studies reported SARS-CoV-2 point prevalence in a total of 112,131 subjects, [12][13][14][15][16][17][18][19][20][21][22][23][30][31][32] including one study providing data collected during two rounds of testing within the COVID-19 Schools Infection Survey. 23 A total of 326 coronavirus infections were detected.…”

“…We identified 21 studies that reported data on SARS-CoV-2 infections in diverse educational settings, from kindergartens and daycares to primary and high schools (eTable 1 in the Supplement), [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] involving more than 120,000 subjects. Fifteen studies were from Europe, 12,13,[15][16][17][19][20][21][22][23][24]27,29,30 five from US, 16,18,25,26,28 one from Israel. 14 Overall, studies documented SARS-CoV-2 positivity rates from the beginning of the pandemic in March 2020 until May 2021, including periods of low and high community transmission.…”

“…Nine cross-sectional studies 13,[15][16][17][18]20,23,31 and five cohort studies reported infections detected in children and in adults separately, 24,[26][27][28][29] including one reporting estimates for two rounds of testing (eTable 1 in the Supplement). 23 Children and adults showed comparable SARS-CoV-2 positivity rates in most studies, and the pooled OR estimate was 0.83 (95% CI: 0.53-1.29), with low heterogeneity (I 2 = 41%, Figure 2b).…”