Abstract
Background: Data on pediatric coronavirus disease 2019 (COVID-19) has lagged behind adults throughout the pandemic. An understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral dynamics in children would enable data-driven public health guidance.
Methods: Respiratory swabs were collected from children with COVID-19. Viral load was quantified by reverse-transcription polymerase chain reaction (RT-PCR); viral culture was assessed by direct observation of cytopathic effects and semiquantitative viral titers. Correlations with age, symptom duration, and disease severity were analyzed. SARS-CoV-2 whole genome sequences were compared with contemporaneous sequences.
Results: One hundred ten children with COVID-19 (median age, 10 years [range, 2 weeks-21 years]) were included in this study. Age did not impact SARS-CoV-2 viral load. Children were most infectious within the first 5 days of illness, and severe disease did not correlate with increased viral loads. Pediatric SARS-CoV-2 sequences were representative of those in the community and novel variants were identified.
Conclusions: Symptomatic and asymptomatic children can carry high quantities of live, replicating SARS-CoV-2, creating a potential reservoir for transmission and evolution of genetic variants. As guidance around social distancing and masking evolves following vaccine uptake in older populations, a clear understanding of SARS-CoV-2 infection dynamics in children is critical for rational development of public health policies and vaccination strategies to mitigate the impact of COVID-19.
Keywords: SARS-CoV-2; pediatric COVID-19; viral dynamics.
【저자키워드】 SARS-CoV-2, pediatric COVID-19, viral dynamics., 【초록키워드】 COVID-19, coronavirus disease, public health, Evolution, Vaccine, coronavirus, pandemic, social distancing, SARS-COV-2 infection, pediatric, children, disease severity, variant, Transmission, Asymptomatic, symptom duration, Community, viral dynamics, age, genetic variants, Swab, respiratory, viral culture, Critical, Guidance, Cytopathic effect, severe disease, Vaccination strategy, observation, acute respiratory syndrome, Older, median age, SARS-CoV-2 viral load, viral loads, SARS-CoV-2 sequence, whole genome sequence, mitigate, populations, data-driven, polymerase chain, analyzed, collected, quantified, children with COVID-19, creating, 【제목키워드】 coronavirus 2, respiratory,