SARS-CoV-2 in children and their accompanying caregivers: Implications for testing strategies in resource limited hospitals.
SARS-CoV-2 in children and their accompanying caregivers: Implications for testing strategies in resource limited hospitals.
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DOI：
10.1016/j.afjem.2022.04.007
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发表时间：
2022-09
期刊：
影响因子：
--
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中科院分区：
文献类型：
--
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识别SARS-CoV-2感染者是防止医院传播的当务之急，但基于症状的筛查可能无法识别无症状/轻度症状的感染性儿童及其照顾者。2020年8月13日至26日在泰格伯格医院进行了一项新冠肺炎时期患病率研究，在进行初步症状筛查后，对所有儿童及其随行的无症状照顾者进行了测试。用实时逆转录聚合酶链式反应(RRT-PCR)检测SARS-CoV-2患者的鼻咽拭子。同时，对出现与可能感染SARS-CoV-2相容的症状的儿童进行了额外的呼吸道病毒16-多重RRT-PCR检测。分析包括196名儿童和116名照顾者的SARS-Co-V2 RT-PCR检测。儿童SARS冠状病毒2型感染率为5.6%(11/196)，而无症状照顾者为15.5%(18/116)(P<；0.01)。出现症状与SARS-CoV-2试验阳性无关；无典型症状的儿童阳性率高于有典型症状的儿童(10.2%[10/99]vs 1%[1/97]；p<；0.01)。以急性呼吸道(68/97，70.1%)、发热(17/97，17.5%)、胃肠道不适(12/97，12.4%)、人鼻病毒(23/81，28.4%)和呼吸道合胞病毒(18/81，22.2%)为主要表现的典型症状儿童(97/196，49.5%)。83.3%的儿童-照料者对SARS-CoV-2检测结果不一致；15/18名受感染的照顾者的孩子检测结果为阴性。仅基于症状的新冠肺炎筛查就会漏掉90%的阳性儿童和100%的无症状但阳性的照顾者。鉴于SARS-CoV-2症状与RT-PCR检测阳性之间的相关性较差，在新冠肺炎社区传播高发期，对于急诊和住院儿科住院患者，应考虑对儿童及其随行照顾者进行普遍检测。普及个人防护用品和优化通风可能是控制呼吸道病毒感染传播的最有效方法，包括SARS-CoV-2，在那里普遍检测是不可行的。在这些情况下，重复的点流行率研究可能有助于为当地的检测和队列战略提供信息。
Identification of SARS-CoV-2 infected individuals is imperative to prevent hospital transmission, but symptom-based screening may fail to identify asymptomatic/mildly symptomatic infectious children and their caregivers. A COVID-19 period prevalence study was conducted between 13 and 26 August 2020 at Tygerberg Hospital, testing all children and their accompanying asymptomatic caregivers after initial symptom screening. One nasopharyngeal swab was submitted for SARS-CoV-2 using real-time reverse-transcription polymerase chain reaction (rRT-PCR). An additional Respiratory Viral 16-multiplex rRT-PCR test was simultaneously done in children presenting with symptoms compatible with possible SARS-CoV-2 infection. SARS-Co-V 2 RT-PCR tests from 196 children and 116 caregivers were included in the analysis. The SARS-CoV-2 period prevalence in children was 5.6% (11/196) versus 15.5% (18/116) in asymptomatic caregivers (p<0.01). Presenting symptoms did not correlate with SARS-CoV-2 test positivity; children without typical symptoms of SARS-CoV-2 were more likely to be positive than those with typical symptoms (10.2% [10/99] vs 1% [1/97]; p<0.01). Children with typical symptoms (97/196; 49.5%) mainly presented with acute respiratory (68/97; 70.1%), fever (17/97; 17.5%), or gastro-intestinal complaints (12/97; 12.4%); Human Rhinovirus (23/81; 28.4%) and Respiratory Syncytial Virus (18/81; 22.2%) were frequently identified in this group. Children-caregiver pairs’ SARS-CoV-2 tests were discordant in 83.3%; 15/18 infected caregivers’ children tested negative. Symptom-based COVID-19 screening alone would have missed 90% of the positive children and 100% of asymptomatic but positive caregivers. Given the poor correlation between SARS-CoV-2 symptoms and RT-PCR test positivity, universal testing of children and their accompanying caregivers should be considered for emergency and inpatient paediatric admissions during high COVID-19 community transmission periods. Universal PPE and optimising ventilation is likely the most effective way to control transmission of respiratory viral infections, including SARS-CoV-2, where universal testing is not feasible. In these settings, repeated point prevalence studies may be useful to inform local testing and cohorting strategies.
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影响因子：
5.5
作者：
Abbas M;Robalo Nunes T;Martischang R;Zingg W;Iten A;Pittet D;Harbarth S
通讯作者：
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DOI：
10.1016/j.cmi.2021.01.023
发表时间：
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期刊：
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
影响因子：
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