SARS-CoV-2 Infection Dynamics in Children and Household Contacts in a Slum in Rio de Janeiro.
SARS-CoV-2 Infection Dynamics in Children and Household Contacts in a Slum in Rio de Janeiro.
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DOI：
10.1542/peds.2021-050182
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发表时间：
2021-07
期刊：
影响因子：
8
通讯作者：
Brasil P
中科院分区：
文献类型：
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作者：
Lugon P;Fuller T;Damasceno L;Calvet G;Resende PC;Matos AR;Machado Fumian T;Malta FC;Salgado AD;Fernandes FCM;Abreu de Carvalho LM;Guaraldo L;Bastos L;Cruz OG;Whitworth J;Smith C;Nielsen-Saines K;Siqueira M;Carvalho MS;Brasil P
旨在调查儿童及其家庭接触者等弱势群体中严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染的动态。入组后，在初级卫生保健诊所就诊期间，对儿童及其家庭接触者进行了 SARS-CoV-2 逆转录聚合酶链反应测定和 2019 年冠状病毒病 (COVID-19) 免疫球蛋白 G 血清学检测。参与者在研究入组后的第 1、2、4 周以及每季度通过对里约热内卢贫困城市贫民窟 Manguinhos 的家访收集样本，对参与者进行了前瞻性跟踪。 2020 年 5 月至 9 月，来自 259 个家庭的 667 名参与者参加了研究。其中包括 323 名儿童（0-13 岁）、54 名青少年（14-19 岁）和 290 名成人。 45 名 (13.9%) 儿童的 SARS-CoV-2 聚合酶链反应检测结果呈阳性。 SARS-CoV-2 感染最常见于 1 岁以下儿童 (25%) 和 11 至 13 岁儿童 (21%)。没有儿童出现严重的 COVID-19 症状。年龄<14岁儿童的无症状感染率高于≥14岁儿童（分别为74.3%和51.1%）。所有被诊断患有 SARS-CoV-2 感染的儿童 (n = 45) 都曾与有近期感染证据的成年人有过接触。在我们的环境中，儿童似乎不是 SARS-CoV-2 感染源，并且最常从成人那里感染病毒。我们的研究结果表明，在我们这样的环境中，如果采取适当的 COVID-19 缓解措施并且对工作人员进行适当的免疫接种，学校和托儿所可能会安全地重新开放。
To investigate the dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a vulnerable population of children and their household contacts. SARS-CoV-2 reverse transcription polymerase chain reaction assays and coronavirus disease 2019 (COVID-19) immunoglobulin G serology tests were performed in children and their household contacts after enrollment during primary health care clinic visits. Participants were followed prospectively with subsequent specimens collected through household visits in Manguinhos, an impoverished urban slum (a favela) in Rio de Janeiro at 1, 2, and 4 weeks and quarterly post study enrollment. Six hundred sixty-seven participants from 259 households were enrolled from May to September 2020. This included 323 children (0–13 years), 54 adolescents (14–19 years), and 290 adults. Forty-five (13.9%) children had positive test results for SARS-CoV-2 polymerase chain reaction. SARS-CoV-2 infection was most frequent in children aged <1 year (25%) and children aged 11 to 13 years (21%). No child had severe COVID-19 symptoms. Asymptomatic infection was more prevalent in children aged <14 years than in those aged ≥14 years (74.3% and 51.1%, respectively). All children (n = 45) diagnosed with SARS-CoV-2 infection had an adult contact with evidence of recent infection. In our setting, children do not seem to be the source of SARS-CoV-2 infection and most frequently acquire the virus from adults. Our findings suggest that, in settings such as ours, schools and child care potentially may be reopened safely if adequate COVID-19 mitigation measures are in place and staff are appropriately immunized.