Symptoms and Transmission of SARS-CoV-2 Among Children - Utah and Wisconsin, March-May 2020
Symptoms and Transmission of SARS-CoV-2 Among Children - Utah and Wisconsin, March-May 2020
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DOI：
10.1542/peds.2020-027268
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发表时间：
2021-01-01
期刊：
影响因子：
8
通讯作者：
Kirking, Hannah L.
中科院分区：
文献类型：
--
作者：
Laws, Rebecca L.;Chancey, Rebecca J.;Kirking, Hannah L.
背景和证据：关于儿童严重急性呼吸综合征冠状病毒2的数据有限。我们描述了2019年冠状病毒病患者的儿科家庭接触者的感染率和症状特征。方法：我们招募了2019年冠状病毒病患者及其家庭接触者，前瞻性评估了14 d的日常症状，并获得了用于严重急性呼吸综合征冠状病毒2型实时逆转录聚合酶链反应和血清学检测的标本。在儿科接触者中（18岁），我们描述了传播，评估了感染的危险因素，并计算了症状阳性和阴性预测值。我们比较了继发感染率和症状之间的儿童和成人接触广义estimating equations.RESULTS：在58户，188接触者（120名成人，68名儿童）。成人（30%）和儿童（28%）的继发感染率相似。在有可能从儿童传播的家庭中，10个家庭中有2个可能发生儿童-成人传播（20%），6个家庭中有1个可能发生儿童-儿童传播（17%）。儿科病例患者最常报告头痛（79%）、咽喉痛（68%）和流涕（68%）;除测量的发热（100%; 95%置信区间[CI]：44%至100%）外，症状的阳性预测值较低。与有症状的成年人相比，儿童咳嗽的可能性较小（比值比[OR]：0.15; 95% CI：0.04 - 0.57），味觉丧失（OR：0.21; 95% CI：0.06 - 0.74）和嗅觉丧失（OR：0.29; 95%CI：0.09 ~ 0.96），更容易报告咽喉痛（OR：3.4; 95%CI：1.04 ~ 11.18）。结论：儿童和成人的继发感染率相似，但儿童的症状较轻。在大流行早期的两个州，我们在大约五分之一有可能观察到这种传播模式的家庭中观察到可能的儿童传播。
BACKGROUND AND OBJECTIVES: Limited data exist on severe acute respiratory syndrome coronavirus 2 in children. We described infection rates and symptom profiles among pediatric household contacts of individuals with coronavirus disease 2019.METHODS: We enrolled individuals with coronavirus disease 2019 and their household contacts, assessed daily symptoms prospectively for 14 days, and obtained specimens for severe acute respiratory syndrome coronavirus 2 real-time reverse transcription polymerase chain reaction and serology testing. Among pediatric contacts (,18 years), we described transmission, assessed the risk factors for infection, and calculated symptom positive and negative predictive values. We compared secondary infection rates and symptoms between pediatric and adult contacts using generalized estimating equations.RESULTS: Among 58 households, 188 contacts were enrolled (120 adults; 68 children). Secondary infection rates for adults (30%) and children (28%) were similar. Among households with potential for transmission from children, child-to-adult transmission may have occurred in 2 of 10 (20%), and child-to-child transmission may have occurred in 1 of 6 (17%). Pediatric case patients most commonly reported headache (79%), sore throat (68%), and rhinorrhea (68%); symptoms had low positive predictive values, except measured fever (100%; 95% confidence interval [CI]: 44% to 100%). Compared with symptomatic adults, children were less likely to report cough (odds ratio [OR]: 0.15; 95% CI: 0.04 to 0.57), loss of taste (OR: 0.21; 95% CI: 0.06 to 0.74), and loss of smell (OR: 0.29; 95% CI: 0.09 to 0.96) and more likely to report sore throat (OR: 3.4; 95% CI: 1.04 to 11.18).CONCLUSIONS: Children and adults had similar secondary infection rates, but children generally had less frequent and severe symptoms. In two states early in the pandemic, we observed possible transmission from children in approximately one-fifth of households with potential to observe such transmission patterns.