Comparison of Upper Respiratory Viral Load Distributions in Asymptomatic and Symptomatic Children Diagnosed with SARS-CoV-2 Infection in Pediatric Hospital Testing Programs.
COVID-19
SARS-CoV-2
diagnostics
pediatric infectious disease
Journal
Journal of clinical microbiology
ISSN: 1098-660X
Titre abrégé: J Clin Microbiol
Pays: United States
ID NLM: 7505564
Informations de publication
Date de publication:
17 12 2020
17 12 2020
Historique:
received:
12
10
2020
accepted:
21
10
2020
pubmed:
24
10
2020
medline:
29
12
2020
entrez:
23
10
2020
Statut:
epublish
Résumé
The distribution of upper respiratory viral loads (VL) in asymptomatic children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unknown. We assessed PCR cycle threshold (Ct) values and estimated VL in infected asymptomatic children diagnosed in nine pediatric hospital testing programs. Records for asymptomatic and symptomatic patients with positive clinical SARS-CoV-2 tests were reviewed. Ct values were (i) adjusted by centering each value around the institutional median Ct value from symptomatic children tested with that assay and (ii) converted to estimated VL (numbers of copies per milliliter) using internal or manufacturer data. Adjusted Ct values and estimated VL for asymptomatic versus symptomatic children (118 asymptomatic versus 197 symptomatic children aged 0 to 4 years, 79 asymptomatic versus 97 symptomatic children aged 5 to 9 years, 69 asymptomatic versus 75 symptomatic children aged 10 to 13 years, 73 asymptomatic versus 109 symptomatic children aged 14 to 17 years) were compared. The median adjusted Ct value for asymptomatic children was 10.3 cycles higher than for symptomatic children (
Identifiants
pubmed: 33093026
pii: JCM.02593-20
doi: 10.1128/JCM.02593-20
pmc: PMC7771452
pii:
doi:
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2020 American Society for Microbiology.
Références
Coronavirus disease 2019 in children—United States, February 12–April 2, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:422–426.
doi: 10.15585/mmwr.mm6914e4
Mithal LB, Machut KZ, Muller WJ, Kociolek LK. SARS-CoV-2 infection in infants less than 90 days old. J Pediatr. 2020;224:150–152.
doi: 10.1016/j.jpeds.2020.06.047
Zachariah P, Johnson CL, Halabi KC, Ahn D, Sen AI, Fischer A, Banker SL, Giordano M, Manice CS, Diamond R, Sewell TB, Schweickert AJ, Babineau JR, Carter RC, Fenster DB, Orange JS, McCann TA, Kernie SG, Saiman L. Epidemiology, clinical features, and disease severity in patients with coronavirus disease 2019 (COVID-19) in a children's hospital in New York City, New York. JAMA Pediatr. 2020;174:e202430.
doi: 10.1001/jamapediatrics.2020.2430
Cao Q, Chen YC, Chen CL, Chiu CH. SARS-CoV-2 infection in children: transmission dynamics and clinical characteristics. J Formos Med Assoc. 2020;119:670–673.
doi: 10.1016/j.jfma.2020.02.009
Park YJ, Choe YJ, Park O, Park SY, Kim YM, Kim J, Kweon S, Woo Y, Gwack J, Kim SS, Lee J, Hyun J, Ryu B, Jang YS, Kim H, Shin SH, Yi S, Lee S, Kim HK, Lee H, Jin Y, Park E, Choi SW, Kim M, Song J, Choi SW, Kim D, Jeon BH, Yoo H, Jeong EK. Contact tracing during coronavirus disease outbreak, South Korea, 2020. Emerg Infect Dis. 2020;26:2465–2468.
doi: 10.3201/eid2610.201315
Kim J, Choe YJ, Lee J, Park YJ, Park O, Han MS, Kim JH, Choi EH. Role of children in household transmission of COVID-19. Arch Dis Child. 2020;2020.
doi: 10.1136/archdischild-2020-319910
Moreira LP, Watanabe ASA, Camargo CN, Melchior TB, Granato C, Bellei N. Respiratory syncytial virus evaluation among asymptomatic and symptomatic subjects in a university hospital in Sao Paulo, Brazil, in the period of 2009–2013. Influenza Other Respi Viruses. 2018;12:326–330.
doi: 10.1111/irv.12518
Tsang TK, Cowling BJ, Fang VJ, Chan KH, Ip DK, Leung GM, Peiris JS, Cauchemez S. Influenza A virus shedding and infectivity in households. J Infect Dis. 2015;212:1420–1428.
doi: 10.1093/infdis/jiv225
Jones TC, Mühlemann B, Veith T, Biele G, Zuchowski M, Hoffmann J, Stein A, Edelmann A, Corman VM, Drosten C. An analysis of SARS-CoV-2 viral load by patient age. medRxiv. 2020.
doi: 10.1101/2020.06.08.20125484:2020.06.08.20125484
Heald-Sargent T, Muller WJ, Zheng X, Rippe J, Patel AB, Kociolek LK. Age-related differences in nasopharyngeal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) levels in patients with mild to moderate coronavirus disease 2019 (COVID-19). JAMA Pediatr. 2020;174:902.
doi: 10.1001/jamapediatrics.2020.3651
L'Huillier AG, Torriani G, Pigny F, Kaiser L, Eckerle I. Culture-competent SARS-CoV-2 in nasopharynx of symptomatic neonates, children, and adolescents. Emerg Infect Dis. 2020;26:2494–2497.
doi: 10.3201/eid2610.202403
Goldberg SA, Lennerz J, Klompas M, Mark E, Pierce VM, Thompson RW, Pu CT, Ritterhouse LL, Dighe A, Rosenberg ES, Grabowski DC. Presymptomatic transmission of SARS-CoV-2 amongst residents and staff at a skilled nursing facility: results of real-time PCR and serologic testing. Clin Infect Dis. 2020.
doi: 10.1093/cid/ciaa991
Moghadas SM, Fitzpatrick MC, Sah P, Pandey A, Shoukat A, Singer BH, Galvani AP. The implications of silent transmission for the control of COVID-19 outbreaks. Proc Natl Acad Sci U S A. 2020;117:17513–17515.
doi: 10.1073/pnas.2008373117
Sandooja R, Vura N, Morocco M. Heightened ACE activity and unfavorable consequences in COVID-19 diabetic subjects. Int J Endocrinol. 2020;2020:7847526.
doi: 10.1155/2020/7847526
Obukhov AG, Stevens BR, Prasad R, Li Calzi S, Boulton ME, Raizada MK, Oudit GY, Grant MB. SARS-CoV-2 infections and ACE2: clinical outcomes linked with increased morbidity and mortality in individuals with diabetes. Diabetes. 2020;69:1875–1886.
doi: 10.2337/dbi20-0019
Huff HV, Singh A. Asymptomatic transmission during the COVID-19 pandemic and implications for public health strategies. Clin Infect Dis. 2020.
doi: 10.1093/cid/ciaa654
Hung IF, Cheng VC, Li X, Tam AR, Hung DL, Chiu KH, Yip CC, Cai JP, Ho DT, Wong SC, Leung SS, Chu MY, Tang MO, Chen JH, Poon RW, Fung AY, Zhang RR, Yan EY, Chen LL, Choi CY, Leung KH, Chung TW, Lam SH, Lam TP, Chan JF, Chan KH, Wu TC, Ho PL, Chan JW, Lau CS, To KK, Yuen KY. SARS-CoV-2 shedding and seroconversion among passengers quarantined after disembarking a cruise ship: a case series. Lancet Infect Dis. 2020;20:1051–1060.
doi: 10.1016/s1473-3099(20)30364-9
Arons MM, Hatfield KM, Reddy SC, Kimball A, James A, Jacobs JR, Taylor J, Spicer K, Bardossy AC, Oakley LP, Tanwar S, Dyal JW, Harney J, Chisty Z, Bell JM, Methner M, Paul P, Carlson CM, McLaughlin HP, Thornburg N, Tong S, Tamin A, Tao Y, Uehara A, Harcourt J, Clark S, Brostrom-Smith C, Page LC, Kay M, Lewis J, Montgomery P, Stone ND, Clark TA, Honein MA, Duchin JS, Jernigan JA. Presymptomatic SARS-CoV-2 infections and transmission in a skilled nursing facility. N Engl J Med. 2020;382:2081–2090.
doi: 10.1056/NEJMoa2008457
Mizumoto K, Kagaya K, Zarebski A, Chowell G. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro Surveill. 2020;25:2000180.
doi: 10.2807/1560-7917.ES.2020.25.10.2000180
Payne DC, Smith-Jeffcoat SE, Nowak G, Chukwuma U, Geibe JR, Hawkins RJ, Johnson JA, Thornburg NJ, Schiffer J, Weiner Z, Bankamp B, Bowen MD, MacNeil A, Patel MR, Deussing E, Gillingham BL. SARS-CoV-2 infections and serologic responses from a sample of U.S. Navy service members—USS Theodore Roosevelt, April 2020. MMWR Morb Mortal Wkly Rep. 2020;69:714–721.
doi: 10.15585/mmwr.mm6923e4
Lee S, Kim T, Lee E, Lee C, Kim H, Rhee H, Park SY, Son HJ, Yu S, Park JW, Choo EJ, Park S, Loeb M, Kim TH. Clinical course and molecular viral shedding among asymptomatic and symptomatic patients with SARS-CoV-2 infection in a community treatment center in the Republic of Korea. JAMA Intern Med. 2020;2020:e203862.
doi: 10.1001/jamainternmed.2020.3862
Lavezzo E, Franchin E, Ciavarella C, Cuomo-Dannenburg G, Barzon L, Del Vecchio C, Rossi L, Manganelli R, Loregian A, Navarin N, Abate D, Sciro M, Merigliano S, De Canale E, Vanuzzo MC, Besutti V, Saluzzo F, Onelia F, Pacenti M, Parisi SG, Carretta G, Donato D, Flor L, Cocchio S, Masi G, Sperduti A, Cattarino L, Salvador R, Nicoletti M, Caldart F, Castelli G, Nieddu E, Labella B, Fava L, Drigo M, Gaythorpe KAM, Brazzale AR, Toppo S, Trevisan M, Baldo V, Donnelly CA, Ferguson NM, Dorigatti I, Crisanti A. Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo'. Nature. 2020;584:425–429.
doi: 10.1038/s41586-020-2488-1
Lennon NJ, Bhattacharyya RP, Mina MJ, Rehm HL, Hung DT, Smole S, Woolley A, Lander ES, Gabriel SB. Comparison of viral levels in individuals with or without symptoms at time of COVID-19 testing among 32,480 residents and staff of nursing homes and assisted living facilities in Massachusetts. medRxiv. 2020.
doi: 10.1101/2020.07.20.20157792:2020.07.20.20157792
Quicke K, Gallichote E, Sexton N, Young M, Janich A, Gahm G, Carlton EJ, Ehrhart N, Ebel GD. Longitudinal surveillance for SARS-CoV-2 RNA among asymptomatic staff in five Colorado skilled nursing facilities: epidemiologic, virologic and sequence analysis. medRxiv. 2020.
doi: 10.1101/2020.06.08.20125989
Bai Y, Yao L, Wei T, Tian F, Jin DY, Chen L, Wang M. Presumed asymptomatic carrier transmission of COVID-19. JAMA. 2020;323:1406–1407.
doi: 10.1001/jama.2020.2565
Furukawa NW, Brooks JT, Sobel J. Evidence supporting transmission of severe acute respiratory syndrome coronavirus 2 while presymptomatic or asymptomatic. Emerg Infect Dis. 2020;26:e201595.
doi: 10.3201/eid2607.201595
Hu Z, Song C, Xu C, Jin G, Chen Y, Xu X, Ma H, Chen W, Lin Y, Zheng Y, Wang J, Hu Z, Yi Y, Shen H. Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China. Sci China Life Sci. 2020;63:706–711.
doi: 10.1007/s11427-020-1661-4
Zhang J, Tian S, Lou J, Chen Y. Familial cluster of COVID-19 infection from an asymptomatic. Crit Care. 2020;24:119.
doi: 10.1186/s13054-020-2817-7
Hoehl S, Rabenau H, Berger A, Kortenbusch M, Cinatl J, Bojkova D, Behrens P, Böddinghaus B, Götsch U, Naujoks F, Neumann P, Schork J, Tiarks-Jungk P, Walczok A, Eickmann M, Vehreschild M, Kann G, Wolf T, Gottschalk R, Ciesek S. Evidence of SARS-CoV-2 infection in returning travelers from Wuhan, China. N Engl J Med. 2020;382:1278–1280.
doi: 10.1056/NEJMc2001899
Perera R, Tso E, Tsang OTY, Tsang DNC, Fung K, Leung YWY, Chin AWH, Chu DKW, Cheng SMS, Poon LLM, Chuang VWM, Peiris M. SARS-CoV-2 virus culture and subgenomic RNA for respiratory specimens from patients with mild coronavirus disease. Emerg Infect Dis. 2020;26:2701–2704.
doi: 10.3201/eid2611.203219
Wölfel R, Corman VM, Guggemos W, Seilmaier M, Zange S, Müller MA, Niemeyer D, Jones TC, Vollmar P, Rothe C, Hoelscher M, Bleicker T, Brünink S, Schneider J, Ehmann R, Zwirglmaier K, Drosten C, Wendtner C. Virological assessment of hospitalized patients with COVID-2019. Nature. 2020;581:465–469.
doi: 10.1038/s41586-020-2196-x
Bullard J, Dust K, Funk D, Strong JE, Alexander D, Garnett L, Boodman C, Bello A, Hedley A, Schiffman Z, Doan K, Bastien N, Li Y, Van Caeseele PG, Poliquin G. Predicting infectious SARS-CoV-2 from diagnostic samples. Clin Infect Dis. 2020.
doi: 10.1093/cid/ciaa638
Chau NVV, Thanh Lam V, Thanh Dung N, Yen LM, Minh NNQ, Hung LM, Ngoc NM, Dung NT, Man DNH, Nguyet LA, Nhat LTH, Nhu LNT, Ny NTH, Hong NTT, Kestelyn E, Dung NTP, Xuan TC, Hien TT, Thanh Phong N, Tu TNH, Geskus RB, Thanh TT, Thanh Truong N, Binh NT, Thuong TC, Thwaites G, Tan LV. The natural history and transmission potential of asymptomatic SARS-CoV-2 infection. Clin Infect Dis. 2020.
doi: 10.1093/cid/ciaa711
Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, Yu J, Kang M, Song Y, Xia J, Guo Q, Song T, He J, Yen HL, Peiris M, Wu J. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med. 2020;382:1177–1179.
doi: 10.1056/NEJMc2001737
Hurst JH, Heston SM, Chambers HN, Cunningham HM, Price MJ, Suarez L, Crew C, Bose S, Aquino JN, Carr ST, Griffin SM, Smith SH, Jenkins K, Pfeiffer TS, Rodriguez J, Demarco CT, De Naeyer NA, Gurley TC, Louzao R, Cunningham CK, Steinbach WJ, Denny TN, Lugo DJ, Moody MA, Permar SR, Rotta AT, Turner NA, Walter EB, Woods CW, Kelly MS. SARS-CoV-2 infections among children in the Biospecimens from Respiratory Virus-Exposed Kids (BRAVE Kids) Study. medRxiv. 2020.
doi: 10.1101/2020.08.18.20166835:2020.08.18.20166835
Rivett L, Sridhar S, Sparkes D, Routledge M, Jones NK, Forrest S, Young J, Pereira-Dias J, Hamilton WL, Ferris M, Torok ME, Meredith L, The CITIID-NIHR COVID-19 BioResource CollaborationGupta R, Lyons PA, Toshner M, Warne B, Bartholdson Scott J, Cormie C, Gill H, Kean I, Maes M, Reynolds N, Wantoch M, Caddy S, Caller L, Feltwell T, Hall G, Hosmillo M, Houldcroft C, Jahun A, Khokhar F, Yakovleva A, Butcher H, Caputo D, Clapham-Riley D, Dolling H, Furlong A, Graves B, Gresley EL, Kingston N, Papadia S, Stark H, Stirrups KE, Webster J, Calder J, Harris J, Hewitt S, Kennet J, Meadows A, et al. Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission. Elife. 2020;9:e58728.
doi: 10.7554/eLife.58728
Poline J, Gaschignard J, Leblanc C, Madhi F, Foucaud E, Nattes E, Faye A, Bonacorsi S, Mariani P, Varon E, Smati-Lafarge M, Caseris M, Basmaci R, Lachaume N, Ouldali N. Systematic SARS-CoV-2 screening at hospital admission in children: a French prospective multicenter study. Clin Infect Dis. 2020.
doi: 10.1093/cid/ciaa1044
Han MS, Seong MW, Kim N, Shin S, Cho SI, Park H, Kim TS, Park SS, Choi EH. Viral RNA load in mildly symptomatic and asymptomatic children with COVID-19, Seoul, South Korea. Emerg Infect Dis. 2020;26:2497–2499.
doi: 10.3201/eid2610.202449
Magleby R, Westblade LF, Trzebucki A, Simon MS, Rajan M, Park J, Goyal P, Safford MM, Satlin MJ. Impact of SARS-CoV-2 viral load on risk of intubation and mortality among hospitalized patients with coronavirus disease 2019. Clin Infect Dis. 2020.
doi: 10.1093/cid/ciaa851
Zachariah P, Halabi KC, Johnson CL, Whitter S, Sepulveda J, Green DA. Symptomatic infants have higher nasopharyngeal SARS-CoV-2 viral loads but less severe disease than older children. Clin Infect Dis. 2020.
doi: 10.1093/cid/ciaa608