Infectious Disease Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore.
Duke-NUS Graduate Medical School, Singapore.
Epidemiol Infect. 2021 Jan 11;149:e18. doi: 10.1017/S095026882100008X.
It is important to understand the temporal trend of the paediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load to estimate the transmission potential of children in schools and communities. We determined the differences in SARS-CoV-2 viral load dynamics between nasopharyngeal samples of infected asymptomatic and symptomatic children. Serial cycle threshold values of SARS-CoV-2 from the nasopharynx of a cohort of infected children were collected for analysis. Among 17 infected children, 10 (58.8%) were symptomatic. Symptomatic children, when compared to asymptomatic children, had higher viral loads (mean cycle threshold on day 7 of illness 28.6 vs. 36.7, P = 0.02). Peak SARS-CoV-2 viral loads occurred around day 2 of illness in infected children. Although we were unable to directly demonstrate infectivity, the detection of significant amount of virus in the upper airway of asymptomatic children suggest that they have the potential to shed and transmit SARS-CoV-2. Our study highlights the importance of contact tracing and screening for SARS-CoV-2 in children with epidemiological risk factors regardless of their symptom status, in order to improve containment of the virus in the community, including educational settings.
了解儿童感染 SARS-CoV-2 的病毒载量的时间趋势对于评估学校和社区中儿童的传播潜力非常重要。我们确定了感染无症状和有症状儿童的鼻咽样本中 SARS-CoV-2 病毒载量动态的差异。对感染儿童队列的鼻咽拭子中的 SARS-CoV-2 进行了连续的循环阈值检测。在 17 名感染儿童中，有 10 名（58.8%）出现症状。与无症状儿童相比，有症状儿童的病毒载量更高（发病第 7 天的平均循环阈值为 28.6 对 36.7，P=0.02）。感染儿童的 SARS-CoV-2 病毒载量峰值出现在发病第 2 天左右。尽管我们无法直接证明传染性，但无症状儿童上呼吸道中大量病毒的检测表明，他们有可能传播 SARS-CoV-2。我们的研究强调了无论症状如何，对具有流行病学风险因素的儿童进行 SARS-CoV-2 的接触者追踪和筛查的重要性，以改善社区（包括教育环境）中对病毒的控制。
