Strutner John, Ramchandar Nanda, Dubey Shruti, Gamboa Mary, Vanderpool Michelle K, Mueller Teresa, Wang Wei, Cannavino Christopher, Tovar Padua Leidy, Malicki Denise, Pong Alice
Department of Pediatrics, University of California San Diego, USA.
Division of Infectious Diseases, Department of Pediatrics, University of California at San Diego, USA.
Clin Infect Dis. 2021 Sep 15. doi: 10.1093/cid/ciab403.
Understanding viral kinetics of SARS-CoV-2 is important to assess risk of transmission, manage treatment, and determine the need for isolation and protective equipment. The impact of viral load in asymptomatic infected children is important to understand transmission potential. We sought to determine whether children deemed to be asymptomatic had a difference in the PCR cycle threshold (Ct) value of respiratory samples from symptomatic children with SARS-CoV-2 infection.
This was a retrospective cross-sectional study to compare PCR Ct values of children who tested positive for SARS-CoV-2 by respiratory samples collected over a 4-month period at a large tertiary care children's hospital.
We analyzed 728 children who tested positive for SARS-CoV-2 by RT-PCR from a respiratory sample over a 4-month period and for whom data was available in the electronic medical record. Overall, 71.2% of infected children were symptomatic. The mean Ct value for symptomatic patients (Ct mean 19.9, SD 6.3) was significantly lower than asymptomatic patients (Ct mean 23.5, SD 6.5) (P value < 0.001, CI 95th 2.6 - 4.6). The mean PCR Ct value was lowest in children less than 5 years of age.
In this retrospective review of children who tested positive by RT-PCR for SARS CoV-2, the mean Ct was significantly lower in symptomatic children and was lowest in children under 5 years of age, indicating that symptomatic children and younger children infected with SARS-CoV-2 may have a higher viral load in the nasopharynx compared to asymptomatic children. Further studies are needed to assess the transmission potential from asymptomatic children.
了解严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的病毒动力学对于评估传播风险、管理治疗以及确定隔离和防护设备的需求至关重要。了解无症状感染儿童的病毒载量对传播潜力的影响也很重要。我们试图确定被认为无症状的儿童与有症状的SARS-CoV-2感染儿童呼吸道样本的聚合酶链反应循环阈值（Ct）值是否存在差异。
这是一项回顾性横断面研究，旨在比较一家大型三级儿童专科医院在4个月期间收集的呼吸道样本中SARS-CoV-2检测呈阳性的儿童的PCR Ct值。
我们分析了728名在4个月期间通过呼吸道样本经逆转录聚合酶链反应（RT-PCR）检测SARS-CoV-2呈阳性且电子病历中有可用数据的儿童。总体而言，71.2%的感染儿童有症状。有症状患者的平均Ct值（Ct平均值19.9，标准差6.3）显著低于无症状患者（Ct平均值23.5，标准差6.5）（P值<0.001，95%置信区间2.6 - 4.6）。平均PCR Ct值在5岁以下儿童中最低。
在这项对RT-PCR检测SARS-CoV-2呈阳性的儿童的回顾性研究中，有症状儿童的平均Ct值显著更低，且在5岁以下儿童中最低，这表明与无症状儿童相比，有症状儿童和感染SARS-CoV-2的年幼儿童鼻咽部的病毒载量可能更高。需要进一步研究来评估无症状儿童的传播潜力。
