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Asymptomatic Children With SARS-CoV-2 Have Lower Viral Load

WEDNESDAY, Oct. 28, 2020 — Children with asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have lower viral load (VL) than symptomatic children, according to a study published online Oct. 16 in the Journal of Clinical Microbiology.

Larry K. Kociolek, M.D., from the Ann & Robert H. Lurie Children’s Hospital of Chicago, and colleagues assessed polymerase chain reaction cycle threshold (Ct) values and estimated VL in infected asymptomatic children diagnosed in nine pediatric hospital testing programs. Records were reviewed for asymptomatic and symptomatic children (339 and 478, respectively) with positive clinical SARS-CoV-2 tests.

The researchers found that the median adjusted Ct value was 10.3 cycles higher in asymptomatic children than in symptomatic children and VL 3 to 4 logs lower; across all four age brackets (ages, 0 to 4, 5 to 9, 10 to 13, and 14 to 17 years), these differences were consistent. These differences were also consistent across all institutions and by sex, ethnicity, and race. The estimated risk for having a Ct value in the lowest quartile was higher for asymptomatic children with diabetes, recent contact, and testing for surveillance (odds ratios, 6.5, 2.3, and 2.7, respectively) compared with children without, while no impact was seen for immunocompromised status.

“While these findings provide some reassurance about the safety of asymptomatically infected children attending school, these unanswered questions suggest that risk mitigation measures in daycares, schools, and the community remain critical to reduce the spread of COVID-19,” Kociolek said in a statement. “Children must continue to wear masks, maintain social distance and wash their hands frequently.”

Several authors disclosed financial ties to the pharmaceutical industry.

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