The role of children in transmission of Covid-19 and further propagating the pandemic is now being increasingly scrutinised and data is still evolving. Adding to the evidence, a new study says that asymptomatic and symptomatic children can carry high amounts of live and actively dividing SARS-CoV-2, regardless of the severity of the infection.Researchers from MIT, Harvard and the Massachusetts General Hospital (MGH), Brigham and Women’s Hospital, Ragon Institute examined respiratory sw...
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Dr Veena Aggarwal, Consultant Womens’ Health, CMD and Editor-in-Chief, IJCP Group & Medtalks Trustee, Dr KK’s Heart Care Foundation of India, 19 October 2021 #Multispeciality
The role of children in transmission of Covid-19 and further propagating the pandemic is now being increasingly scrutinised and data is still evolving. Adding to the evidence, a new study says that asymptomatic and symptomatic children can carry high amounts of live and actively dividing SARS-CoV-2, regardless of the severity of the infection.
Researchers from MIT, Harvard and the Massachusetts General Hospital (MGH), Brigham and Women’s Hospital, Ragon Institute examined respiratory swabs obtained from 110 children, aged 2 weeks-21 years) with Covid-19. Viral load was quantified by SARS-CoV-2 RT-PCR test.
Children, both symptomatic and asymptomatic, were found to be the most infectious within the first five days of the onset of illness. The viral load in the upper respiratory tract was highest in the first two days of symptoms, which declined significantly after 5 days and even further after 10 days. The viral load was either similar to or higher than the viral loads in hospitalized adults with Covid-19 duration of less than 10 days. The live virus was cultured from 33 samples from 32 participants.
However, no association was observed between viral load and age suggesting that children of all ages can have high viral loads, including variants of SARS-CoV-2. Similarly, there was no correlation between the viral load and disease severity i.e., high viral load did not automatically indicate a more severe disease. Alpha and iota variants were also identified in samples obtained from the children.
It was earlier thought that children are immune to Covid-19. But this can no longer be taken to be a fact. Children too are at risk of developing the infection similar to adults. In a sero-survey conducted by AIIMS, 55.7% of children had developed antibodies compared to 63.5% among adults. In Delhi, nearly 75% of the population, which included adults and children as well, was found to have been exposed to the infection. In another sero-survey of 2700 children conducted by PGIMER Chandigarh, 71% of them had developed antibodies.
This study reported in the Journal of Infectious Diseases has shown that children, whether they have symptoms or not, are carriers of the virus making them an important link in the chain of disease transmission. This gives rise to a concern that as potential reservoirs of the actively replicating SARS-CoV-2, they are a source of infection and may trigger a new wave of infections, including emergence of new variants. It is important that immunization of children be taken up at the earliest as part of the nationwide Covid-19 vaccination drive.
Yonker LM, et al. Virologic features of SARS-CoV-2 infection in children. J Infect Dis. 2021 Oct 14;jiab509. doi: 10.1093/infdis/jiab509.
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