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Severe Acute Respiratory Syndrome Coronavirus 2 Infections Among Children in the Biospecimens from Respiratory Virus-Exposed Kids (BRAVE Kids) Study

Jillian H. HurstChildren’s Health and Discovery Institute, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USASarah M. HestonDepartment of Pediatrics, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USAHailey N. ChambersDuke University School of Medicine, Durham, North Carolina, USAHannah CunninghamDuke University School of Medicine, Durham, North Carolina, USAMeghan PriceDuke University School of Medicine, Durham, North Carolina, USALilianna SuarezDuke University School of Medicine, Durham, North Carolina, USACarter CrewChildren’s Health and Discovery Institute, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USAShree BoseDuke University School of Medicine, Durham, North Carolina, USAJhoanna N. AquinoDepartment of Pediatrics, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USAStuart CarrDepartment of Pediatrics, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USAShannon M. GriffinChildren’s Clinical Research Unit, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USAStephanie H. SmithDuke Human Vaccine Institute, Duke University School of Medicine, Durham, North Carolina, USAKirsten JenkinsDepartment of Pediatrics, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USATrevor S. PfeifferDepartment of Pediatrics, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USAJavier RodriguezChildren’s Clinical Research Unit, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USAC. Todd DeMarcoDuke Human Vaccine Institute, Duke University School of Medicine, Durham, North Carolina, USANicole A. De NaeyerDuke Human Vaccine Institute, Duke University School of Medicine, Durham, North Carolina, USAThaddeus C. GurleyDuke Human Vaccine Institute, Duke University School of Medicine, Durham, North Carolina, USARaul LouzaoDuke Human Vaccine Institute, Duke University School of Medicine, Durham, North Carolina, USACongwen ZhaoDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, USAColeen K. CunninghamDepartment of Pediatrics, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USAWilliam J. SteinbachDepartment of Pediatrics, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USAThomas N. DennyDuke Human Vaccine Institute, Duke University School of Medicine, Durham, North Carolina, USADebra J. LugoDepartment of Pediatrics, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USAM. Anthony MoodyDepartment of Pediatrics, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USASallie R. PermarChildren’s Health and Discovery Institute, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USAAlexandre T. RottaDepartment of Pediatrics, Division of Pediatric Critical Care Medicine, Duke University School of Medicine, Durham, North Carolina, USANicholas TurnerDepartment of Medicine, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USAEmmanuel B. WalterDepartment of Pediatrics, Division of Primary Care Pediatrics, Duke University School of Medicine, Durham, North Carolina, USAChristopher W. WoodsDepartment of Medicine, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USAMatthew S. KellyDepartment of Pediatrics, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA

2020en

ABI

Annotatsiya

BACKGROUND: Child with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection typically have mild symptoms that do not require medical attention, leaving a gap in our understanding of the spectrum of SARS-CoV-2-related illnesses that the viruses causes in children. METHODS: We conducted a prospective cohort study of children and adolescents (aged <21 years) with a SARS-CoV-2-infected close contact. We collected nasopharyngeal or nasal swabs at enrollment and tested for SARS-CoV-2 using a real-time polymerase chain reaction assay. RESULTS: Of 382 children, 293 (77%) were SARS-CoV-2-infected. SARS-CoV-2-infected children were more likely to be Hispanic (P < .0001), less likely to have asthma (P = .005), and more likely to have an infected sibling contact (P = .001) than uninfected children. Children aged 6-13 years were frequently asymptomatic (39%) and had respiratory symptoms less often than younger children (29% vs 48%; P = .01) or adolescents (29% vs 60%; P < .001). Compared with children aged 6-13 years, adolescents more frequently reported influenza-like (61% vs 39%; P < .001) , and gastrointestinal (27% vs 9%; P = .002), and sensory symptoms (42% vs 9%; P < .0001) and had more prolonged illnesses (median [interquartile range] duration: 7 [4-12] vs 4 [3-8] days; P = 0.01). Despite the age-related variability in symptoms, wWe found no difference in nasopharyngeal viral load by age or between symptomatic and asymptomatic children. CONCLUSIONS: Hispanic ethnicity and an infected sibling close contact are associated with increased SARS-CoV-2 infection risk among children, while asthma is associated with decreased risk. Age-related differences in clinical manifestations of SARS-CoV-2 infection must be considered when evaluating children for coronavirus disease 2019 and in developing screening strategies for schools and childcare settings.

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Identifikatorlar

DOI: 10.1093/cid/ciaa1693

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