The study shows 2/3 of Dutch children


Coronavirus with severe acute respiratory distress syndrome (SARS-CoV-2) claimed more than 5.3 million lives worldwide by December 17, 2021 and continues to be a global threat.

It is estimated that about 20-50% of cases of SARS-CoV-2 infections in children under 18 years of age are asymptomatic. However, several researchers believe that the true incidence of SARS-CoV-2 infections in children may be underestimated. This is further complicated by the lack of systematic quantification or available comparisons to compare the symptoms and incidence of SARS-CoV-2 infections with acute respiratory disease (ARI) due to other infections in children.

study: Incidence and symptoms of SARS-CoV-2 infections in children and parents: a longitudinal study of CoKids in the household. Image credit: Dragana Gordic / Shutterstock.com

In the near future medRxiv * pre-press study, the researchers conducted intensive and longitudinal surveillance of households with children of different ages. Here, the researchers aimed to assess the incidence in the community of symptomatic and asymptomatic SARS-CoV-2 infections in children. In addition, they also assessed the symptoms of SARS-CoV-2 positive versus SARS-CoV-2 negative ARIs.

About the study

The current prospective study includes households with at least one child under the age of 18 and was obtained from three existing Dutch cohorts. These include the RESCEU cohort, which consists of children between the ages of 0-3, the MUIS cohort, which consists of children between the ages of 6-8, and the R cohort, which consists of children between the ages of 14 and 17. .

Eligibility for the study included screening for SARS-CoV-2 at 4-6 week intervals for all household members during the 23-week follow-up period. The newly emerging respiratory symptoms were actively reported until July 1, 2021.

Follow-up was temporarily enhanced after new respiratory symptoms in a household member or a positive SARS-CoV-2 test result. This follow-up process also includes daily recording of symptoms, multiple polymerase chain reaction (PCR) testing of samples from the nose, throat, saliva and faeces, and measurement of SARS-CoV-2 antibodies to paired dried blood stains) in all members of the the household.

Statistical analyzes were used to calculate age-stratified morbidity levels for SARS-CoV-2 positive and negative episodes. Symptomatology and severity of respiratory episodes were also compared according to the status and age of SARS-CoV-2.

Survey results

The final analysis included 307 households enrolled with a total of 1209 subjects. The researchers found 64 SARS-CoV-2 positive cases and 118 SARS-CoV-2 negative respiratory foci.

The highest incidence of SARS-CoV-2 adverse events was found in children under 12 years of age. The positive incidence of SARS-CoV-2 in this age group was 0.21 / person-year (PY) for confirmed cases only and 0.41 / PY after inclusion of all positive cases.

The frequency of SARS-CoV-2 does not differ by age group. However, nasal congestion / runny nose, with or without cough and fatigue, are the three most common groups of symptoms for all types of respiratory episodes, including those that are positive or negative for SARS-CoV-2.

No difference in symptoms and severity of SARS-CoV-2 positive versus negative respiratory episodes was observed in children. However, in adults, SARS-CoV-2 positive episodes had a significantly higher number and severity of symptoms and a longer duration.

Researchers have found a high incidence of SARS-CoV-2 infections in children who are similar to adults. The findings also highlight that after almost two years since the COVID-19 pandemic, more than 60% of Dutch children under the age of 12 have been infected with SARS-CoV-2.

Най-честите групи от симптоми на епизод на SARS-CoV-2 положителни и отрицателни респираторни епизоди при деца (<18 години) и възрастни.  Бележка под линия: Фигура A (n=41), B (n=63), C (n=178) и D (n=151).
The most common groups of symptoms per episode of SARS-CoV-2 are positive and negative respiratory episodes in children (<18 years) and adults. Footnote: Figure A (n = 41), B (n = 63), C (n = 178) and D (n = 151).

Consequences

The present study suggests that the symptoms and severity of SARS-CoV-2 in children are similar to respiratory diseases for other reasons. In adults, SARS-COV-2 positive episodes are characterized by a greater number and prolonged symptoms and greater severity.

Топлинна карта на индивидуалните симптоми до 25-ия ден на SARS-CoV-2 положителни и отрицателни респираторни епизоди при деца (<18 години) и възрастни.
Heat chart of individual symptoms up to day 25 of SARS-CoV-2 positive and negative respiratory episodes in children (<18 years) and adults.

These findings can support public health decisions on child vaccination policies against coronavirus 2019 (COVID-19), which makes public health authorities more active in providing priority vaccination to children.

*Important message

medRxiv publishes preliminary scientific reports that are not reviewed by partners and therefore should not be considered convincing, guiding clinical practice / health-related behavior, or treated as established information.



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