Comparison of Clinical and Epidemiological Characteristics of Asymptomatic and Symptomatic SARS-CoV-2 Infection in Child
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RESEARCH ARTICLE
Comparison of Clinical and Epidemiological Characteristics of Asymptomatic and Symptomatic SARS-CoV-2 Infection in Children Jiehao Cai1 • Xiangshi Wang1 • Jun Zhao2 • Yanling Ge1 • Jin Xu3 • He Tian1 • Hailing Chang1 • Aimei Xia1 • Jiali Wang1 • Jinqiang Zhang4 • Zhongqiu Wei1 • Jingjing Li1 • Chuning Wang1 • Jianshe Wang1 Qirong Zhu1 • Xiaowen Zhai5 • Mei Zeng1
•
Received: 19 July 2020 / Accepted: 11 October 2020 Ó Wuhan Institute of Virology, CAS 2020
Abstract To understand the epidemiological and clinical features of the symptomatic and asymptomatic pediatric cases of COVID-19, we carried out a prospective study in Shanghai during the period of January 19 to April 30, 2020. A total of 49 children (mean age 11.5 ± 5.12 years) confirmed with SARS-CoV-2 infection were enrolled in the study, including 11 (22.4%) domestic cases and 38 (77.6%) imported cases. Nine (81.8%) local cases and 12 (31.6%) imported cases had a definitive epidemiological exposure. Twenty-eight (57.1%) were symptomatic and 21 (42.9%) were asymptomatic. Neither asymptomatic nor symptomatic cases progressed to severe diseases. The mean duration of viral shedding for SARS-CoV-2 in upper respiratory tract was 14.1 ± 6.4 days in asymptomatic cases and 14.8 ± 8.4 days in symptomatic cases (P [ 0.05). Fortyfive (91.8%) cases had viral RNA detected in stool. The mean duration of viral shedding in stool was 28.1 ± 13.3 days in asymptomatic cases and 30.8 ± 18.6 days in symptomatic participants (P [ 0.05). Children \ 7 years shed viral RNA in stool for a longer duration than school-aged children (P \ 0.05). Forty-three (87.8%) cases had seropositivity for antibodies against SARS-CoV-2 within 1–3 weeks after confirmation with infection. In conclusion, asymptomatic SARS-CoV-2 infection may be common in children in the community during the COVID-19 pandemic wave. Asymptomatic cases shed viral RNA in a similar pattern as symptomatic cases do. It is of particular concern that asymptomatic individuals are potentially seed transmission of SARS-CoV-2 and pose a challenge to disease control. Keywords SARS-CoV-2 infection Children Epidemiology Viral shedding Seropositivity
Introduction Jiehao Cai, Xiangshi Wang and Jun Zhao have contributed equally to this article. & Mei Zeng [email protected] & Xiaowen Zhai [email protected] 1
Department of Infectious Diseases, Children’s Hospital of Fudan University, Shanghai 201102, China
2
Department of Pediatrics, Shanghai Public Health Clinical Center of Fudan University, Shanghai 201102, China
3
Department of Clinical Laboratory, Children’s Hospital of Fudan University, Shanghai 201102, China
4
Department of Infectious Diseases, Xiamen Children’s Hospital, Children’s Hospital of Fudan University Xiamen Branch, Shanghai 201102, China
5
Department of Hematology, Children’s Hospital of Fudan University, Shanghai 201102, China
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spar
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