05 Aug Young Children Have Same or More COVID-19 in Respiratory Tract as Adults
MedicalResearch.com Interview with:
Taylor Heald-Sargent, M.D., Ph.D.
Ann & Robert H. Lurie Children’s Hospital
MedicalResearch.com: What is the background for this study?
Response: Given the ongoing debate around the ability of children to transmit SARS-CoV-2, we noticed that our clinical data could address one of the prevalent assumptions. Some people postulated that the reason children have less severe infections with SARS-CoV-2 is because they are not able to replicate virus as much as adults and therefore may not transmit as readily.
MedicalResearch.com: What are the main findings?
Response: At our pediatric institution, we noticed that even though our youngest patients were not clinically as affected by the virus, their nasopharyngeal swabs did contain high amounts of viral nucleic acid. When we compared the viral loads between children and adult samples, we found that the youngest group of children actually had higher amounts of viral RNA compared to older children and adults.
MedicalResearch.com: What should readers take away from your report?
Response: The primary take home message from our findings is that young children can replicate virus in their upper respiratory tract to the same extent, if not more, than older children and adults.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: There are at least two lines of inquiry that follow from our initial observation. First, studies into transmission of SARS-CoV-2 in pediatrics are needed especially as public spaces, schools, and daycares reopen. Although our study does not address transmission, other work on SARS-CoV-2 has shown that levels of viral nucleic acid similar to what we found in our population reflects levels of infectious virus. Together with studies one other viruses that have linked high amounts of virus to increased transmission, and the behaviors of young children, it is reasonable to hypothesize that children could spread the virus as efficiently as adults. However, studies need to be done to investigate that assumption.
The second intriguing question is why children have less severe infection relative to adults when they have similar viral loads in the upper respiratory tract. There are many possible explanations including some currently under investigation looking at differences in the immune response to SARS-CoV-2 infection and the abundance of the viral receptor in children. Perhaps the key to improving outcomes in adults will be found by looking at infection in children.
Heald-Sargent T, Muller WJ, Zheng X, Rippe J, Patel AB, Kociolek LK. Age-Related Differences in Nasopharyngeal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Levels in Patients With Mild to Moderate Coronavirus Disease 2019 (COVID-19). JAMA Pediatr. Published online July 30, 2020. doi:10.1001/jamapediatrics.2020.3651
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