SARS-CoV-2 Infections Among Children in the Biospecimens from Respiratory Virus-Exposed Kids (BRAVE Kids) Study.

Hurst, Jillian H

Heston, Sarah M

Chambers, Hailey N

Cunningham, Hannah M

Price, Meghan J

Suarez, Liliana

Crew, Carter G

Bose, Shree

Aquino, Jhoanna N

Carr, Stuart T

Griffin, S Michelle

Smith, Stephanie H

Jenkins, Kirsten

Pfeiffer, Trevor S

Rodriguez, Javier

DeMarco, C Todd

De Naeyer, Nicole A

Gurley, Thaddeus C

Louzao, Raul

Cunningham, Coleen K

Steinbach, William J

Denny, Thomas N

Lugo, Debra J

Moody, M Anthony

Permar, Sallie R

Rotta, Alexandre T

Turner, Nicholas A

Walter, Emmanuel B

Woods, Christopher W

Kelly, Matthew S

2021-01-04T20:54:16Z

2021-01-04T20:54:16Z

2020-09-01

2021-01-04T20:54:15Z

BACKGROUND: Children with SARS-CoV-2 infection typically have mild symptoms that do not require medical attention, leaving a gap in our understanding of the spectrum of illnesses that the virus causes in children. METHODS: We conducted a prospective cohort study of children and adolescents (<21 years of age) 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 PCR assay. RESULTS: Of 382 children, 289 (76%) were SARS-CoV-2-infected. SARS-CoV-2-infected children were more likely to be Hispanic (p<0.0001), less likely to have a history of asthma (p=0.009), and more likely to have an infected sibling contact (p=0.0007) than uninfected children. Children ages 6-13 years were frequently asymptomatic (38%) and had respiratory symptoms less often than younger children (30% vs. 49%; p=0.008) or adolescents (30% vs. 59%; p<0.0001). Compared to children ages 6-13 years, adolescents more frequently reported influenza-like (61% vs. 39%; p=0.002), gastrointestinal (26% vs. 9%; p=0.003), and sensory symptoms (43% vs. 9%; p<0.0001), and had more prolonged illnesses [median (IQR) duration: 7 (4, 12) vs. 4 (3, 8) days; p=0.004]. Despite the age-related variability in symptoms, we found no differences 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 a history of asthma is associated with decreased risk. Age-related differences in the clinical manifestations of SARS-CoV-2 infection must be considered when evaluating children for COVID-19 and in developing screening strategies for schools and childcare settings.

https://hdl.handle.net/10161/21992

eng

Cold Spring Harbor Laboratory

medRxiv

10.1101/2020.08.18.20166835

SARS-CoV-2 Infections Among Children in the Biospecimens from Respiratory Virus-Exposed Kids (BRAVE Kids) Study.

Journal article

Hurst, Jillian H|0000-0001-5079-9920

Heston, Sarah M|0000-0001-6150-1149

Cunningham, Coleen K|0000-0002-7725-3052

Moody, M Anthony|0000-0002-3890-5855

Rotta, Alexandre T|0000-0002-4406-2276

Woods, Christopher W|0000-0001-7240-2453

Kelly, Matthew S|0000-0001-8819-2315

School of Medicine

Duke Global Health Institute

Pathology

Pediatrics, Infectious Diseases

Duke

University Institutes and Centers

Institutes and Provost's Academic Units

Clinical Science Departments

Pediatrics

Duke Human Vaccine Institute

Medicine, Duke Human Vaccine Institute

Institutes and Centers

Medicine

Immunology

Basic Science Departments

Molecular Genetics and Microbiology

Duke Innovation & Entrepreneurship

Initiatives

Duke Clinical Research Institute

Pediatrics, Primary Care Pediatrics

Staff

Pediatrics, Critical Care Medicine

Published online