SARS-CoV-2 Nasopharyngeal Load Higher in Children Than Adults

THURSDAY, Aug. 20, 2020 (HealthDay News) — Children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have the highest nasopharyngeal viral load in the first two days of symptoms, according to a study published online Aug. 20 in The Journal of Pediatrics.

Lael M. Yonker, M.D., from Massachusetts General Hospital in Boston, and colleagues enrolled 192 children ages 0 to 22 years with suspected SARS-CoV-2 infection presenting to urgent care clinics or hospitalized for confirmed/suspected SARS-CoV-2 infection or multisystem inflammatory syndrome in children (MIS-C). Participants provided nasopharyngeal, oropharyngeal, and/or blood specimens.

The researchers found that 26 percent of the children were diagnosed with acute SARS-CoV-2 infection; 9 percent of children met the criteria for MIS-C. Overall, 51 percent of the children with acute SARS-CoV-2 presented with fever; if present, symptoms of SARS-CoV-2 were nonspecific. In children, nasopharyngeal viral load was highest in the first two days of symptoms and was significantly higher than in hospitalized adults with severe disease. Viral load was not affected by age, but lower angiotensin-converting enzyme 2 expression was seen in younger children. In severe MIS-C, immunoglobulin M (IgM) and IgG to the receptor binding domain of the SARS-CoV-2 spike protein were increased, with dysregulated humoral responses.

“This study provides much-needed facts for policymakers to make the best decisions possible for schools, daycare centers, and other institutions that serve children,” a coauthor said in a statement. “Kids are a possible source of spreading this virus, and this should be taken into account in the planning stages for reopening schools.”

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