SARS-CoV-2 in Nasopharynx of Symptomatic Neonates, Children, and Adolescents

SARS-CoV-2 in Nasopharynx of Symptomatic Neonates, Children, and Adolescents. Jefferson T, Spencer EA, Heneghan C.

https://www.cebm.net/study/sars-cov-2-in-nasopharynx-of-symptomatic-neonates-children-and-adolescents/

Published on September 1, 2020

Reference L’Huillier A, Torriani G, Pigny F, Kaiser L, Eckerle I. Culture-Competent SARS-CoV-2 in Nasopharynx of Symptomatic Neonates, Children, and Adolescents. Emerging Infectious Disease journal. 2020;26(10) 2020
Study type
Country Switzerland
Setting Hospital
Funding Details Non reported
Transmission mode Respiratory, Viral Load
Exposures

Bottom Line

Half of the under 16s who were positive for SARS CoV-2 shed live viruses indicating the possibility of contagiousness. However, numbers were very small (out of 628 samples 23 were positive and 12 were live shedders.

Evidence Summary

Of the 638 nasopharyngeal swab samples, 23 (3.6%) tested positive for SARS CoV-2 , 12 (52% of PCR positive) from symptom start 1 to 4 days were positive with a ct around 28.
Severity of symptoms was associated with likelihood of viral culture

Median viral load was higher for patients with isolation (1.7 × 108 copies/mL) than for those without isolation (6.9 × 103] copies/mL; p = 0.002) (see the Figure). 

Culture-Competent SARS-CoV-2 in Nasopharynx of Symptomatic Neonates, Children, and Adolescents. Emerging Infectious Disease journal. 2020;26(10).

What did they do?

What did they do?

The study was carried out on 638 patients aged less than 16 years – median age of 12 years (range 7 days  to 14.9 years) in a Geneva Hospital. 

SARS-CoV-2 isolation was determined by presence of CPE and increased viral RNA in the supernatant (see the Table; and  Appendix Figure).

Study reliability

The series is small and the criteria for selection for testing are unclear

Clearly defined setting Demographic characteristics described Follow-up length was sufficient Transmission outcomes assessed Main biases are taken into consideration
Unclear Yes Yes Yes Unclear

What else should I consider?

This is an important case series given the dearth of evidence from this age group and requires replication.

About the authors

Carl Heneghan

Carl Heneghan

Carl is Professor of EBM & Director of CEBM at the University of Oxford. He is also a GP and tweets @carlheneghan. He has an active interest in discovering the truth behind health research findings

Elizabeth Spencer

Elizabeth Spencer

Dr Elizabeth Spencer; MMedSci, PhD. Epidemiologist, Nuffield Department for Primary Care Health Sciences, University of Oxford.

Tom Jefferson

Tom Jefferson

Tom Jefferson is a senior associate tutor and honorary research fellow, Centre for Evidence-Based Medicine, University of Oxford.