RESUMEN
OBJECTIVES: Studies comparing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA load in the upper respiratory tract (URT) between children and adults-who either presented with coronavirus disease 2019 (COVID-19) or were asymptomatic-have yielded inconsistent results. Here, we conducted a retrospective, single-centre study to address this issue. PATIENTS AND METHODS: Included were 1184 consecutive subjects (256 children and 928 adults) testing positive for SARS-CoV-2 RNA in nasopharyngeal exudates (NPs); of these, 424 (121 children and 303 adults) had COVID-19 and 760 (135 children and 625 adults) were asymptomatic close contacts of COVID-19 patients. SARS-CoV-2 RNA testing was carried out using the TaqPath COVID-19 Combo Kit (Thermo Fisher Scientific, MS, USA). The AMPLIRUN® TOTAL SARS-CoV-2 RNA Control (Vircell SA, Granada, Spain) was used for estimating SARS-CoV-2 RNA loads (in copies/mL). SARS-CoV-2 RNA loads at the time of laboratory diagnosis (single specimen/patient) were used for comparison purposes. RESULTS: Median initial SARS-CoV-2 RNA load was lower (p 0.094) in children (6.98 log10 copies/mL, range 3.0-11.7) than in adults (7.14 log10 copies/mL, range 2.2-13.4) with COVID-19. As for asymptomatic individuals, median SARS-CoV-2 RNA load was comparable (p 0.97) in children (6.20 log10 copies/mL, range 1.8-11.6) and adults (6.48 log10 copies/mL, range 1.9-11.8). Children with COVID-19 symptoms displayed SARS-CoV-2 RNA loads (6.98 log10 copies/mL, range 3.0-11.7) comparable to those of their asymptomatic counterparts (6.20 log10 copies/mL, range 1.8-11.6) (p 0.61). Meanwhile in adults, median SARS-CoV-2 RNA load was significantly higher in symptomatic (7.14 log10 copies/mL, range 2.2-13.4) than in asymptomatic subjects (6.48 log10 copies/mL, range 1.9-11.8) (p < 0.001). Overall, the observed URT SARS-CoV-2 RNA clearance rate was faster in children than in adults. CONCLUSIONS: Based on viral load data at the time of diagnosis, our results suggest that SARS-CoV-2-infected children, with or without COVID-19, may display NP viral loads of comparable magnitude to those found in their adult counterparts. However, children may have shorter viral shedding than adults.
Asunto(s)
COVID-19 , Nasofaringe/virología , ARN Viral , SARS-CoV-2 , Carga Viral , Adulto , Infecciones Asintomáticas , COVID-19/diagnóstico , Niño , Humanos , ARN Viral/aislamiento & purificación , Estudios RetrospectivosRESUMEN
The state of alarm decreed by the Spanish Government, due to the Coronavirus Disease-19 (COVID-19) pandemic, has demanded the lockdown of children and has conditioned a new organization of the Emergency Departments (ED). A pre-triage station and 2 independent circuits were established: suspected COVID-19 and not suspected COVID-19. The ED visits decreased 84,5% from pre-alarm with no increase in the level of urgencies. During the alarm state, 40.97% of the children were classified as suspected COVID-19. Fever and respiratory symptoms, used as discriminators, generated 2 groups of patients with different characteristics. Although the interruption of sports activities and isolation of children at home contributed to the decrease in emergencies, it was also probably conditioned by adults' fear of contagion, who avoided going to the hospital in situations that would never have really required ED and resolved themselves in primary care or spontaneously.
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