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July 31, 2020
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Young children ‘potentially important drivers of SARS-CoV-2’

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A small study published in JAMA Pediatrics showed that children aged younger than 5 years carry higher amounts of SARS-CoV-2 RNA in their nasopharynx compared with youths aged 5 to 17 years and adults aged 18 to 65 years.

“Our study is limited to detection of viral nucleic acid, rather than infectious virus, although SARS-CoV-2 pediatric studies reported a correlation between higher nucleic acid levels and the ability to culture infectious virus,” Taylor Heald-Sargent, MD, PhD, pediatric infectious disease specialist at Lurie Children’s Hospital of Chicago, and colleagues wrote. “Thus, young children can potentially be important drivers of SARS-CoV-2 spread in the general population, as has been demonstrated with respiratory syncytial virus, where children with high viral loads are more likely to transmit.”

In a news release, Heald-Sargent said the finding “has important public health implications, especially during discussions on the safety of reopening schools and day care.”

Heald-Sargent and colleagues tested nasopharyngeal swabs collected from 145 patients — 46 younger than 5 years, 51 aged 5 to 17 years, and 48 aged between 18 and 65 years.

The researchers reported similar median cycle threshold (CT) values in youths aged 5 to 17 years (11.1 [6.3-15.7]) and adults (11 [6.9-17.5]), but children aged younger than 5 years had significantly lower CT values (6.5[4.8-12]), “indicating that young children have equivalent or more viral nucleic acid in their upper respiratory tract compared with older children and adults.

“The observed differences in median CT values between young children and adults approximate a 10-fold to 100-fold greater amount of SARS-CoV-2 in the upper respiratory tract of young children,” Heald-Sargent and colleagues wrote.