Cycle threshold values in PCR testing lower in symptomatic children with COVID-19
Recent study findings suggested that symptomatic children infected with SARS-CoV-2 had higher viral loads in their upper airways compared with asymptomatic children.
John Strutner, MD, MPH, a resident at the University of California, San Diego School of Medicine, and colleagues presented their findings at the St. Jude Pediatric Infectious Diseases Research Conference.
The researchers performed a retrospective cross-sectional study to compare PCR cycle threshold values among 728 children who tested positive for SARS-CoV-2.
The children were aged 0 to 18 years, all of whom tested positive for SARS-CoV-2 through reverse transcription PCR testing. Respiratory samples were collected over the course of 4 months.
According to the researchers, 71.2% of the children presented with symptoms. The mean cycle threshold value for symptomatic patients was 19.9, whereas those who were asymptomatic had a mean value of 23.5 (95% CI, 2.6-4.6).
The authors noted the mean cycle threshold value was lowest among symptomatic children who were aged younger than 5 years.
“Understanding viral kinetics of SARS-CoV-2 is important to assess risk of transmission, manage treatment, and determine the need for isolation and protective equipment,” the authors wrote. “Children have been noted to have less severe illness than adults and may have less transmission potential.”
Perspective
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Improving our understanding of viral transmission and asymptomatic carriage are key to making informed public health decisions regarding COVID-19. The role children have played in viral transmission during the COVID-19 pandemic has been greatly debated. Children generally have less severe disease and are potentially less likely to spread the virus compared with adults. Reasons for this remain unclear. It is likely a combination of factors, including differences in immunity, comorbidities and behavioral patterns of children compared with those of adults.
This study suggests symptomatic children, especially those aged younger than 5 years, have a higher viral load in their upper airway compared with asymptomatic children. What this means for transmission remains unclear, but this adds valuable data to the growing information we know about COVID-19 in children. This type of information is essential to make data-driven decisions on school reopening and other public health policies that have major implications for children’s health.
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Strutner A, et al. Abstract 27. Presented at: St. Jude/PIDS Pediatric Infectious Diseases Research Conference; March 4-6, 2021 (virtual meeting).
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