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Citation: Jiehao Cai, Xiangshi Wang, Jun Zhao, Yanling Ge, Jin Xu, He Tian, Hailing Chang, Aimei Xia, Jiali Wang, Jinqiang Zhang, Zhongqiu Wei, Jingjing Li, Chuning Wang, Jianshe Wang, Qirong Zhu, Xiaowen Zhai, Mei Zeng. Comparison of Clinical and Epidemiological Characteristics of Asymptomatic and Symptomatic SARS-CoV-2 Infection in Children [J].VIROLOGICA SINICA, 2020, 35(6) : 803-810.  http://dx.doi.org/10.1007/s12250-020-00312-4

Comparison of Clinical and Epidemiological Characteristics of Asymptomatic and Symptomatic SARS-CoV-2 Infection in Children

  • Corresponding author: Xiaowen Zhai, zengmeigao@163.com, ORCID: http://orcid.org/0000-0002-8127-3232
    Mei Zeng, zhaixiaowendy@163.com, ORCID: http://orcid.org/0000-0002-3491-5298
  • Received Date: 19 July 2020
    Accepted Date: 11 October 2020
    Published Date: 04 November 2020
    Available online: 01 December 2020
  • To understand the epidemiological and clinical features of the symptomatic and asymptomatic pediatric cases of COVID-19, we carried out a prospective study in Shanghai during the period of January 19 to April 30, 2020. A total of 49 children (mean age 11.5 ± 5.12 years) confirmed with SARS-CoV-2 infection were enrolled in the study, including 11 (22.4%) domestic cases and 38 (77.6%) imported cases. Nine (81.8%) local cases and 12 (31.6%) imported cases had a definitive epidemiological exposure. Twenty-eight (57.1%) were symptomatic and 21 (42.9%) were asymptomatic. Neither asymptomatic nor symptomatic cases progressed to severe diseases. The mean duration of viral shedding for SARS-CoV-2 in upper respiratory tract was 14.1 ± 6.4 days in asymptomatic cases and 14.8 ± 8.4 days in symptomatic cases (P > 0.05). Forty-five (91.8%) cases had viral RNA detected in stool. The mean duration of viral shedding in stool was 28.1 ± 13.3 days in asymptomatic cases and 30.8 ± 18.6 days in symptomatic participants (P > 0.05). Children < 7 years shed viral RNA in stool for a longer duration than school-aged children (P < 0.05). Forty-three (87.8%) cases had seropositivity for antibodies against SARS-CoV-2 within 1–3 weeks after confirmation with infection. In conclusion, asymptomatic SARS-CoV-2 infection may be common in children in the community during the COVID-19 pandemic wave. Asymptomatic cases shed viral RNA in a similar pattern as symptomatic cases do. It is of particular concern that asymptomatic individuals are potentially seed transmission of SARS-CoV-2 and pose a challenge to disease control.

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    Comparison of Clinical and Epidemiological Characteristics of Asymptomatic and Symptomatic SARS-CoV-2 Infection in Children

      Corresponding author: Xiaowen Zhai, zengmeigao@163.com
      Corresponding author: Mei Zeng, zhaixiaowendy@163.com
    • 1. Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai 201102, China
    • 2. Department of Pediatrics, Shanghai Public Health Clinical Center of Fudan University, Shanghai 201102, China
    • 3. Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai 201102, China
    • 4. Department of Infectious Diseases, Xiamen Children's Hospital, Children's Hospital of Fudan University Xiamen Branch, Shanghai 201102, China
    • 5. Department of Hematology, Children's Hospital of Fudan University, Shanghai 201102, China

    Abstract: To understand the epidemiological and clinical features of the symptomatic and asymptomatic pediatric cases of COVID-19, we carried out a prospective study in Shanghai during the period of January 19 to April 30, 2020. A total of 49 children (mean age 11.5 ± 5.12 years) confirmed with SARS-CoV-2 infection were enrolled in the study, including 11 (22.4%) domestic cases and 38 (77.6%) imported cases. Nine (81.8%) local cases and 12 (31.6%) imported cases had a definitive epidemiological exposure. Twenty-eight (57.1%) were symptomatic and 21 (42.9%) were asymptomatic. Neither asymptomatic nor symptomatic cases progressed to severe diseases. The mean duration of viral shedding for SARS-CoV-2 in upper respiratory tract was 14.1 ± 6.4 days in asymptomatic cases and 14.8 ± 8.4 days in symptomatic cases (P > 0.05). Forty-five (91.8%) cases had viral RNA detected in stool. The mean duration of viral shedding in stool was 28.1 ± 13.3 days in asymptomatic cases and 30.8 ± 18.6 days in symptomatic participants (P > 0.05). Children < 7 years shed viral RNA in stool for a longer duration than school-aged children (P < 0.05). Forty-three (87.8%) cases had seropositivity for antibodies against SARS-CoV-2 within 1–3 weeks after confirmation with infection. In conclusion, asymptomatic SARS-CoV-2 infection may be common in children in the community during the COVID-19 pandemic wave. Asymptomatic cases shed viral RNA in a similar pattern as symptomatic cases do. It is of particular concern that asymptomatic individuals are potentially seed transmission of SARS-CoV-2 and pose a challenge to disease control.