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

摘要

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.