Comparison of Upper Respiratory Viral Load Distributions in Asymptomatic and Symptomatic Children Diagnosed with SARS-CoV-2 Infection in Pediatric Hospital Testing Programs.

Autor:	Kociolek LK; Division of Infectious Diseases, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Muller WJ; Division of Infectious Diseases, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Yee R; Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA., Dien Bard J; Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA.; Keck School of Medicine, University of Southern California, Los Angeles, California, USA., Brown CA; Texas Children's Hospital, Houston, Texas, USA.; Baylor College of Medicine, Houston, Texas, USA., Revell PA; Texas Children's Hospital, Houston, Texas, USA.; Baylor College of Medicine, Houston, Texas, USA., Wardell H; Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA., Savage TJ; Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA., Jung S; Department of Pathology and Laboratory Medicine, Children's Hospital Colorado, Aurora, Colorado, USA., Dominguez S; Department of Pathology and Laboratory Medicine, Children's Hospital Colorado, Aurora, Colorado, USA.; Department of Pediatrics, Division of Infectious Diseases, University of Colorado, Aurora, Colorado, USA., Parikh BA; Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri, USA., Jerris RC; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Kehl SC; Department of Pathology, Children's Wisconsin, Milwaukee, Wisconsin, USA.; Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Campigotto A; Department of Paediatric Laboratory Medicine, Hospital for Sick Kids, Toronto, Canada., Bender JM; Division of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, California, USA.; Keck School of Medicine, University of Southern California, Los Angeles, California, USA., Zheng X; Department of Pathology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Muscat E; Division of Infectious Diseases, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.; Department of Pathology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA., Linam M; Children's Healthcare of Atlanta, Atlanta, Georgia, USA.; Division of Pediatric Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA., Abuogi L; Department of Pediatrics, Division of Infectious Diseases, University of Colorado, Aurora, Colorado, USA., Smith C; Department of Pediatrics, Division of Infectious Diseases, University of Colorado, Aurora, Colorado, USA., Graff K; Department of Pediatrics, Division of Infectious Diseases, University of Colorado, Aurora, Colorado, USA., Hernandez-Leyva A; Division of Allergy and Immunology, Washington University School of Medicine, Saint Louis, Missouri, USA., Williams D; Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts, USA., Pollock NR; Department of Laboratory Medicine, Boston Children's Hospital, Boston, Massachusetts, USA nira.pollock@childrens.harvard.edu.
Jazyk:	angličtina
Zdroj:	Journal of clinical microbiology [J Clin Microbiol] 2020 Dec 17; Vol. 59 (1). Date of Electronic Publication: 2020 Dec 17 (Print Publication: 2020).
DOI:	10.1128/JCM.02593-20
Abstrakt:	The distribution of upper respiratory viral loads (VL) in asymptomatic children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unknown. We assessed PCR cycle threshold (Ct) values and estimated VL in infected asymptomatic children diagnosed in nine pediatric hospital testing programs. Records for asymptomatic and symptomatic patients with positive clinical SARS-CoV-2 tests were reviewed. Ct values were (i) adjusted by centering each value around the institutional median Ct value from symptomatic children tested with that assay and (ii) converted to estimated VL (numbers of copies per milliliter) using internal or manufacturer data. Adjusted Ct values and estimated VL for asymptomatic versus symptomatic children (118 asymptomatic versus 197 symptomatic children aged 0 to 4 years, 79 asymptomatic versus 97 symptomatic children aged 5 to 9 years, 69 asymptomatic versus 75 symptomatic children aged 10 to 13 years, 73 asymptomatic versus 109 symptomatic children aged 14 to 17 years) were compared. The median adjusted Ct value for asymptomatic children was 10.3 cycles higher than for symptomatic children ( P < 0.0001), and VL were 3 to 4 logs lower than for symptomatic children ( P  < 0.0001); differences were consistent ( P  < 0.0001) across all four age brackets. These differences were consistent across all institutions and by sex, ethnicity, and race. Asymptomatic children with diabetes (odds ratio [OR], 6.5; P  = 0.01), a recent contact (OR, 2.3; P  = 0.02), and testing for surveillance (OR, 2.7; P  = 0.005) had higher estimated risks of having a Ct value in the lowest quartile than children without, while an immunocompromised status had no effect. Children with asymptomatic SARS-CoV-2 infection had lower levels of virus in their nasopharynx/oropharynx than symptomatic children, but the timing of infection relative to diagnosis likely impacted levels in asymptomatic children. Caution is recommended when choosing diagnostic tests for screening of asymptomatic children. (Copyright © 2020 American Society for Microbiology.)
Databáze:	MEDLINE
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