A new study has provided critical data showing that children play a major role in the community spread of COVID-19.
The comprehensive pediatric study, conducted by Massachusetts General Hospital (MGH) and Mass General Hospital for Children (MGHfC), shows that children are silent spreaders of COVID-19, reflecting higher levels of the virus in their airways that hospitalize adults. in ICU need Covid19 treatment.
The study examined viral load, immune response, and hyperinflammation in pediatric COVID-19 cases, showing that out of 192 children aged 0-22, 49 children tested positive for the virus, and an additional 18 children were delayed. , COVID-19 -related disease. This breakthrough challenge challenges the current hypothesis that because children have lower levels of immune receptors for COVID-19, this makes them less likely to become infected than seriously ill.
The study, ‘Pediatric SARS-CoV-2: Clinical Presentation, Infectivity, and Immune Representatives’, was published in the Journal of Pediatrics.
High levels of the virus were found in children
The authors say that although younger children have lower levels of the virus receptor than older children and adults, this does not correlate with a reduced viral load. According to the authors, this finding suggests that children may carry a high viral load, which means that they are more contagious despite their susceptibility to developing a COVID-19 infection.
Risk of infection is much greater with a high viral load, and, together with viral load, the researchers examined expression of the viral receptor and anti-antibody response in healthy children, children with acute COVID-19, and a smaller number of children with multisystem inflammation Syndrome in children (MIS-C).
Lael Yonker, MD, director of the MGH Cystic Fibrosis Center and lead author of the study, said: ‘I was surprised by the high levels of virus we found in children of all ages, especially during the first two days of infection. . I did not expect the viral load to be so high. You think of a hospital, and of all the precautions taken to treat seriously ill adults, but the viral loads of these hospital patients are significantly lower than a ‘healthy child’ that has a high SARS-CoV-2 viral load round. ”
This increases the risk of reopening schools, day care centers, and other locations that have a high density of children and close interaction with teachers and staff members.
“Children are not immune to this infection, and their symptoms do not correlate with exposure and infection,” says Alessio Fasano, MD, director of the Mucosal Immunology and Biology Research Center at MGH and senior author of the manuscript. “During this COVID-19 pandemic, we have been investigating mainly symptomatic subjects, so that we have reached the wrong conclusion that the vast majority of people are infected adults. However, our results show that children are not protected against this virus. We should not discount children as potential spreaders of this virus. ”
The researchers also studied immune responses in MIS-C, a multi-organ, systemic infection that can develop several weeks after infection in children with COVID-19, which can cause severe cardiac problems, shock and acute heartbeat. “This is a serious complication as a result of the immune response to COVID-19 infection, and the number of these patients is growing,” says Fasano, who is also a professor of pediatrics at Harvard Medical School (HMS). “And, as in adults with these very serious systemic complications, the heart seems to be the favorite organ that targets post-COVID-19 immune response.”
Early insight into the immune disorder function in MIS-C should prompt caution when developing fax strategies, Yonker notes.
Increasing the risk of spreading the community
Although children are less likely to become seriously ill, their high viral load means that they can carry the virus in their schools and homes, causing families in socio-economic groups disproportionately affected by the pandemic, including multi-generational families who living with vulnerable adults in the same household. For example, in the MGHfC study, 51% of children with acute COVID-19 infection came from low-income communities compared with 2% from high-income communities.
To keep children, teachers and staff safe, the study advises not to rely on body temperature or symptom monitoring to identify COVID-19 in the school setting.
The researchers emphasize that measures for infection control are vital, including social distance, universal mask use (when implementable), effective handwashing protocols, and a combination of distance and personal learning. They consider routine and ongoing screening of all students for COVID-19, with timely reporting of the results an imperative part of a safe back-to-school policy.
