“If they carry the virus in high numbers in their airways, they can certainly spread the virus,” he said. “We need to be aware of that when we open the schools.”
But other experts who were not involved in research disputed that conclusion. The test used to detect coronavirus only shows the presence of viral genetic material, not live virus, and it does not indicate how infected a person is, these critics said.
Dr Cody Meissner, head of pediatric infectious diseases at Tufts Medical Center, called the study ‘shoes’ and without new insights.
“No one disputes the fact that children get it,” Meissner said. “You can not really jump from the assumption that this increases the chances of children transmitting the virus. We have very solid evidence that this is not the case. . . . The evidence that children are important vectors is simply not there. ‘
In contrast, Drs. Mark R. Schleiss, a specialist in infectious diseases in pediatrics at the University of Minnesota Medical School, said the study was “very helpful” and “well done,” confirming another recent study on “the importance of children in the spread and spread of COVID-19. ”
Schleiss said it is “biologically plausible” that children with high viral loads would transmit the disease.
The hospital began the investigation to understand why children were apparently spared COVID-19, Fasano said. Instead, researchers found that in fact many were infected but had no symptoms at all, as mild symptoms could hardly be distinguished from colds or allergies. As a result, children were not tested for the virus.
The study enrolled 192 adolescents up to the age of 22 who were considered at risk for COVID-19 because they had symptoms, had been in contact with an infected person, or lived in a “hot spot” with high rates of infection, such as Chelsea or Revere. Participants provided samples of blood, urine, saliva and swabs from the nose and mouth for Mass. General’s COVID-19 Biorepository.
About a quarter of the participants – 49 – tested positive for the coronavirus, and all had high levels of the virus in their noses, although there was no correlation between the number of virus detected and the severity of symptoms. On average, their viral load was higher than found in adults sick enough to be hospitalized.
“The fact that you have a high viral load in your nose and that you sneeze, you transmit the virus,” Fasano said. ‘They are potential spreaders. This is based on years and years of experience of many other viral infections. ”
Fasano advises that schools reduce the density of classes and wear masks and often require hand hygiene.
The findings are not entirely new. A small study published in late July had also found that children have coronavirus in their noses and throats at levels equal to adults. The lead author of that study, Dr. Taylor Heald-Sargent, an expert in infectious disease in children at Ann and Robert H. Lurie Children’s Hospital of Chicago, said the Mass. General study ‘adds to the growing body of evidence that we need to be careful around children and not assume that they can not spread the virus. ”
Mar Dr. William V. Raszka, Jr., a specialist in infectious disease at the Larner College of Medicine at the University of Vermont, said the study does nothing to change his thinking. Raszka recently co-authored a comment saying that children rarely transmit COVID-19, which appeared in another journal, Pediatrics, where he is associate editor.
“Just because you find virus in the nose, does not mean children are infected,” he said. “This article can say nothing about the children rarely or often can transmit the virus.”
The study has no information on where children got their infection, and other studies on household contacts suggest that children become infected by adults then vice versa, Raszka said.
Dr. Silvia S. Chiang, a pediatrician of Infectious Disease at Rhode Island Hospital and Assistant Professor of Pediatrics at Warren Alpert Medical School at Brown University, agreed that a high viral load does not necessarily mean that someone will transmit the virus.
‘You have to get the virus out of someone else’s nose. “It is possible that children do not cough, sneeze, or talk with as much force as adults,” she said.
Still, Chiang said, were the Mass. General data “certainly not reassuring.” Based on other studies, she said, she believes adolescents can transmit the virus, but younger children may not – “but I want to see more data.”
Most of the 49 children tested positive in the Mass. General studies were older than 11.
Fasano acknowledged that one major limitation of his study was that it was a small sample.
“I’m pretty sure a paper like this will give colleagues the impetus to look for COVID-19 infection in children in a more careful way and not brush it off as a problem that does not involve children,” he said.
The study was supported by the National Institutes of Health, the Cystic Fibrosis Foundation, the Centers for Disease Control and Prevention, Massachusetts General Hospital, and private donors.
Felice J. Freyer can be reached at [email protected]. Follow her on Twitter @felicejfreyer
