CHICAGO (NewsNation) — New research shows that children may be a catalyst in the community spread of COVID-19.
According to the study, published in the Journal of Pediatrics, children who had COVID-19 were shown to have a significantly higher level of virus in their airways than adults who were hospitalized and treated for the virus.
“During this COVID-19 pandemic, we have mainly screened symptomatic subjects, so we have reached the erroneous conclusion that the vast majority of people infected are adults,” said professor of Pediatrics at Harvard Medical School and study co-author, Alessio Fasano. “However, our results show that kids are not protected against this virus. We should not discount children as potential spreaders for this virus.”
The study conducted by Harvard Medical School researchers from Massachusetts General Hospital and Mass General Hospital for Children, examined 192 children ages 0-22 who came to hospitals with symptoms of or suspected exposure to COVID-19. In this group, 49 tested positive for SARS-CoV-2, the virus that causes COVID-19, and another 18 had a late-onset COVID-19-related illness.
“Kids are not immune from this infection, and their symptoms don’t correlate with exposure and infection,” said Fasano, who is also the director of the Mucosal Immunology and Biology Research Center at Mass General Hospital for Children.
The findings suggest that despite their lower number of the virus receptors, children can still carry a high viral load and are therefore more contagious. The results carry implications for the reopening of schools, daycare centers and other facilities with a high density of children and close interaction with teachers and staff members, the authors said.
“I was surprised by the high levels of virus we found in children of all ages, especially in the first two days of infection,” said lead study author Lael Yonker, assistant professor of pediatrics at Mass General Hospital for Children.
“I was not expecting the viral load to be so high, You think of a hospital, and of all of the precautions taken to treat severely ill adults, but the viral loads of these hospitalized patients are significantly lower than a ‘healthy child’ who is walking around with a high SARS-CoV-2 viral load,” said Yonker.
The researchers note that although children with COVID-19 are not likely to become as seriously ill as adults, they can spread infection and bring the virus into their homes if they attend school as asymptomatic carriers or carriers with few symptoms.
Symptoms typical of COVID-19, such as fever, runny nose and cough, often overlap with other common childhood illnesses, including influenza and the common cold, which can confound an accurate diagnosis of COVID-19 in children, said Yonker.
“Kids are not immune from this infection, and their symptoms don’t correlate with exposure and infection.”Alessio Fasano, director of the Mucosal Immunology and Biology Research Center at Mass General Hospital for Children
This is a particular concern for families in certain socioeconomic groups, which have been harder hit in the pandemic, and for multigenerational families with vulnerable older adults in the same household. In the study, 51% of children with acute SARS-CoV-2 infection came from low-income communities compared to 2% from high-income communities.
Recommendations from the study include not relying on body temperature or symptom monitoring to identify SARS-CoV-2 infection in the school setting.
The researchers emphasize infection-control measures, including social distancing, universal mask use when feasible, effective handwashing protocols and a combination of remote and in-person learning. They recommend routine and continued screening of all students for SARS-CoV-2 infection with timely reporting of the results an integral part of a safe return-to-school policy.
“This study provides much-needed facts for policymakers to make the best decisions possible for schools, daycare centers and other institutions that serve children,” said Fasano. “Kids are a possible source of spreading this virus, and this should be taken into account in the planning stages for reopening schools.”
A hurried return to school without proper planning could result in an uptick in COVID-19 infections, according to Fasano. “If schools were to reopen fully without necessary precautions, it is likely that children will play a larger role in this pandemic.”