Susceptibility to SARS-Cov-2 Infection Among Children and Adolescents Compared with Adults

An interesting review and metanalysis in the Journal of the American Medical Association published by Weiner and others in September 2020 looked at the evidence on the susceptibility and transmission of superior 2 SARS-CoV-2 among children and adolescents compared with adults. 

They found in their systemic review and metanalysis including 32 studies that children and adolescence younger than 20 years had 44% lower odds of secondary infection with SARS-CoV-2 compared with adults 20 years and older. 

This finding was most marked in those younger than 10 to 14 years.  Their data were insufficient to conclude whether transmission of SARS-CoV-2 by children is lower than by adults.

Preliminary evidence suggested that children have a lower susceptibility to SARS-CoV-2 infection compared with adults, but the role that children and adolescents play in the transmission of the virus remains unclear. 

This is dependent on susceptibility, symptoms, viral load, social contact patterns and behaviour.  This study had an odds ratio of 0.956 for being an infected contact compared with adults in children and adolescents. 

However, there was weak evidence that children and adolescents played a lesser role than adults in transmission of SARS-CoV-2 at a population level.  This study provided no information on the infectivity of children.

The study went on to conclude that further large, high quality contract tracing studies with repeated swabbing and high quality virus detection and seroimmuno prevalent studies are required.

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