Who Sheds and Thus Transmits SARS-Cov-2 Virus More, Symptomatic Children,
Adolescents or Adults?

An interesting study published in the Clinical Infectious Diseases Oxford Academic Journal by Bellon and others 5 May 2021 investigated this subject. 

The risk of further transmission of SARS-CoV-2 by paediatric or adolescents is still unclear. 

The lack of data on both susceptibility to SARS-CoV-2 infection as well as the risk posed by children to transmit to others has hindered public health and infection prevention strategies for educational institutions. 

Unlike adults, children present without or with less typical symptoms of COVID-19 and thus are much more likely to be under recognised within the current testing algorithms.  The authors analysed nasopharyngeal specimens from 8027 symptomatic SARS-CoV-2 positive individuals across all age groups in relation to a number of symptoms and time since symptom onset. 

They found that the mean viral load was slightly lower at the time of SARS-CoV-2 infection when diagnosed in children aged 0-13 and adolescents aged 14-19 compared to adults 20 years or older.  In the proportion of adults with a viral load greater than 6 log10 copies/ml, which is the defined threshold for infectious virus was significantly higher when compared to children, 69% versus 58%. 

Analysis of the viral load using the day of symptom onset showed that the viral load peaked within three days post symptom onset with viral load in children peaking and declining slightly faster compared to adults.  All groups, however, presented with a viral load greater than 6 log10 copies/ml up to five days post symptom onset.  The authors argue that the SARS-CoV-2 viral load can serve as a correlate for infectious virus presence and transmission and as such in the first three days there were less infectious children and adolescents than adults. 

The London General Practice, a leading London doctors’ clinic, is delighted to be on the Government approved list for COVID-19 testing.  

It offers all types of tests including fit to fly, test for release, day two and day eight COVID-19 testing and day five test for release testing.  

It is also able to offer a rapid PCR swab with results available within three hours.

Dr Paul Ettlinger
Founder, The London General Practice

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