Thread by @apsmunro

It's time for another quick update on paediatric #COVID19 evidence!

Most new information is about transmission so we'll focus on that for now. It's pretty interesting!

Lets take a look...

#FOAMed #tweetorial

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First, pre-print systematic review of transmission (search on May 16th)

medrxiv.org/content/10.110…

I won't go into depth as all studies covered in a previous thread, however useful meta-analysis of contact tracing studies

OR = 0.44 of infection in children compared to adults

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This is conservative as they use raw Odds Ratios, not those adjusted for contact type from initial studies

Some criticisms of these include potential lack of testing of non-symptomatic children missing cases

Well fortunately we've got some new evidence there...

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Here are 2 studies which both tested all household contacts regardless of symptoms

Israel
journals.lww.com/pidj/Abstract/…

New York
academic.oup.com/jpids/advance-…

Both found children half as likely to become infected as adults

How about false negatives as difficult to swab kids?

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Well in the Netherlands they didn't rely on swabs. They did serology.

ntvg.nl/artikelen/de-r…

Guess what? Same thing!

Young children about 50% as likely to get infected as adults/teens in household

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Same study looked at infection pairs from a national database to see who was infecting who.

Almost all transmission adult to adult. Minimal child to adult or child to child.

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Finally a revisit to a sero-prevalence study from Switzerland (prev seen as pre-print)

Population tested in Geneva and results adjusted and extrapolated for population estimates

thelancet.com/journals/lance…

Children <10yrs had Odds of 0.32 for being infected compared to adults

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Studies are consistently finding children get infected less easily than adults (however you look for it) and good size sero-epidemiology finding lower numbers of younger children have been infected

Super spreaders? Doesn't look like it.

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For all this and more on paediatric #COVID19 evidence, check out our review (in collaboration with the RCPCH) of ALL the published evidence so far on @DFTBubbles

Thanks for reading!

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dontforgetthebubbles.com/evidence-summa…