Thread by @ShamezLadhani

1/ Comparison of Symptoms and RNA Levels in Children and Adults With SARS-CoV-2 Infection in the Community Setting

👉 @JAMAPediatrics paper comparing kids vs adults - most findings are as expected but good to see them confirmed in a large study… 🧵

👉jamanetwork.com/journals/jamap…

2/ This cross-sectional population-based survey included a convenience sample of 37,000 kids & adults in King County, Washington, who enrolled online for home self-collection of upper respiratory samples for SARS-CoV-2 testing from Mar-Nov 2020

3/ 37,067 samples were tested & 673 (1.8%) were #sarscov2 positive (1.6% in adults, 3.4% in kids)

Most kids (80%) had a known SARS-CoV-2 +ve contact, & most contacts (68%) were in the same household

But only 41% of SARS-CoV-2 +ve adults (41.4%) reported any known +ve contact

4/ Among 555 SARS-CoV-2–positive participants, 47/123 (38%) kids were asymptomatic vs 31/432 (7%) adults

Also, asymptomatic children were younger than symptomatic children (mean [SD] age, 6.2 [4.5] years vs 8.3 [5.7] years; P < .001)

👉younger kids less likely to have symptoms

5/ When symptomatic, fewer symptoms were reported in kids vs adults

(mean number of symptoms [SD], 1.6 [2.0] vs 4.5 [3.1])

The duration of symptoms was also shorter in kids than in adults

(mean (SD) of 3.8 (3.8) days of symptoms vs 4.9 (4.1) days in symptomatic adults)

6/ The most common signs & symptoms in kids were runny or stuffy nose, fever, headache, and cough, while adults most frequently reported headache, cough, & fatigue

Note that this study was done before the Alpha or Delta variant was circulating in the US

7/ Co-infection with other viruses was rare

Of 555 SARS-CoV-2 +ve swabs, 487 were tested for 24 respiratory pathogens by RT-PCR. Only 3/108 kids (2.8%) had another virus (2 rhinovirus, 1 adenovirus) vs 10/379 adults (2.6%): 7 rhinovirus, 1 adenovirus, 1 enterovirus, 1 influenza

8/ Symptomatic individuals had lower Ct values (corresponding to higher viral RNA levels) than asymptomatic individuals

Also, Ct values (virus levels) were not significantly different btwn symptomatic kids & symptomatic adults or between asymptomatic kids & asymptomatic adults

9/ Accompanying editorial summarises findings & implications in detail

👉 Take home message: children were less frequently symptomatic, had fewer symptoms & shorter duration of symptoms vs adults - all likely to contribute to lower risk of transmission

👉jamanetwork.com/journals/jamap…