SARS-CoV-2
NIAID
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Children become infected with a new coronavirus infection COVID-19 less often than adults, many of the symptoms typical of older patients do not appear, but the RNA of the virus is detected longer in their feces, according to Nature medicine. Probably, the virus from children to other people is often transmitted by the fecal-oral route.
Most cases of SARS-CoV-2 infection (COVID-19 pathogen) have been detected in adults. Morbidity and mortality among children so far seems to be the lowest. It is necessary to understand whether this is actually so and what role people of younger age categories play in the spread of the virus.
Employees of Guangzhou Medical University, led by Sitang Gong, processed information on 745 children and 3,174 adults who had close contact with the infected in a two-week period before going to the doctor. (The sick were given interferons to fight the virus.)
Virus RNA in these patients was detected by real-time PCR with reverse transcription (RT-PCR) swabs from the nasopharynx. Doctors determined the incidence in these two groups and compared the symptoms of coronavirus infection in children and adults. Researchers also took smears from the anus every day from infected individuals and, using RT-PCR, searched for SARS-CoV-2 genetic material in them.
The polymerase chain reaction revealed a new coronavirus in 10 children and 111 adults. This is 1.3 and 3.5 percent of the total number of the corresponding age group. The numbers differ 2.7 times, and this difference is statistically significant (P = 0.002). The age of sick children ranged from 2 months to 15 years, six were boys. All of them entered treatment independently of each other.
Many of the symptoms typical of acute respiratory syndromes in children did not occur. Three did not have a fever (moreover, during hospitalization, everyone had a body temperature not exceeding 39 degrees Celsius), five had a cough, and only two had a runny nose. Computed tomography of the lungs did not reveal unambiguous signs of pneumonia, and a “frosted glass symptom” was found in only half of the small patients.
The most common adult symptoms of COVID-19, such as headache, muscle weakness, vomiting, nausea, and disorientation, were not observed in children. All this suggests that many cases of coronavirus infection among the youngest population were not detected due to the atypical clinical picture.
–SARS-CoV-2 RNA in smears from the nasopharynx and rectum of infected children on different days after hospitalization
Yi Xu et al. / Nature Medicine, 2020
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– It is important that the virus RNA continued to be detected in rectal swabs of 8 out of 10 children for several days after it was no longer detected in nasopharyngeal swabs. This may indicate that SARS-CoV-2 from younger patients is often spread by the fecal-oral route (through unwashed hands after use of the toilet, as in dysentery).
Although evidence has already emerged of the likelihood of such a transfer, this method of infection with a new coronavirus has not yet been confirmed: replicable SARS-CoV-2 particles have not yet been found in human feces. In any case, the authors of the article believe that PCR smears from the anus in the case of children may be more informative for the search for infection than PCR swabs from the nasopharynx.
About how SARS-CoV-2 is detected in Russia and the world, read our material “Crown in a Haystack”. And we asked virologists about what medicines they are now offering to use to fight a new infection.
Svetlana Yastrebova
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