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1.
Euro Surveill ; 25(29)2020 07.
Article in English | MEDLINE | ID: covidwho-689092

ABSTRACT

On 13 March 2020, Israel's government declared closure of all schools. Schools fully reopened on 17 May 2020. Ten days later, a major outbreak of coronavirus disease (COVID-19) occurred in a high school. The first case was registered on 26 May, the second on 27 May. They were not epidemiologically linked. Testing of the complete school community revealed 153 students (attack rate: 13.2%) and 25 staff members (attack rate: 16.6%) who were COVID-19 positive.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus , Pneumonia, Viral/epidemiology , Schools , Students/statistics & numerical data , Adolescent , Adult , Betacoronavirus , Child , Coronavirus Infections/diagnosis , Disease Outbreaks , Female , Humans , Incidence , Israel/epidemiology , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnosis
2.
Front Immunol ; 11: 1665, 2020.
Article in English | MEDLINE | ID: covidwho-688896

ABSTRACT

We report a case of an 8-year-old girl who underwent a SARS-CoV-2 infection manifesting with atypical symptoms spearheaded by abdominal discomfort and systemic inflammation and partially mimicking hemophagocytic lymphohistiocytosis (HLH) or macrophage activation syndrome (MAS), which however did not fulfill the HLH/MAS diagnostic criteria. In this case of what has since been described as Pediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-COV-2 (PIMS-TS) we documented excellent clinical response to immunosuppression with systemic corticosteroids and intravenous immunoglobulins. We show a detailed longitudinal development of neutrophil immunophenotype which suggests activation and engagement of neutrophils during PIMS-TS with compensatory contraction of the response and contra-regulation of neutrophil phenotype during recovery.


Subject(s)
Adrenal Cortex Hormones/administration & dosage , Betacoronavirus , Coronavirus Infections , Immunoglobulins, Intravenous/administration & dosage , Immunosuppression , Lymphohistiocytosis, Hemophagocytic , Macrophage Activation Syndrome , Pandemics , Pneumonia, Viral , Betacoronavirus/immunology , Betacoronavirus/metabolism , Child , Coronavirus Infections/blood , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Coronavirus Infections/immunology , Female , Humans , Inflammation/diagnosis , Inflammation/drug therapy , Inflammation/immunology , Lymphohistiocytosis, Hemophagocytic/diagnosis , Lymphohistiocytosis, Hemophagocytic/drug therapy , Lymphohistiocytosis, Hemophagocytic/immunology , Macrophage Activation Syndrome/diagnosis , Macrophage Activation Syndrome/drug therapy , Macrophage Activation Syndrome/immunology , Neutrophils , Pneumonia, Viral/blood , Pneumonia, Viral/diagnosis , Pneumonia, Viral/drug therapy , Pneumonia, Viral/immunology
3.
Indian J Med Microbiol ; 38(1): 1-8, 2020.
Article in English | MEDLINE | ID: covidwho-688753

ABSTRACT

A novel coronavirus infection, which began as an outbreak of unusual viral pneumonia in Wuhan, a central city in China, has evolved into a global health crisis. The outbreak is an unembellished reminder of the hazard coronaviruses pose to public health. Government and researchers around the world have been taking swift measures to control the outbreak and conduct aetiological studies to understand the various facets of the outbreak. This review is an attempt at providing an insight about the current understanding, knowledge gaps and a perspective on the future of coronavirus disease 2019 (COVID-19) infections. All the authentic data published so far on COVID-19 has been systematically analysed. PubMed, NCBI, World Health Organisation, Ministry of Health and Family Welfare (India), and Centers for Disease Control and Prevention databases and bibliographies of relevant studies up to 22nd June 2020 have been included. The Wuhan outbreak is a stark reminder of the continuing threat posed by zoonotic diseases to global health. Despite an armamentarium of Government officials, researchers and medical fraternity working towards the containment of this novel coronavirus viral pneumonia continues to spread at an alarming rate infecting multitudes and claiming hundreds of lives.


Subject(s)
Betacoronavirus/isolation & purification , Communicable Disease Control/methods , Coronavirus Infections/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Zoonoses/transmission , Adolescent , Adult , Aged , Aged, 80 and over , Animals , Biomedical Research/trends , Child , Child, Preschool , Communicable Disease Control/organization & administration , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Female , Global Health , Humans , Infant , Infant, Newborn , Male , Middle Aged , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Young Adult
4.
Lancet Infect Dis ; 20(6): 669-677, 2020 06.
Article in English | MEDLINE | ID: covidwho-688245

ABSTRACT

BACKGROUND: In the face of rapidly changing data, a range of case fatality ratio estimates for coronavirus disease 2019 (COVID-19) have been produced that differ substantially in magnitude. We aimed to provide robust estimates, accounting for censoring and ascertainment biases. METHODS: We collected individual-case data for patients who died from COVID-19 in Hubei, mainland China (reported by national and provincial health commissions to Feb 8, 2020), and for cases outside of mainland China (from government or ministry of health websites and media reports for 37 countries, as well as Hong Kong and Macau, until Feb 25, 2020). These individual-case data were used to estimate the time between onset of symptoms and outcome (death or discharge from hospital). We next obtained age-stratified estimates of the case fatality ratio by relating the aggregate distribution of cases to the observed cumulative deaths in China, assuming a constant attack rate by age and adjusting for demography and age-based and location-based under-ascertainment. We also estimated the case fatality ratio from individual line-list data on 1334 cases identified outside of mainland China. Using data on the prevalence of PCR-confirmed cases in international residents repatriated from China, we obtained age-stratified estimates of the infection fatality ratio. Furthermore, data on age-stratified severity in a subset of 3665 cases from China were used to estimate the proportion of infected individuals who are likely to require hospitalisation. FINDINGS: Using data on 24 deaths that occurred in mainland China and 165 recoveries outside of China, we estimated the mean duration from onset of symptoms to death to be 17·8 days (95% credible interval [CrI] 16·9-19·2) and to hospital discharge to be 24·7 days (22·9-28·1). In all laboratory confirmed and clinically diagnosed cases from mainland China (n=70 117), we estimated a crude case fatality ratio (adjusted for censoring) of 3·67% (95% CrI 3·56-3·80). However, after further adjusting for demography and under-ascertainment, we obtained a best estimate of the case fatality ratio in China of 1·38% (1·23-1·53), with substantially higher ratios in older age groups (0·32% [0·27-0·38] in those aged <60 years vs 6·4% [5·7-7·2] in those aged ≥60 years), up to 13·4% (11·2-15·9) in those aged 80 years or older. Estimates of case fatality ratio from international cases stratified by age were consistent with those from China (parametric estimate 1·4% [0·4-3·5] in those aged <60 years [n=360] and 4·5% [1·8-11·1] in those aged ≥60 years [n=151]). Our estimated overall infection fatality ratio for China was 0·66% (0·39-1·33), with an increasing profile with age. Similarly, estimates of the proportion of infected individuals likely to be hospitalised increased with age up to a maximum of 18·4% (11·0-37·6) in those aged 80 years or older. INTERPRETATION: These early estimates give an indication of the fatality ratio across the spectrum of COVID-19 disease and show a strong age gradient in risk of death. FUNDING: UK Medical Research Council.


Subject(s)
Coronavirus Infections/mortality , Pandemics/statistics & numerical data , Pneumonia, Viral/mortality , Adolescent , Adult , Aged , Aged, 80 and over , Betacoronavirus , Child , Child, Preschool , China/epidemiology , Hospitalization/statistics & numerical data , Humans , Incidence , Infant , Infant, Newborn , Middle Aged , Models, Statistical , Young Adult
6.
JCI Insight ; 5(10)2020 05 21.
Article in English | MEDLINE | ID: covidwho-687860

ABSTRACT

BACKGROUNDThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a novel viral pneumonia (COVID-19), which is rapidly spreading throughout the world. The positive result of nucleic acid test is a golden criterion to confirm SARS-CoV-2 infection, but the detection features remain unclear.METHODSWe performed a retrospective analysis in 5630 high-risk individuals receiving SARS-CoV-2 nucleic acid tests in Wuhan, China, and investigated their characteristics and diagnosis rates.RESULTSThe overall diagnosis rate was 34.7% (1952/5630). Male (P = 0.025) and older populations (P = 2.525 × 10-39) were at significantly higher risk of SARS-CoV-2 infection. People were generally susceptible, and most cases concentrated in people of 30-79 years. Furthermore, we investigated the association between diagnosis rate and the amount of testing in 501 subjects. Results revealed a 1.27-fold improvement (from 27.9% to 35.5%) of diagnosis rate from testing once to twice (P = 5.847 × 10-9) and a 1.43-fold improvement (from 27.9% to 39.9%) from testing once to 3 times (P = 7.797 × 10-14). More than 3 testing administrations was not helpful for further improvement. However, this improvement was not observed in subjects with pneumonia (P = 0.097).CONCLUSIONAll populations are susceptible to SARS-CoV-2 infection, and male and older-aged populations are at significantly higher risk. Increasing the amount of testing could significantly improve diagnosis rates, except for subjects with pneumonia. It is recommended to test twice in those high-risk individuals whose results are negative the first time, and performing 3 tests is better, if possible.FUNDINGThis work was supported by National Mega Project on Major Infectious Disease Prevention (no. 2017ZX10103005-007) and National Key Research and Development Program of China (no. 2018YFE0204500).


Subject(s)
Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Child , Child, Preschool , China/epidemiology , Clinical Laboratory Techniques/methods , Coronavirus Infections/epidemiology , Female , Humans , Incidence , Infant , Infant, Newborn , Male , Middle Aged , Molecular Diagnostic Techniques , Pandemics , Pneumonia, Viral/epidemiology , RNA, Viral/analysis , Real-Time Polymerase Chain Reaction , Retrospective Studies , Sex Factors , Young Adult
7.
Community Dent Health ; 37(2): 108-109, 2020 May 29.
Article in English | MEDLINE | ID: covidwho-687598

ABSTRACT

It seems a strange thing to be writing about child oral health in the middle of a virus pandemic that has, in the UK at least, paused all routine dental care. Perhaps not; as thoughts turn to the return of "normal" opera- tion there are concerns over potential ongoing impacts from COVID-19 on health services including stricter infection-control requirements and economic impacts from the lockdown. It invites ridicule to try and predict what will happen in the coming years, but the economic and social impacts are likely to increase vulnerability among the already vulnerable and the delivery of dental care is likely to be more problematic and more expensive. More than ever we need to reduce the burden of avoidable dental disease.


Subject(s)
Oral Health , Pneumonia, Viral , Betacoronavirus , Child , Coronavirus Infections , Humans , Pandemics
8.
Acta Biomed ; 91(2): 172-176, 2020 May 11.
Article in English | MEDLINE | ID: covidwho-685518

ABSTRACT

BACKGROUND AND AIM: Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Its outbreak in many states of the world, forced the World Health Organization (WHO) to declare a pandemic. Currently, COVID-19 has infected 1 991 562 patients causing 130 885 deaths globally as of 16 April 2020. The aim of this review is to underline the epidemiological, clinical and management characteristics in children affected by COVID-19. METHODS: We searched Pubmed, from January to April 2020, for the following search terms: "COVID-19", "children", "SARS-COV2", "complications", "epidemiology", "clinical features", focusing our attention mostly on epidemiology and symptoms of COVID-19 in children. RESULTS: Usually, infants and children present milder symptoms of the disease with a better outcome than adults. Consequently, children may be considered an infection reservoir that may play a role as spreader of the infection in community.


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Child , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Humans , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Radiography, Thoracic , Severity of Illness Index , Ultrasonography
9.
Eur J Immunol ; 50(5): 623, 2020 05.
Article in English | MEDLINE | ID: covidwho-685129
10.
BMC Infect Dis ; 20(1): 549, 2020 Jul 29.
Article in English | MEDLINE | ID: covidwho-684717

ABSTRACT

BACKGROUND: We aimed to report the epidemiological and clinical characteristics of hospitalized patients with coronavirus disease-19 (COVID-19) in Zengdu District, Hubei Province, China. METHODS: Clinical data on COVID-19 inpatients in Zengdu Hospital from January 27 to March 11, 2020 were collected; this is a community hospital in an area surrounding Wuhan and supported by volunteer doctors. All hospitalized patients with COVID-19 were included in this study. The epidemiological findings, clinical features, laboratory findings, radiologic manifestations, and clinical outcomes of these patients were analyzed. The patients were followed up for clinical outcomes until March 22, 2020. Severe COVID-19 cases include severe and critical cases diagnosed according to the seventh edition of China's COVID-19 diagnostic guidelines. Severe and critical COVID-19 cases were diagnosed according to the seventh edition of China's COVID-19 diagnostic guidelines. RESULTS: All hospitalized COVID-19 patients, 276 (median age: 51.0 years), were enrolled, including 262 non-severe and 14 severe patients. The proportion of patients aged over 60 years was higher in the severe group (78.6%) than in the non-severe group (18.7%, p < 0.01). Approximately a quarter of the patients (24.6%) had at least one comorbidity, such as hypertension, diabetes, or cancer, and the proportion of patients with comorbidities was higher in the severe group (85.7%) than in the non-severe group (21.4%, p < 0.01). Common symptoms included fever (82.2% [227/276]) and cough (78.0% [218/276]). 38.4% (106/276) of the patients had a fever at the time of admission. Most patients (94.9% [204/276]) were cured and discharged; 3.6% (10/276) deteriorated to a critical condition and were transferred to another hospital. The median COVID-19 treatment duration and hospital stay were 14.0 and 18.0 days, respectively. CONCLUSIONS: Most of the COVID-19 patients in Zengdu had mild disease. Older patients with underlying diseases were at a higher risk of progression to severe disease. The length of hospital-stay and antiviral treatment duration for COVID-19 were slightly longer than those in Wuhan. This work will contribute toward an understanding of COVID-19 characteristics in the areas around the core COVID-19 outbreak region and serve as a reference for decision-making for epidemic prevention and control in similar areas.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Length of Stay/statistics & numerical data , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Adolescent , Adult , Child , Child, Preschool , China/epidemiology , Comorbidity , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Cough/epidemiology , Female , Fever/epidemiology , Humans , Hypertension/epidemiology , Infant , Infant, Newborn , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnosis , Retrospective Studies , Treatment Outcome , Young Adult
11.
J Clin Microbiol ; 58(8)2020 Jul 23.
Article in English | MEDLINE | ID: covidwho-684350

ABSTRACT

Molecular testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the gold standard for diagnosis of coronavirus disease 2019 (COVID-19), but the clinical performance of these tests is still poorly understood, particularly with regard to disease course, patient-specific factors, and viral shedding. From 10 March to 1 May 2020, NewYork-Presbyterian laboratories performed 27,377 SARS-CoV-2 molecular assays from 22,338 patients. Repeat testing was performed for 3,432 patients, of which 2,413 had initial negative and 802 had initial positive results. Repeat-tested patients were more likely to have severe disease and low viral loads. The negative predictive value of the first-day result among repeat-tested patients was 81.3% The clinical sensitivity of SARS-CoV-2 molecular assays was estimated between 58% and 96%, depending on the unknown number of false-negative results in single-tested patients. Conversion to negative was unlikely to occur before 15 to 20 days after initial testing or 20 to 30 days after the onset of symptoms, with 50% conversion occurring at 28 days after initial testing. Conversion from first-day negative to positive results increased linearly with each day of testing, reaching 25% probability in 20 days. Sixty patients fluctuated between positive and negative results over several weeks, suggesting that caution is needed when single-test results are acted upon. In summary, our study provides estimates of the clinical performance of SARS-CoV-2 molecular assays and suggests time frames for appropriate repeat testing, namely, 15 to 20 days after a positive test and the same day or next 2 days after a negative test for patients with high suspicion for COVID-19.


Subject(s)
Betacoronavirus/isolation & purification , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Diagnostic Tests, Routine/methods , Pneumonia, Viral/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Betacoronavirus/genetics , Child , Child, Preschool , Coronavirus Infections/pathology , Coronavirus Infections/virology , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , New York , Pandemics , Pneumonia, Viral/pathology , Pneumonia, Viral/virology , Predictive Value of Tests , Sensitivity and Specificity , Viral Load , Young Adult
13.
J Pediatric Infect Dis Soc ; 9(3): 393-398, 2020 Jul 13.
Article in English | MEDLINE | ID: covidwho-681598

ABSTRACT

We present a series of 6 critically ill children with multisystem inflammatory syndrome in children. Key findings of this syndrome include fever, diarrhea, shock, and variable presence of rash, conjunctivitis, extremity edema, and mucous membrane changes.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Pneumonia, Viral/complications , Systemic Inflammatory Response Syndrome/etiology , Adolescent , Child , Child, Preschool , Coronavirus Infections/pathology , Female , Humans , Male , Pandemics , Pneumonia, Viral/pathology , Systemic Inflammatory Response Syndrome/pathology , Systemic Inflammatory Response Syndrome/virology
15.
Int J Eat Disord ; 53(7): 1142-1154, 2020 07.
Article in English | MEDLINE | ID: covidwho-680160

ABSTRACT

The necessity to employ distance-based methods to deliver on-going eating disorder care due to the novel coronavirus (COVID-19) pandemic represents a dramatic and urgent shift in treatment delivery. Yet, TeleHealth treatments for eating disorders in youth have not been adequately researched or rigorously tested. Based on clinical experience within our clinic and research programs, we aim to highlight the common challenges clinicians may encounter in providing family-based treatment (FBT) via TeleHealth for children and adolescents with anorexia nervosa and bulimia nervosa. We also discuss possible solutions and offer practical considerations for providers delivering FBT in this format. Additional research in TeleHealth treatment for eating disorders in youth may lead to improved access, efficiency, and effectiveness of FBT delivered via videoconferencing.


Subject(s)
Anorexia Nervosa/therapy , Bulimia Nervosa/therapy , Coronavirus Infections/prevention & control , Family Therapy/methods , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Telemedicine/methods , Adolescent , Betacoronavirus , Child , Female , Humans , Videoconferencing
16.
Global Health ; 16(1): 69, 2020 07 28.
Article in English | MEDLINE | ID: covidwho-680059

ABSTRACT

BACKGROUND: The outbreak of 2019 coronavirus disease (COVID-19) could increase the risk of depression. However, epidemiological data on outbreak-associated depressive morbidity of female adolescents are not available. This study determines the incidence and correlates of depression among female adolescents aged 11-18 years during the COVID-19 outbreak in mainland China. METHODS: A large cross-sectional sample, nationwide online survey was conducted during the COVID-19 outbreak. Depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D), and the correlative factors of depression were analyzed. RESULTS: In this study, 4805 female adolescents were enrolled with a median (range) age of 15 (11-18) years. Of them, 1899 (39.5%) suffered from depression with a CES-D score of > 15. The onset of depression was significantly related to age, grade, distant learning, attitude toward COVID-19, sleep duration, and physical exercise duration. Furthermore, participants aged 15-18 years (OR = 1.755, 95% CI: 1.550-1.987, p < 0.001), participating in distant learning (OR = 0.710, 95% CI: 0.564-0.894, p = 0.004), concerned about COVID-19 (OR = 0.414, 95% CI: 0.212-0.811, p = 0.010), with sleep duration/day of < 6 h (OR = 2.603, 95% CI: 1.946-3.483, p < 0.001),and with physical exercise duration/day < 30 min (OR = 1.641, 95% CI: 1.455-1.850, p < 0.001) represented to be independent factors for suffering from depression. CONCLUSION: During the COVID-19 outbreak, depression was common among female adolescents. Older age, distant learning, concern about COVID-19, short sleep duration, and physical exercise duration represented the independent factors for suffering from depression.


Subject(s)
Coronavirus Infections/epidemiology , Depression/epidemiology , Disease Outbreaks , Pneumonia, Viral/epidemiology , Adolescent , Child , China/epidemiology , Cross-Sectional Studies , Female , Humans , Pandemics , Prevalence , Risk Factors , Surveys and Questionnaires
17.
Environ Microbiol ; 22(7): 2445-2456, 2020 07.
Article in English | MEDLINE | ID: covidwho-679961

ABSTRACT

In the absence of an efficient drug treatment or a vaccine, the control of the COVID-19 pandemic relies on classic infection control measures. Since these means are socially disruptive and come with substantial economic loss for societies, a better knowledge of the epidemiology of the new coronavirus epidemic is crucial to achieve control at a sustainable cost and within tolerable restrictions of civil rights.


Subject(s)
Asymptomatic Infections/epidemiology , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Betacoronavirus , Child , China/epidemiology , Coronavirus , Coronavirus Infections/mortality , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Europe/epidemiology , Humans , Immunity, Herd , Masks , Models, Theoretical , Molecular Epidemiology/statistics & numerical data , Nursing Homes/statistics & numerical data , Olfaction Disorders/virology , Pandemics/prevention & control , Pneumonia, Viral/mortality , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Public Health , Risk Factors , Seroepidemiologic Studies , Singapore , United States/epidemiology
18.
Can J Cardiol ; 36(7): 1130-1134, 2020 07.
Article in English | MEDLINE | ID: covidwho-679670

ABSTRACT

Children with congenital heart disease (CHD) are at risk for both COVID-19 and secondary cardiovascular outcomes. Their increased cardiovascular risk may be mitigated through physical activity, but public health measures implemented for COVID-19 can make physical activity challenging. We objectively measured the impact of the COVID-19 pandemic on physical activity, continuously measured by Fitbit step counts, in children with CHD. Step counts were markedly lower in late March and early April 2020, compared with 2019 and early March 2020. It is vital to understand how precautions for COVID-19 will affect the health of children with CHD, especially if they persist long term.


Subject(s)
Child Health , Coronavirus Infections/epidemiology , Exercise/physiology , Heart Defects, Congenital/epidemiology , Heart Defects, Congenital/rehabilitation , Pneumonia, Viral/epidemiology , Adolescent , British Columbia , Child , Cohort Studies , Coronavirus Infections/diagnosis , Databases, Factual , Female , Follow-Up Studies , Heart Defects, Congenital/diagnosis , Hospitalization/statistics & numerical data , Hospitals, Pediatric , Humans , Male , Needs Assessment , Pandemics , Pneumonia, Viral/diagnosis , Prospective Studies , Risk Factors
20.
Dtsch Arztebl Int ; 117(33-34): 553-560, 2020 07 21.
Article in English | MEDLINE | ID: covidwho-676459

ABSTRACT

BACKGROUND: Six months into the COVID-19 pandemic, children appear largely spared from the direct effects of disease, suggesting age as an important predictor of infection and severity. They remain, however, impacted by far-reaching public health interventions. One crucial question often posed is whether children generally transmit SARS-CoV-2 effectively. METHODS: We assessed the components of transmission and the different study designs and considerations necessary for valid assessment of transmission dynamics. We searched for published evidence about transmission of SARS-CoV-2 by children employing a narrative review methodology through 25 June, 2020. RESULTS: Transmission dynamics must be studied in repre - sentative pediatric populations with a combination of study designs including rigorous epidemiological studies (e.g. in households, schools, daycares, clinical settings) and laboratory studies while taking into account the social and socio-economic contexts. Viral load (VL) estimates from representative pediatric samples of infected children are missing so far. Currently available evidence suggests that the secondary attack rate stratified by age of the infector is lower for children, however this age pattern needs to be better quantified and understood. CONCLUSION: A generalizable pediatric evidence base is urgently needed to inform policy making now, later when facing potential subsequent waves, and extending through a future in which endemicity alongside vaccination may become the enduring reality.


Subject(s)
Coronavirus Infections/transmission , Pandemics , Pneumonia, Viral/transmission , Child , Coronavirus Infections/epidemiology , Humans , Pneumonia, Viral/epidemiology
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