Exhaled Aerosols in PCR-confirmed SARS-CoV-2-infected Children

ABSTRACT

Background Available data on aerosol emisions in children and adolescents during spontaneous breathing are limited. Our aim was to gain insight into the role of children in the spread of SARS-CoV-2 and whether aerosol measurements in children can be used to help detect so-called superspreaders - infected individuals with extremely high numbers of exhaled aerosol particles. Methods In this prospective study, the aerosol concentration of SARS-CoV-2 PCR-positive and SARS-CoV-2 PCR-negative children and adolescents (2-17 years) was investigated. All subjects were asked about their current health status and medical history. The exhaled aerosol particle counts of PCR-negative and PCR-positive subjects were measured using the Resp-Aer-Meter (Palas GmbH, Karlsruhe, Germany) and compared using linear regresion. The study was registered in the German Register of Clinical Studies (DRKS), DRKS00028539. Results A total of 250 children and adolescents were included in the study, 105 of whom were SARS-CoV-2 positive and 145 of whom were SARS-CoV-2 negative. The median age acros both groups was nine years (IQR 7-11). A total of 124 (49.6%) participants were female, and 126 (50.4%) participants were male. A total of 81.9% of the SARS-CoV-2-positive group had symptoms of viral infection. The median particle count of all individuals was 79.55 p/l (IQR 44.55-141.15). There was a tendency for older children to exhale more particles (1-5 years 79.54 p/l;6-11 years 77.96 p/l;12-17 years 98.63 p/l). SARS-CoV-2 PCR status was not a bivariate predictor (t=.82, p=.415) for the exhaled aerosol particle count;however, the SARS-CoV-2 status was shown to be a significant predictor in a multiple regresion model together with age, body mas index (BMI), covid vaccination, and past SARS-CoV-2 infection (t=.2.81 p=.005). Covid vaccination status was a highly significant predictor of exhaled aerosol particles (p <.001).Conclusion During SARS-CoV-2 infection, children and adolescents do not have elevated aerosol levels. In addition, no superspreaders were found. Children and adolescents are not the main driver of the SARS-CoV-2 pandemic. .