Risk Factors for SARS-CoV-2 Among Individuals Aged <18 Years in Mississippi
abstract
This abstract is available on the publisher's site.
Access this abstract nowAs of December 14, 2020, children and adolescents aged <18 years have accounted for 10.2% of coronavirus disease 2019 (COVID-19) cases reported in the United States.* Mitigation strategies to prevent infection with SARS-CoV-2, the virus that causes COVID-19, among persons of all ages, are important for pandemic control. Characterization of risk factors for SARS-CoV-2 infection among children and adolescents can inform efforts by parents, school and program administrators, and public health officials to reduce SARS-CoV-2 transmission. To assess school, community, and close contact exposures associated with pediatric COVID-19, a case-control study was conducted to compare exposures reported by parents or guardians of children and adolescents aged <18 years with SARS-CoV-2 infection confirmed by reverse transcription-polymerase chain reaction (RT-PCR) testing (case-patients) with exposures reported among those who received negative SARS-CoV-2 RT-PCR test results (control participants). Among 397 children and adolescents investigated, in-person school or child care attendance ≤14 days before the SARS-CoV-2 test was reported for 62% of case-patients and 68% of control participants and was not associated with a positive SARS-CoV-2 test result (adjusted odds ratio [aOR] = 0.8, 95% confidence interval [CI] = 0.5-1.3). Among 236 children aged ≥2 years who attended child care or school during the 2 weeks before SARS-CoV-2 testing, parents of 64% of case-patients and 76% of control participants reported that their child and all staff members wore masks inside the facility (aOR = 0.4, 95% CI = 0.2-0.8). In the 2 weeks preceding SARS-CoV-2 testing, case-patients were more likely to have had close contact with a person with known COVID-19 (aOR = 3.2, 95% CI = 2.0-5.0), have attended gatherings† with persons outside their household, including social functions (aOR = 2.4, 95% CI = 1.1-5.5) or activities with other children (aOR = 3.3, 95% CI = 1.3-8.4), or have had visitors in the home (aOR = 1.9, 95% CI = 1.2-2.9) than were control participants. Close contacts with persons with COVID-19 and gatherings contribute to SARS-CoV-2 infections in children and adolescents. Consistent use of masks, social distancing, isolation of infected persons, and quarantine of those who are exposed to the virus continue to be important to prevent COVID-19 spread.
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Factors Associated with Positive SARS-CoV-2 Test Results in Outpatient Health Facilities and Emergency Departments Among Children and Adolescents Aged <18 Years — Mississippi, September–November 2020
MMWR Morb. Mortal. Wkly. Rep. 2020 Dec 18;[EPub Ahead of Print], CV Hobbs, LM Martin, SS Kim, BM Kirmse, L Haynie, S McGraw, P Byers, KG Taylor, MM Patel, B FlanneryFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
A significant current controversy is about what role children play in the spread of the SARS-CoV-2, which of course is the linchpin of the school reopening debate. Although it seems clear that children are far less affected by the direct ravages of the virus, the question of how much they may contribute to spread of transmission either at home or in society at large is a major one.
This study examined children (<18 years of age) who were tested via PCR for SARS-CoV-2 at an academic health center in Mississippi. They were interviewed to try to ascertain what factors may be associated with infection. Biggest single takeaway? Those who were positive were far more likely to have attended different types of gatherings (weddings, funerals, parties, or playdates) but were not more likely to have attended child care or in-person school.
Now, the study is rife with limitations, including recall bias, and it’s not a study of the general population, so it doesn’t necessarily take into account asymptomatic individuals who may not seek testing. But still, it offers some insight into the theory that school and child care don’t seem to represent the same kind of risk that social gatherings do.