Duration of Viral Clearance in Children With SARS-CoV-2 Infection in Rajasthan, India

Gupta, Manohar Lal; Gothwal, Sunil; Gupta, Raj K.; Sharma, Ram Babu; Meena, Jeetam Singh; Sulaniya, Pawan Kumar; Dev, Deveshwar; Gupta, Deepak

doi:10.1007/s13312-021-2125-6

Cited by 9 publications

(7 citation statements)

References 17 publications

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“…In addition, there is growing evidence that the prolonged presence of viral RNA does not necessarily imply infectivity. A recent study conducted in children with COVID-19 showed an average viral spread duration of about 11 and 23 days from the onset of symptoms through the respiratory tract and gastrointestinal tract, respectively [44]. A study on virus culture and contact traceability suggested that patients with mild to moderate COVID-19 are highly unlikely to be infectious beyond 10 days after the onset of symptoms [45].…”

Section: After How Many Days Should the Swab Be Repeated In Case Of Positive Sars-cov-2 Result?mentioning

confidence: 99%

COVID-19 Management in the Pediatric Age: Consensus Document of the COVID-19 Working Group in Paediatrics of the Emilia-Romagna Region (RE-CO-Ped), Italy

Esposito

Marchetti

Lanari

et al. 2021

IJERPH

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Since December 2019, coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread, becoming the first pandemic of the 21st century by number of deaths (over 2,000,000 worldwide). Many aspects of SARS-CoV-2 infection in children and adolescents remain unclear, and optimal treatment has not yet been defined. Therefore, our goal was to develop a consensus document, practically synthesizing the accumulated data and clinical experience of our expert group. Literature research was carried out using the keywords “COVID-19” or “SARS-CoV-2” and “children” or “pediatrics” and “prevention” or “diagnosis” or “MIS-C” or “treatment” in electronic databases (MEDLINE, PUBMED), existing guidelines and gray literature. The fact that the majority of the problems posed by SARS-CoV-2 infection in pediatric age do not need hospital care and that, therefore, infected children and adolescents can be managed at home highlights the need for a strengthening of territorial pediatric structures. The sharing of hospitalization and therapeutic management criteria for severe cases between professionals is essential to ensure a fair approach based on the best available knowledge. Moreover, the activity of social and health professionals must also include the description, management and limitation of psychophysical-relational damage resulting from the SARS-CoV-2 pandemic on the health of children and adolescents, whether or not affected by COVID-19. Due to the characteristics of COVID-19 pathology in pediatric age, the importance of strengthening the network between hospital and territorial pediatrics, school, educational, social and family personnel both for strictly clinical management and for the reduction in discomfort, with priority in children of more frail families, represents a priority.

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Section: After How Many Days Should the Swab Be Repeated In Case Of Positive Sars-cov-2 Result?mentioning

confidence: 99%

COVID-19 Management in the Pediatric Age: Consensus Document of the COVID-19 Working Group in Paediatrics of the Emilia-Romagna Region (RE-CO-Ped), Italy

Esposito

Marchetti

Lanari

et al. 2021

IJERPH

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“…The negative RT-PCR in the nasopharyngeal swab could be attributed to delay in testing after symptom appearance, low viral load in the sample, or viral clearance as she had completed 14 days from the symptom onset and it is known that the median duration for 50% viral clearance is around 7 days, and almost all children get a viral clearance within 14 days. 24 The extensive negative evaluation for stroke in this child had financial implications for the family. Early testing for SARS-CoV-2 by RT-PCR and serology would have helped in arriving at an early diagnosis especially amid the pandemic where COVID-19 infection-associated stroke might be more common than other rare causes of childhood stroke.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Acute Ischemic Stroke in a Young Child and Its Association with SARS-CoV-2 Infection

Shree

Kommalur

Lakshmi

et al. 2021

Journal of Pediatric Neurology

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The coronavirus disease 2019 (COVID-19) in children has been shown to have lower morbidity and mortality in children as compared with adults. The neurological complications related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are increasingly reported in children, yet the cerebrovascular complications are rare. We report a case of a toddler who presented with right-sided hemiparesis and motor aphasia, with an antecedent history suggestive of COVID-19 infection. The child tested negative on the nasopharyngeal swab for real-time reverse transcription-polymerase chain reaction (RT-PCR), but the serology for anti-SARS-CoV-2 IgG assay was positive. The neuroimaging showed an acute infarct in the left middle cerebral artery territory. A detailed evaluation for causes of childhood stroke was unrevealing, except for the presence of severe iron deficiency anemia (IDA). The child was diagnosed as acute ischemic stroke (AIS) most probably secondary to mild COVID-19 infection. The objective of this case report is to explain the possibility of AIS after a mild COVID-19 infection, complicated by the underlying severe IDA. Therefore, an association between COVID-19 and stroke in children needs to be emphasized and RT-PCR for SARS-CoV-2 as well as serological assay must be included in the workup of stroke in the young.

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“…Regarding VC we found three relevant studies: Gupta et al ( 22 ) analysed data of 85 children and adolescents (aged 0–18) who were tested positive for SARS-CoV-2 and admitted to hospital during April and May 2020 in Rajasthan/India. The participants were tested by PCR every 3 days.…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 viral clearance and viral load kinetics in young children (1–6 years) compared to adults: Results of a longitudinal study in Germany

et al. 2022

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ObjectiveTo investigate SARS-COV-2 viral clearance and viral load kinetics in the course of infection in children aged 1–6 years in comparison with adults.MethodsProspective cohort study of infected daycare children and staff and their close contacts in households from 11/2020 to 06/2021. Adult participants took upper respiratory tract specimen from themselves and/or their children, for PCR tests on SARS-CoV-2. Data on symptoms and exposure were used to determine the date of probable infection for each participant. We determined (a) viral clearance, and (b) viral load dynamics over time. Samples were taken from day 4–6 to day 16–18 after diagnosis of the index case in the respective daycare group (5 samples per participant).ResultsWe included 40 children (1–6 years) and 67 adults (18–77 years) with SARS-CoV-2 infection. Samples were available at a mean of 4.3 points of time per participant. Among the participants, the 12-day study period fell in different periods within the individual course of infection, ranging from day 5–17 to day 15–26 after assumed infection.Children reached viral clearance at a median of 20 days after assumed infection (95% CI 17–21 days, Kaplan-Meier Analysis), adults at 23 days (95% CI 20–25 days, difference not significant). In both children and adults, viral load decreased over time with trajectories of the mean viral load not being statistically different between groups. Kaplan-Meier calculations show that from day 15 (95% CI 13–15), 50% of all participants had a viral load <1 million copies/ml, i.e. were no longer infectious or negative.ConclusionChildren aged 1–6 and adults infected with SARS-CoV-2 (wild type and Alpha variant) did not differ significantly in terms of viral load kinetics and time needed to clear the virus. Therefore, containment measures are important also in the daycare settings as long as the pandemic continues.

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Duration of Viral Clearance in Children With SARS-CoV-2 Infection in Rajasthan, India

Cited by 9 publications

References 17 publications

COVID-19 Management in the Pediatric Age: Consensus Document of the COVID-19 Working Group in Paediatrics of the Emilia-Romagna Region (RE-CO-Ped), Italy

COVID-19 Management in the Pediatric Age: Consensus Document of the COVID-19 Working Group in Paediatrics of the Emilia-Romagna Region (RE-CO-Ped), Italy

Acute Ischemic Stroke in a Young Child and Its Association with SARS-CoV-2 Infection

SARS-CoV-2 viral clearance and viral load kinetics in young children (1–6 years) compared to adults: Results of a longitudinal study in Germany

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