Lower nasopharyngeal viral loads in pediatric population. The missing piece to understand SARS-CoV-2 infection in children?

Abstract

SARS-CoV-2 virus infects children but, contrary to other respiratory viruses, children tend to be asymptomatic or to have less symptoms than adults and are rarely the index case in household transmission chains. The aim of this study was to compare the relative viral loads in nasopharyngeal samples from children aged 0 to 17 years with those of an adult population. We selected 126 positive nasopharyngeal samples from children. Relative viral loads were measured by RT-PCR and the comparative ∆Ct method using primers and probes targeting the viral gene E and the human RNAseP. Relative viral loads were significantly lower in the children population than in the adult one.

Similar patterns of [18F]-FDG brain PET hypometabolism in paediatric and adult patients with long COVID: a paediatric case series

“…Our study is the first to identify brain PET hypometabolism in children suspected of having long COVID. Further studies will be needed to determine whether this pattern could be used as a biomarker to help with the positive or differential diagnosis of severe or atypical forms of long COVID, especially in children, in whom acute COVID-19 diagnosis is more difficult and often not biologically proven [11][12][13][14]. It could also be useful during the followup to evaluate recovery, as suggested in children #4 and #7 of our series.…”

“…Current recommendations specify that a positive biological confirmation of SARS-CoV-2 is not required to identify these patients [8][9][10]. Indeed, many of these patients with mild to moderate, or even asymptomatic, initial presentation have not been tested by RT-PCR at the acute stage, or at least not at the time of high viral load excretion, and cases with negative serology have also been described, especially those involving younger patients [11][12][13][14]. In this context, we previously identified a brain PET hypometabolism in adult patients with long COVID, involving the olfactory bulb, and the brain network connected to this region, in particular the limbic temporal lobe, the brainstem and the cerebellum [15][16][17].…”

Similar patterns of 18F-FDG brain PET hypometabolism in paediatric and adult patients with long COVID: a paediatric case series

“…Our study is the rst to identify brain PET hypometabolism in children suspected of having long COVID. Further studies will be needed to determine whether this pattern could be used as a biomarker to help with the positive or differential diagnosis of severe or atypical forms of long COVID, especially in children, in whom acute COVID-19 diagnosis is more di cult and often not biologically proven [11][12][13][14] . It could also be useful during the follow-up to evaluate recovery, as suggested in children #4 and #7 of our series.…”

“…Current recommendations specify that a positive biological con rmation of SARS-CoV-2 is not required to identify these patients [8][9][10] . Indeed, many of these patients with mild to moderate, or even asymptomatic, initial presentation have not been tested by RT-PCR at the acute stage, or at least not at the time of high viral load excretion, and cases with negative serology have also been described, especially those involving younger patients [11][12][13][14] . In this context, we previously identi ed a brain PET hypometabolism in adult patients with long COVID, involving the olfactory bulb, and the brain network connected to this region, in particular the temporal lobe, the brainstem, and the cerebellum [15][16][17] .…”

Viral loads observed under competing strain dynamics

“…We also did not consider how patient-level factors affect viral loads. Some limited evidence exists to suggest that children exhibit systematically lower viral loads than adults, with observations also affected by external factors such as swab quality or viral location within the respiratory tract [16,38,39]. Clinical severity may also affect viral load kinetics, with symptomatic patients exhibiting slower clearance rates than asymptomatic infections [32,40].…”