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Corona pandemic: what role do children play?

Corona pandemic: what role do children play?



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Children have a SARS-CoV-2 viral load similar to that of adults

Children and adolescents are probably as infectious as adults with the SARS-CoV-2 coronavirus. This emerges from the largest German analysis to date, in which data from over 3,700 people with COVID-19 from different age groups were evaluated and compared. The analysis suggests that an unrestricted opening of all schools and kindergartens must be viewed with caution.

A research team from the Charité Universitätsmedizin Berlin headed by virologist Professor Dr. Christian Drosten published the first major analysis, which allows an initial assessment of the role of children in the coronavirus pandemic. The evaluation of 3,712 COVID-19 sufferers showed that there was no significant difference in the SARS-CoV-2 viral load in the different age groups. The analysis entitled: "An analysis of SARS-CoV-2 viral load by patient age" can be viewed on the Charité website.

Children seem to be as infectious as adults

The viral load in the airways does not differ significantly between different age groups, reports a research group led by virologist Professor Dr. Christian Drosten. The team analyzed the viral load of 3,712 COVID-19 patients from different age categories. No significant difference between the individual age groups could be found. This suggests that children are as infectious as adults.

Limitation of the study

The data is a preliminary result that has not yet been through a peer review process and has not been published in any specialist journal. Only the viral branch was examined. It remains unclear whether children pass on the virus as often as adults. This question is currently difficult to clarify, since all schools and day care centers are closed and there is therefore no possibility of carrying out a study on this under real conditions.

No definitive statement about infectivity is possible

The data are laboratory evaluations. In his NDR podcast, Professor Drosten emphasized that such data "can only provide indirect information". Nevertheless, it can be derived from previous studies that the viral load in the throat correlates with the transmission potential.

According to the virologist, some aguments also suggest that children could be less infectious despite the same viral load. SARS-CoV-2 infections are more often asymptomatic or mild in children, they cough less and could therefore release fewer viruses into the air they breathe. On the other hand, they would also keep less distance from other children and caregivers.

Drosten: "The result was clear."

For the first time, the Charité team staggered the available data into age groups and subdivided them into social categorizations such as kindergarten, elementary school, secondary schools, students, adults and older adults. This comparison showed a clear result: "We cannot prove in groups of children that they have different virus concentrations in the airways compared to adults," said Drosten.

High viral branch even with low symptoms

The analysis also showed that children who did not develop symptoms after SARS-CoV-2 infection also had a high viral load. In direct comparison to children with symptoms, the viral load was even higher in the asymptomatic children - suggesting that asymptomatic courses in children could even be associated with a higher risk of further infections.

Children's clinic paints a different picture

A research team of Dr. von Haunersche Children's Hospital in Munich instead advocates critically rethinking the closings of schools and daycare centers. In a report recently published in the “Deutsches Ärzteblatt”, the researchers have combined evidence from several studies that suggest that children play a minor role in the spread of SARS-CoV-2.

According to the research group, only two to three percent of the reported COVID-19 cases in Germany are currently in childhood. In two studies from Iceland and Italy, SARS-CoV-2 was not detected in children under ten years of age. Children and adolescents very rarely experience severe COVID-19 courses. In this context, deaths are much rarer. As of March 31, 2020, the research team was only aware of seven cases worldwide.

Everything revolves around the question of whether children transmit SARS-CoV-2

But the researchers of Dr. von Haunersche Children's Hospital point out that the question of transmission has not been conclusively clarified. Since so many children develop asymptomatic courses, it can be assumed that the number of unreported children is extremely high. Because children are tested far less because of the lack of symptoms.

The researchers found evidence that children also seem to play a subordinate role here. According to a report by the WHO Joint Mission Team in China, studies of the outbreak have not shown that children are responsible for infecting adults. Data from studies on household transfers also indicate that children are generally not responsible for household infections. However, the data are vague, since many schools were already closed and children had few opportunities to become infected.

Slow SARS-CoV-2 spread among young people

The research team points out that mathematical models also show that the average age of the population plays a role in SARS-CoV-2 spread. For example, the younger the average age of the population, the lower the number of reproductions R0 from country to country. In developing countries with a high proportion of children, a slower spread of SARS-CoV-2 was observed - further evidence that children do not play a major role.

The right to education must have priority

The researchers of Dr. von Haunersche Children's Hospital come to the conclusion that, according to the current state of knowledge, children do not appear to be significantly involved in the transmission of SARS-CoV-2 and that the area-wide closure of schools, kindergartens and crèches is less likely than expected to help contain the pandemic. Therefore "priority should be given to children's right to education and participation in society."

Why is it so difficult to judge children?

Overall, there is a conflicting picture of the role of children in the coronavirus pandemic. Since early school closures occurred in most countries, there is little experience with possible consequences. Since children predominantly have asymptomatic SARS-CoV-2 infections, there is little reliable data. In addition, existing data were mainly collected under the current measures and do not allow any clear conclusions to be drawn about normal circumstances. Such an investigation could probably be carried out most easily in Sweden at the moment. Professor Drosten was amazed that there doesn't seem to be a research project in this direction. (vb)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Graduate editor (FH) Volker Blasek

Swell:

  • Christian Drosten, including: An analysis of SARS-CoV-2 viral load by patient age, Charité Universitätsmedizin Berlin, 2020, zoonosen.charite.de
  • Tilmann Schober, Anita Rack-Hoch, Anna Kern, u.a .: Children have the right to education; in: Deutsches Ärzteblatt, Issue 19, 2020, aerzteblatt.de
  • NDR: Coronavirus Update (37) with Christian Drosten: Again children: Two new studies (published: April 30th, 2020), ndr.de


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