The patients were identified for testing through contact tracing or by developing symptoms, with 22% never developing symptoms, 20% initially asymptomatic but developing symptoms later, and 58% being symptomatic at their initial test.
New research has found that children can shed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), even if they never develop symptoms, or long after their symptoms have cleared, according to a Children’s National Hospital press release.
The patients were identified for testing through contact tracing or by developing symptoms, with 22% never developing symptoms, 20% initially asymptomatic but developing symptoms later, and 58% being symptomatic at their initial test. Over the course of the study, the hospitals where these children stayed continued to test them every 3 days on average to ] better estimate how long viral shedding continues over time.
The findings showed that the duration of symptoms varied widely, from 3 days to nearly 3 weeks, according to the study authors. Additionally, there was a significant spread in how long children continued to shed the virus and could be potentially infectious.
Although the virus was detectable for an average of approximately 2.5 weeks in the entire group, a significant portion of the children were still shedding the virus at the 3-week mark.
The study authors mentioned 3 important findings, including the large number of asymptomatic patients who were followed in the study, how children can retain symptoms for weeks, and the duration of viral shedding.
However, the authors still expressed concern regarding the link between testing and transmission despite these findings. A qualitative “positive” or “negative” on testing platforms may not necessarily reflect infectivity, with some positives reflecting bits of genetic material that may not be able to make someone sick or negatives reflecting low levels of the virus that may still be infectious.
Testing reliability may be further limited by the testers themselves, with sampling along different portions of the respiratory tract, or even by different staff members, leading to different laboratory results. In addition, it is unknown whether asymptomatic individuals are shedding different quantities of the virus than those with symptoms, according to the study authors.
The researchers only tested for viral shedding from the respiratory tract even though multiple studies have detected the virus in other bodily fluids, including stool. Further, testing only for active virus instead of antibodies ignores the vast number of individuals who may have had and cleared an asymptomatic or mild infection, which is important for understanding herd immunity.
The study authors note that each of these findings and additional questions could affect public health efforts continually being developed and refined to bring the coronavirus disease 2019 pandemic under control in the United States and on a global level.
Children with no COVID-19 symptoms may shed virus for weeks. Children’s National Hospital. https://childrensnational.org/news-and-events/childrens-newsroom/2020/children-with-no-covid-19-symptoms-may-shed-virus-for-weeks. Published August 28, 2020. Accessed September 1, 2020.