Clinical Characterization, Transmissibility, and Seroconversion of SARS-CoV-2 Infection in Children (before the Start of Vaccination) in the Barcelona Metropolitan Region (Spain)

Abstract

Objective Analyzing the clinical and microbiological characteristics of coronavirus disease 2019 (COVID-19) infection in children seems essential to determine their role in the etiopathogenesis of the disease.

Methods A prospective, longitudinal, and observational study, including children with severe acute respiratory syndrome coronavirus-2 infection, in the Barcelona Metropolitan Region (Spain), was performed. The recruitment pathways were: (1) children who attended a summer school and were included in an active surveillance study and (2) children who were visited in the Emergency Department of Hospital Sant Joan de Déu with symptoms. Close contacts with positive polymerase chain reaction (PCR) results were also included. The children recruited were followed up for 5 weeks. Evaluation of participants included a questionnaire for COVID-19 symptoms, nasopharyngeal swabbing for real-time PCR at 0, 7, and 14 days (weekly repeated up to week 5 if it resulted positive at 14 days), and serology testing at the recruitment and at the fifth week of follow-up.

Results A total of 90 children were recruited, of which 32% were asymptomatic. Transmission was studied in 70/90 children, and in 12 cases (17%), transmission to other children or adults was observed. No clinical or epidemiological differences were found between children who transmitted and those who did not. At the end of the follow-up, 11% of nasopharyngeal PCR remained positive. The serological response was studied in 73/90 children, and 80.82% of children seroconverted.

Conclusion No differences in epidemiological characteristics were found between children who transmitted and those who did not. PCR can be persistently positive for more than 5 weeks. The majority of patients who suffer from the disease produce antibodies against it.

Keywords

SARS-CoV-2 - children - RNA persistence - serological response - antibodies - infectivity

Ethical Approval

The study was approved by the Institutional Review Board and the HSJD Ethics Committee (PIC-153-20) and followed the recommendations of the Helsinki Declaration.

Consent to Participate

All participants or their legal guardians provided written informed consent.

Consent for Publication

Patients signed informed consent regarding publishing their data.

Availability of Data and Material

The datasets generated and/or analyzed during the current study are not publicly available due to individual privacy could be compromised but are available from the corresponding author on reasonable request.

Authors' Contributions

All authors have made substantial contributions to all the following: (1) the conception and design of the study, acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, and (3) final approval of the submitted version.

^* These authors contributed equally and should share senior authorship.

Publication History

Received: 22 November 2023

Accepted: 13 May 2024

Article published online:
22 July 2024

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