Severe Acute Respiratory Syndrome Coronavirus 2 Infections Among Children in the Biospecimens from Respiratory Virus-Exposed Kids (BRAVE Kids) Study.

Journal Article (Journal Article)

BACKGROUND: Child with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection typically have mild symptoms that do not require medical attention, leaving a gap in our understanding of the spectrum of SARS-CoV-2-related illnesses that the viruses causes in children. METHODS: We conducted a prospective cohort study of children and adolescents (aged <21 years) with a SARS-CoV-2-infected close contact. We collected nasopharyngeal or nasal swabs at enrollment and tested for SARS-CoV-2 using a real-time polymerase chain reaction assay. RESULTS: Of 382 children, 293 (77%) were SARS-CoV-2-infected. SARS-CoV-2-infected children were more likely to be Hispanic (P < .0001), less likely to have asthma (P = .005), and more likely to have an infected sibling contact (P = .001) than uninfected children. Children aged 6-13 years were frequently asymptomatic (39%) and had respiratory symptoms less often than younger children (29% vs 48%; P = .01) or adolescents (29% vs 60%; P < .001). Compared with children aged 6-13 years, adolescents more frequently reported influenza-like (61% vs 39%; P < .001) , and gastrointestinal (27% vs 9%; P = .002), and sensory symptoms (42% vs 9%; P < .0001) and had more prolonged illnesses (median [interquartile range] duration: 7 [4-12] vs 4 [3-8] days; P = 0.01). Despite the age-related variability in symptoms, wWe found no difference in nasopharyngeal viral load by age or between symptomatic and asymptomatic children. CONCLUSIONS: Hispanic ethnicity and an infected sibling close contact are associated with increased SARS-CoV-2 infection risk among children, while asthma is associated with decreased risk. Age-related differences in clinical manifestations of SARS-CoV-2 infection must be considered when evaluating children for coronavirus disease 2019 and in developing screening strategies for schools and childcare settings.

Full Text

Duke Authors

Cited Authors

  • Hurst, JH; Heston, SM; Chambers, HN; Cunningham, HM; Price, MJ; Suarez, L; Crew, CG; Bose, S; Aquino, JN; Carr, ST; Griffin, SM; Smith, SH; Jenkins, K; Pfeiffer, TS; Rodriguez, J; DeMarco, CT; De Naeyer, NA; Gurley, TC; Louzao, R; Zhao, C; Cunningham, CK; Steinbach, WJ; Denny, TN; Lugo, DJ; Moody, MA; Permar, SR; Rotta, AT; Turner, NA; Walter, EB; Woods, CW; Kelly, MS

Published Date

  • November 2, 2021

Published In

Volume / Issue

  • 73 / 9

Start / End Page

  • e2875 - e2882

PubMed ID

  • 33141180

Pubmed Central ID

  • PMC7665428

Electronic International Standard Serial Number (EISSN)

  • 1537-6591

Digital Object Identifier (DOI)

  • 10.1093/cid/ciaa1693


  • eng

Conference Location

  • United States