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Grand Rounds

SARS-CoV-2 Infection Among Young Children: Transmission Risk in the Daycare Setting

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BACKGROUND AND PURPOSE:

  • Lachassinne et al. (The Lancet Child & Adolescent Health, 2021) assessed the extent to which young children contribute to SARS-CoV-2 transmission

METHODS:

  • Cross-sectional, multicenter, seroprevalence study
    • Some daycare centers remained open for key workers’ children during a nationwide lockdown in France (March 15 and May 9, 2020)
  • Participants
    • Children and staff who attended one of 22 daycare centers during a nationwide lockdown
    • Hospital staff not occupationally exposed to patients with COVID-19, or to children, were enrolled in a comparator group
  • Study design
    • Presence of SARS-CoV-2 antibodies, measured using a rapid chromatographic immunoassay in capillary whole blood
  • Protocols in the daycare were strictly enforced
    • Indoor surfaces were disinfected | Daycare staff had to wear a mask all day long, and comply with social distancing measures | Parents screened their children for symptoms | Parents could not enter the daycare center | Children cold not attend if symptomatic
  • Primary outcome
    • SARS-CoV-2 seroprevalence

RESULTS:

  • Daycare: 327 children | 197 staff
    • Children: mean age 1.9 years
    • Staff: mean age 40 years
  • Comparator group: 164 adults
    • Mean age: 42 years
  • Raw seroprevalence (not taking into account assay characteristics)
    • Children: 4.3% (95% CI, 2.6 to 7.1)
    • Staff: 7.7% (95% CI, 4.2 to 11.6)
    • Comparators: 5.5% (95% CI, 2.9 to 10.1)
  • Seroprevalence after taking into account assay characteristics
    • Children: 3.7% (95% CrI, 1.3 to 6.8)
    • Staff: 6.8% (95% CrI, 3.2 to 11.5)
    • Comparators: 5.0% (95% CrI, 1.6 to 9.8)
  • In exploratory analysis, seropositive children were more likely than seronegative children to have been exposed to an adult household member with laboratory-confirmed COVID-19
    • Seropositive children: 43%
    • Seronegative children: 6%
    • Relative risk 7.1 (95% CI, 2.2 to 22.4)

CONCLUSION:

  • In a daycare setting with strict infection control protocols, the number of young children with seroprevalence of SARS-CoV-2 antibodies was lower than among the adults
  • Seroprevalence among daycare staff was similar to the comparator group who did not have occupational contact with children
  • The authors suggest intrafamily transmission was more likely than transmission in daycare centers

Learn More – Primary Sources:

SARS-CoV-2 transmission among children and staff in daycare centres during a nationwide lockdown in France: a cross-sectional, multicentre, seroprevalence study

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Related ObG Topics:

A Possible Explanation for Differing Rates of COVID-19 Infection between Adults and Children
Household SARS-CoV-2 Transmission Risks: Presymptomatic vs Symptomatic
What is the Data on School Attendance and Positive COVID-19 Results in Children?

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