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Infectious Diseases

Updated 18 September 2020

Coronavirus: Fewer child asymptomatic carriers than believed, evidence from Italy suggests

Data do not support the hypothesis that children are at higher risk of carrying the new coronavirus asymptomatically than adults.

  • Several researchers have warned that asymptomatic infection by the SARS-C0V-2 virus among children could be high
  • However, according to a recent study, adults are more likely to be asymptomatic carriers
  • Researchers believe that children's role as spreaders of the virus should be reconsidered

To date, several studies, such as this one reported on by Health24, have indicated that transmission of the Covid-19 virus by children may largely be asymptomatic (displaying no symptoms).

However, according to a new case-control study that compared the numbers of test results indicating viral infection among children and adults who were admitted to a hospital in Milan, Italy, and were asymptomatic, children may carry the virus less frequently than adults.

The study was published in JAMA Pediatrics in September.

Asymptomatic infection in children vs. adults

The study authors wrote that social and public health policies, such as school closures, have been implemented in many countries, and that, based on this, the role of children in asymptomatically carrying SARS-CoV-2 needs to be investigated.

For their study, they analysed patients who were admitted for non-infectious conditions to Fondazione Ca’ Granda Ospedale Maggiore Policlinico hospital in Milan, from 1 March to 30 April 2020.

Milan is one of the cities with the highest case numbers of Covid-19 in the world – in May 2020, the BBC reported that Italy had the third-highest officially recorded Covid-19 deaths.

They then compared the rates of infection between the paediatric (under the age of 18 years) and adult patients via a statistical test called the 2-tailed Fisher test. 

Children's role in viral transmission should be considered

According to the authors, a total of 881 children presented to the paediatric emergency department, and 83 fulfilled the eligibility criteria of asymptomatic infection.

Within that same period, among the 3 610 adults presenting to the adult emergency department, 131 were found to be asymptomatic carriers of the virus.

“Children were found to be less frequently positive than adults (one in 83 children, or 1.2%, vs. 12 in 131 adults, or 9.2%),” the authors wrote, later suggesting that children’s “role as facilitators of the spreading of SARS-CoV-2 infection could be reconsidered”.

However, the researchers also noted some limitations in their study, including that their data was based on a single hospital’s admissions. Nevertheless, their preliminary results can help to understand the epidemiology of SARS-CoV-2 infections, they said.