The role of children in transmission of SARS-CoV-2: A rapid review

• Published in: Journal of Global Health
• Main Authors: Li, Xue, Xu, Wei, Dozier, Marshall, He, Yazhou, Kirolos, Amir, Theodoratou, Evropi
• Format: Text
• Language: English
• Published: International Society of Global Health 2020
• Subjects: Research Theme 7: Rapid Reviews on COVID-19 Evidence; Iceland
• Online Access: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323934/; http://www.ncbi.nlm.nih.gov/pubmed/32612817; https://doi.org/10.7189/jogh.10.011101

BACKGROUND: Understanding the role of children in the transmission of SARS-CoV-2 is urgently required given its policy implications in relation to the reopening of schools and intergenerational contacts. METHODS: We conducted a rapid review of studies that investigated the role of children in the transmission of SARS-CoV-2. We synthesized evidence for four categories: 1) studies reporting documented cases of SARS-CoV-2 transmission by infected children; 2) studies presenting indirect evidence on the potential of SARS-CoV-2 transmission by (both symptomatic and asymptomatic) children; 3) studies reporting cluster outbreaks of COVID-19 in schools; 4) studies estimating the proportions of children infected by SARS-CoV-2, and reported results narratively. RESULTS: A total of 16 unique studies were included for narrative synthesis. There is limited evidence detailing transmission of SARS-CoV-2 from infected children. We found two studies that reported a 3-month-old whose parents developed symptomatic COVID-19 seven days after caring for the infant and two children who may have contracted COVID-19 from the initial cases at a school in New South Wales. In addition, we identified six studies presenting indirect evidence on the potential for SARS-CoV-2 transmission by children, three of which found prolonged virus shedding in stools. There is little data on the transmission of SARS-CoV-2 in schools. We identified only two studies reporting outbreaks of COVID-19 in school settings and one case report of a child attending classes but not infecting any other pupils or staff. Lastly, we identified six studies estimating the proportion of children infected; data from population-based studies in Iceland, Italy, South Korea, Netherlands, California and a hospital-based study in the UK suggest children may be less likely to be infected. CONCLUSIONS: Preliminary results from population-based and school-based studies suggest that children may be less frequently infected or infect others, however current evidence is limited. ...