David R Peaper1, Christina Murdzek2, Carlos R Oliveira3,4, Thomas S Murray2,3. 1. From the Department of Laboratory Medicine, Yale School of Medicine. 2. Department of Infection Prevention, Yale New Haven Hospital. 3. Section of Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Yale School of Medicine. 4. Section of Health Informatics, Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut.
Abstract
BACKGROUND: The objective was to evaluate patterns of pediatric coronavirus disease 2019 testing in a large health system throughout the pandemic, before and after school reopening. METHODS: This was a cross-sectional time-series study of clinical virology results from children tested for severe acute respiratory syndrome coronavirus 2 in Southern Connecticut and areas of New York and Rhode Island. Data collected include demographics, hospital admission, changes in percent positive tests over time, detection intervals in persistently positive children and cycle threshold values. The setting was the Yale New Haven Health System has 6 hospitals at 4 Connecticut locations, 1 hospital in Rhode Island and ambulatory locations in Connecticut, Rhode Island and New York. Participants included twenty-three-thousand one-hundred thirty-seven children ≤ 18 years of age, tested for coronavirus disease 2019 at an ambulatory testing site, the emergency department or on an inpatient unit within the Yale New Haven Health System. RESULTS: Among all tests, 3.2% were positive. Older children consistently made up the larger portion of positive pediatric cases, regardless of community prevalence. Increased pediatric cases later in the pandemic when prevalence in adults was relatively low correlates with a higher number of tests performed in children and not with an increased positivity rate. No significant changes in trends of positivity were detected after the reopening of schools. Symptomatic and asymptomatic children had similar cycle threshold values regardless of age, and a subset of children demonstrated persistent viral detection, some for as long as 6 weeks. CONCLUSION: An increase in pediatric cases documented in the late summer was predominately due to increased access to testing for children. The percent positivity in children did not change in the first 3 weeks after school opened. A subset of children has detectable severe acute respiratory syndrome coronavirus 2 RNA in the upper respiratory tract for weeks after the initial infection.
BACKGROUND: The objective was to evaluate patterns of pediatric coronavirus disease 2019 testing in a large health system throughout the pandemic, before and after school reopening. METHODS: This was a cross-sectional time-series study of clinical virology results from children tested for severe acute respiratory syndrome coronavirus 2 in Southern Connecticut and areas of New York and Rhode Island. Data collected include demographics, hospital admission, changes in percent positive tests over time, detection intervals in persistently positive children and cycle threshold values. The setting was the Yale New Haven Health System has 6 hospitals at 4 Connecticut locations, 1 hospital in Rhode Island and ambulatory locations in Connecticut, Rhode Island and New York. Participants included twenty-three-thousand one-hundred thirty-seven children ≤ 18 years of age, tested for coronavirus disease 2019 at an ambulatory testing site, the emergency department or on an inpatient unit within the Yale New Haven Health System. RESULTS: Among all tests, 3.2% were positive. Older children consistently made up the larger portion of positive pediatric cases, regardless of community prevalence. Increased pediatric cases later in the pandemic when prevalence in adults was relatively low correlates with a higher number of tests performed in children and not with an increased positivity rate. No significant changes in trends of positivity were detected after the reopening of schools. Symptomatic and asymptomatic children had similar cycle threshold values regardless of age, and a subset of children demonstrated persistent viral detection, some for as long as 6 weeks. CONCLUSION: An increase in pediatric cases documented in the late summer was predominately due to increased access to testing for children. The percent positivity in children did not change in the first 3 weeks after school opened. A subset of children has detectable severe acute respiratory syndrome coronavirus 2 RNA in the upper respiratory tract for weeks after the initial infection.
Authors: Cecilia L H Xu; Manjri Raval; Jesse A Schnall; Jason C Kwong; Natasha E Holmes Journal: Pediatr Infect Dis J Date: 2020-09 Impact factor: 2.129
Authors: Walter S Gilliam; Amyn A Malik; Mehr Shafiq; Madeline Klotz; Chin Reyes; John Eric Humphries; Thomas Murray; Jad A Elharake; David Wilkinson; Saad B Omer Journal: Pediatrics Date: 2020-10-14 Impact factor: 7.124
Authors: Leora R Feldstein; Erica B Rose; Steven M Horwitz; Jennifer P Collins; Margaret M Newhams; Mary Beth F Son; Jane W Newburger; Lawrence C Kleinman; Sabrina M Heidemann; Amarilis A Martin; Aalok R Singh; Simon Li; Keiko M Tarquinio; Preeti Jaggi; Matthew E Oster; Sheemon P Zackai; Jennifer Gillen; Adam J Ratner; Rowan F Walsh; Julie C Fitzgerald; Michael A Keenaghan; Hussam Alharash; Sule Doymaz; Katharine N Clouser; John S Giuliano; Anjali Gupta; Robert M Parker; Aline B Maddux; Vinod Havalad; Stacy Ramsingh; Hulya Bukulmez; Tamara T Bradford; Lincoln S Smith; Mark W Tenforde; Christopher L Carroll; Becky J Riggs; Shira J Gertz; Ariel Daube; Amanda Lansell; Alvaro Coronado Munoz; Charlotte V Hobbs; Kimberly L Marohn; Natasha B Halasa; Manish M Patel; Adrienne G Randolph Journal: N Engl J Med Date: 2020-06-29 Impact factor: 91.245
Authors: Shamez N Ladhani; Zahin Amin-Chowdhury; Hannah G Davies; Felicity Aiano; Iain Hayden; Joanne Lacy; Mary Sinnathamby; Simon de Lusignan; Alicia Demirjian; Heather Whittaker; Nick Andrews; Maria Zambon; Susan Hopkins; Mary Elizabeth Ramsay Journal: Arch Dis Child Date: 2020-08-12 Impact factor: 3.791
Authors: Ramanan Laxminarayan; Brian Wahl; Shankar Reddy Dudala; K Gopal; Chandra Mohan B; S Neelima; K S Jawahar Reddy; J Radhakrishnan; Joseph A Lewnard Journal: Science Date: 2020-09-30 Impact factor: 47.728