Thread by @apsmunro, It's time for another quick update on paediatric #COVID19 evidence!Most new information [...]

Alasdair Munro

apsmunro

It's time for another quick update on paediatric #COVID19 evidence!

Most new information is about transmission so we'll focus on that for now. It's pretty interesting!

Lets take a look...

#FOAMed #tweetorial

1/9

First, pre-print systematic review of transmission (search on May 16th)

https://www.medrxiv.org/content/10.1101/2020.05.20.20108126v1

I won't go into depth as all studies covered in a previous thread, however useful meta-analysis of contact tracing studies

OR = 0.44 of infection in children compared to adults

2/9

This is conservative as they use raw Odds Ratios, not those adjusted for contact type from initial studies

Some criticisms of these include potential lack of testing of non-symptomatic children missing cases

Well fortunately we've got some new evidence there...

3/9

Here are 2 studies which both tested all household contacts regardless of symptoms

Israel
https://journals.lww.com/pidj/Abstract/9000/The_Role_of_Children_in_the_Dynamics_of_Intra.96128.aspx

New York
https://academic.oup.com/jpids/advance-article/doi/10.1093/jpids/piaa070/5849922

Both found children half as likely to become infected as adults

How about false negatives as difficult to swab kids?

4/9

Well in the Netherlands they didn't rely on swabs. They did serology.

https://www.ntvg.nl/artikelen/de-rol-van-kinderen-de-transmissie-van-sars-cov-2/volledig

Guess what? Same thing!

Young children about 50% as likely to get infected as adults/teens in household

5/9

Same study looked at infection pairs from a national database to see who was infecting who.

Almost all transmission adult to adult. Minimal child to adult or child to child.

6/9

Finally a revisit to a sero-prevalence study from Switzerland (prev seen as pre-print)

Population tested in Geneva and results adjusted and extrapolated for population estimates

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31304-0/fulltext?utm_campaign=tlcoronavirus20&utm_content=131614326&utm_medium=social&utm_source=twitter&hss_channel=tw-27013292#seccestitle10

Children <10yrs had Odds of 0.32 for being infected compared to adults

7/9

Studies are consistently finding children get infected less easily than adults (however you look for it) and good size sero-epidemiology finding lower numbers of younger children have been infected

Super spreaders? Doesn't look like it.

8/9

For all this and more on paediatric #COVID19 evidence, check out our review (in collaboration with the RCPCH) of ALL the published evidence so far on @DFTBubbles

Thanks for reading!

9/9 https://dontforgetthebubbles.com/evidence-summary-paediatric-covid-19-literature/

An evidence summary of Paediatric COVID-19 literature

A rapid review of the published original research of COVID-19 in children ....

https://dontforgetthebubbles.com/evidence-summary-paediatric-covid-19-literature/

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