More than 20 percent of children with COVID-19 are asymptomatic

(HealthDay)—A considerable proportion of children with confirmed COVID-19 remain asymptomatic, according to a study published online Aug. 28 in JAMA Pediatrics.

Mi Seon Han, M.D., Ph.D., from the Seoul National University College of Medicine in South Korea, and colleagues examined the full clinical course and duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detectability in children confirmed with COVID-19 from South Korea. Ninety-one children with confirmed COVID-19 were included.

The researchers found that there were 20 children (22 percent) who were asymptomatic for the entire observation period. Of the symptomatic cases, 66, 25, and 9 percent had unrecognized symptoms before diagnosis, developed symptoms after diagnosis, and were diagnosed at the time of symptom onset, respectively. Lower respiratory tract infections were reported among 22 children (24 percent). In upper respiratory samples, the mean duration of SARS-CoV-2 RNA presence was 17.6 days. In asymptomatic individuals, virus RNA was detected for a mean of 14.1 days. The duration of virus RNA detection did not differ between children with upper and lower respiratory tract infections (mean, 18.7 versus 19.9 days). Fourteen children received lopinavir-ritonavir and/or hydroxychloroquine treatment. All cases recovered, with no fatalities.

"The potential role of children in transmitting disease in the community needs to be further elucidated, and strategies to contain COVID-19 should reflect its effects," the authors write. "Heightened surveillance using laboratory screening will allow detection in children with unrecognized SARS-CoV-2 infection."