Children Have Similar Reverse Transcription Polymerase Chain Reaction Cycle Threshold for Severe Acute Respiratory Syndrome Coronavirus 2 in Comparison With Adults
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Abstract
The viral dynamics and the role of children in the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are not completely understood. Our aim was to evaluate reverse transcription polymerase chain reaction (RT-PCR) cycle threshold (Ct) values among children with confirmed SARS-CoV-2 compared with that of adult subjects.
Methods:
Patients (from 2 months to ≤18 years of age and adults) with signs and symptoms of acute SARS-CoV-2 infection for less than 7 days were prospectively enrolled in the study from May to November 2020. All participants performed RT-PCR assay for SARS-CoV-2 detection; Ct values of ORF1ab , N and S gene targets and the average of all the 3 probes were used as surrogates of viral load.
Results:
There were 21 infants (2 months to <2 years), 40 children (≥2 to <12 years), 22 adolescents (≥12 to <18 years) and 293 adults of 376 participants with confirmed SARS-CoV-2 infections. RT-PCR Ct values from all participants less than 18 years of age, as well as from all childhood subgroups, were not significantly different from adults, comparing ORF1ab , N , S and all the gene targets together ( P = 0.453).
Conclusions:
Ct values for children were comparable with that of adults. Although viral load is not the only determinant of SARS-CoV-2 transmission, children may play a role in the spread of coronavirus disease 2019 in the community.
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SciScore for 10.1101/2021.04.20.21255059: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The study was performed in accordance with the declaration of Helsinki and Good Clinical Practice Guidelines, after approval by the Hospital Moinhos de Vento Institutional Review Board (IRB number 30749720.4.1001.5330) submitted April 14th, 2020 and a decision made April 17th, 2020 (decision number 3.977.144).
Consent: All participants included in this study provided either a written informed consent, or a legal responsible provided written informed consent.Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect …
SciScore for 10.1101/2021.04.20.21255059: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The study was performed in accordance with the declaration of Helsinki and Good Clinical Practice Guidelines, after approval by the Hospital Moinhos de Vento Institutional Review Board (IRB number 30749720.4.1001.5330) submitted April 14th, 2020 and a decision made April 17th, 2020 (decision number 3.977.144).
Consent: All participants included in this study provided either a written informed consent, or a legal responsible provided written informed consent.Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study has some limitations worth mentioning. We have included only symptomatic participants during the early stage of SARS-CoV-2 infection, so that we cannot draw conclusions about asymptomatic individuals or those later in the course of the disease. Another limitation was a restricted sample size of infected children. Social distancing, closed schools and daycare centers, together with the concern to take children to ERs have led to a sharp reduction in the overall number of pediatric consultations. Therefore, the real scenario of COVID-19 in the pediatric population is not yet known13,17,18. There was also a great variability observed in the days of SO to inclusion, which could introduce some bias introduced by different timing for PCR collection, as not all subjects were at the same stage of disease. Furthermore, the quality and volume of viral RNA on collected swabs could vary depending on how sample collection was conducted19. We have not corrected our sample for the amount of viral RNA, since it would only add another step to the diagnostic routine that was already overstretched at that point of the pandemic. But it is well known that Cycle threshold values can be affected by a batch effect20, since variations among different runs can occur. Despite these limitations our findings are strong enough to suggest that symptomatic children may play a significant role in SARS-CoV-2 transmission since they harbor viral loads that are not lower than adults. Our finding sugge...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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