Longer incubation periods of SARS-CoV-2 infection in infants than children

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Abstract

Objective

A large body of research has described the incubation period of SARS-CoV-2 infection, an important metric for assessing the risk of developing a disease as well as surveillance. While longer incubation periods for elderly have been found, it remains elusive whether this also holds true for infants and children, partly due to the lack of data. The present work clarified the incubation periods of COVID-19 for infants and children.

Methods

Using the data released by the Chinese health authorities and municipal offices, statistical comparisons of clinical features were made between infants (aged below 1 year) and children (aged between 1 and 17 years). An age-varying incubation period distribution period was modeled using maximum likelihood estimation modified for interval censored exposure time and age.

Discussion

Reported in 56 web pages, a total of 65 cases from 20 provinces dated between January and June 2020, including 18 infants and 47 children, were eligible for inclusion. Infants appeared to bear more severe clinical courses, as demonstrated by the higher prevalence of breathing difficulty as well as nasal congestion. In contrast, fever was less prominent in infants than in children. The incubation period was found to decrease with age, with infants appearing to have longer incubation periods.

Conclusion

Fever remained to be one of the most commonly seen symptoms in infants and children with SARS-CoV-2 infection and have continued to determine the time of symptom onset. While shorter incubation periods should be seen in patients with weaker immune system due to weaker antiviral response that is beneficial for viral growth, the longer incubation period in infants may be due to their weaker febrile response to the virus, leading to prolonged symptom onset.

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  1. SciScore for 10.1101/2021.05.07.21256798: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot 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:
    Selection bias is the major limitation of the present work. Although the choice of the search terms inevitably leads to bias, data of incubation period are relatively rare thus the public domain remains an alternative source of information, as demonstrated in existing literature1-3.

    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.

    Results from scite Reference Check: We found no unreliable references.


    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.