Symptomatic Infection is Associated with Prolonged Duration of Viral Shedding in Mild Coronavirus Disease 2019: A Retrospective Study of 110 Children in Wuhan

Yingying Lu, Yi Li, Wenyue Deng, Mingyang Liu, Yuanzhi He, Lingyue Huang, Mengxue Lv, Jianxin Li, Hao Du, Yingying Lu, Yi Li, Wenyue Deng, Mingyang Liu, Yuanzhi He, Lingyue Huang, Mengxue Lv, Jianxin Li, Hao Du

Abstract

Background: Information regarding viral shedding in children with coronavirus disease 2019 (COVID-19) was limited. This study aims to investigate the clinical and laboratory characteristics associated with viral shedding in children with mild COVID-19.

Methods: The clinical and laboratory information of 110 children with COVID-19 at Wuhan Children's Hospital, Wuhan, China, from January 30 to March 10, 2020, were analyzed retrospectively.

Results: The median age was 6 years old. The median period of viral shedding of COVID-19 was 15 days (interquartile range [IQR], 11-20 days) as measured from illness onset to discharge. This period was shorter in asymptomatic patients (26.4%) compared with symptomatic patients (73.6%) (11 days vs. 17 days). Multivariable regression analysis showed increased odds of symptomatic infection was associated with age <6 years (odds ratio [OR] 8.94, 95% confidence interval [CI]: 2.55-31.35; P = 0.001), hypersensitive C-reactive protein >3.0 mg/L (OR 4.89; 95% CI: 1.10-21.75; P = 0.037) and presenting pneumonia in chest radiologic findings (OR 8.45; 95% CI: 2.69-26.61; P < 0.001). Kaplan-Meier analysis displayed symptomatic infection (P < 0.001), fever (P = 0.006), pneumonia (P = 0.003) and lymphocyte counts <2.0 × 10/L (P = 0.008) in children with COVID-19 were associated with prolonged duration of viral shedding in children with COVID-19.

Conclusion: Prolonged duration of viral shedding in children with COVID-19 was associated with symptomatic infection, fever, pneumonia and lymphocyte count less than 2.0 × 10/L. Monitoring of symptoms could help to know the viral shedding in children with COVID-19.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1.
FIGURE 1.
Factors associated with prolonged duration of viral shedding in children with COVID-19. Figure shows symptomatic infection (A), fever (B), pneumonia (C) and lymphocytes 9/L (D) were associated with prolonged duration of viral shedding in Children with COVID-19. Data were analyzed by the Kaplan-Meier method and negative conversion of SARS-CoV-2 was selected as the event endpoint. COVID-19, coronavirus disease 2019; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.

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Source: PubMed

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