Results of Testing Children for Severe Acute Respiratory Syndrome Coronavirus-2 Through a Community-based Testing Site

Abstract

Objective: To describe the demographics, clinical features, and test results of children referred from their primary provider for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in the community setting.

Study design: Retrospective cross-sectional study of children ≤22 years of age who were tested for SARS-CoV-2 at a community-based specimen collection site in Washington, DC, affiliated with a large children's hospital between March 21 and May 16, 2020.

Results: Of the 1445 patients tested at the specimen collection site for SARS-CoV-2 virus, 408 (28.2%) had a positive polymerase chain reaction test. The daily positivity rate increased over the study period, from 5.4% during the first week to a peak of 47.4% (P_trend < .001). Patients with fever (aOR, 1.7; 95% CI, 1.3-2.3) or cough (aOR, 1.4; 95% CI, 1.1-1.9) and those with known contact with someone with confirmed SARS-CoV-2 infection (aOR, 1.6; 95% CI, 1.0-2.4.) were more likely have a positive test, but these features were not highly discriminating.

Conclusions: In this cohort of mildly symptomatic or well children and adolescents referred to a community drive-through/walk-up SARS-CoV-2 testing site because of risk of exposure or clinical illness, 1 in 4 patients had a positive test. Children and young adults represent a considerable burden of SARS-CoV-2 infection. Assessment of their role in transmission is essential to implementing appropriate control measures.

Keywords: COVID-19; SARS-CoV-2; asymptomatic; children; mildly symptomatic; pediatric.

Figure 1

Trends in testing and positivity rates. Average number of daily SARS-CoV-2 specimen collections and positive test rates.

Figure 2

Referral reasons for SARS-CoV-2 testing. Frequency of referral reasons for SARS-CoV-2 testing.

Figure 3

Geographic distribution of patients referred to specimen collection site. Geographic distribution of patients referred to testing site across 3 distinct regions: Washington DC, Maryland, and Virginia. The star and the arrow show the location of the specimen collection site.