Low Rate of SARS-CoV-2 Infections in Symptomatic Patients Attending a Pediatric Emergency Department

Abstract

Children and adolescents seem to be at lower risk of developing clinical symptoms of COVID-19. We analyzed the rate of SARS-CoV-2 infections among 3,605 symptomatic children and adolescents at 4,402 outpatient visits presenting to a pediatric emergency department. In a total of 1,105 (32.6%) episodes, the patients fulfilled clinical case definitions for SARS-CoV-2 infection and were tested by nucleic acid testing. A SARS-CoV-2 infection was diagnosed in 10/1,100 episodes (0.3% of analyzed episodes, 0.91% of validly tested patients). Symptoms at presentation did not differ between patients with and without SARS-CoV-2 infection, apart from the frequency of measured temperature ≥37.5°C at presentation. Three percent of analyzed children reported disturbances of olfactory or gustatory senses, but none of them was infected with SARS-CoV-2. The rate of SARS-CoV-2 infections among symptomatic children and adolescents was low and SARS-CoV-2 infections could not reliably be differentiated from other infections without nucleic acid testing.

Keywords: COVID - 19; SARS-CoV-2; emergency department; epidemiology; respiratory infections.

Figure 1

Flow chart of excluded and analyzed patients. A total of 595 of 3,605 patients (16.5%) had more than one visit. The range of visits per patient was 1 to 10.

Figure 2

Counts per week of outpatient visits of patients suspicious and tested for SARS-CoV-2 infection (light gray bars) and SARS-CoV-2 positive patients (dark gray bars) including single patients with PIMS-TS (*), 7-day incidence in the community (gray line) and non-pharmaceutical measures during the study period. In the first week, screening for criteria suspicious for SARS-CoV-2 infection started on Thursday explaining the low number of tested patients in this week.