Prevalence of asymptomatic SARS-CoV-2 infection in children in Sivas province, Central Anatolia

Objectives: Transmission from asymptomatic patients is one of the biggest challenges in controlling the Coronavirus disease 2019 (COVID-19) outbreak because these cases are a potential source for disease spread. Based on this situation, the aim of our study is to determine the prevalence of COVID-19 in asymptomatic pediatric dental patients representing Sivas and surrounding provinces. Methods: The population of the study consists of pediatric patients between the ages of 0-14 who applied to Sivas Oral and Dental Health Hospital General Operating Room for dental treatments between July 2020 and August 2021. Results: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was detected in only 5 patients (approximately 1.80%) out of 278 asymptomatic pediatric patients. Conclusions: It is thought that the COVID-19 infection, which threatens the whole world, can progress asymptomatically in children, and therefore it may be a risk factor for the spread of the infection. To tackle the COVID-19 pandemic, it is recommended to maintain a high level of infection control measures in schools and day-care and to implement widespread testing on a global scale targeting the pediatric population.

___

  • 1. WHO Coronavirus (COVID-19) Dashboard. (https://covid19.who.int). Accessed 5 October 2021.
  • 2. Coronavirus. (https://www.who.int/westernpacific/health-topics/coronavirus). Accessed 23 July 2021.
  • 3. Izda V, Jeffries MA, Sawalha AH. COVID-19: a review of therapeutic strategies and vaccine candidates. Clin Immunol 2021;222:108634.
  • 4. Buitrago-Garcia D, Egli-Gany D, Counotte MJ, Hossmann S, Imeri H, Ipekci AM, et al. Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: a living systematic review and meta-analysis. PLoS Med 2020;17:e1003346.
  • 5. Sayampanathan AA, Heng CS, Pin PH, Pang J, Leong TY, Lee VJ. Infectivity of asymptomatic versus symptomatic COVID-19. Lancet 2021;397:93-4.
  • 6. Salzberger B, Buder F, Lampl B, Ehrenstein B, Hitzenbichler F, Holzmann T, et al. Epidemiology of SARS-CoV-2. Infection 2021;49:233-9.
  • 7. Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C, et al. Transmission of 2019-nCoV infection from an asymptomatic contact in Germany. N Engl J Med 2020;382:970-1.
  • 8. Gao M, Yang L, Chen X, Deng Y, Yang S, Xu H, et al. A study on infectivity of asymptomatic SARS-CoV-2 carriers. Respir Med 2020;169:106026.
  • 9. Johansson MA, Quandelacy TM, Kada S, Prasad PV, Steele M, Brooks JT, et al. SARS-CoV-2 transmission from people without COVID-19 symptoms. JAMA Netw Open 2021;4:e2035057.
  • 10. Karbuz A, Akkoc G, Bedir Demirdag T, Yilmaz Ciftdogan D, Ozer A, Cakir D, et al. Epidemiological, clinical, and laboratory features of children with COVID-19 in Turkey. Front Pediatr 2021;9:172.
  • 11. Mantovani A, Rinaldi E, Zusi C, Beatrice G, Saccomani MD, Dalbeni A. Coronavirus disease 2019 (COVID-19) in children and/or adolescents: a meta-analysis. Pediatr Res 2021;89:733-7.
  • 12. Yasuhara J, Kuno T, Takagi H, Sumitomo N. Clinical characteristics of COVID-19 in children: a systematic review. Pediatr Pulmonol 2020;55:2565-75.
  • 13. Mehta NS, Mytton OT, Mullins EWS, Fowler TA, Falconer CL, Murphy OB, et al. SARS-CoV-2 (COVID-19): what do we know about children? A systematic review. Clin Infect Dis 2020;71:2469-79.
  • 14. Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiology of COVID-19 among children in China. Pediatrics 2020;145:e20200702.
  • 15. Bhuiyan MU, Stiboy E, Hassan MZ, Chan M, Islam MS, Haider N, et al. Epidemiology of COVID-19 infection in young children under five years: a systematic review and meta-analysis. Vaccine 2021;39:667-77.
  • 16. Rostami A, Sepidarkish M, Leeflang MMG, Riahi SM, Nourollahpour Shiadeh M, Esfandyari S, et al. SARS-CoV-2 seroprevalence worldwide: a systematic review and meta-analysis. Clin Microbiol Infect 2021;27:331-40.
  • 17. García-Miguel FJ, Serrano-Aguilar PG, López-Bastida J. Preoperative assessment. Lancet 2003;362:1749-57.
  • 18. Struyf T, Deeks JJ, Dinnes J, Takwoingi Y, Davenport C, Leeflang MM, et al. Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID‐19 disease. Cochrane Database Syst Rev 2020;2020:CD013665.
  • 19. Yong SEF, Anderson DE, Wei WE, Pang J, Chia WN, Tan CW, et al. Connecting clusters of COVID-19: an epidemiological and serological investigation. Lancet Infect Dis 2020;20:809-15.
  • 20. Infectious Diseases Society of America Guidelines on the Diagnosis of COVID-19. (https://www.idsociety.org/practice-guideline/covid-19-guideline-diagnostics/). Accessed 31 August 2021.
  • 21. Temaslı Takibi, Salgın Yönetimi, Evde Hasta İzlemi ve Filyasyon. (https://covid19.saglik.gov.tr/TR-66339/temasli-takibi-salgin-yonetimi-evde-hasta-izlemi-ve-filyasyon.html). Accessed 23 September 2021.
  • 22. Júnior VCP, Moura LFWG, Cavalcante RC, Lima JRC, Bezerra AS, Dantas DR de S, et al. Prevalence of COVID-19 in children, adolescents and adults in remote education situations in the city of Fortaleza, Brazil. Int J Infect Dis 2021;108:20-6.
  • 23. Healthcare Workers. (https://www.cdc.gov/coronavirus/2019-ncov/hcp/pediatric-hcp.html). Accessed 1 September 2021.
  • 24. Gudbjartsson DF, Helgason A, Jonsson H, Magnusson OT, Melsted P, Norddahl GL, et al. Spread of SARS-CoV-2 in the Icelandic population. N Eng J Med 2020;382:2302-15.
  • 25. Sutton D, Fuchs K, D’Alton M, Goffman D. Universal screening for SARS-CoV-2 in women admitted for delivery. N Eng J Med 2020;382:2163-4.
  • 26. Yu J, Ouyang W, Chua MLK, Xie C. SARS-CoV-2 transmission in patients with cancer at a tertiary care hospital in Wuhan, China. JAMA Oncol 2020;6:1108-10.
  • 27. Patel AB, Clifford A, Creaden J, Kato K, Malakooti MR, Muller WJ, et al. Severe acute respiratory syndrome coronavirus 2 point prevalence among asymptomatic hospitalized children and subsequent healthcare worker evaluation. J Pediatr Infect Dis Soc 2020;9:617-9.
  • 28. Martins MM, Prata-Barbosa A, da Cunha AJLA. Update on SARS-CoV-2 infection in children. Paediatr Int Child Health 2021;41:56-64.
  • 29. Gao Y-D, Ding M, Dong X, Zhang J-J, Kursat Azkur A, Azkur D, et al. Risk factors for severe and critically ill COVID-19 patients: a review. Allergy 2021;76:428-55.
  • 30. Farinholt T, Doddapaneni H, Qin X, Menon V, Meng Q, Metcalf G, et al. Transmission event of SARS-CoV-2 delta variant reveals multiple vaccine breakthrough infections. BMC Med 2021:19:255.
  • 31. Haitao T, Vermunt JV, Abeykoon J, Ghamrawi R, Gunaratne M, Jayachandran M, et al. COVID-19 and sex differences. Mayo Clin Proc 2020;95:2189-203.
  • 32. Luo CH, Morris CP, Sachithanandham J, Amadi A, Gaston D, Li M, et al. Infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) delta variant is associated with higher recovery of infectious virus compared to the alpha variant in both unvaccinated and vaccinated individuals. Clin Infect Dis 2022;75:e715-25.
  • 33. Alsohime F, Temsah M-H, Al-Nemri AM, Somily AM, Al-Subaie S. COVID-19 infection prevalence in pediatric population: etiology, clinical presentation, and outcome. J Infect Public Health 2020;13:1791-6.