The Research Luxembourg COVID-19 task force has recently published a report focusing on SARS-CoV-2 infections in children. Written by Prof. Rudi Balling, director of the Luxembourg Centre for Systems Biomedicine (LCSB) at the University of Luxembourg, and Dr Isabel de la Fuente Garcia, infectious disease paediatrician at the Kannerklinik of the Centre Hospitalier du Luxembourg (CHL), this document addresses several questions regarding children’s health and briefly presents the current state of scientific knowledge.
In Luxembourg, one of many measures taken to curb the exponential spread of the virus was to close schools and day-care centres. After more than two months, primary schools, crèches and Maison Relais will reopen on 25 May. Infants and children will have regular social contacts with their classmates, teachers and caretakers again. In this context, several questions arise. Primarily how easily can children become infected with COVID-19 and whether they can develop severe symptoms, but also how contagious they are and whether there are risk groups among them that need special protection. The report, available in German and English on the Research Luxembourg website, addresses these questions.
Risk of a SARS-CoV-2 infection in children
Children can clearly become infected with the SARS-CoV-2 virus. Yet, the course of infection in children is almost always very mild or even asymptomatic. Only in rare individual cases, children can develop severe forms and even die as a result of the infection. The infection rate of children is currently still uncertain due to different test strategies in different countries and to the lack of biological data.
“In Luxembourg, as of 8 May, only 0.24% of those who tested positive were younger than five,” details Dr Isabel de la Fuente Garcia. “So far, two children with SARS-CoV-2 infection had to be treated in intensive care. Both affected children are on the mend.”
Are children infectious?
Information about the risk of infection from children would be extremely important when assessing public preventive measures, especially those relating to schools, kindergartens and other preschool institutions. At the moment, it is not clear whether and to what extent children can infect other children or adults themselves. Several studies report that children can generally be infectious, but the transmission rate is very likely to be lower in comparison to adults. Yet, there is still more research required in this aspect.
Risk factors in children
Risk factors that could potentially affect the sensitivity of young patients are still not well known. The classic age-related risk factors such as diabetes or high blood pressure do not seem to have a major impact on the course of COVID-19 in children. On the other hand, children with serious coexisting illnesses such as leukaemia or other organ diseases are at highest risk. There is a clear need for research to ensure the necessary protection of particularly sensitive people.
Call for the implementation of a children’s prevalence study
Reliable data on the prevalence, herd immunity or the dynamics of the COVID-19 pandemic among children in Luxembourg are currently not available. “Such data are essential as a basis for political decisions in the field of child healthcare. Plus, the high proportion of asymptomatic children increases the risk of undiscovered SARS-CoV-2 infections in the paediatric environment,” underlines Prof. Rudi Balling. “For these reasons, we would like to encourage the implementation of a children’s prevalence study. The know-how required for this is available in Luxembourg.”