Pre-admission virus detection during the COVID-19 pandemic in children with and without symptoms of infection

Acta Paediatr. 2024 Jul;113(7):1679-1684. doi: 10.1111/apa.17195. Epub 2024 Mar 6.

Abstract

Aim: Pre-admission viral screening is used only in exceptional situations such as pandemics. We therefore evaluated pre-admission screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), respiratory syncytial virus (RSV) and influenza during the COVID-19 pandemic, comparing epidemiology and clinical features of admitted children.

Methods: Children were screened at a paediatric emergency department from 1 March 2020 to 30 June 2022 by nasopharyngeal sampling and polymerase chain reaction kit. We retrospectively retrieved positive results from the laboratory and scrutinised charts of admitted children.

Results: Out of 15 927 screened children, 522, 127 and 572 were positive and admitted with RSV, influenza A or SARS-CoV-2, respectively. Of these, 29 (5.6%), 26 (24.1%) and 245 (44.8%) were incidental findings, lacking symptoms of infection. RSV and influenza A were initially absent but re-emerged in the autumn of 2021. The rate of COVID-19 rose when the Omicron variant emerged in December 2021. The median age of children with RSV was 0.3 years, of those with influenza A 6.7 years and of those with COVID-19 1.6 years. Major complications were rare.

Conclusion: Frequent incidental detections of SARS-CoV-2 likely reflected widespread presence of a mild infection. Clinically, COVID-19 was like other viral respiratory infections in children.

Keywords: COVID‐19; influenza; pre‐admission screening; respiratory syncytial virus; severe acute respiratory syndrome coronavirus 2.

MeSH terms

  • Adolescent
  • COVID-19* / diagnosis
  • COVID-19* / epidemiology
  • Child
  • Child, Preschool
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Influenza, Human* / diagnosis
  • Influenza, Human* / epidemiology
  • Influenza, Human* / virology
  • Male
  • Pandemics
  • Respiratory Syncytial Virus Infections* / diagnosis
  • Respiratory Syncytial Virus Infections* / epidemiology
  • Retrospective Studies