key: cord-0963857-6vj01qq5
authors: Ferranti, Juliana Ferreira; Degaspare, Natalia Viu; Mau, Luciana Becker; Delgado, Artur Figueiredo; Brunow de Carvalho, Werther
title: Comment Regarding Pediatric SARS-CoV-2: Clinical Presentation, Infectivity, and Immune Responses
date: 2020-09-18
journal: J Pediatr
DOI: 10.1016/j.jpeds.2020.09.034
sha: a1e89374b6fcc4ad658cd96bce91aff7402ec5b6
doc_id: 963857
cord_uid: 6vj01qq5

nan

instead of comparing asymptomatic/early infection with adults at a later stage of the disease.

One study found higher viral load in adults during the first week of symptoms with progressive decreasing over time, as observed in the present study in children, reinforcing that comparing viral load at different stages of the disease may be inadequate 2 . Also, they correlated MIS-C with low viremia, and posed it as an obstacle to control strategies as reopening schools.

However, studies show that MIS-C is a later complication, with low incidence and mortality 3, 4 .

suggest that the majority of pediatric cases are mild or asymptomatic 5, 6 .

Therefore, we should ponder the impact of quarantine on childhood. There are psychological and physical burden imposed on children with home confinement and school closure: lack of children-children interaction and inadequate eating patterns generate distress, obesity/malnutrition, depression and many other behavioral and neurodevelopmental disorders. Additionally, vulnerable children like those exposed to domestic violence and abuse have no place to shelter 7, 8 . Furthermore, in low income countries, the socio-educational disparity may be enhanced, since there is no universal access to audio-visual systems and internet; in addition, some children receive vital nutritional assistance in schools that has been halted since the pandemic began 7 .

Mitigating psychosocial impact may require risk stratification of children, teachers, and their household contacts and contact tracing all symptomatic individuals making isolation possible 9 . The central question after their findings is if there is direct correlation between viral load and transmissibility 10 .

Clinical Presentation, Infectivity, and Immune Responses

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