Symptoms in the acute phase of SARS-CoV-2 infection among Danish children aged 0-14 years

Selina Kikkenborg Berg; Pernille Palm; Susanne Dam Nielsen; Ulrikka Nygaard; Henning Bundgaard; Siri Rosenkilde; Anne Bonde Thorsted; Annette Kjær Ersbøll; Lau Casper Thygesen; Maria Nivi Schmidt Petersen; Anne Vinggaard Christensen

doi:10.1016/j.ijregi.2023.04.012

Symptoms in the acute phase of SARS-CoV-2 infection among Danish children aged 0-14 years

IJID Reg. 2023 Apr 27:7:262-267. doi: 10.1016/j.ijregi.2023.04.012. eCollection 2023 Jun.

Authors

Affiliations

¹ Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
² Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
³ Department of Paediatric and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
⁴ Department of Infectious Disease, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
⁵ National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.

Abstract

Objectives: To investigate the prevalence and burden of proxy-reported acute symptoms in children in the first 4 weeks after detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, and factors associated with symptom burden.

Methods: Nationwide cross-sectional survey using parental proxy reporting of symptoms associated with SARS-CoV-2 infection. In July 2021, a survey was sent to the mothers of all Danish children aged 0-14 years with a positive SARS-CoV-2 polymerase chain reaction (PCR) test between January 2020 and July 2021. The survey included 17 symptoms associated with acute SARS-CoV-2 infection and questions about comorbidities.

Results: Of 38,152 children with a positive SARS-CoV-2 PCR test, 10,994 (28.8%) mothers responded. The median age was 10.2 (range 0.2-16.0) years and 51.8% were male. Among participants, 54.2% (n=5957) reported no symptoms, 43.7% (n=4807) reported mild symptoms, and 2.1% (n=230) reported severe symptoms. The most common symptoms were fever (25.0%), headache (22.5%) and sore throat (18.4%). Asthma {odds ratio (OR) 1.91 [95% confidence interval (CI) 1.57-2.32) and OR 2.11 (95% CI 1.36-3.28)}, allergy [OR 1.31 (95% CI 1.14-1.52) and OR 1.70 (95% CI 1.18-2.46], eczema [OR 1.43 (95% CI 1.20-1.71) and OR 2.03 (95% CI 1.38-2.97)] and OCD/anxiety/depression [OR 2.06 (95% CI 1.39-3.06) and OR 3.79 (95% CI 1.80-7.97)] were associated with reporting a higher symptom burden [values indicate outcomes reporting three or more acute symptoms (upper quartile) and reporting a severe symptom burden, respectively]. The highest prevalence of symptoms was found among children aged 0-2 and 12-14 years.

Conclusions: Among SARS-CoV-2-positive children aged 0-14 years, approximately half reported no acute symptoms within the first 4 weeks after a positive PCR test. Most symptomatic children reported mild symptoms. Several comorbidities were associated with reporting a higher symptom burden.

Keywords: Adolescent; COVID-19; Children; SARS-CoV-2; Symptoms.