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Abstract：
To understand the epidemiological and clinical features of the symptomatic and asymptomatic pediatric cases of COVID-19, we carried out a prospective study in Shanghai during the period of January 19 to April 30, 2020. A total of 49 children (mean age 11.5 ± 5.12 years) confirmed with SARS-CoV-2 infection were enrolled in the study, including 11 (22.4%) domestic cases and 38 (77.6%) imported cases. Nine (81.8%) local cases and 12 (31.6%) imported cases had a definitive epidemiological exposure. Twenty-eight (57.1%) were symptomatic and 21 (42.9%) were asymptomatic. Neither asymptomatic nor symptomatic cases progressed to severe diseases. The mean duration of viral shedding for SARS-CoV-2 in upper respiratory tract was 14.1 ± 6.4 days in asymptomatic cases and 14.8 ± 8.4 days in symptomatic cases (P > 0.05). Forty-five (91.8%) cases had viral RNA detected in stool. The mean duration of viral shedding in stool was 28.1 ± 13.3 days in asymptomatic cases and 30.8 ± 18.6 days in symptomatic participants (P > 0.05). Children < 7 years shed viral RNA in stool for a longer duration than school-aged children (P < 0.05). Forty-three (87.8%) cases had seropositivity for antibodies against SARS-CoV-2 within 1-3 weeks after confirmation with infection. In conclusion, asymptomatic SARS-CoV-2 infection may be common in children in the community during the COVID-19 pandemic wave. Asymptomatic cases shed viral RNA in a similar pattern as symptomatic cases do. It is of particular concern that asymptomatic individuals are potentially seed transmission of SARS-CoV-2 and pose a challenge to disease control.
摘要：
为了解COVID-19有症状和无症状儿科病例的流行病学和临床特征，我们于2020年1月19日至4月30日在上海开展了一项前瞻性研究。共纳入49名确诊为SARS-CoV-2感染的儿童(平均年龄11.5±5.12岁),包括11例(22.4%)国内病例和38例(77.6%)输入性病例。9例（81.8％）本地病例和12例（31.6％）输入病例具有明确的流行病学暴露。28例（57.1％）有症状，21例（42.9％）无症状。无症状或有症状的病例均未发展为严重疾病。SARS-CoV-2在上呼吸道的平均病毒脱落时间在无症状病例中为14.1±6.4天，在有症状病例中为14.8±8.4天（P>0.05）。45例（91.8％）在粪便中检测到病毒RNA。在无症状病例中，粪便中病毒脱落的平均持续时间为28.1±13.3天，在有症状的参与者中为30.8±18.6天（P>0.05）。<7岁儿童粪便中病毒RNA脱落的时间比学龄儿童长（P<0.05）。在确认感染后的1-3周内，有43例（87.8％）对SARS-CoV-2的抗体呈血清阳性。总之,在COVID-19大流行期间，无症状的SARS-CoV-2感染可能在社区儿童中很常见。无症状病例以与有症状病例相似的模式脱落病毒RNA。特别值得关注的是，无症状的个体可能是SARS-CoV-2的种子传播，并对疾病控制构成挑战。
