Positive Predictors of SARS-CoV-2 Infection in Pediatric Populations

Researchers sought to identify the symptoms that are likely to occur among pediatric patients with SARS-CoV-2 infection detected via polymerase chain reaction testing.

The following article is a part of conference coverage from the IDWeek 2021, being held virtually from September 29 to October 3, 2021. The team at Infectious Disease Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from the IDWeek 2021.

Research into the COVID-19 pandemic is continually progressing, especially in regard to pediatric populations. With schools reopening, many researchers have begun to focus their efforts on identifying the variation and duration of symptoms that may occur in pediatric patients with SARS-CoV-2 infection. Among pediatric populations, a loss of taste and smell was found to be a specific, positive indicator SARS-CoV-2 infection. In addition, headache, cough, and cold-like symptoms were also suggestive of positive SARS-CoV-2 infection. These findings were presented at IDWeek, held virtually from September 29 to October 3, 2021.

 Researchers conducted a study among patients younger than 18 years of age with SARS-CoV-2 infection who were hospitalized at a single health system in central Pennsylvania between March and December 2020. The researchers used a random number generator to include an additional 150 pediatric patients who were negative for SARS-CoV-2 infection via polymerase chain reaction testing. Patients who were asymptomatic and those without clinical data in their electronic health records were excluded from the final analysis.

Of a total of 544 pediatric patients included in the final analysis. 412 (76%) were positive for SARS-CoV-2 infection via PCR testing. The researchers noted that patients with PCR-positive COVID-19 were statistically significantly more likely to have a known contact with SARS-CoV-2 infection, have no comorbidities, and to have specific symptoms including cough, cold-like symptoms, headache, and loss of taste and/or smell. Of note, loss of taste and/or smell occurred among all pediatric patients with PCR-positive SARS-CoV-2 infection. Compared with patients who tested negative for SARS-CoV-2 infection via PCR testing, those who tested positive were statistically significantly less likely to have fever, emesis, or require hospitalization or respiratory support. Multivariable regression analysis identified several positive predictors of PCR-positivite SARS-CoV-infection among the study patients, including increased age, cough, cold symptoms, headache, and identifying as non-White. Factors that were found to be less common among patients with PCR-postive SARS-CoV-2 infection were fever and gastrointestinal symptoms.

“[These] data suggest that screening questions developed for adults may be less applicable in children,” additionally, “future research, including more dedicated and prospective studies, is warranted to identify patients [for] whom a positive SARS-CoV2- test is sufficiently likely to warrant isolation and testing,” the researchers concluded.


Sudbury FC, Williams A, Kwon M, Musser L, Gavigan P, Ericson JE. Characteristics associated with SARS-CoV-2 infection in children. Presented at: IDWeek 2021; September 29 to October 3, 2021. Poster 882.

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