{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T20:58:20Z","timestamp":1787000300826,"version":"build-2736575974"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>There is limited information on severe acute respiratory syndrome virus 2 (SARS-CoV-2) infection in children.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We retrieved data from the national database on SARS-CoV-2 infections. We studied in-family transmission. The level of viral load was categorized as high, moderate, or low based on the cycle threshold values.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>We studied 203 SARS-CoV-2-infected children (median age: 11 years; range: 6 days to 18.4 years); 111 (54.7%) had an asymptomatic infection. Among the 92 children (45.3%) with coronavirus disease 2019 (COVID-19), 24 (26.1%) were hospitalized. Infants &lt;1 year were more likely to develop COVID-19 (19.5% of all COVID-19 cases) (<jats:italic toggle=\"yes\">P<\/jats:italic>-value = 0.001). There was no significant difference between viral load and age, sex, underlying condition, fever and hospitalization, as well as between type of SARS-CoV-2 infection and age, sex, underlying condition and viral load. Transmission from a household member accounted for 132 of 178 (74.2%) children for whom the source of infection was identified. An adult member with COVID-19 was the first case in 125 (66.8%) family clusters. Child-to-adult transmission was found in one occasion only.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>SARS-CoV-2 infection is mainly asymptomatic or mild during childhood. Adults appear to play a key role in spread of the virus in families. Most children have moderate or high viral loads regardless of age, symptoms or severity of infection. Further studies are needed to elucidate the role of children in the ongoing pandemic and particularly in light of schools reopening and the need to prioritize groups for vaccination, when COVID-19 vaccines will be available.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/inf.0000000000002899","type":"journal-article","created":{"date-parts":[[2020,10,8]],"date-time":"2020-10-08T18:34:42Z","timestamp":1602182082000},"page":"e388-e392","source":"Crossref","is-referenced-by-count":82,"title":["Children and Adolescents With SARS-CoV-2 Infection"],"prefix":"10.1097","volume":"39","author":[{"given":"Helena C.","family":"Maltezou","sequence":"first","affiliation":[{"name":"Directorate for Research, Studies, and Documentation, National Public Health Organization, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioanna","family":"Magaziotou","sequence":"additional","affiliation":[{"name":"Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xanthi","family":"Dedoukou","sequence":"additional","affiliation":[{"name":"Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eirini","family":"Eleftheriou","sequence":"additional","affiliation":[{"name":"Second Department of Pediatrics, National and Kapodistrian University of Athens, Aglaia Kyriakou Children\u2019s Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasilios","family":"Raftopoulos","sequence":"additional","affiliation":[{"name":"Epidemiological Surveillance of HIV\/AIDS Department, National Public Health Organization, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Michos","sequence":"additional","affiliation":[{"name":"First Department of Pediatrics, National and Kapodistrian University of Athens, Aghia Sophia Children\u2019s Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasia","family":"Lourida","sequence":"additional","affiliation":[{"name":"Infection Prevention and Control Committee, Aghia Sofia Children\u2019s Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Panopoulou","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, Democritus University of Thrace, Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Stamoulis","sequence":"additional","affiliation":[{"name":"National Blood Transfusion Center, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliki","family":"Papaevangelou","sequence":"additional","affiliation":[{"name":"Third Department of Pediatrics, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efthimia","family":"Petinaki","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, University of Thessaly, Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Mentis","sequence":"additional","affiliation":[{"name":"National Reference Laboratory for Influenza and other Respiratory Viruses, Hellenic Pasteur Institute, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Papa","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Tsakris","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Roilides","sequence":"additional","affiliation":[{"name":"Third Department of Pediatrics, Aristotle University School of Health Sciences, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George A.","family":"Syrogiannopoulos","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Thessaly, Larissa, Greece."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Tsolia","sequence":"additional","affiliation":[{"name":"Second Department of Pediatrics, National and Kapodistrian University of Athens, Aglaia Kyriakou Children\u2019s Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for Greek Study Group on SARS-CoV-2 Infections in Children","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,10,6]]},"reference":[{"key":"R2-20230912","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/S0140-6736(20)30154-9","article-title":"A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster.","volume":"395","author":"Chan","year":"2020","journal-title":"Lancet"},{"key":"R3-20230912","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1007\/s15010-020-01427-2","article-title":"Clinical characteristics of COVID-19 in children compared with adults in Shandong Province, 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moderate coronavirus disease 2019 (COVID-19).","author":"Heald-Sargent","year":"2020","journal-title":"JAMA Pediatr"},{"key":"R18-20230912","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/S1473-3099(20)30232-2","article-title":"Viral dynamics in mild and severe cases of COVID-19.","volume":"20","author":"Liu","year":"2020","journal-title":"Lancet Infect Dis"},{"key":"R19-20230912","doi-asserted-by":"crossref","DOI":"10.3201\/eid2610.202449","article-title":"Viral RNA load in mildly symptomatic and asymptomatic children with COVID-19, Seoul.","volume":"26","author":"Han","year":"2020","journal-title":"Emerg Infect Dis"}],"container-title":["Pediatric Infectious Disease 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