Activity

Activity ID

12711

Expires

July 6, 2025

Format Type

Journal-based

CME Credit

1

Fee

30

CME Provider: JAMA Network Open

Description of CME Course

Importance  The impact of the SARS-CoV-2 pandemic on children remains unclear. Better understanding of the burden of COVID-19 among children and their risk of reinfection is crucial, as they will be among the last groups vaccinated.

Objective  To characterize the burden of COVID-19 and assess how risk of symptomatic reinfection may vary by age among children.

Design, Setting, and Participants  In this prospective, community-based pediatric cohort study conducted from March 1, 2020, to October 15, 2021, 1964 nonimmunocompromised children aged 0 to 14 years were enrolled by random selection from the Nicaraguan Pediatric Influenza Cohort, a community-based cohort in District 2 of Managua, Nicaragua. Additional newborn infants aged 4 weeks or younger were randomly selected and enrolled monthly via home visits.

Exposures  Prior COVID-19 infection as confirmed by positive anti–SARS-CoV-2 antibodies (receptor binding domain and spike protein) or real-time reverse transcriptase–polymerase chain reaction (RT-PCR)–confirmed COVID-19 infection at least 60 days before current COVID-19 infection.

Main Outcomes and Measures  Symptomatic COVID-19 cases confirmed by real-time RT-PCR and hospitalization within 28 days of symptom onset of a confirmed COVID-19 case.

Results  This cohort study assessed 1964 children (mean [SD] age, 6.9 [4.4] years; 985 [50.2%] male). Of 1824 children who were tested, 908 (49.8%; 95% CI, 47.5%-52.1%) were seropositive during the study. There were also 207 PCR-confirmed COVID-19 cases, 12 (5.8%) of which were severe enough to require hospitalization. Incidence of COVID-19 was highest among children younger than 2 years (16.1 cases per 100 person-years; 95% CI, 12.5-20.5 cases per 100 person-years), which was approximately 3 times the incidence rate in any other child age group assessed. In addition, 41 symptomatic SARS-CoV-2 episodes (19.8%; 95% CI, 14.4%-25.2%) were reinfections.

Conclusions and Relevance  In this prospective, community-based pediatric cohort study, rates of symptomatic and severe COVID-19 were highest among the youngest participants, with rates stabilizing at approximately 5 years of age. In addition, symptomatic reinfections represented a large proportion of symptomatic COVID-19 cases.

Disclaimers

1. This activity is accredited by the American Medical Association.
2. This activity is free to AMA members.

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No

NOTE: If a Member Board has not deemed this activity for MOC approval as an accredited CME activity, this activity may count toward an ABMS Member Board’s general CME requirement. Please refer directly to your Member Board’s MOC Part II Lifelong Learning and Self-Assessment Program Requirements.

Educational Objectives

To identify the key insights or developments described in this article

Keywords

Infectious Diseases, Coronavirus (COVID-19), Public Health, Vaccination, Pediatrics

Competencies

Medical Knowledge

CME Credit Type

AMA PRA Category 1 Credit

DOI

10.1001/jamanetworkopen.2021.10330

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