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Symptomatic and Asymptomatic Viral Shedding in Pediatric Patients Infected With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)Under the Surface

Educational Objective
To understand symptomatic and asymptomatic viral shedding in children infected with severe COVID-19
1 Credit CME

Since the global emergence and spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), initial attention appropriately focused on severely affected adults, who represent the highest proportion of symptomatic infections.1 However, as the pandemic has evolved, a significant effect on children has also become evident.2 Data from multiple affected countries have corroborated that children are clearly susceptible to infection and may develop severe primary and unique secondary inflammatory complications of infection, including multisystem inflammatory syndrome of children.35 However, the vast majority of infected children have mild or unrecognized disease, and this population may play important epidemiologic roles by potentiating spread of infection through communities6 and/or boosting herd immunity. Only small numbers of children have been included in prior studies focused on kinetics of viral shedding in the setting of symptomatic or asymptomatic SARS-CoV-2 infection.712 To our knowledge, no prior studies have systematically focused on the frequency of asymptomatic infection in children or the duration of symptoms and viral shedding in both asymptomatic and symptomatic children.

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Article Information

Corresponding Author: Roberta L. DeBiasi, MD, MS, Division of Pediatric Infectious Diseases, Children’s National Hospital and Research Institute, 111 Michigan Ave NW, West Wing 3.5, Ste 100, Washington, DC 20010 (rdebiasi@childrensnational.org).

Published Online: August 28, 2020. doi:10.1001/jamapediatrics.2020.3996

Conflict of Interest Disclosures: None reported.

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Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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