key: cord-0811255-bezbdgku
authors: Tayal, Anshula; Jat, Kana Ram
title: Is There a Need to Screen Children for COVID-19 for Elective Procedures?
date: 2022-04-25
journal: Indian J Pediatr
DOI: 10.1007/s12098-022-04235-8
sha: a64d1f25fd067b4369d730e693ea60bb7e848198
doc_id: 811255
cord_uid: bezbdgku

nan

The patients with symptomatic COVID-19 are well known to transmit the virus. However, studies have also observed person-to-person transmission in asymptomatic COVID-19 infection. A systematic review and meta-analysis showed an asymptomatic transmission rate of 24.51%, though considerable heterogeneity in the population [3] . When population subgroups were analyzed, the asymptomatic transmission rate among familial clusters, adults, children, and healthcare workers was 15.72%, 29.48%, 24.09%, and 0%, respectively [3] . The study in question suggested that a tenth of all patients undergoing medical procedures may silently harbor infection with SARS-CoV-2 [1] . This is a considerable proportion as these patients may potentially transmit the virus to other patients and healthcare personnel.

The authors reported average cycle threshold (Ct) value as 35.8 (range 31.9 to 37.8) in their asymptomatic positive cases [1] . The higher Ct value suggest lower viral load and initial reports suggested very low/no risk of transmission, if Ct value was > 30, but later on, studies reported positive virus culture in up to 50% cases of Ct values > 30, suggesting infectivity [4] . Therefore, still there is no concrete cutoff of Ct values to suggest noninfectivity.

Most of the studies on the risk of transmission are from prevaccine period, and so, the effects of vaccination on transmissibility from asymptomatic carriers needs to be ascertained. Furthermore, appropriate use of personal protective equipment (PPE) by healthcare workers during the pandemic have shown significantly decreased risk of transmission.

The COVID-19 pandemic has already caused a significant delay in patient care; and routine screening of children for asymptomatic children may cause further delay in appropriate care for them. With availability of effective vaccines, low risk of transmission of COVID-19 from asymptomatic carriers (having high Ct values), and use of appropriate PPE, there is hardly any added risk to healthcare professionals, if routine screening of asymptomatic carrier is not done. This will facilitate timely management of children, jeopardized by COVID-19 by now. Recently, Indian Council of Medical 

Screening for COVID-19 in children undergoing elective invasive procedures

Asymptomatic SARS-CoV-2 infection: a systematic review and meta-analysis

Asymptomatic infection and transmission of COVID-19 among clusters: systematic review and meta-analysis

SARS-CoV-2, CT-values, and infectivity-conclusions to be drawn from side observations

ICMR. Advisory on purposive testing strategy for COVID-19 in India. (Version VII, dated 10 th

Conflict of Interest None.