Teams from the pediatric departments of the Jean-Verdier AP-HP hospital, the clinical research unit and the microbiology department of the Avicenne AP-HP hospital, the universities of Sorbonne Paris Nord and Sorbonne University as well as Inserm, in a multicenter study, analyzed the role of very young children in the transmission of SARS-CoV-2 in nurseries that remained open to accommodate the children of essential workers, mainly caregivers, during the period of the 1st confinement.
This work, which was the subject of a publication in the journal The Lancet Child and Adolescent Health on February 8, 2021, shows that the virus did not circulate much in nurseries under the special conditions applied during the first confinement (strict confinement of the rest of the population , possibility of small groups of children and reinforcement of barrier measures), including in a group of children considered to be more at risk (infants dependent on staff, parents at risk of infection because caregivers continue to travel). The type of daycare in a crèche, under these conditions, does not seem to be responsible for an increased risk for the children and the staff who care for them.
The frequency of the presence of antibodies against the SARS-CoV-2 coronavirus (seroprevalence) could be studied between June 4 and July 3, 2020 in children who had been received during the first national confinement from March 15 to May 9 2020. It made it possible to retrospectively estimate the number of previous infections. The result of their rapid serological test carried out on a few drops of blood was also communicated to the parents in less than 15 minutes.
Among the 22 nurseries studied, there are 20 nurseries in Ile-de-France and 2 nurseries located in Rouen and Annecy, in regions with less viral circulation. Twelve nurseries were hospitals (including 7 at the AP-HP) and 10 were managed by the City of Paris or the Department of Seine-Saint-Denis. 327 children and 197 nursery staff participated in this study.
The seroprevalence in children was low: 4.3% (14 positive children from 13 different nurseries out of 327 children included).
The seroprevalence among nursery staff was also low: 7.7% (ie 14 positive nursery staff out of 197) and similar to that of a group of 164 hospital staff not professionally exposed to patients and / or children.
All SARS-CoV-2 PCRs carried out in children in June 2020 were found to be negative (197 nasopharyngeal swabs and 261 stool swabs).
The additional exploratory analysis performed suggested that HIV-positive children were more likely to have been exposed at home to an adult with a confirmed COVID-19 infection (43% vs. 6%) and to have at least 1 HIV-positive parent.
The hypothesis of intra-family contamination remains more plausible than transmission within nurseries. This type of childcare, in these conditions, does not seem to be responsible for an increased risk for the children and the staff in charge of them.
The extrapolation of these results to other situations or other periods of viral circulation cannot be done without additional studies but they are consistent with the knowledge on the place of very young children in the circulation of SARS-CoV-2.
The COVIDOCRECHE study, promoted and funded by AP-HP, was carried out with the methodological support of the Clinical Research Unit of Paris Seine-Saint-Denis University Hospitals and of the Pierre Louis Institute of Epidemiology and of Public Health of Sorbonne University, as well as the support of the City of Paris and the Departmental Council of Seine-Saint-Denis.
Référence : SARS-CoV-2 transmission among children and care staff in daycare centres during lockdown: a cross-sectional, multicentre seroprevalence study in France.
Eric Lachassinne, MD; Loïc de Pontual, PhD; Marion Caseris, MD; Mathie Lorrot, PhD; Carole Guilluy, MD; Aurélie Naud, MD; Marie-Aliette Dommergues, MD; Didier Pinquier, MD; Evelyne Wannepain, MD; Elisabeth Hausherr, MD; Camille Jung, MD; Vincent Gajdos, PhD; Robert Cohen, PhD; Jean-Ralph Zahar, PhD; Ségolène Brichler, PhD; Romain Basmaci, PhD; Pierre-Yves Boelle, PhD; Coralie Bloch-Queyrat *, PhD; Camille Aupiais *, PhD.
* Contributed equally to this work
DOI : https://doi.org/10.1016/S2352-4642(21)00024-9
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