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Dear editor: Covid-19 pandemic has brought the implementation of multiple measures to reduce the transmission of SARS-CoV-2, including the partial or total closure of schools. This policy has been controversial, and it has been proposed that reopening schools without solid mitigation of Covid-19 could cause more transmission, with more infectious and possibly more virulent variants, which would result in more closures.1 On the other hand, and derived from a better understanding of the transmission of the virus,2 it has been reported that returning to the classroom is safe after establishing specific measures to reduce the risk of contagion.3,4,5
We carried out an observational study in pediatric patients (2 to 18 years) with respiratory or digestive symptoms enrolled in an educational institution who attended the Centro de Salud de Servicios Ampliados La Libertad (Puebla, Mexico) for evaluation in September 2021. Covid-19 antigen tests were performed on symptomatic children between days 0-7 from the onset of symptoms.
A total of 225 children were attended for respiratory or digestive symptoms. The mean age was 11±4 years, 58.1% (n= 129) were female. 35.6% of the children had a positive SARS-CoV-2 antigen test (n= 80), and it was negative in 64.4% (n= 145). Fever was the most frequent symptom (48%), followed by headache (46.7%).
Most of the children attended in-person classes 77.3% (n= 174) and 22.7% to virtual classes. 60.4% (n= 136) had a history of contact with a Covid-19 patient; of which 55.6% (n= 125) had contact with a family member and 4.9% (n= 11) had a history of contact with a sick schoolmate.
Of the 125 children with a history of contact with a sick family member, 40% (n= 50) had a positive test. From 11 children who had contact with a confirmed sick schoolmate of Covid-19, only 18% (n= 2) had a positive test, so the ORs were estimated according to the type of contact presented (table I). Regarding the risk of presenting a positive test according to the type of school, we found that children with in-person classes had an OR of 0.659 (95%CI 0.348,1.247; p= 0.198), and children with virtual classes had an OR of 1.517 (95%CI 0.802,2.870; p= 0.198).
Table I Odds ratio for positive SARS-CoV-2 antigen test according to the type of contact. Puebla, Mexico. September 2021
|
Odds ratio |
95%CI |
P-value |
|
|
Any contact (schoolmate and family) |
1.349 |
0.766, 2.374 |
0.299 |
|
Schoolmate |
0.387 |
0.082, 1.839 |
0.227 |
|
Family |
1.556 |
0.891, 2.717 |
0.119 |
This study found no increased risk of Covid-19 in children who had contact with sick schoolmates. There was a tendency to acquire SARS-CoV-2 infection when they lived with a sick family member. Concerning the type of classes, the findings were similar. These results annex the growing evidence that attendance at face-to-face classes can be achieved with minimal risk of SARS-CoV-2 transmission when adequate measures are implemented to prevent transmission.
