Background Describing the SARS-CoV-2 viral-load distribution in different patient groups and age categories. Methods All results from first nasopharyngeal (NP) and oropharyngeal (OP) swabs from unique patients tested via SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) collected between 1 January and 1 December 2020 predominantly in the Public Health Services regions Kennemerland and Hollands Noorden, province of North Holland, the Netherlands, were included in this study. SARS-CoV-2 PCR crossing-point (Cp)-values were used to estimate viral loads. Results In total, 278 455 unique patients were tested, of whom 9.1% (n = 25.374) were SARS-CoV-2-positive. PCRs performed by Public Health Services (n = 211 914), in which sampling and inclusion were uniform, revealed a clear relation between age and SARS-CoV-2 viral load, with especially children aged <12 years showing lower viral loads than adults (β: –0.03, 95% confidence interval: –0.03 to –0.02, p < 0.001), independently of sex and/or symptom duration. Interestingly, the median Cp-values between the >79- and <12-year-old populations differed by more than four PCR cycles, suggesting an ∼16-fold difference in viral load. In addition, the proportion of children aged <12 years with a low load (Cp-value >30) was higher compared with other patients (31.1% vs 17.2%, p-value < 0.001). Conclusions In patients tested by Public Health Services, SARS-CoV-2 viral load increases with age. Further studies should elucidate whether the lower viral load in children is indeed related to their suggested limited role in SARS-CoV-2 transmission. Moreover, as rapid antigen tests are less sensitive than PCR, these results suggest that SARS-CoV-2 antigen tests have lower sensitivity in children than in adults.

中文翻译：

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SARS-CoV-2 病毒载量分布揭示病毒载量随着年龄的增长而增加：一项回顾性横断面队列研究

背景 描述不同患者组和年龄组中 SARS-CoV-2 病毒载量的分布。方法 2020 年 1 月 1 日至 12 月 1 日期间收集的独特患者的首例鼻咽 (NP) 和口咽 (OP) 拭子的所有结果均通过 SARS-CoV-2 逆转录聚合酶链式反应 (RT-PCR) 进行检测，主要收集于公共卫生服务地区本研究包括荷兰北荷兰省的肯尼默兰和荷兰诺登。SARS-CoV-2 PCR 交叉点 (Cp) 值用于估计病毒载量。结果 总共对 278 455 名患者进行了检测，其中 9.1% (n = 25.374) 为 SARS-CoV-2 阳性。公共卫生服务部门 (n = 211 914) 进行的 PCR（采样和纳入是统一的）揭示了年龄与 SARS-CoV-2 病毒载量之间的明确关系，尤其是 12 岁以下的儿童，其病毒载量低于成人（β：–0.03，95% 置信区间：–0.03 至 –0.02，p < 0.001），与性别和/或症状持续时间无关。有趣的是，>79 岁和<12 岁人群之间的中位 Cp 值相差超过 4 个 PCR 周期，表明病毒载量存在约 16 倍的差异。此外，与其他患者相比，年龄＜12岁的儿童具有低负荷(Cp值＞30)的比例较高(31.1％对17.2％，p值＜0.001)。结论 在接受公共卫生服务检测的患者中，SARS-CoV-2 病毒载量随着年龄的增长而增加。进一步的研究应阐明儿童较低的病毒载量是否确实与其在 SARS-CoV-2 传播中的有限作用有关。此外，由于快速抗原检测的敏感性低于 PCR，这些结果表明 SARS-CoV-2 抗原检测在儿童中的敏感性低于成人。