What is it about?

The epidemiology of childhood COVID-19 in the tropics remains a relatively neglected research topic, in part because SARS-CoV-2 typically causes fewer severe illnesses, hospitalizations, and deaths in children than in adults. This study showed that 45% of 660 participants in a birth cohort study in the Brazilian Amazon had SARS-CoV-2 antibodies at the age of 5 years, although only 5% of them reported previously diagnosed COVID-19 episodes – implying that as many as 8 in 9 SARS-CoV-2 infections had remained undiagnosed in these young children. Only 16% of the seropositive children had reportedly experienced cough, shortness of breath, and/or loss of taste or smell. The most socioeconomically vulnerable participants were more likely to have experienced SARS-CoV-2 infection and overt COVID-19 by the age of 5 years. Importantly, children exposed to household food insecurity, which affects 54% of our study participants, had their COVID-19 risk increased by 76%.

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Why is it important?

Childhood SARS-CoV-2 infection and COVID-19-associated illness were substantially underdiagnosed and underreported in the Amazon. Children in the most socioeconomically vulnerable households were disproportionately affected by SARS-CoV-2 infection and disease.


The present study provided new insights into the epidemiology of SARS-CoV-2 infection and COVID-19 and its association with social inequalities in young Amazonian children. Our results indicated that SARS-CoV-2 infections were frequent but substantially underreported among 5 years-old children in the Brazilian Amazon and possibly in other similar high-prevalence tropical settings.

Marly Cardoso
Universidade de Sao Paulo Campus da Capital

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This page is a summary of: SARS-CoV-2 seropositivity and COVID-19 among 5 years-old Amazonian children and their association with poverty and food insecurity, PLoS Neglected Tropical Diseases, July 2022, PLOS,
DOI: 10.1371/journal.pntd.0010580.
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