AUTHOR=Kern Anna , Kuhlmann Pia H. , Matl Stefan , Ege Markus , Maison Nicole , Eckert Jana , von Both Ulrich , Behrends Uta , Anger Melanie , Frühwald Michael C. , Gerstlauer Michael , Woelfle Joachim , Neubert Antje , Melter Michael , Liese Johannes , Goettler David , Sing Andreas , Liebl Bernhard , Hübner Johannes , Klein Christoph , the COVID Kids Bavaria Consortium , Kindermann Hannah , Schober Tilmann , Schmied Patricia , Neuner Alexander , Dech Laura , Rieber Nikolaus , Geisperger Jonas , Oehler Philip , Mittermeier Anna , Moritz Katrin , Schulze Christopher , Toni Irmgard , Seebauer Ludwig , Härtel Christoph , Streng Andrea , Niekler Patricia , Eberle Ute , Ackermann Nikolaus , Wieser Andreas , Acero Raquel Rubio TITLE=Surveillance of Acute SARS-CoV-2 Infections in Elementary Schools and Daycare Facilities in Bavaria, Germany (09/2020–03/2021) JOURNAL=Frontiers in Pediatrics VOLUME=10 YEAR=2022 URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.888498 DOI=10.3389/fped.2022.888498 ISSN=2296-2360 ABSTRACT=Introduction

Here we report our results of a multi-center, open cohort study (“COVID-Kids-Bavaria”) investigating the distribution of acute SARS-CoV-2 infections among children and staff in 99 daycare facilities and 48 elementary schools in Bavaria, Germany.

Materials and Methods

Overall, 2,568 children (1,337 school children, 1,231 preschool children) and 1,288 adults (466 teachers, 822 daycare staff) consented to participate in the study and were randomly tested in three consecutive phases (September/October 2020, November/December 2020, March 2021). In total, 7,062 throat swabs were analyzed for SARS-CoV-2 by commercial RT-PCR kits.

Results

In phase I, only one daycare worker tested positive. In phase II, SARS-CoV-2 was detected in three daycare workers, two preschool children, and seven school children. In phase III, no sample tested positive. This corresponds to a positive test rate of 0.05% in phase I, 0.4% in phase II and 0% in phase III. Correlation of a positive PCR test result with the local-7-day incidence values showed a strong association of a 7-day-incidence of more than 100/100,000 as compared to <100/100,000 (OR = 10.3 [1.5–438], p < 0.005). After phase III, antibody testing was offered to 713 study participants in elementary schools. A seroprevalence rate of 7.7% (students) and 4.5% (teachers) was determined.

Discussion

During the initial waves of the SARS-CoV-2 pandemic, the risk of a positive SARS-CoV-2 result correlated positively with the local 7-day incidence. Hence, the occurrence of SARS-CoV-2 infections were reflected in schools and daycare facilities. An increased risk of SARS-CoV-2 transmission in the setting of daycare and elementary schooling was unlikely.