A cross-sectional investigation of SARS-CoV-2 seroprevalence and associated risk factors in children and adolescents in the United States

Levorson, Rebecca; Christian, Erica; Hunter, Brett D.; Sayal, Jasdeep; Sun, Jiayang; Bruce, Scott A.; Garofalo, Stephanie; Southerland, Matthew; Ho, Svetlana; Levy, Shira; Defillipi, Christopher; Peake, Lilian; Place, Frederick; Hourigan, Suchitra K.

doi:10.1371/journal.pone.0259823

Cited by 19 publications

(25 citation statements)

References 27 publications

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“…12,13 Recently, a cross sectional investigation of SARS in Virginia reported 8•5% seropositivity in a study of 1,038 children; seroprevalence was highest (13•7%) in children in the 0-5 year age group. 14 Our data are consistent with the observation that rates of seropositivity are higher in LMIC settings and underscore the widespread distribution of infection in very young children in these areas, with no risk factors identified other than occurrence in the midst of an epidemic wave.…”

Section: Commentsupporting

confidence: 89%

SARS-CoV-2 infections in infants in Haiti 2020-2021; evidence from a serological cohort

Louis

Logan

et al. 2022

Preprint

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Section: Commentsupporting

confidence: 89%

SARS-CoV-2 infections in infants in Haiti 2020-2021; evidence from a serological cohort

Louis

Logan

et al. 2022

Preprint

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“… 12 – 14 ). Beyond the neonatal period, infants may be at heighted risk of SARS-CoV-2 transmission from infected caregivers due to the frequency and intensity of close contact care and feeding ( 15 , 16 ), and may have higher risks of severe infection relative to older children due to less developed immune responses ( 6 , 17 , 18 ). Outcomes of breastfed children exposed to SARS-CoV-2 infected mothers are of further interest, as milk is not a source of SARS-CoV-2 transmission but is a source of persistent SARS-CoV-2 specific antibodies ( 19 – 23 ) and likely other antiviral agents ( 24 , 25 ).…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 specific antibody trajectories in mothers and infants over two months following maternal infection

et al. 2022

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Infants exposed to caregivers infected with SARS-CoV-2 may have heightened infection risks relative to older children due to their more intensive care and feeding needs. However, there has been limited research on COVID-19 outcomes in exposed infants beyond the neonatal period. Between June 2020 – March 2021, we conducted interviews and collected capillary dried blood spots from 46 SARS-CoV-2 infected mothers and their infants (aged 1-36 months) for up to two months following maternal infection onset (COVID+ group, 87% breastfeeding). Comparative data were also collected from 26 breastfeeding mothers with no known SARS-CoV-2 infection or exposures (breastfeeding control group), and 11 mothers who tested SARS-CoV-2 negative after experiencing symptoms or close contact exposure (COVID- group, 73% breastfeeding). Dried blood spots were assayed for anti-SARS-CoV-2 S-RBD IgG and IgA positivity and anti-SARS-CoV-2 S1 + S2 IgG concentrations. Within the COVID+ group, the mean probability of seropositivity among infant samples was lower than that of corresponding maternal samples (0.54 and 0.87, respectively, for IgG; 0.33 and 0.85, respectively, for IgA), with likelihood of infant infection positively associated with the number of maternal symptoms and other household infections reported. COVID+ mothers reported a lower incidence of COVID-19 symptoms among their infants as compared to themselves and other household adults, and infants had similar PCR positivity rates as other household children. No samples returned by COVID- mothers or their infants tested antibody positive. Among the breastfeeding control group, 44% of mothers but none of their infants tested antibody positive in at least one sample. Results support previous research demonstrating minimal risks to infants following maternal COVID-19 infection, including for breastfeeding infants.

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“…Although some research shows that young children are less susceptible to infection than adults 33-35 , other research shows that children may be as likely as adults to become infected with COVID-19 36 . In fact, a recent epidemiologic study 37 of a pediatric sample in Virginia reported a SARS-CoV-2 infection rate (8.5%) that was higher than a sample of adults (2.4%) from a similar region and period 38 . Further, children appear to play a role in community transmission through their social interactions and hygienic habits 33 , a finding that underscores the importance of risk-mitigation strategies among youth especially as the COVID-19 pandemic continues to evolve and become even more transmissible, as in the case of the most recent circulating variant (Omicron).…”

Section: Discussionmentioning

confidence: 91%

Association between COVID-19 Risk-Mitigation Behaviors and Specific Mental Disorders in Youth

Conway

Bhardwaj

Michel

et al. 2022

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ImportanceAlthough studies of adults show that pre-existing mental disorders increase risk for COVID–19 infection and severity, there is limited information about this association among youth. Mental disorders in general as well as specific types of disorders may influence their ability to comply with risk-mitigation strategies to reduce COVID-19 infection and transmission.ObjectiveTo examine associations between specific mental disorders and COVID-19 risk-mitigation practices among 314 female and 514 male youth.DesignYouth compliance (rated as “Never,” “Sometimes,” “Often,” or “Very often/Always”) with risk mitigation was reported by parents on the CoRonavIruS Health Impact Survey (CRISIS) in January 2021. Responses were summarized using factor analysis of risk mitigation, and their associations with lifetime mental disorders (assessed via structured diagnostic interviews) were identified with linear regression analyses (adjusted for covariates). All analyses used R Project for Statistical Computing for Mac (v.4.0.5).SettingThe Healthy Brain Network (HBN) in New York City Participants. 314 female and 514 male youth (ages 5-21)Main Outcome(s) and Measure(s)COVID-19 risk mitigation behaviors among youthResultsA two-factor model was the best-fitting solution. Factor 1 (avoidance behaviors) included avoiding groups, indoor settings, and other peoples’ homes; avoidance was more likely among youth with any anxiety disorder (p=.01). Factor 2 (hygiene behaviors) included using hand sanitizer, washing hands, and maintaining social distance; practicing hygiene was less likely among youth with ADHD (combined type) (p=.02). Mask wearing, which did not load on either factor, was not associated with any mental health disorder.Conclusion and RelevanceFindings suggest that education and monitoring of risk-mitigation strategies in certain subgroups of youth may reduce risk of exposure to COVID-19 and other contagious diseases. Additionally, they highlight the need for greater attention to vaccine prioritization for individuals with ADHD.Key PointsQuestionAre mental disorders among youth associated with COVID-19 risk-mitigation behaviors?FindingsBased on the parent CoRonavIruS Health Impact Survey (CRISIS) of 314 females and 514 males aged 5-21, youth with anxiety disorders were more likely to avoid high-risk exposure settings, and those with ADHD (combined type) were less likely to follow hygiene practices. In contrast, mask wearing was not associated with youth mental disorders.MeaningSpecific types of disorders in youth may interfere with their ability to employ risk-mitigation strategies that may lead to greater susceptibility to COVID-19.

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A cross-sectional investigation of SARS-CoV-2 seroprevalence and associated risk factors in children and adolescents in the United States

Cited by 19 publications

References 27 publications

SARS-CoV-2 infections in infants in Haiti 2020-2021; evidence from a serological cohort

SARS-CoV-2 infections in infants in Haiti 2020-2021; evidence from a serological cohort

SARS-CoV-2 specific antibody trajectories in mothers and infants over two months following maternal infection

Association between COVID-19 Risk-Mitigation Behaviors and Specific Mental Disorders in Youth

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