Asymptomatic or mild symptomatic SARS-CoV-2 infection elicits durable neutralizing antibody responses in children and adolescents

Garrido, Carolina; Hurst, Jillian H.; Lorang, Cynthia G.; Aquino, Jhoanna N.; Rodriguez, Javier; Pfeiffer, Trevor S; Singh, Tulika; Semmes, Eleanor C; Lugo, Debra J.; Rotta, Alexandre T.; Turner, Nicholas; Burke, Thomas W.; McClain, Micah T.; Petzold, Elizabeth; Permar, Sallie R.; Moody, M. Anthony; Woods, Christopher W.; Kelly, Matthew S.; Fouda, Genevieve G.

doi:10.1172/jci.insight.150909

Cited by 45 publications

(31 citation statements)

References 48 publications

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“…Such cross-reactivity with other coronaviruses occurs in all age groups but manifests most in the elderly due to their long time of exposure. Concerning the high titers of anti-S among children in our study, similar results were noted by Garrido et al, who reported higher anti-RBD and neutralizing antibodies in children than in adults, up to 4 months post-COVID-19 infection [ 34 ]. In addition to cross-reactivity with other coronaviruses, Karron et al, explained the higher SARS-CoV-2 seropositivity among children by their exaggerated tenfold higher RBD antibody titers than adults, while adults had a higher neutralizing ability than children [ 35 ].…”

Section: Discussionsupporting

confidence: 91%

A pre-vaccine exploratory survey of SARS-CoV-2 humoral immunity among Egyptian general population

et al. 2022

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Background Population-based studies on COVID-19 have important implications for modeling the pandemic and determining vaccination policies. Limited data are available from such surveys in Egypt. Methods This cross-sectional was conducted throughout the period between January and June 2021, which coincided with the second and third waves of the COVID-19 pandemic in Egypt. At that time, vaccines against COVID-19 were not available to the general population. The study was carried out in eight Egyptian governorates and included 2360 participants, who were recruited through a multistage stratified cluster sample technique, based on gender, age, and district followed by a random sample within each district. Socio-demographic data were recorded and serum samples were collected and tested for SARS-Co-V2 spike (S) antibodies. Results The overall adjusted prevalence of anti-S was 46.3% (95% CI 44.2–48.3%), with significant differences between governorates. Factors associated with anti-S seropositivity were: being female (p = 0.001), living in a rural area (p = 0.008), and reporting a history of COVID-19 infection (p = 0.001). Higher medians of anti-S titers were significantly associated with: extremes of age (p < 0.001), living in urban areas, having primary education (p = 0.009), and reporting a history of COVID-19 infection, especially if based on chest CT or PCR (p < 0.001). Conclusions High seroprevalence rates indicate increased COVID-19 infection and immune response among a considerable percentage of the community. Age, gender, residence, educational level, and previous PCR-confirmed COVID-19 infections were all determinants of the immune response.

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Section: Discussionsupporting

confidence: 91%

A pre-vaccine exploratory survey of SARS-CoV-2 humoral immunity among Egyptian general population

et al. 2022

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“…In a small cohort of children, anti-SARS-CoV-2 IgG declined six months after infection with lower levels than their infected parents at the same time point [61]. In a recent larger cohort study, children and adolescents showed high and durable antibody responses to SARS-CoV-2, following mild or asymptomatic infection [62]. Regarding cell-mediated immunity, only a few reports describe a lower or similar magnitude of SARS-CoV-2-specific T cells in children [21,57,63].…”

Section: Immune Response To Sars-cov-2 Infection In Childrenmentioning

confidence: 93%

“…In Switzerland, a serosurvey showed a significantly lower seroprevalence among children aged 5-9 years (0.8%) and a lower risk of seropositivity compared to individuals aged 20-49 years (RR 0.32) [116], therefore confirming the studies on attack rate. Only few studies have been published on this topic, and it will also be important to assess the durability of antibodies following SARS-CoV-2 infection in children for the interpretation of seroprevalence studies [61,62].…”

Section: Sars-cov-2 Transmission By Children In Household Studiesmentioning

confidence: 99%

Pediatric COVID-19: Immunopathogenesis, Transmission and Prevention

et al. 2021

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Children are unique in the context of the COVID-19 pandemic. Overall, SARS-CoV-2 has a lower medical impact in children as compared to adults. A higher proportion of children than adults remain asymptomatic following SARS-CoV-2 infection and severe disease and death are also less common. This relative resistance contrasts with the high susceptibility of children to other respiratory tract infections. The mechanisms involved remain incompletely understood but could include the rapid development of a robust innate immune response. On the other hand, children develop a unique and severe complication, named multisystem inflammatory syndrome in children, several weeks after the onset of symptoms. Although children play an important role in the transmission of many pathogens, their contribution to the transmission of SARS-CoV-2 appears lower than that of adults. These unique aspects of COVID-19 in children must be considered in the benefit–risk analysis of vaccination. Several COVID-19 vaccines have been authorized for emergency use in adolescents and clinical studies are ongoing in children. As the vaccination of adolescents is rolled out in several countries, we shall learn about the impact of this strategy on the health of children and on transmission within communities.

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“…Several prior studies reported associations between age, comorbidities, and the severity of the acute infection with the magnitude and durability of the immune response (3,4). This can be seen in several studies linking increasing disease severity with more robust humoral and cellular immune responses, suggesting that the immune response to natural infection is highly variable (5)(6)(7).…”

Section: Introductionmentioning

confidence: 91%

Mild reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant: First case report from Indonesia

Isnaini

Mardian²,

Lokida

et al. 2022

Front. Med.

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BackgroundReinfection with SARS-CoV-2 has been well documented, yet little is known about the degree of protection a previous infection provides against reinfection, especially against Variants of Concern (VOC).Case presentationHere we describe a case of an unvaccinated 49-year-old man who experienced two sequential SARS-CoV-2 infections with two different variants, as evidenced by genomic sequencing. The first episode was caused by the Pango lineage B.1.466.2 and resulted in severe COVID-19 with 5 days in an intensive care unit (ICU). The second episode occurred approximately 6 months later, during the Delta surge in Indonesia. Genomic analysis showed that the second infection was caused by the Delta variant (Pango lineage B.1.617.2) and resulted in mild disease that did not require hospitalization. No SARS-CoV-2 nucleic acid was detected between the two episodes, but both binding and neutralizing antibodies to SARS-CoV-2 were detected prior to the reinfection, with the second infection leading to an increase in the levels of antibody.ConclusionWe confirmed that the patient experienced a reinfection instead of persistent viral shedding from the first infection based on epidemiological, clinical, serological, and genomic analyses. Our case supports the hypothesis that SARS-CoV-2 reinfection may occur once antibody titers decrease or following the emergence of a new variant. The milder presentation in the patient’s second infection deserves further investigation to provide a clear picture of the role of post-infection immunity in altering the course of subsequent disease.

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Asymptomatic or mild symptomatic SARS-CoV-2 infection elicits durable neutralizing antibody responses in children and adolescents

Cited by 45 publications

References 48 publications

A pre-vaccine exploratory survey of SARS-CoV-2 humoral immunity among Egyptian general population

A pre-vaccine exploratory survey of SARS-CoV-2 humoral immunity among Egyptian general population

Pediatric COVID-19: Immunopathogenesis, Transmission and Prevention

Mild reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant: First case report from Indonesia

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