Clinical features and severe acute respiratory syndrome-coronavirus-2 structural protein-based serology of Mexican children and adolescents with coronavirus disease 2019

Abstract

Severe acute respiratory syndrome (SARS)-coronavirus (CoV)-2 infection in children and adolescents primarily causes mild or asymptomatic coronavirus disease 2019 (COVID-19), and severe illness is mainly associated with comorbidities. However, the worldwide prevalence of COVID-19 in this population is only 1%–2%. In Mexico, the prevalence of COVID-19 in children has increased to 10%. As serology-based studies are scarce, we analyzed the clinical features and serological response (SARS-CoV-2 structural proteins) of children and adolescents who visited the Hospital Infantil de México Federico Gómez (October 2020–March 2021). The majority were 9-year-old children without comorbidities who were treated as outpatients and had mild-to-moderate illness. Children aged 6–10 years and adolescents aged 11–15 years had the maximum number of symptoms, including those with obesity. Nevertheless, children with comorbidities such as immunosuppression, leukemia, and obesity exhibited the lowest antibody response, whereas those aged 1–5 years with heart disease had the highest levels of antibodies. The SARS-CoV-2 spike receptor-binding domain-localized peptides and M and E proteins had the best antibody response. In conclusion, Mexican children and adolescents with COVID-19 represent a heterogeneous population, and comorbidities play an important role in the antibody response against SARS-CoV-2 infection.

Clinical Characteristics of Coronavirus Disease (COVID-19) in Mexican Children and Adolescents

“…In Mexico, obesity in children is very common and strongly related to COVID-19 and severe illness [ 15 ]. In this population, underlying conditions such as asthma and obesity were also associated with severe COVID-19 [ 11 , 37 ]. A systematic review of critically unwell children and the association with underlying comorbidities showed that those with pre-existing cardiac diseases were critically unwell [ 38 ].…”

“…This group had clinical follow-ups, and patients were considered convalescent. A study showed that comorbidities in this population play an essential role in the antibody response against SARS-CoV-2 infection [ 11 ]. However, we did not identify a tendency in this population and only found a high incidence of low antibody levels.…”

“…Demographic data included sex and age, and clinical features were patient status, comorbidities, signs, and symptoms. The type of SARS-CoV-2 infection was classified as asymptomatic in patients without any COVID-19 symptoms and attended ambulatorily; mild COVID-19, patients with signs and symptoms but with ambulatory management; moderate COVID-19, patients with mild illness but with hospital management; and severe COVID-19, patients who were admitted to the ICU for COVID-19, were intubated, or died [ 11 ]. The HIMFG is a tertiary-care pediatric hospital that admits a large population of children and adolescents for surgery, metabolic disease, organ transplants, and chemotherapy.…”

“…Structural protein-based serology was performed using indirect ELISA with recombinant structural proteins of SARS-CoV-2 (RBD-S, N, E, and M proteins), as antigens that were obtained in a previous study [ 11 ]. During this study, a biobank was generated in HIMFG during the COVID-19 pandemic for children and adolescents whose parents accepted and signed the informed consent form.…”

Frequency of Respiratory Virus-Associated infection among Children and Adolescents from a Tertiary-Care Hospital in Mexico City

“…Demographic data included sex and age, and clinical data included patient status, comorbidities, and signs/symptoms. The comorbidities were de ned by Flores-Alanis et al and the signs/symptoms were de ned by Cortés-Sarabia et al [24,59].…”