Estimated SARS-CoV-2 Seroprevalence in Healthy Children and Those with Chronic Illnesses in the Washington Metropolitan Area as of October 2020

Bahar, Burhanuddin; Simpson, Joelle; Biddle, Cara; Campbell, Andrew; Dome, Jeffrey S.; DeBiasi, Roberta L.; Mowbray, Catriona; Marguilies, Stefanie; Sherman, Adrienne; Reuben, Jacqueline; Delaney, Meghan

doi:10.1097/inf.0000000000003140

Cited by 7 publications

(9 citation statements)

References 9 publications

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“… 20 In the previous seroprevalence study of children at CNH, Hispanic ethnicity was also a significant risk factor for COVID‐19 with 18.5% of Hispanic patients with SARS‐CoV2 IgG as of October 2020. 5 …”

Section: Discussionmentioning

confidence: 99%

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Examining multi‐level immune response to determine prevalence of COVID‐19 in pediatric tonsillectomy

et al. 2022

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Objective To determine the prevalence of COVID‐19 in a cohort of children undergoing tonsillectomy through assessment of B cell immune responses to SARS‐CoV‐2 in both peripheral blood and tonsil tissue. Methods In this cohort study at a tertiary pediatric hospital (Children's National Hospital) in Washington, DC, we recruited 100 children undergoing tonsillectomy from late September 2020 to January 2021. Serum, peripheral blood cells, and tonsil tissue were collected and examined for immune reactivity to SARS‐CoV‐2. Parent‐reported clinical histories were compared to antibody and B‐cell responses. Results Among 100 children undergoing tonsillectomy, 19% had evidence of immune responses to SARS‐CoV‐2 (CoV2+), indicating prior COVID‐19. In all seropositive participants, we detected SARS‐CoV‐2 specific B cells in both peripheral blood mononuclear cells and tonsils, providing evidence for tissue‐specific immunity in these children. Of the 19, 63% reported no known history of COVID‐19, and an additional 3 were asymptomatic or unaware of an acute infection when detected on pre‐surgery screen. Hispanic children represented 74% of CoV2+ subjects compared to 37% of the full cohort. 100% of CoV2+ children lived in a zip code with poverty level >10%. Conclusions Nearly one‐fifth of children undergoing tonsillectomy at an urban U.S. hospital had evidence of prior COVID‐19 during the early pandemic, with the majority unaware of prior infection. Our results underscore the ethnic and socio‐economic disparities of COVID‐19. We found concordant evidence of humoral immune responses in children in both blood and tonsil tissue, providing evidence of local immune responses in the upper respiratory tract. Level of Evidence 3 Laryngoscope , 2022

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Section: Discussionmentioning

confidence: 99%

“…4 The estimated SARS‐CoV‐2 seroprevalence up to October 2020 in children was 9.46% for the Washington Metropolitan area. 5 …”

Section: Introductionmentioning

confidence: 99%

Examining multi‐level immune response to determine prevalence of COVID‐19 in pediatric tonsillectomy

et al. 2022

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“…One reported a seroprevalence range of 2.5% to 16.3% between May and September 2020 [ 7 ]. Another in metro DC between July and October 2020 showed a seroprevalence of 9.5% in children undergoing venipuncture for another reason [ 8 ]. Limitations exist in both reports as to applicability to the entire pediatric population due to use of residual blood samples in children with other medical concerns.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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Background Pediatric SARS-CoV-2 data remain limited and seropositivity rates in children were reported as <1% early in the pandemic. Seroepidemiologic evaluation of SARS-CoV-2 in children in a major metropolitan region of the US was performed. Methods Children and adolescents ≤19 years were enrolled in a cross-sectional, observational study of SARS-CoV-2 seroprevalence from July-October 2020 in Northern Virginia, US. Demographic, health, and COVID-19 exposure information was collected, and blood analyzed for SARS-CoV-2 spike protein total antibody. Risk factors associated with SARS-CoV-2 seropositivity were analyzed. Orthogonal antibody testing was performed, and samples were evaluated for responses to different antigens. Results In 1038 children, the anti-SARS-CoV-2 total antibody positivity rate was 8.5%. After multivariate logistic regression, significant risk factors included Hispanic ethnicity, public or absent insurance, a history of COVID-19 symptoms, exposure to person with COVID-19, a household member positive for SARS-CoV-2 and multi-family or apartment dwelling without a private entrance. 66% of seropositive children had no symptoms of COVID-19. Secondary analysis included orthogonal antibody testing with assays for 1) a receptor binding domain specific antigen and 2) a nucleocapsid specific antigen had concordance rates of 80.5% and 79.3% respectively. Conclusions A much higher burden of SARS-CoV-2 infection, as determined by seropositivity, was found in children than previously reported; this was also higher compared to adults in the same region at a similar time. Contrary to prior reports, we determined children shoulder a significant burden of COVID-19 infection. The role of children’s disease transmission must be considered in COVID-19 mitigation strategies including vaccination.

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“…In work performed in middle and upper income countries, SARS-CoV-2 seropositivity in children generally identified as below the age of five has been highly variable, from less than 1% in German and Switzerland to 6% in Spain after during the first surge of the pandemic [13][14][15]. Several U.S. studies examined antibody prevalence in residual blood samples of children during the late spring and early fall of 2020, with seroprevalence rates of 9�5-16�3% [16][17][18]. 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 [19].…”

Section: Plos Onementioning

confidence: 99%

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

Louis

Logan

et al. 2022

PLoS ONE

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Few data are available on frequency of SARS-CoV-2 infection among very young children in low- to middle-income countries (LMIC), with the studies that are available biased towards higher income countries with low reported infection and seroconversion rates. Between February 2019 and March 2021, 388 dried blood spot (DBS) samples were obtained from 257 children less than 30 months of age as part of a prospective observational cohort study of pregnant women and their infants in Haiti; longitudinal samples were available for 107 children. In a subsequent retrospective analysis, DBS samples were tested by ELISA for antibody targeting the receptor binding domain of the SARS-CoV-2 S1 protein. Over the course of the study, 16·7% of the infants became seropositive. All seropositive samples were collected after March 19, 2020 (the date of the first reported COVID-19 case in Haiti) with the highest hazards measured in August 2020. Sampling date was the only covariate associated with the hazard of seroconversion. Our data provide an estimate of SARS-CoV-2 infection rates among very young children without prior SARS-CoV-2 exposure during the initial pandemic waves in Haiti, and demonstrate that these children mount a detectable serological response which is independent of patient age.

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Estimated SARS-CoV-2 Seroprevalence in Healthy Children and Those with Chronic Illnesses in the Washington Metropolitan Area as of October 2020

Cited by 7 publications

References 9 publications

Examining multi‐level immune response to determine prevalence of COVID‐19 in pediatric tonsillectomy

Examining multi‐level immune response to determine prevalence of COVID‐19 in pediatric tonsillectomy

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

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

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