Longitudinal Rise in Seroprevalence of SARS-CoV-2 Infections in Children in Western Germany—A Blind Spot in Epidemiology?

Brinkmann, Folke; Diebner, Hans H.; Matenar, Chantal; Schlegtendal, Anne; Spiecker, Jan; Eitner, Lynn; Timmesfeld, Nina; Maier, Christoph; Lücke, Thomas

doi:10.3390/idr13040088

Cited by 20 publications

(30 citation statements)

References 12 publications

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“…A population-based study in Geneva also observed lower seroprevalence rates among younger (6–9 years old) children [ 23 ]. Moreover, in this study, high rates of seroconversion were observed in multiple pediatric age groups, a finding also reported in German and Danish studies [ 4 , 24 ]. However, a large cohort study in Canada observed that younger children were more likely than older children to transmit SARS-CoV-2 infection to other household members, suggestive of divergent dynamics of disease transmission [ 25 ].…”

Section: Discussionsupporting

confidence: 88%

“…People below 18 years of age comprise nearly 34% of the Indian population [ 1 ], but prior to the emergence of newer variants of concern accounted for <5% of the total burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections [ 2 ]. Global evidence is indicative of children and adolescents having less susceptibility to SARS-CoV-2 infection than adults, with much lower rates of severe coronavirus disease 2019 (COVID-19) [ 3 , 4 ]. A retrospective analysis of mortality data from the state of Odisha in India with a population of approximately 43 million reported only 36 COVID-19-related child deaths through August 2021 [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Seroprevalence of immunoglobulin G antibodies against SARS-CoV-2 in children and adolescents in Delhi, India, from January to October 2021: a repeated cross-sectional analysis

Sharma¹,

Basu²,

Mishra³

et al. 2022

PHRP

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Objectives: The aim of this study was to assess changes in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) seroprevalence among children and adolescents in Delhi, India from January 2021 to October 2021Methods: This was a repeated cross-sectional analysis of participants aged 5 to 17 years from 2 SARS-CoV-2 seroprevalence surveys conducted in Delhi, India during January 2021 and September to October 2021. Anti-SARS-CoV-2 IgG antibodies were detected by using the VITROS assay (90% sensitivity, 100% specificity).Results: The seroprevalence among 5- to 17-year-old school-age children and adolescents increased from 52.8% (95% confidence interval [CI], 51.3%−54.3%) in January 2021 to 81.8% (95% CI, 80.9%−82.6%) in September to October 2021. The assay-adjusted seroprevalence was 90.8% (95% CI, 89.8%−91.7%). Seropositivity positively correlated with participants’ age (p<0.001), but not sex (p=0.388). A signal to cut-off ratio ≥4.00, correlating with the presence of neutralization antibodies, was observed in 4,814 (57.9%) participants.Conclusion: The high percentage of seroconversion among children and adolescents indicates the presence of natural infection-induced immunity from past exposure to the SARS-CoV-2 virus. However, the lack of hybrid immunity and the concomitant likelihood of lower levels of neutralization antibodies than in adults due to the absence of vaccination warrants careful monitoring and surveillance of infection risk and disease severity from newer and emergent variants.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Seroprevalence of immunoglobulin G antibodies against SARS-CoV-2 in children and adolescents in Delhi, India, from January to October 2021: a repeated cross-sectional analysis

Sharma¹,

Basu²,

Mishra³

et al. 2022

PHRP

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“…In a standardised approach from 1 June 2020 to 1 February 2021, all asymptomatic children and adolescents from 6 months to 18 years of age who attended outpatient paediatric practices in three regions of Germany for scheduled mandatory routine examinations were invited to participate in the study (Corkid study, 'Corona in Kids') [ 3 ]. Participants and their parents were asked to fill in an electronic questionnaire (pre-installed on a tablet) with 14 questions (see Supplementary material ) available in five different languages (German, English, Turkish, Arabic and Russian).…”

Section: Methodsmentioning

confidence: 99%

“…Children are frequently oligo- or asymptomatic and therefore undertested and underdiagnosed. Seropositivity studies, however, reveal that the rate of SARS-CoV-2 infections in adults and children is similar [ 1 - 3 ].…”

Section: Introductionmentioning

confidence: 99%

Seroconversion rate and socio-economic and ethnic risk factors for SARS-CoV-2 infection in children in a population-based cohort, Germany, June 2020 to February 2021

et al. 2022

Self Cite

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Introduction Socio-economic and ethnic background have been discussed as possible risk factors for SARS-CoV-2 infections in children. Improved knowledge could lead to tailored prevention strategies and help improve infection control. Aim We aimed to identify risk factors for SARS-CoV-2 infections in children in the first and second wave of the pandemic. Methods We performed an observational population-based cohort study in children (6 months–18 years) scheduled for legally required preventive examination and their parents in a metropolitan region in Germany. Primary endpoint was the SARS-CoV-2 seroconversion rate during the study period. Risk factors assessed included age, pre-existing medical conditions, socio-economic factors and ethnicity. Results We included 2,124 children and their parents. Seroconversion rates among children in all age groups increased 3–4-fold from June 2020 to February 2021. Only 24 of 58 (41%) seropositive children reported symptoms. In 51% of infected children, at least one parent was also SARS-CoV-2-positive. Low level of parental education (OR = 3.13; 95% CI: 0.72–13.69) non-significantly increased the risk of infection. Of the total cohort, 38.5% had a migration background, 9% of Turkish and 5% of Middle Eastern origin, and had the highest risk for SARS-CoV-2 infections (OR = 6.24; 95% CI: 1.38–28.12 and OR = 6.44 (95% CI: 1.14–36.45) after adjustment for other risk factors. Conclusion In the second half of 2020, seroprevalence for SARS-CoV-2 in children increased especially in families with lower-socioeconomic status. Culture-sensitive approaches are essential to limit transmission and could serve as a blueprint for vaccination strategies.

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“…This may become problematic if a variant emerges that causes more severe disease in these age groups than previous variants. Yet, we cannot rule out the possibility that we underestimated the extent of under-ascertainment in these age groups, as the factors we used where informed by seroprevalence studies based on blood samples donated by adults (ages 18-74), while it has been reported that under-ascertainment ratios can assume values ranging from 2 up to 6 or 8 for children [29][30][31].…”

Section: Resultsmentioning

confidence: 99%

Estimating the distribution of COVID-19-susceptible, -recovered, and -vaccinated individuals in Germany up to April 2022

Maier

Rose

Burdinski

et al. 2022

Preprint

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After having affected the population for two years, the COVID-19 pandemic has reached a phase where a considerable number of people in Germany have been either infected with a SARS-CoV-2 variant, vaccinated, or both. Yet the full extent to which the population has been in contact with either virus or vaccine remains elusive, particularly on a regional level, because (a) infection counts suffer from under-reporting, and (b) the overlap between the vaccinated and recovered subpopulations is unknown. Since previous infection, vaccination, or especially a combination of both reduce the risk of severe disease, a high share of individuals with SARS-CoV-2 immunity lowers the probability of severe outbreaks that could potentially overburden the public health system once again, given that emerging variants do not escape this reduction in susceptibility. Here, we estimate the share of immunologically naïve individuals by age group for each of the 16 German federal states by integrating an infectious disease model based on weekly incidences of SARS-CoV-2 infections in the national surveillance system and vaccine uptake, as well as assumptions regarding under-ascertainment. We estimate a median share of 7.0% of individuals in the German population have neither been in contact with vaccine nor any variant as of March 31, 2022 (quartile range [3.6%– 9.8%]). For the adult population at higher risk of severe disease, this figure is reduced to 3.5% [1.3%–5.5%] for ages 18–59 and 4.3% [2.7%–5.8%] for ages 60 and above. However, estimates vary between German states mostly due to heterogeneous vaccine uptake. Excluding Omicron infections from the analysis, 16.1% [14.0%–17.8%] of the population in Germany, across all ages, are estimated to be immunologically naïve, highlighting the large impact the Omicron wave had until the beginning of spring in 2022.

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Longitudinal Rise in Seroprevalence of SARS-CoV-2 Infections in Children in Western Germany—A Blind Spot in Epidemiology?

Cited by 20 publications

References 12 publications

Seroprevalence of immunoglobulin G antibodies against SARS-CoV-2 in children and adolescents in Delhi, India, from January to October 2021: a repeated cross-sectional analysis

Seroprevalence of immunoglobulin G antibodies against SARS-CoV-2 in children and adolescents in Delhi, India, from January to October 2021: a repeated cross-sectional analysis

Seroconversion rate and socio-economic and ethnic risk factors for SARS-CoV-2 infection in children in a population-based cohort, Germany, June 2020 to February 2021

Estimating the distribution of COVID-19-susceptible, -recovered, and -vaccinated individuals in Germany up to April 2022

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