Long-Term Antibody Response to SARS-CoV-2 in Children
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Abstract
Almost 2 years into the pandemic and with vaccination of children significantly lagging behind adults, long-term pediatric humoral immune responses to SARS-CoV-2 are understudied. The C19.CHILD Hamburg (COVID-19 Child Health Investigation of Latent Disease) Study is a prospective cohort study designed to identify and follow up children and their household contacts infected in the early 2020 first wave of SARS-CoV-2. We screened 6113 children < 18 years by nasopharyngeal swab-PCR in a low-incidence setting after general lockdown, from May 11 to June 30, 2020. A total of 4657 participants underwent antibody testing. Positive tests were followed up by repeated PCR and serological testing of all household contacts over 6 months. In total, the study identified 67 seropositive children (1.44%); the median time after infection at first presentation was 83 days post-symptom onset (PSO). Follow-up of household contacts showed less than 100% seroprevalence in most families, with higher seroprevalence in families with adult index cases compared to pediatric index cases (OR 1.79, P = 0.047). Most importantly, children showed sustained seroconversion up to 9 months PSO, and serum antibody concentrations persistently surpassed adult levels (ratio serum IgG spike children vs. adults 90 days PSO 1.75, P < 0.001; 180 days 1.38, P = 0.01; 270 days 1.54, P = 0.001). In a low-incidence setting, SARS-CoV-2 infection and humoral immune response present distinct patterns in children including higher antibody levels, and lower seroprevalence in families with pediatric index cases. Children show long-term SARS-CoV-2 antibody responses. These findings are relevant to novel variants with increased disease burden in children, as well as for the planning of age-appropriate vaccination strategies.
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SciScore for 10.1101/2022.02.11.22270611: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: A written informed consent was obtained for each participating subject (Supplementary Methods).
IRB: The study was approved by the local ethical committee of Hamburg (reference number: PV7336) and published at clinicaltrials.gov (NCT04534608).Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources Analyses were performed using R software (version 4.0.2) and GraphPad Prism (version 8.4). GraphPad Prismsuggested: (GraphPad Prism, RRID:SCR_002798)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open …
SciScore for 10.1101/2022.02.11.22270611: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: A written informed consent was obtained for each participating subject (Supplementary Methods).
IRB: The study was approved by the local ethical committee of Hamburg (reference number: PV7336) and published at clinicaltrials.gov (NCT04534608).Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources Analyses were performed using R software (version 4.0.2) and GraphPad Prism (version 8.4). GraphPad Prismsuggested: (GraphPad Prism, RRID:SCR_002798)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:There are limitations to this study. Teenagers were relatively underrepresented when compared to younger children and Hamburg census data. The retrospective nature of serological testing in this study did not allow for confirmation of infection by direct virus detection (PCR), therefore seropositivity is used as a surrogate marker for past infection. Furthermore, PCR test results from study participants from the time of infection were not available and index cases in family clusters were identified based on patient history of symptomatic illness (Supplementary Table S2). A selection bias needs to be considered when interpreting our findings. First, our study included over 50 % volunteers, second, blood draws were more likely to have been carried out in older children. In this study, no serum neutralization tests have been performed. Instead, seropositivity was defined based on two different serum antibody tests, both of which have shown good correlation with plaque reduction neutralization tests [52,53]. While this approach does not measure direct antibody mediated protective immunity, it reduces the probability of false positive tests, especially when multiple family members are assessed. Since the samples used for antibody measurements in this study were obtained after the first 2020 wave of infections, they represent infections with the ancestral SARS-CoV-2 which has now been replaced by more recent viral variants. In spite of this, our data is relevant to antibody respons...
Results from TrialIdentifier: We found the following clinical trial numbers in your paper:
Identifier Status Title NCT04534608 Active, not recruiting COVID-19 Child Health Investigation of Latent Disease in Ham… Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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