Pediatric SARS-CoV-2 Seroprevalence in Arkansas Over the First Year of the COVID-19 Pandemic

  1. Karl W Boehme
  2. Joshua L Kennedy
  3. Jessica Snowden
  4. Shana M Owens
  5. Marianne Kouassi
  6. Ryan L Mann
  7. Amairani Paredes
  8. Claire Putt
  9. Laura James
  10. Jing Jin
  11. Ruofei Du
  12. Catherine Kirkpatrick
  13. Zeel Modi
  14. Katherine Caid
  15. Sean Young
  16. Namvar Zohoori
  17. Atul Kothari
  18. Bobby L Boyanton
  19. J Craig Forrest

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Abstract

Background

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) seroprevalence studies largely focus on adults, but little is known about spread in children. We determined SARS-CoV-2 seroprevalence in children and adolescents from Arkansas over the first year of the coronavirus disease of 2019 (COVID-19) pandemic.

Methods

We tested remnant serum samples from children ages 1-18 years who visited Arkansas hospitals or clinics for non-COVID-19-related reasons from April 2020 through April 2021 for SARS-CoV-2 antibodies. We used univariable and multivariable regression models to determine the association between seropositivity and participant characteristics.

Results

Among 2357 participants, seroprevalence rose from 7.9% in April/May 2020 (95% CI, 4.9-10.9) to 25.0% in April 2021 (95% CI, 21.5-28.5). Hispanic and black children had a higher association with antibody positivity than non-Hispanic and white children, respectively, in multiple sampling periods.

Conclusions

By spring 2021, most children in Arkansas were not infected with SARS-CoV-2. With the emergence of SARS-CoV-2 variants, recognition of long-term effects of COVID-19, and the lack of an authorized pediatric SARS-CoV-2 vaccine at the time, these results highlight the importance of including children in SARS-CoV-2 public health, clinical care, and research strategies.

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  1. Version published to 10.1093/jpids/piac010
  2. Version published to 10.1101/2021.08.04.21261592v3 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2021.08.04.21261592: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Human specimens: All human specimens were obtained with oversight from the UAMS Institutional Review Board (IRB), and waiver of consent and HIPAA applied.
    Sex as a biological variablenot detected.
    RandomizationAn additional 5% of negative sera were randomly selected and tested in parallel.
    Blindingnot detected.
    Power Analysisnot detected.
    Cell Line Authenticationnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Purified proteins were confirmed by Coomassie and western blot using antigen-specific antibodies and stored at -80°C.
    antigen-specific
    suggested: None
    Experimental Models: Cell Lines
    SentencesResources
    Protein production and purification: HEK293T cells were cultured in Dulbecco’s minimum essential media (DMEM; Gibco) supplemented with 10% heat-inactivated calf serum (CS, VWR), 2 mM L-glutamine (Invitrogen), and 100 U/mL penicillin/100 µg/mL streptomycin (Invitrogen).
    HEK293T
    suggested: None
    Recombinant DNA
    SentencesResources
    Briefly, 15 cm dishes seeded with 9×106 cells on the preceding day were transfected with 20 µg of pCAGGS-SARS-CoV-2 Wuhan-Hu-1 RBD-C-terminal 6-His tag (BEI Resources), pCAGGS SARS-CoV-2
    pCAGGS-SARS-CoV-2
    suggested: None
    pCAGGS
    suggested: RRID:Addgene_18926)
    Wuhan-Hu-1 ectodomain Spike glycoprotein gene-C-terminal 6-His tag, or pCMV3 2019-nCoV
    pCMV3
    suggested: RRID:Addgene_161029)
    Software and Algorithms
    SentencesResources
    Clinical and demographic variables were stored in a secure REDCap database16,17 and included age, sex, race/ethnicity, zip code, and county of residence.
    REDCap
    suggested: (REDCap, RRID:SCR_003445)
    Plates were coated with 2 µg/mL RBD, spike, nucleoprotein, or bovine serum albumin (BSA; Sigma Aldrich) and FACT ELISA was performed as above.
    BSA; Sigma Aldrich
    suggested: None
    We conducted all analyses using SAS version 9.4 (SAS Institute).
    SAS Institute
    suggested: (Statistical Analysis System, RRID:SCR_008567)

    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: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    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.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2021.08.04.21261592v2 on medRxiv
  5. Version published to 10.1101/2021.08.04.21261592v1 on medRxiv