Seroprevalence of SARS-CoV-2 antibodies in children: a prospective multicentre cohort study

  1. Thomas Waterfield
  2. Chris Watson
  3. Rebecca Moore
  4. Kathryn Ferris
  5. Claire Tonry
  6. Alison Watt
  7. Claire McGinn
  8. Steven Foster
  9. Jennifer Evans
  10. Mark David Lyttle
  11. Shazaad Ahmad
  12. Shamez Ladhani
  13. Michael Corr
  14. Lisa McFetridge
  15. Hannah Mitchell
  16. Kevin Brown
  17. Gayatri Amirthalingam
  18. Julie-Ann Maney
  19. Sharon Christie

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Abstract

Studies based on molecular testing of oral/nasal swabs underestimate SARS-CoV-2 infection due to issues with test sensitivity, test timing and selection bias. The objective of this study was to report the presence of SARS-CoV-2 antibodies, consistent with previous infection.

Design

This multicentre observational cohort study, conducted between 16 April to 3 July 2020 at 5 UK sites, recruited children of healthcare workers, aged 2–15 years. Participants provided blood samples for SARS-CoV-2 antibody testing and data were gathered regarding unwell contacts and symptoms.

Results

1007 participants were enrolled, and 992 were included in the final analysis. The median age of participants was 10·1 years. There were 68 (6.9%) participants with positive SARS-CoV-2 antibody tests indicative of previous SARS-CoV-2 infection. Of these, 34/68 (50%) reported no symptoms prior to testing. The presence of antibodies and the mean antibody titre was not influenced by age. Following multivariable analysis four independent variables were identified as significantly associated with SARS-CoV-2 seropositivity: known infected household contact OR=10.9 (95% CI 6.1 to 19.6); fatigue OR=16.8 (95% CI 5.5 to 51.9); gastrointestinal symptoms OR=6.6 (95% CI 3.0 to 13.8); and changes in sense of smell or taste OR=10.0 (95% CI 2.4 to 11.4).

Discussion

Children demonstrated similar antibody titres in response to SARS-CoV-2 irrespective of age. Fatigue, gastrointestinal symptoms and changes in sense of smell or taste were the symptoms most strongly associated with SARS-CoV-2 antibody positivity.

Trial registration number

NCT0434740 .

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2020.08.31.20183095: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementConsent: Informed consent: Informed consent was obtained, and assent given by children where possible.
    IRB: Office for Research Ethics Committees (OREC) and local Research Governance: Ethical approval was obtained from the London – Chelsea Research Ethics Committee (REC Reference – 20/HRA/1731) and the Belfast Health & Social Care Trust Research Governance (Reference 19147TW-SW).
    Randomizationnot detected.
    BlindingTo minimise recall bias, data relating to exposures and illness episodes were collected blinded to antibody testing results.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Serum and/or plasma were tested for antibodies to SARS-CoV-2, in UKAS accredited laboratories using the following assays, which have been validated for use (22-24): The Abbott, Roche and DiaSorin assays are highly specific for SARS-CoV-2 antibodies, using the manufacturer’s suggested cut-offs, with specificities of 1.00 (95% CI 0.98 to 1.00), 1.00 (95% CI 0.99 to 1.00
    SARS-CoV-2
    suggested: None
    Software and Algorithms
    SentencesResources
    Serum and/or plasma were tested for antibodies to SARS-CoV-2, in UKAS accredited laboratories using the following assays, which have been validated for use (22-24): The Abbott, Roche and DiaSorin assays are highly specific for SARS-CoV-2 antibodies, using the manufacturer’s suggested cut-offs, with specificities of 1.00 (95% CI 0.98 to 1.00), 1.00 (95% CI 0.99 to 1.00
    Abbott
    suggested: (Abbott, RRID:SCR_010477)
    Study data were collected on a case report form (CRF) using REDCap (Research Electronic Data Capture) electronic data capture tools (25).
    REDCap
    suggested: (REDCap, RRID:SCR_003445)

    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: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04347408RecruitingSeroprevalence of SARS-Cov-2 Antibodies in Children

    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.

    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.

  2. Version published to 10.1136/archdischild-2020-320558
  3. Version published to 10.1101/2020.08.31.20183095v1 on medRxiv