Prior infection by seasonal coronaviruses, as assessed by serology, does not prevent SARS-CoV-2 infection and disease in children, France, April to June 2020

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Abstract

Children have a low rate of COVID-19 and secondary severe multisystem inflammatory syndrome (MIS) but present a high prevalence of symptomatic seasonal coronavirus infections.

Aim

We tested if prior infections by seasonal coronaviruses (HCoV) NL63, HKU1, 229E or OC43 as assessed by serology, provide cross-protective immunity against SARS-CoV-2 infection.

Methods

We set a cross-sectional observational multicentric study in pauci- or asymptomatic children hospitalised in Paris during the first wave for reasons other than COVID (hospitalised children (HOS), n = 739) plus children presenting with MIS (n = 36). SARS-CoV-2 antibodies directed against the nucleoprotein (N) and S1 and S2 domains of the spike (S) proteins were monitored by an in-house luciferase immunoprecipitation system assay. We randomly selected 69 SARS-CoV-2-seropositive patients (including 15 with MIS) and 115 matched SARS-CoV-2-seronegative patients (controls (CTL)). We measured antibodies against SARS-CoV-2 and HCoV as evidence for prior corresponding infections and assessed if SARS-CoV-2 prevalence of infection and levels of antibody responses were shaped by prior seasonal coronavirus infections.

Results

Prevalence of HCoV infections were similar in HOS, MIS and CTL groups. Antibody levels against HCoV were not significantly different in the three groups and were not related to the level of SARS-CoV-2 antibodies in the HOS and MIS groups. SARS-CoV-2 antibody profiles were different between HOS and MIS children.

Conclusion

Prior infection by seasonal coronaviruses, as assessed by serology, does not interfere with SARS-CoV-2 infection and related MIS in children.

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  1. SciScore for 10.1101/2020.06.29.20142596: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    In a fraction of samples, we assessed by LIPS tests, antibodies to the nucleoprotein and to the full spike ectodomain in a pre-fusion conformation for SARS-CoV-2, and the four human coronaviruses (HKU1, NL63, OC43, and 229E).
    SARS-CoV-2
    suggested: None
    HKU1
    suggested: None
    NL63
    suggested: None
    Software and Algorithms
    SentencesResources
    We also included in this study during the same period patients presenting with a MIS disease, as defined by the American Heart Association21.
    American Heart
    suggested: (American Heart Association, RRID:SCR_007210)
    Statistical analyses were conducted with Excel or GraphPad Prism 8 (GraphPad Software, LLC).
    Excel
    suggested: None
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)
    GraphPad
    suggested: (GraphPad Prism, RRID:SCR_002798)
    Data were processed with R 3.6.3 using GGPlot2 with GGally for matrices of plots, and ggfortify for PCA plots packages.
    GGPlot2
    suggested: (ggplot2, RRID:SCR_014601)

    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:
    However, this represents a limitation as cases of infection have been reported to be seronegative as revealed by isolated T-cell responses31. Seasonal HCoVs include alphacoronaviruses (229E and NL63) and betacoronaviruses lineage A (OC43 and HKU1), which primarily replicate in the respiratory tract and mostly cause common colds32. These viruses show a worldwide distribution and multiple HCoV infections in various combinations are common10,32–34,35. Infection takes place in very early childhood and seroprevalence studies show very high prevalence rates36, up to 100% in adult populations10,37,38. It is therefore very likely that infection by HCoVs preceded infection by SARS-CoV-2 in our cohort. Previous seasonal HCoV infections could have an impact on SARS-CoV-2 replication. Indeed, antibodies are unlikely to act as primary effectors of protection, as there is no or very low11 cross neutralization between these coronaviruses, but antibodies serve as an indicator of underlying cellular responses. We found no evidence of cross-protective immunity linked to previous infection by seasonal HCoVs. First, similar seasonal HcoV prevalence was found in SARS-CoV-2 positive versus negative patients. Second, on a quantitative side, there was no significant correlation between SARS-CoV-2 and any HCoV antibody titres, whatever the antigen considered (S or N). On the contrary, the level of SARS-CoV-2 antibodies to N and S were correlated, which corresponds to a good internal control. This was...

    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.
    • Thank you for including a protocol registration statement.

    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. SciScore for 10.1101/2020.06.29.20142596: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board Statementnot detected.Randomizationnot detected.Blindingnot detected.Power Analysisnot detected.Sex as a biological variablenot detected.Cell Line Authenticationnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Antibody frequency and titres against Nucleocapsid (N) and Spike (S) of the four seasonal coronaviruses (NL63, HKU1, 229E, OC43) were measured in a subset of seropositive patients (54 SARS-CoV-2 (HOS-P subgroup) and 15 MIS (MIS-P subgroup)), and in 118 matched SARS-CoV-2 seronegative patients (CTL subgroup).
    NL63
    suggested: None
    The level of anti-SARS-CoV-2 antibodies was not significantly different in children who had prior seasonal coronavirus infection.
    anti-SARS-CoV-2
    suggested: None
    In a fraction of samples, we assessed by LIPS tests, antibodies to the nucleoprotein and to the full spike ectodomain in a pre-fusion conformation for SARS-CoV-2, and the four human coronaviruses (HKU1, NL63, OC43, and 229E).
    HKU1
    suggested: None
    2-Profiling SARS-CoV-2 antibody responses in HOS-P and MIS-P patients HOS-P patients Ab profile was characterized by a dominant S2 response compared to responses to S1, N and to the full S ectodomain (Figure 3).
    2-Profiling SARS-CoV-2
    suggested: None
    Neutralizing titres of PNT+ and PRNT+ sera of MIS-P patients were similar to those of HOS-P patients (Figure 3). 4-Relationship between SARS-CoV-2 and seasonal HCoV infections We compared the prevalence of anti-N and -S antibodies against the four seasonal HCoVs in a subpopulation of children among the HOS-P (n=54), MIS-P (n=15) and CTL (n=118) groups (Figure 1).
    anti-N
    suggested: (Novus Cat# NB500-118, AB_10001231)
    This would diminish or impair SARS-CoV-2 antibody responses, which should therefore be lower in patients with high anti-HCoV Ab levels.
    anti-HCoV
    suggested: None
    Experimental Models: Cell Lines
    SentencesResources
    Although those Abs neutralized entry of SARS-CoV-2 S-pseudo-typed lentiviruses in HEK-293T cells mediated by the spike protein, the clinical relevance of the SARS-CoV-2 pseudo-neutralisation test is questionable, because the mechanism of entry did not involve the ACE2 receptor of the virus.
    HEK-293T
    suggested: KCB Cat# KCB 200744YJ, CVCL_0063
    Software and Algorithms
    SentencesResources
    We searched in PubMed, MedRxiv and BioRxiv for publications from inception to June 15, 2020, using the terms “COVID-19, SARS-CoV-2, children, serology, Kawasaki, Corona Virus”.
    PubMed
    suggested: (PubMed, SCR_004846)
          <div style="margin-bottom:8px">
            <div><b>BioRxiv</b></div>
            <div>suggested: (bioRxiv, <a href="https://scicrunch.org/resources/Any/search?q=SCR_003933">SCR_003933</a>)</div>
          </div>
        </td></tr><tr><td style="min-width:100px;vertical-align:top;border-bottom:1px solid lightgray">We also included in this study during the same period patients presenting with a MIS disease, as defined by the American Heart Association21.</td><td style="min-width:100px;border-bottom:1px solid lightgray">
          <div style="margin-bottom:8px">
            <div><b>American Heart</b></div>
            <div>suggested: (American Heart Association, <a href="https://scicrunch.org/resources/Any/search?q=SCR_007210">SCR_007210</a>)</div>
          </div>
        </td></tr><tr><td style="min-width:100px;vertical-align:top;border-bottom:1px solid lightgray">Statistical analyses were conducted with Excel or GraphPad Prism 8 (GraphPad Software, LLC).</td><td style="min-width:100px;border-bottom:1px solid lightgray">
          <div style="margin-bottom:8px">
            <div><b>Excel</b></div>
            <div>suggested: None</div>
          </div>
        
          <div style="margin-bottom:8px">
            <div><b>GraphPad Prism</b></div>
            <div>suggested: (GraphPad Prism, <a href="https://scicrunch.org/resources/Any/search?q=SCR_002798">SCR_002798</a>)</div>
          </div>
        
          <div style="margin-bottom:8px">
            <div><b>GraphPad</b></div>
            <div>suggested: (GraphPad Prism, <a href="https://scicrunch.org/resources/Any/search?q=SCR_002798">SCR_002798</a>)</div>
          </div>
        </td></tr><tr><td style="min-width:100px;vertical-align:top;border-bottom:1px solid lightgray">Data were processed with R 3.6.3 using GGPlot2 with GGally for matrices of plots, and ggfortify for PCA plots packages.</td><td style="min-width:100px;border-bottom:1px solid lightgray">
          <div style="margin-bottom:8px">
            <div><b>GGPlot2</b></div>
            <div>suggested: (ggplot2, <a href="https://scicrunch.org/resources/Any/search?q=SCR_014601">SCR_014601</a>)</div>
          </div>
        </td></tr></table>
    

    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 OddPub: We did not find a statement about open data. We also did not find a statement about open code. Researchers are encouraged to share open data when possible (see Nature blog).


    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 is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, including references cited, please follow this link.