Level and Duration of IgG and Neutralizing Antibodies to SARS-CoV-2 in Children with Symptomatic or Asymptomatic SARS-CoV-2 Infection
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Abstract
There are conflicting data about level and duration of Abs to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children after symptomatic or asymptomatic infection. In this human population, we enrolled adults and children in a prospective 6-mo study in the following categories: 1) symptomatic, SARS-CoV-2 PCR+ (SP+; children, n = 8; adults, n = 16), 2) symptomatic, PCR−, or untested (children, n = 27), 3) asymptomatic exposed (children, n = 13), and 4) asymptomatic, no known exposure (children, n = 19). Neutralizing Abs (nAbs) and IgG Abs to SARS-CoV-2 Ags and spike protein variants were measured by multiplex serological assay. All SP+ children developed nAb, whereas 81% of SP+ adults developed nAb. Decline in the presence of nAb over 6 mo was not significant in symptomatic children (100 to 87.5%; p = 0.32) in contrast to adults (81.3 to 50.0%; p = 0.03). Among children with nAb (n = 22), nAb titers and change in titers over 6 mo were similar in symptomatic and asymptomatic children. In children and adults, nAb levels postinfection were 10-fold lower than those reported after SARS-CoV-2 mRNA vaccination. Levels of IgG Abs in children to SARS-CoV-2 Ags and spike protein variants were similar to those in adults. IgG levels to primary Ags decreased over time in children and adults, but levels to three spike variants decreased only in children. Children with asymptomatic or symptomatic SARS-CoV-2 infection develop nAbs that remain present longer than in adults but wane in titer over time and broad IgG Abs that also wane in level over time. However, nAb levels were lower postinfection than those reported after immunization.
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SciScore for 10.1101/2022.04.12.22273466: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: Written informed consent was obtained from all participants and/or parents and verbal assent from children aged 7 to 17 years. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Antibodies Sentences Resources The transferred solution was combined with ACE2 coated beads and incubated for 60 minutes; remaining beads were washed and incubated for 60 minutes with anti-IgG-PE beads to detect bound antibodies. anti-IgG-PEsuggested: NoneSoftware and Algorithms Sentences Resources : StataCorp LP) and figures were created using GraphPad Prism 9. StataCorpsuggested: (Stata, RRID:SCR_012763)GraphPad Prismsuggested: …SciScore for 10.1101/2022.04.12.22273466: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: Written informed consent was obtained from all participants and/or parents and verbal assent from children aged 7 to 17 years. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Antibodies Sentences Resources The transferred solution was combined with ACE2 coated beads and incubated for 60 minutes; remaining beads were washed and incubated for 60 minutes with anti-IgG-PE beads to detect bound antibodies. anti-IgG-PEsuggested: NoneSoftware and Algorithms Sentences Resources : StataCorp LP) and figures were created using GraphPad Prism 9. StataCorpsuggested: (Stata, RRID:SCR_012763)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:The relatively small sample size (22 children with SARS-CoV-2 infection and samples at enrollment and follow-up), absence of children with severe SARS-CoV-2 infection, lack of testing for IgG against Delta or Omicron variants, and lack of testing of cellular immunity, which plays a critical role in memory responses to COVID-19 infection8,28-31, are all study limitations. However, the study strengths, notably the evaluation of antibodies over time in children and adults, evaluation of neutralizing antibodies and IgG antibodies against multiple Spike protein variants, and the inclusion of testing in asymptomatic children, provide valuable new data on level and duration of antibody response in children after SARS-CoV-2 infection. In conclusion, our study shows that the neutralizing antibody response to SARS-CoV-2 infection in children after symptomatic or asymptomatic infection is at least as strong as in adults and lasts longer in children than in adults but does wane over time in both children and adults. IgG antibodies to some SARS-CoV-2 antigens showed a greater decrease in children than adults, but the more functionally important neutralizing antibodies showed a greater decrease in adults than children, highlighting the importance of evaluating neutralizing antibodies when assessing changes in immunity over time. Now that SARS-CoV-2 vaccines are available for children, studies of post-vaccination antibody responses in children will be important to determine the extent to wh...
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.
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- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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