In this current outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many studies have been published to determine the spectrum of illness, risk factors, prevention, and treatment strategies. Due to relatively fewer cases among children as compared to adults, there is a paucity of clinical data available to fully understand the risk factors and disease course in the pediatric population. Our understanding is evolving with limited data showing an increased risk of severe or critical disease in children less than one year of age and those with certain underlying medical conditions. Recognition of emerging risk factors for morbidity and mortality is now paramount, to anticipate and provide appropriate clinical care specific to the pediatric population. Obesity has only recently been identified as a risk factor for severe COVID-19 disease in children. Case reports such as this are essential in understanding the pathophysiologic association, associated disease severity, and clinical outcome attributed to obesity and COVID-19 infections in children.

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Point-of-care (POC) antibody testing has a mixed record in detecting prior COVID-19 infection. However, interest remains in POC antibody testing because the numerous patients in need of screening may overwhelm high-complexity laboratory capacity. METHODS: We enrolled subjects with and without a history of COVID-19 infection. Exclusion criteria included a history of immunodeficiency or an immunosuppressed state. A positive infection history was defined by clinical COVID-19 PCR. Demographic and infection history were recorded. We utilized commercial POC antibody tests from Healgen and Access Bio Inc and tested both kits using whole blood and serum. We compared each test to a history of PCR positivity and a validated immunoassay (Elecsys, Roche Inc). Test characteristics were calculated for each test. RESULTS: 467 subjects enrolled, including 88 subjects with a known prior positive COVID-19 PCR. Symptoms among COVID-19-infected subjects included fever > 38C (59%), subjective fever (72%), myalgias (84%), rhinorrhea (47%), cough (81%), dyspnea (64%), gastrointestinal symptoms (58%), anosmia (70%), and dysgeusia (66%). The Healgen kit showed 93.5%/97.6% sensitivity/specificity between whole blood and serum and 95.5%/96.2% between serum testing and the immunoassay. The Access Bio kit showed 98.0%/98.7% sensitivity/specificity between whole blood and serum and 93.8%/100.0% between serum testing and the immunoassay.The Roche immunoassay showed 96.6%/96.0% sensitivity/ specificity with history of PCR positivity. CONCLUSIONS: POC COVID-19 antibody testing showed good concordance between whole blood and serum analyses, and excellent concordance with the Roche immunoassay. POC antibody testing via whole blood and/or serum may be reasonable as a screening step for prior COVID-19 infection.