Cross-sectional seroprevalence surveys of SARS-CoV-2 antibodies in children in Germany, June 2020 to May 2021

Sorg, Anna-Lisa; Bergfeld, Léon; Jank, Marietta; Corman, Victor M.; Semmler, Ilia; Goertz, Anna; Beyerlein, Andreas; Verjans, Eva; Wagner, Norbert; Bernuth, Horst von; Lander, Fabian; Weil, Katharina; Hufnagel, Markus; Spiekerkötter, Ute; Chao, Cho-Ming; Naehrlich, L.; Muntau, Ania C.; Schulze-Sturm, Ulf; Hansen, Gesine; Wetzke, Martin; Jung, Anna-Maria; Niehues, Tim; Fricke-Otto, Susanne; Both, Ulrich von; Hüebner, Johannes; Behrends, Uta; Liese, Johannes G.; Schwerk, Christian; Drosten, Christian; Kries, Rüdiger von; Schroten, Horst

doi:10.1038/s41467-022-30482-6

Cited by 21 publications

(30 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The proportion of children with positive titers against SARS-CoV-2 immunoglobulin G (IgG) was recently published for the SARS-CoV-2 KIDS study [ 8 ]. This is a hospital-based, multi-center, longitudinal study in children aged ≤ 17 years.…”

Section: Methodsmentioning

confidence: 99%

“…The SARS-CoV-2 KIDS study authors reported a seroprevalence of SARS-CoV-2 IgG antibodies of 10.8% (95% CI 8.7, 12.9) for March 2021, and observed no major change through May 2021 [ 8 ]. Additionally, by the end of the observation period, they detected no differences in seroprevalence among the different age groups.…”

Section: Methodsmentioning

confidence: 99%

“…To calculate the risk for the different outcome measurements, we estimated the number of SARS-CoV-2-infected children by using the number of children in the respective age group as reported by the Federal Statistical Office and the SARS-CoV-2 KIDS Study data [ 8 ]. To account for sampling imprecision, the upper and lower limits of the reported 95% confidence intervals served as a denominator for the risk estimate limits regarding the SARS-CoV-2 outcome measurements.…”

Section: Methodsmentioning

confidence: 99%

“…Here, we analyze information from a seroprevalence study in children — the SARS-CoV-2 KIDS study, recently published by Sorg et al [ 8 ] — with publicly accessible data from the nationwide, state-based reporting system for PCR-confirmed SARS-CoV-2 infections in Germany on hospitalization and mortality [ 9 ], and data from a nationwide registry on hospitalized children with COVID-19 and pediatric inflammatory multisystem syndrome temporarily associated with SARS-CoV-2 (PIMS-TS, also known as MIS-C), the latter of which is sponsored by the German Society for Pediatric Infectious Diseases (DGPI) [ 10 , 11 ]. By combining this data, we aimed to provide a risk estimates regarding hospitalization for COVID-19-related treatment, intensive care admission, and death due to COVID-19 and PIMS-TS for children of different age groups.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Risk for severe outcomes of COVID-19 and PIMS-TS in children with SARS-CoV-2 infection in Germany

et al. 2022

Self Cite

View full text Add to dashboard Cite

Although children and adolescents have a lower burden of SARS-CoV-2-associated disease compared to adults, assessing the risk for severe outcomes among SARS-CoV-2-infected children remains difficult due to a high rate of undetected cases. We combine data from three data sources — a national seroprevalence study (the SARS-CoV-2 KIDS study), the nationwide, state-based reporting system for PCR-confirmed SARS-CoV-2 infections in Germany, and a nationwide registry on children and adolescents hospitalized with either SARS-CoV-2 or pediatric inflammatory multisystem syndrome (PIMS-TS, also known as MIS-C) — in order to provide estimates on the risk of hospitalization for COVID-19-related treatment, intensive care admission, and death due to COVID-19 and PIMS-TS in children. The rate of hospitalization for COVID-19-related treatment among all SARS-CoV-2 seropositive children was 7.13 per 10,000, ICU admission 2.21 per 10,000, and case fatality was 0.09 per 10,000. In children without comorbidities, the corresponding rates for severe or fatal disease courses were substantially lower. The lowest risk for the need of COVID-19-specific treatment was observed in children aged 5–11 without comorbidities. In this group, the ICU admission rate was 0.37 per 10,000, and case fatality could not be calculated due to the absence of cases. The overall PIMS-TS rate was 2.47 per 10,000 SARS-CoV-2 infections, the majority being children without comorbidities.Conclusion: Overall, the SARS-CoV-2-associated burden of a severe disease course or death in children and adolescents is low. This seems particularly the case for 5–11-year-old children without comorbidities. By contrast, PIMS-TS plays a major role in the overall disease burden among all pediatric age groups. What is Known:• SARS-CoV-2-associated burden of disease in children is considered to be low, but accurate risk estimates accounting for clinically undiagnosed infections are lacking.• Asymptomatic SARS-CoV-2 infections are common in children. What is New:• We provide risk estimates for hospitalization for COVID-19-related treatment, ICU admission, death from COVID-19, and PIMS-TS for children with SARS-CoV-2 infections by pooling different data sources.• The risk for PIMS-TS exceeds the risk for severe COVID-19 in all age groups; the risk for severe COVID-19 is the lowest in 5–11 years old.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Risk for severe outcomes of COVID-19 and PIMS-TS in children with SARS-CoV-2 infection in Germany

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…The strength of our analysis is the use of population-based data and the inclusion of more than 5 million con rmed infections with a uniform, widely available testing strategy during the observation periodwith more than 30% of seropositive cases identi ed as of March 2021 [19].…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 variants and the risk of Pediatric Inflammatory Multisystem Syndrome temporally associated with SARS-CoV-2 in children in Germany

Sorg

Schönfeld

Hufnagel

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

Purpose: To investigate the risk of Pediatric Inflammatory Multisystem Syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in children depending on periods with different dominant variants of concern (VOC) of SARS-CoV-2.Methods: The risk of developing PIMS-TS in three phases of the pandemic with different VOC (Alpha, Delta, and Omicron) was calculated using data of rtPCR confirmed SARS-CoV-2 infections extracted from the German statutory notification system and reports of cases with PIMS-TS captured by a national, prospective registry. Overall and age group-specific rate ratios of PIMS-TS rates in the different observation periods, using the Alpha period as the baseline, were calculated.Results: The rate of PIMS-TS changed significantly over time. During April-August 2021, with dominant VOC Alpha_B.1.1.7, the PIMS-TS rate was 6.19 (95% confidence intervals (95% CI) 5.17, 7.20), decreased to 1.68 (95% CI 1.49, 1.87) in August 2021 to January 2022 with Delta_AY and to 0.89 (95% CI 0.79, 1.00) in January-April 2022 with Omicron_BA as dominant VOC. This corresponds to a decrease in PIMS-TS rate of 73% (rate ratio 0.271, 95% CI 0.222; 0.332) and 86% (rate ratio 0.048, 95% CI 0.037; 0.062), respectively, compared to the Alpha period. Rate ratios were almost identical for all age groups.Conclusion: The data strongly suggest a relation of the risk for PIMS-TS to the prevailing VOC with the highest risk related to Alpha_B.1.1.7 and the lowest with Omicron_BA. Uniformity of the decrease across age groups does not suggest a major role for vaccination on the risk of PIMS-TS in infected children.

show abstract

Association of SARS-CoV-2 Seropositivity With Myalgic Encephalomyelitis and/or Chronic Fatigue Syndrome Among Children and Adolescents in Germany

Sorg

Becht²,

Jank

et al. 2022

JAMA Netw Open

Self Cite

View full text Add to dashboard Cite

ImportanceDuring the COVID-19 pandemic, a reduction in quality of life and physical and mental health among children and adolescents has been reported that may be associated with SARS-CoV-2 infection and/or containment measures.ObjectiveTo assess the association of SARS-CoV-2 seropositivity with symptoms that may be related to myalgic encephalomyelitis and/or chronic fatigue syndrome (ME/CFS) among children and adolescents.Design, Setting, and ParticipantsThis substudy of the cross-sectional SARS-CoV-2 seroprevalence surveys in Germany (SARS-CoV-2 KIDS) was performed in 9 pediatric hospitals from May 1 to October 31, 2021. Pediatric patients were recruited during an inpatient or outpatient visit regardless of the purpose of the visit. Parental questionnaires and serum samples were collected during clinically indicated blood draws. The parental questionnaire on demographic and clinical information was extended by items according to the DePaul Symptom Questionnaire, a pediatric screening tool for ME/CFS in epidemiological studies in patients aged 5 to 17 years.ExposuresSeropositivity was determined by SARS-CoV-2 IgG antibodies in serum samples using enzyme-linked immunosorbent assays.Main Outcomes and MeasuresKey symptoms of ME/CFS were evaluated separately or as clustered ME/CFS symptoms according to the DePaul Symptom Questionnaire, including fatigue.ResultsAmong 634 participants (294 male [46.4%] and 340 female [53.6%]; median age, 11.5 [IQR, 8-14] years), 198 (31.2%) reported clustered ME/CFS symptoms, including 40 of 100 SARS-CoV-2–seropositive (40.0%) and 158 of 534 SARS-CoV-2–seronegative (29.6%) children and adolescents. After adjustment for sex, age group, and preexisting disease, the risk ratio for reporting clustered ME/CFS symptoms decreased from 1.35 (95% CI, 1.03-1.78) to 1.18 (95% CI, 0.90-1.53) and for substantial fatigue from 2.45 (95% CI, 1.24-4.84) to 2.08 (95% CI, 1.05-4.13). Confinement to children and adolescents with unknown previous SARS-CoV-2 infection status (n = 610) yielded lower adjusted risks for all symptoms except joint pain ME/CFS–related symptoms. The adjusted risk ratio was 1.08 (95% CI, 0.80-1.46) for reporting clustered ME/CFS symptoms and 1.43 (95% CI, 0.63-3.23) for fatigue.Conclusions and RelevanceThese findings suggest that the risk of ME/CFS in children and adolescents owing to SARS-CoV-2 infection may be very small. Recall bias may contribute to risk estimates of long COVID-19 symptoms in children. Extensive lockdowns must be considered as an alternative explanation for complex unspecific symptoms during the COVID-19 pandemic.

show abstract

Cross-sectional seroprevalence surveys of SARS-CoV-2 antibodies in children in Germany, June 2020 to May 2021

Cited by 21 publications

References 28 publications

Risk for severe outcomes of COVID-19 and PIMS-TS in children with SARS-CoV-2 infection in Germany

Risk for severe outcomes of COVID-19 and PIMS-TS in children with SARS-CoV-2 infection in Germany

SARS-CoV-2 variants and the risk of Pediatric Inflammatory Multisystem Syndrome temporally associated with SARS-CoV-2 in children in Germany

Association of SARS-CoV-2 Seropositivity With Myalgic Encephalomyelitis and/or Chronic Fatigue Syndrome Among Children and Adolescents in Germany

Contact Info

Product

Resources

About