Seroconversion and dynamics of the anti-SARS-CoV-2 antibody response related to a hospital COVID-19 outbreak among pediatric oncology patients

Mayanskiy, Nikolay; Luchkina, Polina; Fedorova, Natalia; Lebedin, Yu. S.; Ponomareva, Natalia

doi:10.1038/s41375-021-01288-0

Cited by 8 publications

(7 citation statements)

References 8 publications

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“…Similar investigation was published only by the Moscow group. They investigated a larger number of patients in multiple timepoints and found a 100% seroconversion after 6-weeks which started to decrease after three consecutive weeks to 54% by week 18, similar to our findings [ 14 ]. These results indicate that pediatric cancer patients, immunocompromised due to their underlying malignancy and its treatment, are able to mount a humoral immune response against the SARS-CoV-2 infection, however, this natural immunity may decline four to 5 months after harboring the infection leaving patients unprotected against a reinfection in a new wave of epidemics without vaccination.…”

Section: Discussionsupporting

confidence: 91%

Clinical Course of COVID-19 Disease in Children Treated With Neoplastic Diseases in Hungary

Müller

Szűcs-Farkas

Szegedi

et al. 2022

Pathol. Oncol. Res.

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We report on children with cancer in Hungary suffering from COVID-19, surveying a 13-months-long period of time. We performed a retrospective clinical trial studying the medical documentation of children treated in seven centers of the Hungarian Pediatric Oncology-Hematology Group. About 10% of children admitted to tertiary hemato-oncological centers for anti-neoplastic treatment or diagnosis for de novo malignancies were positive for SARS-CoV-2 infection. Nearly two-thirds of the infected patients were asymptomatic or had only mild symptoms but showed seropositivity by 1–4.5 months after positive PCR. One third of the SARS-CoV-2-positive children were hospitalized due to symptomatic COVID-19. Five children required antiviral treatment with remdesivir. One child was referred to the intensive care unit, requiring intubation and mechanical ventilation. Delay in the scheduled anti-cancer treatment did not exceed 2 weeks in the majority (89%) of cases. There was only one patient requiring treatment deferral longer than a month. There was no COVID-19-related death in patients under 18 years of age, and nor was multisystem inflammatory syndrome diagnosed. In conclusion, SARS-CoV-2 infection did not represent an untoward risk factor among children with cancer in Hungary.

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Section: Discussionsupporting

confidence: 91%

Clinical Course of COVID-19 Disease in Children Treated With Neoplastic Diseases in Hungary

Müller

Szűcs-Farkas

Szegedi

et al. 2022

Pathol. Oncol. Res.

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“…Another study reported dynamics of the anti-SARS-CoV-2 antibody response; seroconversion was observed in 92% of patients (16 with ALL, and 2 brain tumors) by week 3 and in 100% of patients by week 6 post exposure. The seropositivity rate was maintained at around 80% for at least three consecutive weeks, declining to 54% by week 18 post exposure ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

Factors that predict severity of infection and seroconversion in immunocompromised children and adolescents with COVID-19 infection

Shanap

Sughayer²,

Alsmadi³

et al. 2022

Front. Immunol.

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ObjectivesWe aimed to study the outcomes, severity, and seroconversion post SARS-CoV-2 infection in immunocompromised children and adolescents treated at our center.MethodFor this observational study, all pediatric patients who had COVID-19 infection from Sep-22-2020 to Nov-10-2021were identified by reviewing our laboratory records. Their charts were reviewed to determine clinical severity and outcome. Blood samples were drawn for anti-SARS-CoV-2 antibody assay. Serious COVID-19 infection (SVI) was defined if the patient had moderate, severe, or critical illness. A cutoff of 100 U/mL anti-SARS-CoV-2 antibodies was used to categorize low and high titer seroconversion.ResultsWe identified 263 pediatric patients with COVID-19; most (68%) were symptomatic: 5% had severe or critical infection, 25% were hospitalized, 12 required respiratory support, 12 were admitted to the ICU, and five patients (2%) died. Multivariable analysis revealed several factors that predict SVI: Age above 12 years (p=0.035), body mass index above 95th percentile (p=0.034), comorbid conditions (p=0.025), absolute neutrophil count ≤500(p=0.014) and absolute lymphocyte count ≤300 (p=0.022). Levels of anti-SARS-CoV-2 spike antibodies were obtained for 173 patients at a median of 94 days (range, 14–300) after PCR diagnosis; of them 142 (82%) patients seroconverted; the lowest seroconversion rate was observed in patients with hematological malignancies (79%). Our univariable model showed that the following factors were predictive of low titer: lower ANC, p=0.01; hematologic malignancy, p=0.023; receiving steroids in the last 14 days, p=0.032; time since last chemotherapy or immunosuppressive therapy less than 30 days, p=0.002; and being on active chemotherapy in the last 3 months prior to infection, p<0.001.ConclusionsSARS-CoV-2 antibodies developed in most immunocompromised patients with COVID-19 infection in our study. Mortality was relatively low in our patients. Our univariable and multivariable models showed multiple variables that predict severity of infections and antibody response post COVID-19 infection. These observations may guide choice of active therapy during infection and the best timing of vaccination in this high-risk population.

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“…However, by 18 weeks after the onset of COVID-19, this seropositivity rate declined to 54%. However, the authors did not compare the level of antibodies with an immunocompetent control group [12]. On the other hand, researchers from Hungary assessed the level of antibodies in 10 children with cancer at an interval of 1 to 4.5 months after the onset of COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Immune response to SARS-CoV-2 infections in children with secondary immunodeficiencies

Kuczborska

Krzemińska²,

Buda³

et al. 2022

Preprint

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Background and PurposeIt is a matter of research, whether children with immunodeficiencies are able to generate an effective immune response to prevent SARS-CoV-2 reinfection. This study aimed to evaluate and compare the seroconversion rates and cellular immunity to COVID-19 in immunocompetent children and those with secondary immunodeficiencies. MethodsIn 55 children — 28 immunocompromised and 27 immunocompetent — hospitalized with confirmed SARS-CoV-2 infection, the level of IgG antibodies against the Spike protein was determined on two to three occasions. In those children from the study group, whose immunosuppressive treatment did not alter during the study (n=13) and in selected children from the control group (n=11), flow-cytometric evaluation of lymphocyte subsets was performed twice — two weeks and three months post-infection. ResultsSeroconversion reached 96.3% in both studied groups, however, the immunocompromised cohort achieved lower titers of detectable anti-S antibodies. There was no correlation between seroconversion or titers of antibodies and the total number of lymphocytes or their subsets. In the immunocompetent cohort, we reported a significant decrease in NK cells during the infection. In this group and the entire study population, a positive correlation was noticed between the CD4+/CD8+ T cell ratio and the severity of COVID-19 pneumonia. ConclusionsChildren with secondary immunodeficiencies seroconvert in equal percentages but with a significantly lower titer of anti-S antibodies compared to their immunocompetent peers. Lower number of NK cells in the immunocompetent cohort may result from their participation in antiviral immunity. Whereas reduced CD4+/CD8+ T cell ratios among immunocompromised children can be a protective factor against a severe COVID-19.

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Seroconversion and dynamics of the anti-SARS-CoV-2 antibody response related to a hospital COVID-19 outbreak among pediatric oncology patients

Cited by 8 publications

References 8 publications

Clinical Course of COVID-19 Disease in Children Treated With Neoplastic Diseases in Hungary

Clinical Course of COVID-19 Disease in Children Treated With Neoplastic Diseases in Hungary

Factors that predict severity of infection and seroconversion in immunocompromised children and adolescents with COVID-19 infection

Immune response to SARS-CoV-2 infections in children with secondary immunodeficiencies

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