Seroprevalence and clinical characteristics of SARS‐CoV‐2 infection in children with cystic fibrosis

Abstract

BackgroundPeople with cystic fibrosis (PwCF) have chronic lung disease and may be at increased risk of coronavirus disease 2019 (COVID‐19)‐related morbidity and mortality. This study aimed to determine seroprevalence and clinical characteristics of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection in children with cystic fibrosis (CF), and to assess antibody responses following SARS‐CoV‐2 infection or vaccination.MethodsChildren and adolescents with CF followed at Seattle Children's Hospital were enrolled between July 20, 2020 and February 28, 2021. SARS‐CoV‐2 serostatus was determined on enrollment at 6 and 11 months (±2 months) for nucleocapsid and spike IgG. Participants completed intake and weekly surveys inquiring about SARS‐CoV‐2 exposures, viral/respiratory illnesses, and symptoms.ResultsOf 125 PwCF enrolled, 14 (11%) had positive SARS‐CoV‐2 antibodies consistent with recent or past infection. Seropositive participants were more likely to identify as Hispanic (29% vs. 8%, p = 0.04) and have pulmonary exacerbations requiring oral antibiotics in the year prior (71% vs. 41%, p = 0.04). Five seropositive individuals (35.7%) were asymptomatic, while six (42.9%) reported mild symptoms, primarily cough and nasal congestion. Antispike protein IgG levels were approximately 10‐fold higher in participants following vaccination compared with participants who had natural infection alone (p < 0.0001) and resembled levels previously reported in the general population.ConclusionsA majority of PwCF have mild or no symptoms of SARS‐CoV‐2 making it difficult to distinguish from baseline respiratory symptoms. Hispanic PwCF may be disproportionately impacted, consistent with racial and ethnic COVID‐19 disparities among the general US population. Vaccination in PwCF generated antibody responses similar to those previously reported in the general population.

Seroprevalence of SARS-CoV-2 IgG in people with cystic fibrosis

“…To date, only two studies have described the seroprevalence or the impact of COVID19 vaccinations on seroprevalence within the CF population [ 9 , 11 ]. This current study aims to provide more insight regarding the seroprevalence of COVID-19, as well as document the longevity of antibody persistence, both induced and natural, in pwCF.…”