Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Prevalence in Blood in a Large School Community Subject to a Coronavirus Disease 2019 Outbreak: A Cross-sectional Study

Abstract

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>A SARS-CoV-2 outbreak affecting 52 people from a large school community in Santiago, Chile was identified (March 12), nine days after the first country case. We assessed the magnitude of the outbreak and the role students and staff played using a self-administered antibody detection test and survey.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>The school was closed on March 13, and the entire community was placed under quarantine. We implemented a home-delivery, self-administered, IgG/IgM antibody test and survey to a classroom stratified sample of students and all staff from May 4-19. We aimed to determine overall seroprevalence rates by age group, reported symptoms, contact exposure and to explore dynamics of transmission.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Antibody positivity rates were 9.9% (95%CI: 8.2-11.8) for 1,009 students and 16.6% (95%CI: 12.1-21.9) for 235 staff. Among students, positivity was associated with younger age (P=0.01), lower grade level (P=0.05), prior RT-PCR positivity (P=0.03), and history of contact with a confirmed case (P&amp;lt;0.001). Among staff, positivity was higher in teachers (P=0.01) and in those previously RT-PCR positive (P&amp;lt;0.001). Excluding RT-PCR positive individuals, antibody positivity was associated with fever in adults and children (P=0.02; P=0.002), abdominal pain in children (P=0.001), and chest pain in adults (P=0.02). Within antibody positive individuals, 40% of students and 18% of staff reported no symptoms (P=0.01).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Teachers were more affected during the outbreak and younger children were at higher infection risk, likely because index case(s) were teachers and/or parents from preschool. Self-administered antibody testing, supervised remotely, proved to be a suitable and rapid tool. Our study provides useful information for school re-openings.</jats:p> </jats:sec>

What is the evidence for transmission of COVID-19 by children in schools? A living systematic review

“…Cross-sectional studies estimated the proportion of SARS-CoV-2 positive cases, to give an insight into how many people have been infected in schools. As described above, the positivity results in the general study population under school environment varied from 0.00 (lowest in eight daycare centers in Belgium) to 25.87% (highest in one high school in France), which is likely to reflect the community positivity rate at the time the study was conducted [18][19][20][21][22][23]. The lower positivity rate in students suggested that students are less susceptible to infection and/or less frequently infected than adult school staff, which indicated that students are not at higher risk of causing super-spreading events in schools.…”

“…A large school community was closed on 13 March in Chile (Santiago) and during quarantine, a homedelivery and self-administered antibody test were conducted among 1,009 students and 235 school staff [19]. Antibody positive rates were 9.91% (100/1009) and 16.60% (39/235) respectively.…”

Seroprevalence and seroconversion rates to SARS-CoV-2 in interns, residents, and medical doctors in a University Hospital in Bogotá, Colombia

“…Latin-America is one of the most affected regions of the world by the pandemic [9], with peak cases occurring between July 20 and August 16 [10]. Although some studies from Latin-American countries evaluating serology in the general population [11,12] or schools have been published [13,14], to our knowledge only one study in an oncology unit in Brazil [15] has assessed seroprevalence in HCW. Our study was performed during a very active increase of SARS-CoV-2 infections in our country and city: during the five weeks of the study 248,205 new cases were identified in Colombia (109,505 vs. 357,710) and 93,907 of these were in Bogotá (34,131 vs. 128,038) (http://saludata.saludcapital.gov.co/osb/index.php/datos-de-salud/enfermedadestrasmisibles/covid19/ page consulted 08 /19/20).…”

Seroprevalence of anti-SARS-CoV-2 IgG Antibodies in the Staff of a Public School System in the Midwestern United States

“…To determine if having a history of mask-wearing reduced seropositivity, we constructed a directed acyclic graph (DAG) based on existing literature evidence and identified gender, age, travel history, school type, and role at LCSC as potential confounders to control for in the multivariable logistic regression ( Supplementary Figure 1). 6,15 Finally, backward-stepwise feature elimination was used to identify the features most predictive of seropositivity in a multivariable logistic regression starting with the thirteen categories queried in the survey (threshold p -value of 0•05). After the model was identified for which all factors were statistically significant, three factors (mask history, travel history, and symptom history) which are understood based on external studies to have an impact on infectivity were reintroduced to this reduced model.…”