Symptoms, SARS-CoV-2 Antibodies, and Neutralization Capacity in a Cross Sectional-Population of German Children

Abstract

Background: Children and youth are affected rather mildly in the acute phase of COVID-19 and thus, SARS-CoV-2 infection infection may easily be overlooked. In the light of current discussions on the vaccinations of children it seems necessary to better identify children who are immune against SARS-CoV-2 due to a previous infection and to better understand COVID-19 related immune reactions in children.Methods: In a cross-sectional design, children aged 1–17 were recruited through primary care pediatricians for the study (a) randomly, if they had an appointment for a regular health check-up or (b) if parents and children volunteered and actively wanted to participate in the study. Symptoms were recorded and two antibody tests were performed in parallel directed against S (in house test) and N (Roche Elecsys) viral proteins. In children with antibody response in either test, neutralization activity was determined.Results: We identified antibodies against SARS-CoV-2 in 162 of 2,832 eligible children (5.7%) between end of May and end of July 2020 in three, in part strongly affected regions of Bavaria in the first wave of the pandemic. Approximately 60% of antibody positive children (n = 97) showed high levels (>97th percentile) of antibodies against N-protein, and for the S-protein, similar results were found. Sufficient neutralizing activity was detected for only 135 antibody positive children (86%), irrespective of age and sex. Initial COVID-19 symptoms were unspecific in children except for the loss of smell and taste and unrelated to antibody responses or neutralization capacity. Approximately 30% of PCR positive children did not show seroconversion in our small subsample in which PCR tests were performed.Conclusions: Symptoms of SARS-CoV-2 infections are unspecific in children and antibody responses show a dichotomous structure with strong responses in many and no detectable antibodies in PCR positive children and missing neutralization activity in a relevant proportion of the young population.

Autoantibodies against interleukin-1 receptor antagonist in multisystem inflammatory syndrome in children: a multicentre, retrospective, cohort study

“…We also included serum samples negative for SARS-CoV-2 antibodies from healthy paediatric control patients, referred to as healthy controls herein, and serum samples from children with a history of asymptomatic or mild COVID-19, from the CoKiBa study. 29 Healthy controls were age and sex-matched with the MIS-C group (multiple matched cases for each MIS-C group). Samples in the CoKiBa study were obtained 1–3 months after the peak of the first pandemic wave (spring 2020) in Bavaria.…”

Analysis of COVID-19 Infection Chains in a School Setting: Data From a School-Based rRT-PCR–Gargle Pool Test System

“…However, it also could not be excluded that other (adult) family members were the source of the infection in the family, as shown in previous studies from the first SARS-CoV-2 wave in spring of 2020. 8 To protect schools from uncontrolled SARS-CoV-2 transmissions, pool PCR screening was recommended to be implemented at a low initial incidence, at much lower incidence rates as reported here, as the effects of pool PCR screening were suspected to lose power as incidence increases. 9 However, we found that the protective effect of the screening does not only depend on incidence but also on the logistics of the testing setup.…”

Coronavirus infection COVID-19 in children: a literature review

“…При этом у 86% из них развивалась достаточная нейтрализующая активность независимо от возраста и пола. Приблизительно у 30% ПЦР-позитивных детей сероконверсия не наблюдалась [30]. В Соединенных Штатах среди 1038 детей исследователи обнаружили антитела IgG против SARS-CoV-2 в 8,5% случаев, притом что у 66% серопозитивных детей не было симптомов COVID-19 ни в анамнезе, ни на момент обследования.…”