SeroCovid19 : prospective seroprevalence monitoring reveals substantially reduced SARS-CoV-2 infection rate among tertiary pediatric patients
2021
Background
Coronavirus disease 2019 (COVID-19) is a clinically heterogeneous entity with several host,
environmental, and viral risk factors identified to date. COVID-19 in children generally manifests
asymptomatic or mild. Pediatric patients with chronic medical conditions are potentially at increased
risk for severe COVID-19, although convincing data is lacking. Among these children, we aimed to
study COVID-19 incidence and disease severity.
Methods
We initiated a prospective cohort study with longitudinal (every 3-6 months) quantification of serum
SARS-CoV-2 IgG (Abbott) and questionnaires in pediatric patients (0-18y) with chronic medical
conditions in follow-up at Ghent University Hospital, a tertiary referral center. This interim analysis
incorporates inclusions from Nov 1, 2020 until Jan 14, 2021.
Results
Here, we present data of the first 250 included patients (mean age 10.4y). Chronic conditions
required follow-up at departments of immunology (26.4%), nephrology (16.7%), rheumatology
(15.4%), gastroenterology (14.5%), endocrinology (8.8%), pulmonology (8.8%) or others (9.3%).
Chronic immunosuppressive drugs were used in 35.6%. Inborn errors of immunity, possibly affecting
antibody responses, were present in 18.0%. Restriction from school or daycare centers (additional to
general lockdown and school closures) was documented in 35.1% and 10.7%, before and after the
summer break, respectively. Since the start of the pandemic, close contacts with proven COVID-19
were known in 21.0%.
An overall SARS-CoV-2 seroprevalence of 6.0% (15/250) was found, substantially lower than
concurrently reported in Belgian blood donors and health care workers (14.4% in Nov 2020), and on
the lower end compared to healthy children measured prior to the second epidemic wave in Flanders
(4.4-14.4% in Sept-Oct).
Asymptomatic COVID-19 was documented in 7/15. One patient with cystic fibrosis (9y) required
hospitalization. All other cases experienced mild COVID-19, at most. Of seropositive cases, 5/15
received immunosuppression, all experiencing mild infection.
Conclusion
A strikingly low SARS-CoV-2 seroprevalence was found in our cohort. Despite no supplementary
preventive measures were imposed for the majority, this cohort seemed additionally shielded from
SARS-CoV-2. Asymptomatic COVID-19 was present in half of cases. These findings may be of
importance for ongoing and future protective measures, clinical management, and vaccination
strategies in these populations
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