Comparison of Seroconversion in Children and Adults With Mild COVID-19

The immune response in children with SARS-CoV-2 infection is not well understood. To compare seroconversion in nonhospitalized children and adults with mild SARS-CoV-2 infection and identify factors that are associated with seroconversion. This household cohort study of SARS-CoV-2 infection collecte...

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Published in:JAMA network open 2022-03, Vol.5 (3), p.e221313-e221313
Main Authors: Toh, Zheng Quan, Anderson, Jeremy, Mazarakis, Nadia, Neeland, Melanie, Higgins, Rachel A, Rautenbacher, Karin, Dohle, Kate, Nguyen, Jill, Overmars, Isabella, Donato, Celeste, Sarkar, Sohinee, Clifford, Vanessa, Daley, Andrew, Nicholson, Suellen, Mordant, Francesca L, Subbarao, Kanta, Burgner, David P, Curtis, Nigel, Bines, Julie E, McNab, Sarah, Steer, Andrew C, Mulholland, Kim, Tosif, Shidan, Crawford, Nigel W, Pellicci, Daniel G, Do, Lien Anh Ha, Licciardi, Paul V
Format: Article
Language:English
Subjects:
Adult
Age Factors
Antibodies, Viral - blood
Child
Child, Preschool
Cohort Studies
Coronaviruses
COVID-19
COVID-19 - epidemiology
COVID-19 - immunology
COVID-19 Serological Testing
Female
Humans
Immunoglobulin G - blood
Infections
Infectious Diseases
Male
Middle Aged
Online Only
Original Investigation
SARS-CoV-2 - immunology
Seroconversion
Serology
Severe acute respiratory syndrome coronavirus 2
Victoria - epidemiology
Viral Load
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Summary:The immune response in children with SARS-CoV-2 infection is not well understood. To compare seroconversion in nonhospitalized children and adults with mild SARS-CoV-2 infection and identify factors that are associated with seroconversion. This household cohort study of SARS-CoV-2 infection collected weekly nasopharyngeal and throat swabs and blood samples during the acute (median, 7 days for children and 12 days for adults [IQR, 4-13] days) and convalescent (median, 41 [IQR, 31-49] days) periods after polymerase chain reaction (PCR) diagnosis for analysis. Participants were recruited at The Royal Children's Hospital, Melbourne, Australia, from May 10 to October 28, 2020. Participants included patients who had a SARS-CoV-2-positive nasopharyngeal or oropharyngeal swab specimen using PCR analysis. SARS-CoV-2 immunoglobulin G (IgG) and cellular (T cell and B cell) responses in children and adults. Seroconversion was defined by seropositivity in all 3 (an in-house enzyme-linked immunosorbent assay [ELISA] and 2 commercial assays: a SARS-CoV-2 S1/S2 IgG assay and a SARS-CoV-2 antibody ELISA) serological assays. Among 108 participants with SARS-CoV-2-positive PCR findings, 57 were children (35 boys [61.4%]; median age, 4 [IQR, 2-10] years) and 51 were adults (28 women [54.9%]; median age, 37 [IQR, 34-45] years). Using the 3 established serological assays, a lower proportion of children had seroconversion to IgG compared with adults (20 of 54 [37.0%] vs 32 of 42 [76.2%]; P  .05 for all comparisons between seronegative and seropositive groups). Symptomatic adults had 3-fold higher SARS-CoV-2 IgG levels than asymptomatic adults (median, 227.5 [IQR, 133.7-521.6] vs 75.3 [IQR, 36.9-113.6] IU/mL), whereas no differences were observed in children regardless of symptoms. Moreover, differences in cellular immune responses were observed in adults compared with children with seroconversion.
ISSN:2574-3805
2574-3805
DOI:10.1001/jamanetworkopen.2022.1313