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- Title
A cross-sectional investigation of SARS-CoV-2 seroprevalence and associated risk factors in children and adolescents in the United States.
- Authors
Levorson, Rebecca E.; Christian, Erica; Hunter, Brett; Sayal, Jasdeep; Sun, Jiayang; Bruce, Scott A.; Garofalo, Stephanie; Southerland, Matthew; Ho, Svetlana; Levy, Shira; Defillipi, Christopher; Peake, Lilian; Place, Frederick C.; Hourigan, Suchitra K.
- Abstract
Background: Pediatric SARS-CoV-2 data remain limited and seropositivity rates in children were reported as <1% early in the pandemic. Seroepidemiologic evaluation of SARS-CoV-2 in children in a major metropolitan region of the US was performed. Methods: Children and adolescents ≤19 years were enrolled in a cross-sectional, observational study of SARS-CoV-2 seroprevalence from July-October 2020 in Northern Virginia, US. Demographic, health, and COVID-19 exposure information was collected, and blood analyzed for SARS-CoV-2 spike protein total antibody. Risk factors associated with SARS-CoV-2 seropositivity were analyzed. Orthogonal antibody testing was performed, and samples were evaluated for responses to different antigens. Results: In 1038 children, the anti-SARS-CoV-2 total antibody positivity rate was 8.5%. After multivariate logistic regression, significant risk factors included Hispanic ethnicity, public or absent insurance, a history of COVID-19 symptoms, exposure to person with COVID-19, a household member positive for SARS-CoV-2 and multi-family or apartment dwelling without a private entrance. 66% of seropositive children had no symptoms of COVID-19. Secondary analysis included orthogonal antibody testing with assays for 1) a receptor binding domain specific antigen and 2) a nucleocapsid specific antigen had concordance rates of 80.5% and 79.3% respectively. Conclusions: A much higher burden of SARS-CoV-2 infection, as determined by seropositivity, was found in children than previously reported; this was also higher compared to adults in the same region at a similar time. Contrary to prior reports, we determined children shoulder a significant burden of COVID-19 infection. The role of children's disease transmission must be considered in COVID-19 mitigation strategies including vaccination.
- Subjects
VIRGINIA; SARS-CoV-2; COVID-19; SEROPREVALENCE; TEENAGERS; JUVENILE diseases; ANTIBODY titer; ETHNICITY
- Publication
PLoS ONE, 2021, Vol 16, Issue 11, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0259823