ABSTRACT
Background: The COVID-19 pandemic in the UK began in late January 2020 and peaked in mid-April before declining. Children typically develop only very mild symptoms and it remains unclear what role children play in the spread of COVID-19. The aim of this study was to report the prevalence of SARS-CoV-2 antibodies in healthy children of healthcare workers. Methods: Healthy children of healthcare workers, were recruited in London during May 2020. Participants had nose and throat swabs tested for SARS-CoV-2 infection via RT-qPCR and blood serums samples for SARS-CoV-2 immunoglobulin G (IgG) antibodies. Findings: A total of 215 children from 126 families took part and 25(12%) were seropositive for SARS-CoV-2. Children of clinical healthcare workers were significantly more likely to be seropositive 23/133(17%) than those of non-clinical healthcare workers 2/83(2%); p=0.001.In children of parents with confirmed COVID-19, seropositivity was 19/47(40%) compared to 3/44(7%) in children of parents with suspected COVID-19 and 3/124(2%) in children of asymptomatic parents (p<0.001). Overall, 15/83(18%) of symptomatic children were seropositive compared to 10/132(8%) of asymptomatic children (p=0.02). The most commonly reported symptoms were fever 7/25(28%), headache 4/25(16%) and lethargy 5/25(20%). None of the children were hospitalised with COVID-19. Interpretation: The secondary attack rate in children of healthcare workers with confirmed COVID-19 was 40% compared to 2% of children in families with no reported symptoms. One in three seropositive children were asymptomatic.Trial Registration: NCT0434740Funding Statement: This study was funded by the Public Health Agency [COM/5596/20].Declaration of Interests: None disclosed.Ethics Approval Statement: The London (Chelsea) research ethics committee reviewed the study protocol and provided a favourable outcome (Project ID 282617, OREC ID 20/HRA/1731).
Subject(s)
COVID-19ABSTRACT
BackgroundStudies based on molecular testing of oral/nasal swabs underestimate SARS-CoV-2 infection due to issues with test sensitivity and timing of testing. The objective of this study was to report the presence of SARS-CoV-2 antibodies, consistent with previous infection, and to report the symptomatology of infection in children. DesignThis multicentre observational cohort study, conducted between 16th April - 3rd July 2020 at 5 UK sites, aimed to recruit 900 children aged 2 to 15 years of age. Participants provided blood samples for SARS-CoV-2 antibody testing and data were gathered regarding unwell contacts and symptoms. Results1007 participants were enrolled, and 992 were included in the final analysis. The median age of participants was 10{middle dot}1 years. There were 68 (6.9%) participants with positive SARS-CoV-2 antibody tests indicative of previous SARS-CoV-2 infection. Of these, 34/68 (50%) reported no symptoms. The presence of antibodies and the mean antibody titre was not influenced by age. Following multivariate analysis 4 independent variables were identified as significantly associated with SARS-CoV-2 infection. These were: known infected household contact; fatigue; gastrointestinal symptoms; and changes in sense of smell or taste. DiscussionIn this study children demonstrated similar antibody titres in response to SARS-CoV-2 irrespective of age. The symptoms of SARS-CoV-2 infection in children were subtle but of those reported, fatigue, gastrointestinal symptoms and changes in sense of smell or taste were most strongly associated with antibody positivity. RegistrationThis study was registered at https://www.clinicaltrials.gov (trial registration: NCT04347408) on the 15/04/2020.