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False-positive SARS-CoV-2 serology in 3 children with Kawasaki disease.
To, Kelvin Kw; Chua, Gilbert T; Kwok, Ka Li; Wong, Joshua Sc; Au, Dennis Chi Yu; Lam, Yuen Yu; Wong, Wilfred Hs; Ho, Marco Hk; Chan, Godfrey Cf; Chui, Celine Sl; Li, Xue; Tung, Keith Ts; Wong, Rosa S; Tso, Winnie Wy; Wong, Ian Ck; Wong, Christina Sm; Fong, Carol Hy; Chan, Kwok Hung; Yuen, Kwok Yung; Ip, Patrick; Kwan, Mike Yw.
  • To KK; Department of Microbiology, Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.
  • Chua GT; Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.
  • Kwok KL; Department of Paediatrics, Kwong Wah Hospital, Hong Kong, SAR, China.
  • Wong JS; Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong, SAR, China.
  • Au DCY; Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong, SAR, China.
  • Lam YY; Department of Paediatrics, Kwong Wah Hospital, Hong Kong, SAR, China.
  • Wong WH; Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.
  • Ho MH; Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.
  • Chan GC; Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.
  • Chui CS; Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, SAR, China.
  • Li X; Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, SAR, China.
  • Tung KT; Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.
  • Wong RS; Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.
  • Tso WW; Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.
  • Wong IC; Research Department of Practice and Policy, UCL School of Pharmacy, University College, London, United Kingdom.
  • Wong CS; Department of Medicine, Queen Mary Hospital, Hong Kong, SAR, China.
  • Fong CH; Department of Microbiology, Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.
  • Chan KH; Department of Microbiology, Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.
  • Yuen KY; Department of Microbiology, Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China. Electronic address: kyyuen@hku.hk.
  • Ip P; Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China. Electronic address: patricip@hku.hk.
  • Kwan MY; Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong, SAR, China. Electronic address: kwanyw1@ha.org.hk.
Diagn Microbiol Infect Dis ; 98(3): 115141, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-714791
ABSTRACT

BACKGROUND:

Kawasaki disease (KD) is an acute febrile and eruptive disease with systemic vasculitis predominantly affecting young East Asian children. Recent reports showed that children with KD-like disease from KD low prevalence regions had positive SARS-CoV-2 serology despite a negative SARS-CoV-2 polymerase chain reaction (PCR) in respiratory samples.

OBJECTIVES:

To describe 3 pediatric Kawasaki Disease patients with false positive SARS-CoV-2 serology. STUDY

DESIGN:

We retrospectively recruited children with KD diagnosed during the COVID-19 outbreak in Hong Kong. Clinical characteristics and laboratory test results including SARS-CoV-2 PCR results were retrieved. We performed a microparticle-based immunoassay for the detection of IgG against nucleoprotein (NP) and spike protein receptor binding domain (RBD), and a microneutralization assay for the detection of neutralizing antibodies.

RESULTS:

Three Chinese children with typical KD were identified. They had no epidemiological links with COVID-19 patients and tested negative for SARS-CoV-2 NPA PCR. They were treated with IVIG and aspirin, and were discharged without complications. Subsequently 2 of them were tested positive against anti-RBD and anti-NP antibodies and 1 was tested positive against anti- RBD antibodies. However, microneutralization assay showed that neutralizing antibodies were absent, suggesting a false-positive IgG result.

CONCLUSION:

Detection of neutralizing antibodies is recommended to confirm previous SARS-CoV-2 infection in IgG-positive but PCR-negative patients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Immunoassay / Serologic Tests / Coronavirus Infections / Antibodies, Neutralizing / Antibodies, Viral / Mucocutaneous Lymph Node Syndrome Type of study: Diagnostic study / Observational study / Prognostic study Limits: Child / Humans Country/Region as subject: Asia Language: English Journal: Diagn Microbiol Infect Dis Year: 2020 Document Type: Article Affiliation country: J.diagmicrobio.2020.115141

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Immunoassay / Serologic Tests / Coronavirus Infections / Antibodies, Neutralizing / Antibodies, Viral / Mucocutaneous Lymph Node Syndrome Type of study: Diagnostic study / Observational study / Prognostic study Limits: Child / Humans Country/Region as subject: Asia Language: English Journal: Diagn Microbiol Infect Dis Year: 2020 Document Type: Article Affiliation country: J.diagmicrobio.2020.115141