False-positive SARS-CoV-2 serology in 3 children with Kawasaki disease.
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. STUDYDESIGN:
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.Keywords
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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