AUTHOR=Laub Otto , Leipold Georg , Toncheva Antoaneta A. , Peterhoff David , Einhauser Sebastian , Neckermann Patrick , Borchers Natascha , Santos-Valente Elisangela , Kheiroddin Parastoo , Buntrock-Döpke Heike , Laub Sarah , Schöberl Patricia , Schweiger-Kabesch Andrea , Ewald Dominik , Horn Michael , Niggel Jakob , Ambrosch Andreas , Überla Klaus , Gerling Stephan , Brandstetter Susanne , Wagner Ralf , Kabesch Michael , Corona Virus Antibodies in Children from Bavaria (CoKiBa) Study Group , Aichholzer Bettina , Mair Georg , Wruk Michaela , Reischl Imke , Antos David , von Koskull Stephan , Becker Christian , Beer Elisabeth , Schirmer Hubert , Birkinger Georg , Blueml Andreas , Castrop Mona , Dieckerhoff Jost , Eichhorn Renate , Ewald Dominik , Fleck Gudrun , Heihoff Alfred , Geuder Jürgen , Grombach Jens , Gutdeutsch Peter , Segerer Florian , Habash Thomas , Habash Sonja , Harner Susanne , Herbst Christoph , Heuschmann Daniela , Hofmann Meike , Horn Michael , Jork-Kaeferlein Birgit , Schwarz Monika , Hopfner Reinhard , Judex Guido , Baumgartner Bastian , Corbacioglu Monika , Lindner Sabrina , Meinel Bettina , Bauer Alena , Löw Hannes , Szulagyi-Kovacs Annamaria , Kabesch Michael , Klein Annegret , Koering Cosima , Landvogt Niclas , Soehngen Claudia , Rasp Karin , Schick-Niedermeier Gudrun , Laub Marinus , Laub Otto , Leipold Georg , Schmid-Seibold Petra , Pawlak Johannes , Reitz Michaela , Puchner Georg , Razeghi Christiane , Razeghi Stefan , Rehe Christine , Rehe Klaus , Scheffel Matthias , Kaesbauer Ludwig , Schmid Roland , Strobelt Michael , Schoetzau Nina , Senjor Marko , Sperlich Michael , Theuerer Guenter , Steidle Guenter , Tretter German , von Arnim Victor , Volz-Fleckenstein Marlene
TITLE=Symptoms, SARS-CoV-2 Antibodies, and Neutralization Capacity in a Cross Sectional-Population of German Children
JOURNAL=Frontiers in Pediatrics
VOLUME=9
YEAR=2021
URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.678937
DOI=10.3389/fped.2021.678937
ISSN=2296-2360
ABSTRACT=Background: Children and youth are affected rather mildly in the acute phase of COVID-19 and thus, SARS-CoV-2 infection infection may easily be overlooked. In the light of current discussions on the vaccinations of children it seems necessary to better identify children who are immune against SARS-CoV-2 due to a previous infection and to better understand COVID-19 related immune reactions in children.
Methods: In a cross-sectional design, children aged 1–17 were recruited through primary care pediatricians for the study (a) randomly, if they had an appointment for a regular health check-up or (b) if parents and children volunteered and actively wanted to participate in the study. Symptoms were recorded and two antibody tests were performed in parallel directed against S (in house test) and N (Roche Elecsys) viral proteins. In children with antibody response in either test, neutralization activity was determined.
Results: We identified antibodies against SARS-CoV-2 in 162 of 2,832 eligible children (5.7%) between end of May and end of July 2020 in three, in part strongly affected regions of Bavaria in the first wave of the pandemic. Approximately 60% of antibody positive children (n = 97) showed high levels (>97th percentile) of antibodies against N-protein, and for the S-protein, similar results were found. Sufficient neutralizing activity was detected for only 135 antibody positive children (86%), irrespective of age and sex. Initial COVID-19 symptoms were unspecific in children except for the loss of smell and taste and unrelated to antibody responses or neutralization capacity. Approximately 30% of PCR positive children did not show seroconversion in our small subsample in which PCR tests were performed.
Conclusions: Symptoms of SARS-CoV-2 infections are unspecific in children and antibody responses show a dichotomous structure with strong responses in many and no detectable antibodies in PCR positive children and missing neutralization activity in a relevant proportion of the young population.