Systemic and Lower Respiratory Tract Immunity to SARS-CoV-2 Omicron and Variants in Pediatric Severe COVID-19 and Mis-C

Juanjie Tang; Adrienne G. Randolph; Tanya Novak; Tracie C. Walker; Laura L. Loftis; Matt S. Zinter; Katherine Irby; Surender Khurana

doi:10.3390/vaccines10020270

Vaccines (Feb 2022)

Systemic and Lower Respiratory Tract Immunity to SARS-CoV-2 Omicron and Variants in Pediatric Severe COVID-19 and Mis-C

Juanjie Tang,
Adrienne G. Randolph,
Tanya Novak,
Tracie C. Walker,
Laura L. Loftis,
Matt S. Zinter,
Katherine Irby,
Surender Khurana

Affiliations

Juanjie Tang: Center for Biologics Evaluation and Research (CBER), Division of Viral Products, Food and Drug Administration (FDA), Silver Spring, MD 20993, USA
Adrienne G. Randolph: Department of Anesthesiology, Critical Care and Pain Medicine, Department of Anesthesia, Harvard Medical School, Boston Children’s Hospital, Boston, MA 02115, USA
Tanya Novak: Department of Anesthesiology, Critical Care and Pain Medicine, Department of Anesthesia, Harvard Medical School, Boston Children’s Hospital, Boston, MA 02115, USA
Tracie C. Walker: Department of Pediatrics, University of North Carolina at Chapel Hill Children’s Hospital, Chapel Hill, NC 27514, USA
Laura L. Loftis: Department of Pediatrics, Division of Critical Care Medicine, Baylor College of Medicine, Houston, TX 77030, USA
Matt S. Zinter: Department of Pediatrics, Divisions of Critical Care and Bone Marrow Transplantation, University of California, San Francisco, CA 94158, USA
Katherine Irby: Department of Pediatrics, Division of Pediatric Critical Care Medicine, Arkansas Children’s Hospital, Little Rock, AR 72202, USA
Surender Khurana: Center for Biologics Evaluation and Research (CBER), Division of Viral Products, Food and Drug Administration (FDA), Silver Spring, MD 20993, USA

DOI: https://doi.org/10.3390/vaccines10020270
Journal volume & issue: Vol. 10, no. 2
p. 270

Abstract

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Mucosal immunity plays an important role in the control of viral respiratory infections like SARS-CoV-2. While systemic immune responses against the SARS-2-CoV-2 have been studied in children, there is no information on mucosal antibody response, especially in the lower respiratory tract of children coronavirus disease 2019 (COVID-19) and post-infectious multisystem inflammatory syndrome in children (MIS-C) against emerging SARS-CoV-2 variants. Therefore, we evaluated neutralizing antibody responses in paired plasma and endotracheal aspirates of pediatric severe, acute COVID-19 or MIS-C patients against SARS-CoV-2 WA1/2020, as well as against variants of concern (VOCs). Neutralizing antibody responses against the SARS-CoV-2 WA1/2020 strain in pediatric plasma were 2-fold or 35-fold higher compared with the matched endotracheal aspirate in COVID-19 or MIS-C patients, respectively. In contrast to plasma, neutralizing antibody responses against the VOCs and variants of interest (VOIs) in endotracheal aspirates were lower, with only one endotracheal aspirate demonstrating neutralizing titers against the Iota, Kappa, Beta, Gamma, and Omicron variants. In conclusion, our findings suggest that children and adolescents with severe COVID-19 or MIS-C have weak mucosal neutralizing antibodies in the trachea against circulating SARS-CoV-2 Omicron and other VOCs, which may have implications for recovery and for re-infection with emerging SARS-CoV-2 variants.

Published in Vaccines

ISSN: 2076-393X (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine
Website: http://www.mdpi.com/journal/vaccines

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