Frontiers in Pediatrics (Oct 2021)

Symptoms, SARS-CoV-2 Antibodies, and Neutralization Capacity in a Cross Sectional-Population of German Children

  • Otto Laub,
  • Georg Leipold,
  • Antoaneta A. Toncheva,
  • David Peterhoff,
  • David Peterhoff,
  • Sebastian Einhauser,
  • Patrick Neckermann,
  • Natascha Borchers,
  • Elisangela Santos-Valente,
  • Parastoo Kheiroddin,
  • Heike Buntrock-Döpke,
  • Heike Buntrock-Döpke,
  • Sarah Laub,
  • Patricia Schöberl,
  • Patricia Schöberl,
  • Andrea Schweiger-Kabesch,
  • Dominik Ewald,
  • Michael Horn,
  • Jakob Niggel,
  • Andreas Ambrosch,
  • Klaus Überla,
  • Stephan Gerling,
  • Susanne Brandstetter,
  • Susanne Brandstetter,
  • Ralf Wagner,
  • Ralf Wagner,
  • Michael Kabesch,
  • Michael Kabesch,
  • Corona Virus Antibodies in Children from Bavaria (CoKiBa) Study Group,
  • Bettina Aichholzer,
  • Georg Mair,
  • Michaela Wruk,
  • Imke Reischl,
  • David Antos,
  • Stephan von Koskull,
  • Christian Becker,
  • Elisabeth Beer,
  • Hubert Schirmer,
  • Georg Birkinger,
  • Andreas Blueml,
  • Mona Castrop,
  • Jost Dieckerhoff,
  • Renate Eichhorn,
  • Dominik Ewald,
  • Gudrun Fleck,
  • Alfred Heihoff,
  • Jürgen Geuder,
  • Jens Grombach,
  • Peter Gutdeutsch,
  • Florian Segerer,
  • Thomas Habash,
  • Sonja Habash,
  • Susanne Harner,
  • Christoph Herbst,
  • Daniela Heuschmann,
  • Meike Hofmann,
  • Michael Horn,
  • Birgit Jork-Kaeferlein,
  • Monika Schwarz,
  • Reinhard Hopfner,
  • Guido Judex,
  • Bastian Baumgartner,
  • Monika Corbacioglu,
  • Sabrina Lindner,
  • Bettina Meinel,
  • Alena Bauer,
  • Hannes Löw,
  • Annamaria Szulagyi-Kovacs,
  • Michael Kabesch,
  • Annegret Klein,
  • Cosima Koering,
  • Niclas Landvogt,
  • Claudia Soehngen,
  • Karin Rasp,
  • Gudrun Schick-Niedermeier,
  • Marinus Laub,
  • Otto Laub,
  • Georg Leipold,
  • Petra Schmid-Seibold,
  • Johannes Pawlak,
  • Michaela Reitz,
  • Georg Puchner,
  • Christiane Razeghi,
  • Stefan Razeghi,
  • Christine Rehe,
  • Klaus Rehe,
  • Matthias Scheffel,
  • Ludwig Kaesbauer,
  • Roland Schmid,
  • Michael Strobelt,
  • Nina Schoetzau,
  • Marko Senjor,
  • Michael Sperlich,
  • Guenter Theuerer,
  • Guenter Steidle,
  • German Tretter,
  • Victor von Arnim,
  • Marlene Volz-Fleckenstein

DOI
https://doi.org/10.3389/fped.2021.678937
Journal volume & issue
Vol. 9

Abstract

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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.

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