1
|
Jans T, Krauthausen M, Bauer C, Forster J, Engels G, Pietsch F, Wallstabe J, Rücker V, Wendel J, Weissbrich B, Heuschmann P, Härtel C, Dölken L, Kurzai O, Gágyor I, Liese JG, Romanos M, Streng A. [Can SARS-CoV-2 Infection Status in Preschool Children be Predicted by Pandemic-related Attitudes and Concerns of their Parents? Data from the Würzburg Daycare Centre Studies (Wü-KiTa-CoV, 2020-2022)]. DAS GESUNDHEITSWESEN 2024. [PMID: 39137922 DOI: 10.1055/a-2386-4490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
As part of the Würzburg KiTa-CoV study series, SARS-CoV-2 pandemic-related attitudes/concerns of parents of preschool children attending day care centres were surveyed over a 21-month period. We expected associations between these parental attitudes/concerns and their change over the course of the pandemic, on the one hand, and the SARS-CoV-2 infection status of the children, on the other. Parents of children from nine day-care centres who completed a survey on pandemic-related attitudes/concerns in October 2020, July 2021 and July 2022, were included in the analysis. In July 2022, the children's infection status was determined by measuring nucleocapsid protein antibodies (N-AK) and, in the case of N-AK negative, unvaccinated children, the measurement results of spike protein antibodies (S-AK) against SARS-CoV-2 as indicators of previous infection were also taken into account. Changes in parental attitudes/concerns were analysed using trend tests, and their significance in predicting the child's infection status was analysed using multiple binomial regression analyses. Data were available from parents of 159 children (mean age 3.2 years). The overall group of parents showed an increasingly relaxed attitude towards the pandemic over the study period, although the parents' concerns towards a possible infection of their own increased. The infection status of the children could not be predicted from the initial attitudes and concerns of the parents. However, the subgroup of parents with an uninfected child tended to have a higher level of concerns over the course of the pandemic than the parents with an infected child and did not show the same increasing composure towards the pandemic event. The parents' increasing composure is understandable in the context of the reduced virulence of the virus variants prevailing over time, the increasing availability of testing strategies and vaccinations, and the withdrawal of pandemic-related restrictions. In addition, the mildness of most children's infections may have contributed to their parents' sense of security. The seemingly contradictory increase in parental concerns about infection may be related to the strong increase in the incidence due to omicron variant infections in the population since January 2022. It is possible that the higher level of concerns among parents of uninfected children had a protective effect behaviourally.
Collapse
Affiliation(s)
- Thomas Jans
- Universitätsklinikum Würzburg, Zentrum für Psychische Gesundheit, Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg, Germany
| | - Maike Krauthausen
- Universitätsklinikum Würzburg, Institut für Allgemeinmedizin, Würzburg, Germany
| | - Carsten Bauer
- Universität Würzburg, Institut für Klinische Epidemiologie und Biometrie, Würzburg, Germany
| | - Johannes Forster
- Universität Würzburg, Institut für Hygiene und Mikrobiologie, Würzburg, Germany
| | - Geraldine Engels
- Universitätsklinikum Würzburg, Kinderklinik und Poliklinik, Würzburg, Germany
| | - Franziska Pietsch
- Universität Würzburg, Institut für Hygiene und Mikrobiologie, Würzburg, Germany
| | - Julia Wallstabe
- Universität Würzburg, Institut für Hygiene und Mikrobiologie, Würzburg, Germany
| | - Victoria Rücker
- Universität Würzburg, Institut für Klinische Epidemiologie und Biometrie, Würzburg, Germany
| | - Julia Wendel
- Universität Würzburg, Institut für Klinische Epidemiologie und Biometrie, Würzburg, Germany
| | - Benedikt Weissbrich
- Universität Würzburg, Institut für Virologie und Immunbiologie, Würzburg, Germany
| | - Peter Heuschmann
- Universität Würzburg, Institut für Klinische Epidemiologie und Biometrie, Würzburg, Germany
- Universitätsklinikum Würzburg, Zentrale für Klinische Studien, Würzburg, Germany
| | - Christoph Härtel
- Universitätsklinikum Würzburg, Kinderklinik und Poliklinik, Würzburg, Germany
| | - Lars Dölken
- Universität Würzburg, Institut für Virologie und Immunbiologie, Würzburg, Germany
| | - Oliver Kurzai
- Universität Würzburg, Institut für Hygiene und Mikrobiologie, Würzburg, Germany
| | - Ildikó Gágyor
- Universitätsklinikum Würzburg, Institut für Allgemeinmedizin, Würzburg, Germany
| | - Johannes G Liese
- Universitätsklinikum Würzburg, Kinderklinik und Poliklinik, Würzburg, Germany
| | - Marcel Romanos
- Universitätsklinikum Würzburg, Zentrum für Psychische Gesundheit, Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg, Germany
| | - Andrea Streng
- Universitätsklinikum Würzburg, Kinderklinik und Poliklinik, Würzburg, Germany
| |
Collapse
|
2
|
Rawat SK, Asati AA, Mishra N, Jain A, Ratho RK. Identification of COVID-19-Associated Hepatitis in Children as an Emerging Complication in the Wake of SARS-CoV-2 Infections: Ambispective Observational Study. JMIRX MED 2024; 5:e48629. [PMID: 39392692 DOI: 10.2196/48629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 03/17/2024] [Accepted: 04/06/2024] [Indexed: 10/13/2024]
Abstract
Background Although the pediatric population has largely remained free of severe COVID-19 symptoms, in some cases, SARS-CoV-2 infection has been associated with complications such as multiple inflammatory syndrome in children (MIS-C). We identified another a unique form of hepatitis occurring subsequent to asymptomatic SARS-CoV-2 infection, designated by us as COVID-19-associated hepatitis in children (CAH-C), in a subset of children who presented with hepatitis. Objective Our study describes the clinical presentations, temporal association, and viral parameters of the CAH-C cases and compares them to those of MIS-C cases or other known forms of hepatitis in children. Methods In an ambispective (retrospective and follow-up) observational study, records from April to July 2021 were reviewed for all children aged ≤14 years who were previously healthy and presented with a sudden onset of hepatitis, elevated transaminases, and nonobstructive jaundice. After performing all routine tests, those lacking marked inflammatory responses and without evidence of (1) other known causes of acute hepatitis or previous underlying liver disease and (2) multisystem involvement were classified as having CAH-C. Their characteristics were compared to those of children with MIS-C or other known forms of hepatitis. Results Among the 5539 children tested for SARS-CoV-2, a total of 475 (8.6%) tested positive and 47 (0.8%) presented with hepatitis. Among the 47 children with hepatitis, 37 (79%) had features of CAH-C: having symptoms of hepatitis only, without protracted illness (mean length of stay 5 d), and an uneventful recovery following supportive treatment. In contrast, the remaining 10 (21%) had features of MIS-C-associated hepatitis: multiple system involvement; protracted illness (mean length of stay 8 d); and requiring admission to critical care, with a mortality rate of 30% (3/10). Conclusions Our data suggest that CAH-C might be one of the new clinical complications associated with the emergence of newer variants of concern of SARS-CoV-2, which often result in changing presentations. Our findings should facilitate its early identification and thorough workup and aid its differentiation from other emerging syndromes in children, which would help initiate appropriate measures, enable better resource prioritization, and thus limit adversities.
Collapse
Affiliation(s)
| | | | - Nitu Mishra
- Bundelkhand Medical College and Hospital, Sagar, India
| | - Ashish Jain
- Bundelkhand Medical College and Hospital, Sagar, India
| | - Radha Kanta Ratho
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
3
|
Wang Y, Su S, Ma M, Weng R, Zhang Z, Liu D, Yan X, Wang J, Wang Y, Zhang W, Yang S, Zhang H, Zhao D, Lu M, Li X, Zhu J, Zhang W, Yu H, Zhang D, Huang Y, Nong G, Cai X, Mao H, Sun F, Wu X, Rong Z, Zhang J, Li Z, Jiang X, Li X, Liu X, Li C, Sun L, Gao S, Yang J, Song H, Tang X. Clinical characteristics and outcomes of COVID-19 in pediatric patients with rheumatic diseases. Pediatr Res 2024:10.1038/s41390-024-03561-1. [PMID: 39375504 DOI: 10.1038/s41390-024-03561-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 07/13/2024] [Accepted: 08/30/2024] [Indexed: 10/09/2024]
Abstract
BACKGROUND This study investigates the clinical characteristics and outcomes of pediatric patients with rheumatic diseases infected with COVID-19 in China. METHODS We conducted a retrospective analysis of pediatric patients with rheumatic diseases who contracted COVID-19. Data were collected via a comprehensive questionnaire with a 14-day follow-up. Multivariable logistic regression was used to assess severe outcomes, and network analyses evaluated symptom correlations. RESULTS A total of 1070 cases were collected. Fever (88.05%) and cough (62.75%) were the most common symptoms. Cough, nasal congestion, and runny nose exhibited a stronger correlation with each other. A higher incidence of fever reduced the incidence of two single symptoms (nasal congestion [r = -0.833], runny nose [r = -0.762]). Vaccinated children showed a shorter time to negative COVID-19 conversion (7.21 days vs. 7.63 days, p < 0.05) and lower hospitalization rates (p = 0.025). Prolonged symptom duration was associated with older age (OR: 1.07 [1.04-1.11]; p < 0.001) and systemic lupus erythematosus (OR: 1.47 [1.01-2.12]; p = 0.046). CONCLUSIONS Pediatric patients with rheumatic diseases exhibited a wide range of clinical symptoms after COVID-19 infection. The infection generally did not lead to severe outcomes in this study. COVID-19 vaccination was associated with reduced hospitalization risk and expediting the time to negativity for virus. IMPACTS This manuscript demonstrates a comprehensive analysis of the clinical characteristics and outcomes of COVID-19 infection in pediatric patients with rheumatic diseases in China. It provides critical insights into the specific challenges faced by this vulnerable population and offers practical recommendations for improving patient management during periods of increased infectious risk.
Collapse
Affiliation(s)
- Yating Wang
- Department of Rheumatology and Immunology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders. Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing, China
| | - Shu Su
- Department of Epidemiology and Biostatistics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingsheng Ma
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Ruohang Weng
- Rheumatology & Immunology Department of Shenzhen Children's Hospital, Shenzhen, China
| | - Zhiyong Zhang
- Department of Rheumatology and Immunology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders. Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing, China
| | - Dawei Liu
- Department of Rheumatology and Immunology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders. Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing, China
| | - Xin Yan
- Department of Rheumatology and Immunology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders. Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing, China
| | - Junjun Wang
- Department of Rheumatology and Immunology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders. Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing, China
| | - Yajun Wang
- Department of Rheumatology and Immunology, The First People's Hospital of Yunnan Province, Kunming, China
| | - Wei Zhang
- Pediatric Immunology and Rheumatology Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Sirui Yang
- Department of pediatric rheumatology, immunology, and allergy, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Hongxia Zhang
- Department of Pediatric Nephrology, Rheumatology and Immunology, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, Shandong, China
| | - Dongmei Zhao
- Department of Rheumatology and Immunology, Children's Hospital of Urumqi, No.1 Jiankang Rd., TianShan Distinct, Urumqi, China
| | - Meiping Lu
- Department of Rheumatology Immunology and Allergy, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Xiaoqing Li
- Department of Rheumatology and Immunology, Xi'an Children's Hospital, Xi'an, 710068, China
| | - Jia Zhu
- Department of Rheumatology and Immunology, The Affiliated Children's Hospital, Capital Institute of Pediatrics, 2 Yabao Road, Chaoyang District, 100020, Beijing, China
| | - Weixi Zhang
- Department of Pediatric Allergy and Immunology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Haiguo Yu
- Department of Rheumatology and Immunology, Children's Hospital of Nanjing Medical University No. 72 Guangzhou Road, Nanjing, 210008, Jiangsu, China
| | - Dongfeng Zhang
- Department of Pediatric Nephrology, Children's Hospital of Hebei Province affiliated to Hebei Medical University, Shijiazhuang, China
| | - Yanjie Huang
- Department of Pediatrics, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 450046, China
| | - Guangmin Nong
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
| | - Xuxu Cai
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, PR China
| | - Huawei Mao
- Department of Immunology, Ministry of Education Key Laboratory of Major Diseases in Children, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, No. 56 Nanlishi Road, 100045, Beijing, China
| | - Fei Sun
- Department of Immunology, Ministry of Education Key Laboratory of Major Diseases in Children, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, No. 56 Nanlishi Road, 100045, Beijing, China
| | - Xiaochuan Wu
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zanhua Rong
- Department of paediatrics, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jianjiang Zhang
- Department of paediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Zhixiang Li
- Inner Mongolia Autonomous Region People's Hospital, Hohhot, China
| | - Xinhui Jiang
- Guiyang Maternal and Child Health Care Hospital (Guiyang Children's Hospital), Guiyang, China
| | - Xiaozhong Li
- Department of Nephrology and Immunology, Children's Hospital of Soochow University, Suzhou, China
| | - Xuemei Liu
- Qilu Children's Hospital of Shandong University, Jinan, China
| | - Chongwei Li
- Department of Rheumatology & Immunology, Tianjin Children's Hospital, No. 238 Longyan Road, Beichen District, Tianjin, China
| | - Lifeng Sun
- Department of Pediatrics, Provincial Hospital Affiliated to Shandong University, Jinan, 250021, China
| | - Sihao Gao
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Jun Yang
- Rheumatology & Immunology Department of Shenzhen Children's Hospital, Shenzhen, China.
| | - Hongmei Song
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
| | - Xuemei Tang
- Department of Rheumatology and Immunology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders. Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing, China.
| |
Collapse
|
4
|
Kuthning D, Raafat D, Holtfreter S, Gramenz J, Wittmann N, Bröker BM, Meyer-Bahlburg A. Variant-specific antibody profiling for tracking SARS-CoV-2 variant infections in children and adolescents. Front Immunol 2024; 15:1434291. [PMID: 39257574 PMCID: PMC11384586 DOI: 10.3389/fimmu.2024.1434291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 08/05/2024] [Indexed: 09/12/2024] Open
Abstract
Monitoring the seroprevalence of SARS-CoV-2 in children and adolescents can provide valuable information for effective SARS-CoV-2 surveillance, and thus guide vaccination strategies. In this study, we quantified antibodies against the spike S1 domains of several SARS-CoV-2 variants (wild-type, Alpha, Delta, and Omicron variants) as well as endemic human coronaviruses (HCoVs) in 1,309 children and adolescents screened between December 2020 and March 2023. Their antibody binding profiles were compared with those of 22 pre-pandemic samples from children and adolescents using an in-house Luminex®-based Corona Array (CA). The primary objectives of this study were to (i) monitor SARS-CoV-2-specific antibodies in children and adolescents, (ii) evaluate whether the S1-specific antibody response can identify the infecting variant of concern (VoC), (iii) estimate the prevalence of silent infections, and (iv) test whether vaccination or infection with SARS-CoV-2 induce HCoV cross-reactive antibodies. Both SARS-CoV-2 infection and vaccination induced a robust antibody response against the S1 domain of WT and VoCs in children and adolescents. Antibodies specific for the S1 domain were able to distinguish between SARS-CoV-2 VoCs in infected children. The serologically identified VoC was typically the predominant VoC at the time of infection. Furthermore, our highly sensitive CA identified more silent SARS-CoV-2 infections than a commercial ELISA (12.1% vs. 6.3%, respectively), and provided insights into the infecting VoC. Seroconversion to endemic HCoVs occurred in early childhood, and vaccination or infection with SARS-CoV-2 did not induce HCoV S1 cross-reactive antibodies. In conclusion, the antibody response to the S1 domain of the spike protein of SARS-CoV-2 is highly specific, providing information about the infecting VoC and revealing clinically silent infections.
Collapse
Affiliation(s)
- Daniela Kuthning
- Pediatric Rheumatology, Department of Pediatric and Adolescent Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Dina Raafat
- Institute of Immunology, University Medicine Greifswald, Greifswald, Germany
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
| | - Silva Holtfreter
- Institute of Immunology, University Medicine Greifswald, Greifswald, Germany
| | - Jana Gramenz
- Pediatric Rheumatology, Department of Pediatric and Adolescent Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Nico Wittmann
- Pediatric Rheumatology, Department of Pediatric and Adolescent Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Barbara M Bröker
- Institute of Immunology, University Medicine Greifswald, Greifswald, Germany
| | - Almut Meyer-Bahlburg
- Pediatric Rheumatology, Department of Pediatric and Adolescent Medicine, University Medicine Greifswald, Greifswald, Germany
| |
Collapse
|
5
|
Tunheim G, Fossum E, Robertson AH, Rø GØI, Chopra A, Vaage JT, Vikse EL, Kran AMB, Magnus P, Trogstad L, Mjaaland S, Hungnes O, Lund-Johansen F. Characterization of the SARS-CoV-2 antibody landscape in Norway in the late summer of 2022: high seroprevalence in all age groups with patterns of primary Omicron infection in children and hybrid immunity in adults. BMC Infect Dis 2024; 24:841. [PMID: 39164637 PMCID: PMC11334563 DOI: 10.1186/s12879-024-09670-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 07/25/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND According to Norwegian registries, 91% of individuals ≥ 16 years had received ≥ 1 dose of COVID-19 vaccine by mid-July 2022, whereas less than 2% of children < 12 years were vaccinated. Confirmed COVID-19 was reported for 27% of the population, but relaxation of testing lead to substantial underreporting. We have characterized the humoral immunity to SARS-CoV-2 in Norway in the late summer of 2022 by estimating the seroprevalence and identifying antibody profiles based on reactivity to Wuhan or Omicron-like viruses in a nationwide cross-sectional collection of residual sera, and validated our findings using cohort sera. METHODS 1,914 anonymized convenience sera and 243 NorFlu-cohort sera previously collected from the Oslo-area with reported infection and vaccination status were analyzed for antibodies against spike, the receptor-binding domain (RBD) of the ancestral Wuhan strain and Omicron BA.2 RBD, and nucleocapsid (N). Samples were also tested for antibodies inhibiting RBD-ACE2 interaction. Neutralization assays were performed on subsets of residual sera against B.1, BA.2, XBB.1.5 and BQ.1.1. RESULTS The national seroprevalence estimate from vaccination and/or infection was 99.1% (95% CrI 97.0-100.0%) based on Wuhan (spike_W and RBD_W) and RBD_BA2 antibodies. Sera from children < 12 years had 2.2 times higher levels of antibodies against RBD_BA2 than RBD_W and their seroprevalence estimate showed a 14.4 percentage points increase when also including anti-RBD_BA2 antibodies compared to Wuhan-antibodies alone. 50.3% (95% CI 45.0-55.5%) of residual sera from children and 38.1% (95% CI 36.0-40.4%) of all residual sera were positive for anti-N-antibodies. By combining measurements of binding- and ACE2-RBD-interaction-inhibiting antibodies, reactivity profiles indicative of infection and vaccination history were identified and validated using cohort sera. Residual sera with a profile indicative of hybrid immunity were able to neutralize newer Omicron variants XBB.1.5 and BQ.1.1. CONCLUSIONS By late summer of 2022, most of the Norwegian population had antibodies to SARS-CoV-2, and almost all children had been infected. Antibody profiles indicated that children mostly had experienced a primary Omicron infection, while hybrid immunity was common among adults. The finding that sera displaying hybrid immunity could neutralize newer Omicron variants indicates that Wuhan-like priming of the immune response did not have a harmful imprinting effect and that infections induce cross-reacting antibodies against future variants.
Collapse
Affiliation(s)
- Gro Tunheim
- Division of Infection Control, Norwegian Institute of Public Health (NIPH), Oslo, Norway.
| | - Even Fossum
- Division of Infection Control, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Anna Hayman Robertson
- Division of Infection Control, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | | | - Adity Chopra
- Department of Immunology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - John T Vaage
- Department of Immunology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Elisabeth Lea Vikse
- Division of Infection Control, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Anne-Marte Bakken Kran
- Division of Infection Control, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Per Magnus
- Center for Fertility and Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Lill Trogstad
- Division of Infection Control, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Siri Mjaaland
- Division of Infection Control, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Olav Hungnes
- Division of Infection Control, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | | |
Collapse
|
6
|
Yin Y, Yang G, Wang N, Zeng M, Jiang H, Yuan S, Wu J, Zhang J, Cui J, Zhou G, Yang X, Zhang Y, Sun Z, Yuan J, Lin J, Chen J, Tang M, Chen J. Exploring the prevalence and chest CT predictors of Long COVID in children: a comprehensive study from Shanghai and Linyi. Front Pediatr 2024; 12:1420196. [PMID: 39170602 PMCID: PMC11335557 DOI: 10.3389/fped.2024.1420196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 07/23/2024] [Indexed: 08/23/2024] Open
Abstract
Introduction COVID-19 constitutes a pandemic of significant detriment to human health. This study aimed to investigate the prevalence of Long COVID following SARS-CoV-2 infection, analyze the potential predictors of chest CT for the development of Long COVID in children. Methods A cohort of children who visited the respiratory outpatient clinics at Shanghai Children's Medical Center or Linyi Maternal and Child Health Care Hospital from December 2022 to February 2023 and underwent chest CT scans within 1 week was followed up. Data on clinical characteristics, Long COVID symptoms, and chest CT manifestations were collected and analyzed. Multivariate logistic regression models and decision tree models were employed to identify factors associated with Long COVID. Results A total of 416 children were included in the study. Among 277 children who completed the follow-up, the prevalence of Long COVID was 23.1%. Chronic cough, fatigue, brain fog, and post-exertional malaise were the most commonly reported symptoms. In the decision tree model for Long COVID, the presence of increased vascular markings, the absence of normal CT findings, and younger age were identified as predictors associated with a higher likelihood of developing Long COVID in children. However, no significant correlation was found between chest CT abnormality and the occurrence of Long COVID. Discussion Long COVID in children presents a complex challenge with a significant prevalence rate of 23.1%. Chest CT scans of children post-SARS-CoV-2 infection, identified as abnormal with increased vascular markings, indicate a higher risk of developing Long COVID.
Collapse
Affiliation(s)
- Yong Yin
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Children’s Medical Center Pediatric Medical Complex (Pudong), Shanghai, China
- Pediatric AI Clinical Application and Research Center, Shanghai Children’s Medical Center, Shanghai, China
- Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
- Child Health Advocacy Institute, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Guijun Yang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Na Wang
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Mei Zeng
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hejun Jiang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuhua Yuan
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinhong Wu
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Zhang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juan Cui
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Guifang Zhou
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Xin Yang
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Yunqin Zhang
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Zhichao Sun
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Jiajun Yuan
- Pediatric AI Clinical Application and Research Center, Shanghai Children’s Medical Center, Shanghai, China
- Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
- Medical Department of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jilei Lin
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Pediatric AI Clinical Application and Research Center, Shanghai Children’s Medical Center, Shanghai, China
- Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
- Child Health Advocacy Institute, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Jiande Chen
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mingyu Tang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Chen
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| |
Collapse
|
7
|
Jia R, Li Z, Hu S, Chang H, Zeng M, Liu P, Lu L, Xu M, Zhai X, Qian M, Xu J. Immunological characterization and comparison of children with COVID-19 from their adult counterparts at single-cell resolution. Front Immunol 2024; 15:1358725. [PMID: 39148728 PMCID: PMC11325098 DOI: 10.3389/fimmu.2024.1358725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 07/17/2024] [Indexed: 08/17/2024] Open
Abstract
Introduction The immunological characteristics that could protect children with coronavirus disease 2019 (COVID-19) from severe or fatal illnesses have not been fully understood yet. Methods Here, we performed single-cell RNA sequencing (scRNA-seq) analysis on peripheral blood samples of 15 children (8 with COVID-19) and compared them to 18 adults (13 with COVID-19). Results The child-adult integrated single cell data indicated that children with the disease presented a restrained response to type I interferon in most of the major immune cell types, along with suppression of upstream interferon regulatory factor and toll-like receptor expression in monocytes, which was confirmed by in vitro interferon stimulation assays. Unlike adult patients, children with COVID-19 showed lower frequencies of activated proinflammatory CD14+ monocytes, possibly explaining the rareness of cytokine storm in them. Notably, natural killer (NK) cells in pediatric patients displayed potent cytotoxicity with a rich expression of cytotoxic molecules and upregulated cytotoxic pathways, whereas the cellular senescence, along with the Notch signaling pathway, was significantly downregulated in NK cells, all suggesting more robust cytotoxicity in NK cells of children than adult patients that was further confirmed by CD107a degranulation assays. Lastly, a modest adaptive immune response was evident with more naïve T cells but less activated and proliferated T cells while less naïve B cells but more activated B cells in children over adult patients. Conclusion Conclusively, this preliminary study revealed distinct cell frequency and activation status of major immune cell types, particularly more robust NK cell cytotoxicity in PBMC that might help protect children from severe COVID-19.
Collapse
Affiliation(s)
- Ran Jia
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Zifeng Li
- Department of Hematology and Oncology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Shiwen Hu
- Department of Hematology and Oncology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Hailing Chang
- Department of Infectious Diseases, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Mei Zeng
- Department of Infectious Diseases, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Pengcheng Liu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Lijuan Lu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Menghua Xu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Xiaowen Zhai
- Department of Hematology and Oncology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Maoxiang Qian
- Institute of Pediatrics and Department of Hematology and Oncology, Children's Hospital of Fudan University, National Children's Medical Center, and the Shanghai Key Laboratory of Medical Epigenetics, International Co-laboratory of Medical Epigenetics and Metabolism (Ministry of Science and Technology), Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Jin Xu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| |
Collapse
|
8
|
Zhang J. Immune responses in COVID-19 patients: Insights into cytokine storms and adaptive immunity kinetics. Heliyon 2024; 10:e34577. [PMID: 39149061 PMCID: PMC11325674 DOI: 10.1016/j.heliyon.2024.e34577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 07/11/2024] [Accepted: 07/11/2024] [Indexed: 08/17/2024] Open
Abstract
SARS-CoV-2 infection can trigger cytokine storm in some patients, which characterized by an excessive production of cytokines and chemical mediators. This hyperactive immune response may cause significant tissue damage and multiple organ failure (MOF). The severity of COVID-19 correlates with the intensity of cytokine storm, involving elements such as IFN, NF-κB, IL-6, HMGB1, etc. It is imperative to rapidly engage adaptive immunity to effectively control the disease progression. CD4+ T cells facilitate an immune response by improving B cells in the production of neutralizing antibodies and activating CD8+ T cells, which are instrumental in eradicating virus-infected cells. Meanwhile, antibodies from B cells can neutralize virus, obstructing further infection of host cells. In individuals who have recovered from the disease, virus-specific antibodies and memory T cells were observed, which could confer a level of protection, reducing the likelihood of re-infection or attenuating severity. This paper discussed the roles of macrophages, IFN, IL-6 and HMGB1 in cytokine release syndrome (CRS), the intricacies of adaptive immunity, and the persistence of immune memory, all of which are critical for the prevention and therapeutic strategies against COVID-19.
Collapse
Affiliation(s)
- Junguo Zhang
- Pulmonology Department, Fengdu General Hospital, Chongqing, 408200, China
| |
Collapse
|
9
|
Baumgart SWL, McLachlan A, Kenny H, McKew G, Maddocks S, Chen SCA, Kok J. Deisolation in the Healthcare Setting Following Recent COVID-19 Infection. Viruses 2024; 16:1131. [PMID: 39066294 PMCID: PMC11281359 DOI: 10.3390/v16071131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/06/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Deisolation of persons infected with SARS-CoV-2, the virus that causes COVID-19, presented a substantial challenge for healthcare workers and policy makers, particularly during the early phases of the pandemic. Data to guide deisolation of SARS-CoV-2-infected patients remain limited, and the risk of transmitting and acquiring infection has changed with the evolution of SARS-CoV-2 variants and population immunity from previous vaccination or infection, or both. AIMS This review examines the evidence to guide the deisolation of SARS-CoV-2-infected inpatients within the hospital setting when clinically improving and also of healthcare workers with COVID-19 prior to returning to work. METHODS A review was performed using relevant search terms in Medline, EMBASE, Google Scholar, and PubMed. RESULTS AND DISCUSSION The evidence is reviewed with regards to the nature of SARS-CoV-2 transmission, the role of testing to guide deisolation, and the impact of SARS-CoV-2-specific immunity. A paradigm and recommendations are proposed to guide deisolation for inpatients and return to work for healthcare workers.
Collapse
Affiliation(s)
- Samuel W. L. Baumgart
- Department of Infectious Diseases and Microbiology, Concord Hospital, Concord, NSW 2137, Australia
| | - Aidan McLachlan
- Department of Infectious Diseases and Microbiology, Concord Hospital, Concord, NSW 2137, Australia
| | - Hayden Kenny
- Department of Infectious Diseases and Microbiology, Concord Hospital, Concord, NSW 2137, Australia
| | - Genevieve McKew
- Department of Infectious Diseases and Microbiology, Concord Hospital, Concord, NSW 2137, Australia
- Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Susan Maddocks
- Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
- Centre for Infectious Diseases and Microbiology, Westmead Hospital, Westmead, NSW 2145, Australia;
| | - Sharon C.-A. Chen
- Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
- Centre for Infectious Diseases and Microbiology, Westmead Hospital, Westmead, NSW 2145, Australia;
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Westmead, NSW 2145, Australia
- Centre for Infectious Diseases and Microbiology—Public Health, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Jen Kok
- Centre for Infectious Diseases and Microbiology, Westmead Hospital, Westmead, NSW 2145, Australia;
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Westmead, NSW 2145, Australia
- Centre for Infectious Diseases and Microbiology—Public Health, Westmead Hospital, Westmead, NSW 2145, Australia
| |
Collapse
|
10
|
Hodgson D, Liu Y, Carolan L, Mahanty S, Subbarao K, Sullivan SG, Fox A, Kucharski A. Memory B cell proliferation drives differences in neutralising responses between ChAdOx1 and BNT162b2 SARS-CoV-2 vaccines. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.11.24310221. [PMID: 39040163 PMCID: PMC11261961 DOI: 10.1101/2024.07.11.24310221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
Vaccination against COVID-19 has been pivotal in reducing the global burden of the disease. However, Phase III trial results and observational studies underscore differences in efficacy across vaccine technologies and dosing regimens. Notably, mRNA vaccines have exhibited superior effectiveness compared to Adenovirus (AdV) vaccines, especially with extended dosing intervals. Using in-host mechanistic modelling, this study elucidates these variations and unravels the biological mechanisms shaping the immune responses at the cellular level. We used data on the change in memory B cells, plasmablasts, and antibody titres after the second dose of a COVID-19 vaccine for Australian healthcare workers. Alongside this dataset, we constructed a kinetic model of humoral immunity which jointly captured the dynamics of multiple immune markers, and integrated hierarchical effects into this kinetics model, including age, dosing schedule, and vaccine type. Our analysis estimated that mRNA vaccines induced 2.1 times higher memory B cell proliferation than AdV vaccines after adjusting for age, interval between doses and priming dose. Additionally, extending the duration between the second vaccine dose and priming dose beyond 28 days boosted neutralising antibody production per plasmablast concentration by 30%. We also found that antibody responses after the second dose were more persistent when mRNA vaccines were used over AdV vaccines and for longer dosing regimens. Reconstructing in-host kinetics in response to vaccination could help optimise vaccine dosing regimens, improve vaccine efficacy in different population groups, and inform the design of future vaccines for enhanced protection against emerging pathogens.
Collapse
Affiliation(s)
- David Hodgson
- Centre of Mathematical Modelling of Infectious Diseases, London School and Hygiene and Tropical Medicine, London, UK
| | - Yi Liu
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Louise Carolan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Siddhartha Mahanty
- Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Kanta Subbarao
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Sheena G. Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Annette Fox
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Adam Kucharski
- Centre of Mathematical Modelling of Infectious Diseases, London School and Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
11
|
Traoré B, Guindo M, Konaté D, Kané F, Incandela N, Traore A, Kanté S, Sidibé M, Keita B, Kasse F, Tangara K, Diallo D, Maiga I, Thiam S, Cisse A, Siby K, Dicko A, Goita M, Kone D, Diallo M, Traore M, Coulibaly Y, Diakité M, Doumbia S, Dolo H, Balam S. Seroprevalence of SARS-CoV-2 Antibodies and Associated Factors in Bamako, Mali: A Population-Based Cross-Sectional Study in September 2022. Influenza Other Respir Viruses 2024; 18:e13343. [PMID: 39044355 PMCID: PMC11300109 DOI: 10.1111/irv.13343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/15/2024] [Accepted: 05/31/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND The sero-epidemiological characteristics of SARS-CoV-2 infections in Mali are not yet well understood. This study assessed SARS-CoV-2 antibody seroprevalence and factors associated with antibody responses in the general population of Bamako, the capital city and epicenter of COVID-19, to assess the magnitude of the pandemic and contribute to control strategy improvements in Mali. METHODS A cross-sectional survey was conducted in September 2022 to collect sociodemographic information, clinical characteristics, comorbid factors, and blood samples. ELISA was performed to determine anti-Spike (anti-S) and anti-RBD antibody levels. A total of 3601 participants were enrolled in REDCap. R-Studio was used for the statistical analysis. The chi-squared (χ2) test was used to compare the proportions across different groups. Logistic regression models were used to elucidate factors associated with antibody responses. RESULT The sex ratio for female-to-male was 3.6:1. The most representative groups were the 20-29-year-olds (28.9%, n = 1043) and the 30-39-year-olds (26.9%, n = 967). The COVID-19 vaccine coverage among the participants was 35.8%, with vaccines from Covishield AstraZeneca (13.4%), Johnson & Johnson (16.7%), Sinovac (3.9%), and BioNTech Pfizer (1.8%). Overall, S protein and RBD antibody seroprevalences were remarkably high in the study population (98% and 97%, respectively). Factors such as youth (1-9 years old) and male sex were associated with lower SARS-CoV-2 antibody responses, whereas COVID-19 vaccinations were associated with increased antibody responses. CONCLUSION This serosurvey demonstrated the high seroprevalence of SARS-CoV-2 antibodies and highlighted the factors influencing antibody responses, while clearly underlining an underestimation of the pandemic in Mali.
Collapse
Affiliation(s)
- Bourama Traoré
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Merepen A. Guindo
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Drissa Konaté
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Fousseyni Kané
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Nathan C. Incandela
- Center for Polymers and Organic Solids, Department of Chemistry and BiochemistryUniversity of California Santa BarbaraSanta BarbaraCaliforniaUSA
| | - Abdouramane Traore
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Salimata Kanté
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Mariam Sidibé
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Bourama Keita
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Fatoumata Kasse
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Karamoko Tangara
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Dramane Diallo
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Issoufi Y. Maiga
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Salif Thiam
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Abdourhamane Cisse
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Khatry M. Siby
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Abdoul R. Dicko
- District Health Center of Commune 4 of BamakoMinister of Health and Social Development of MaliBamakoMali
| | - Mariam Goita
- District Health Center of Commune 4 of BamakoMinister of Health and Social Development of MaliBamakoMali
| | - Diakaridia Kone
- Hospital District Health of Commune 1 of BamakoMinister of Health and Social Development of MaliBamakoMali
| | - Mamadou Diallo
- District Health Center of Commune 6 of BamakoMinister of Health and Social Development of MaliBamakoMali
| | - Modibo Traore
- District Health Center of Commune 5 of BamakoMinister of Health and Social Development of MaliBamakoMali
| | - Yaya I. Coulibaly
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Mahamadou Diakité
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Seydou Doumbia
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Housseini Dolo
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| | - Saidou Balam
- International Center for Excellence in Research (ICER), Faculty of Medicine and Odontostomatology (FMOS), Faculty of Pharmacy (FAPHA)University Clinical Research Center (UCRC) at the University of Sciences, Techniques and Technologies of Bamako (USTTB)BamakoMali
| |
Collapse
|
12
|
Rossi PAQ, Gomes R, Nascimento Salazar TCD, Lustosa Barros EM, Vasconcelos S, da Silva AS, Pereira EM, Melo VB, Fonseca MHG, Teixeira CR, Furtado GP, Pontes LQ, Khouri R, Vasconcelos B, Almeida SSD, Werneck GL, Rossi FE, Santos MAPD. Physical Activity at Different Life Stages and Its Consequence on the Initial Immunization and Inflammatory Response Against COVID-19. J Phys Act Health 2024; 21:717-725. [PMID: 38663845 DOI: 10.1123/jpah.2023-0370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 02/16/2024] [Accepted: 03/08/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND To evaluate the influence of previous physical activity (PA) during childhood, adolescence, and current PA practice on the production of antibodies and inflammatory response between the first and second doses of the COVID-19 vaccine. METHODS Fifty-nine men and 56 women were evaluated before the first vaccine, and 12 weeks later, blood samples were taken to quantify production of anti-severe acute respiratory syndrome coronavirus-2 immunoglobulin G antibodies and cytokines. Previous PA during childhood and adolescence was self-referred, and current PA was assessed using the International Physical Activity Questionnaire. RESULTS A positive and significant association was observed only between PA practice during adolescence and an increase in antibody production in adulthood (β = 2012.077, 95% confidence interval, 257.7953-3766.358, P = .025). Individuals who practiced PA during adolescence showed higher production of antibodies between the first and second vaccine dose compared to nonpractitioners (P = .025) and those that accumulated ≥150 minutes per week of current moderate-vigorous PA (MVPA), and presented higher antibody production in relation to who did <150 minutes per week of MVPA (P = .046). Individuals that were practitioners during childhood produced higher G-CSF (P = .047), and those that accumulated ≥150 minutes per week of current MVPA demonstrated lower IP-10 levels (P = .033). However, PA practitioners during adolescence presented higher G-CSF (P = .025), IL-17 (P = .038), IL-1RA (P = .005), IL-1β (P = .020), and IL-2 (P = .026) levels. CONCLUSION Our results suggest that adults that accumulated at least 150 minutes of MVPA per week or practiced PA during adolescence developed an improved immune and inflammatory response against COVID-19 vaccination.
Collapse
Affiliation(s)
- Priscila Almeida Queiroz Rossi
- Postgraduation Student in Science and Health, Federal University of Piaui, Teresina, PI, Brazil
- Department of Biophysics and Physiology, Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, PI, Brazil
| | - Regis Gomes
- Biotecnologia, Escritório Técnico da Fiocruz Ceará, Eusébio, CE, Brazil
| | - Teresa Cristina do Nascimento Salazar
- Postgraduation Student in Science and Health, Federal University of Piaui, Teresina, PI, Brazil
- Department of Biophysics and Physiology, Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, PI, Brazil
| | - Esmeralda Maria Lustosa Barros
- Department of Biophysics and Physiology, Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, PI, Brazil
| | | | | | | | - Vitoria Braga Melo
- Unidade de Apoio ao Diagnóstico de Covid-19 (UNADIG), Fiocruz Ceará, Eusébio, CE, Brazil
| | | | | | | | | | - Ricardo Khouri
- Gonçalo Moniz Institute, Fiocruz Bahia, Salvador, BA, Brazil
- Faculty of Medicine, Federal University of Bahia, Salvador,BA, Brazil
| | - Beatriz Vasconcelos
- Gonçalo Moniz Institute, Fiocruz Bahia, Salvador, BA, Brazil
- Faculty of Medicine, Federal University of Bahia, Salvador,BA, Brazil
| | - Sandro Soares de Almeida
- Department of Obstetrician, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo,SP, Brazil
- Faculdade Anhanguera de Guarulhos, Guarulhos,SP, Brazil
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | - Fabrício Eduardo Rossi
- Department of Physical Education, Immunometabolism of Skeletal Muscle and Exercise Research Group, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
- Graduate Program in Science and Health, Federal University of Piauí (UFPI), Teresina, PI, Brazil
- Graduate Program in Movement Science, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Marcos Antonio Pereira Dos Santos
- Department of Biophysics and Physiology, Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, PI, Brazil
| |
Collapse
|
13
|
Reynolds-Herbst T, Lowe D, Lozano JM, Maniaci V. The Association Between Early Initiation of Systemic Corticosteroids and the Hospital Length of Stay in Patients With Multisystem Inflammatory Syndrome in Children. Pediatr Emerg Care 2024; 40:536-540. [PMID: 38718820 DOI: 10.1097/pec.0000000000003196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
OBJECTIVE Patients with multisystem inflammatory syndrome in children (MIS-C) often require hospital admission. Treatment of MIS-C has included intravenous immunoglobulin, systemic corticosteroids, and/or immunomodulators. There is no standardized approach to when steroids should be initiated during treatment. The study objective was to determine whether early initiation of steroids in patients with MIS-C is associated with the duration of hospital length of stay (LOS). METHODS This is a single-center retrospective cohort study of patients younger than 21 years who were hospitalized with MIS-C between March 2020 and September 2021 and received steroids. Cases were obtained from an institutional MIS-C log. Patients with culture proven sepsis and/or those who received intravenous immunoglobulin or steroids within the previous 30 days were excluded. We used a multivariable linear regression model, controlling for potential confounders, to assess the association between early steroids and LOS. RESULTS A total of 56 patients hospitalized with MIS-C were identified; 38 received systemic corticosteroids and were included in the study. The mean time from admission to steroid administration was 9.8 hours (SD = 7.7) in the early group and 44.6 hours (SD = 14.2) in the late group. There was a statistically significant difference in baseline characteristics of patients receiving early versus late steroids in initial C-reactive peptide, procalcitonin, brain natriuretic peptide, and cardiac dysfunction. After controlling for confounders, initiating steroids within 24 hours of admission for MIS-C was associated with a decreased hospital LOS: in patients treated with early steroids, LOS was 58.3 hours less (95% confidence interval, -100.0 to -16.6; P = 0.007) than in those who received late steroids. CONCLUSIONS Among patients with MIS-C, initiating systemic corticosteroids within 24 hours of admission was associated with decreased hospital LOS.
Collapse
Affiliation(s)
| | - David Lowe
- From the Department of Emergency Medicine, Nicklaus Children's Hospital
| | - Juan M Lozano
- Division of Medical and Population Health Sciences Research, Florida International University Herbert Wertheim College of Medicine, Miami, FL
| | - Vincenzo Maniaci
- From the Department of Emergency Medicine, Nicklaus Children's Hospital
| |
Collapse
|
14
|
Messiah SE, Talebi Y, Swartz MD, Sabharwal R, Han H, Bergqvist E, Kohl HW, Valerio-Shewmaker M, DeSantis SM, Yaseen A, Kelder SH, Ross J, Padilla LN, Gonzalez MO, Wu L, Lakey D, Shuford JA, Pont SJ, Boerwinkle E. Long-term immune response to SARS-CoV-2 infection and vaccination in children and adolescents. Pediatr Res 2024; 96:525-534. [PMID: 37875728 PMCID: PMC11343709 DOI: 10.1038/s41390-023-02857-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND This analysis examined the durability of antibodies present after SARS-CoV-2 infection and vaccination in children and adolescents. METHODS Data were collected over 4 time points between October 2020-November 2022 as part of a prospective population-based cohort aged 5-to-19 years (N = 810). Results of the (1) Roche Elecsys® Anti-SARS-CoV-2 Immunoassay for detection of antibodies to the SARS-CoV-2 nucleocapsid protein (Roche N-test); and (2) qualitative and semi-quantitative detection of antibodies to the SARS CoV-2 spike protein receptor binding domain (Roche S-test); and (3) self-reported antigen/PCR COVID-19 test results, vaccination and symptom status were analyzed. RESULTS N antibody levels reached a median of 84.10 U/ml (IQR: 20.2, 157.7) cutoff index (COI) ~ 6 months post-infection and increased slightly to a median of 85.25 (IQR: 28.0, 143.0) COI at 12 months post-infection. Peak S antibody levels were reached at a median of 2500 U/mL ~6 months post-vaccination and remained for ~12 months (mean 11.6 months, SD 1.20). CONCLUSIONS This analysis provides evidence of robust durability of nucleocapsid and spike antibodies in a large pediatric sample up to 12 months post-infection/vaccination. This information can inform pediatric SARS-CoV-2 vaccination schedules. IMPACT This study provided evidence of robust durability of both nucleocapsid and spike antibodies in a large pediatric sample up to 12 months after infection. Little is known about the long-term durability of natural and vaccine-induced SARS-CoV-2 antibodies in the pediatric population. Here, we determined the durability of anti-SARS-CoV-2 spike (S-test) and nucleocapsid protein (N-test) in children/adolescents after SARS-CoV-2 infection and/or vaccination lasts at least up to 12 months. This information can inform future SARS-CoV-2 vaccination schedules in this age group.
Collapse
Affiliation(s)
- Sarah E Messiah
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health (UTHealth) Science Center at Houston, School of Public Health in Dallas, Dallas, TX, USA.
- Center for Pediatric Population Health, UTHealth School of Public Health, Dallas, TX, USA.
- Department of Pediatrics, McGovern Medical School, Houston, TX, USA.
| | - Yashar Talebi
- Department of Biostatistics and Data Science, UTHealth Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Michael D Swartz
- Department of Biostatistics and Data Science, UTHealth Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Rachit Sabharwal
- Department of Biostatistics and Data Science, UTHealth Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Haoting Han
- Department of Biostatistics and Data Science, UTHealth Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Emma Bergqvist
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health (UTHealth) Science Center at Houston, School of Public Health in Dallas, Dallas, TX, USA
- Center for Pediatric Population Health, UTHealth School of Public Health, Dallas, TX, USA
| | - Harold W Kohl
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth Science Center at Houston, School of Public Health in Austin, Austin, TX, USA
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
| | - Melissa Valerio-Shewmaker
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health in Brownville, Brownsville, TX, USA
| | - Stacia M DeSantis
- Department of Biostatistics and Data Science, UTHealth Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Ashraf Yaseen
- Department of Biostatistics and Data Science, UTHealth Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Steven H Kelder
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth Science Center at Houston, School of Public Health in Austin, Austin, TX, USA
| | - Jessica Ross
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health (UTHealth) Science Center at Houston, School of Public Health in Dallas, Dallas, TX, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| | - Lindsay N Padilla
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health (UTHealth) Science Center at Houston, School of Public Health in Dallas, Dallas, TX, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| | - Michael O Gonzalez
- Department of Biostatistics and Data Science, UTHealth Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Leqing Wu
- Department of Biostatistics and Data Science, UTHealth Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - David Lakey
- University of Texas System, Austin, TX, USA
- The University of Texas Health Science Center Tyler, Tyler, TX, USA
| | | | - Stephen J Pont
- Texas Department of State Health Services, Austin, TX, USA
| | - Eric Boerwinkle
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health (UTHealth) Science Center at Houston, School of Public Health in Dallas, Dallas, TX, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| |
Collapse
|
15
|
Bagala I, Namuganga JF, Nayebare P, Cuu G, Katairo T, Nabende I, Gonahasa S, Nassali M, Tukwasibwe S, Dorsey G, Nankabirwa J, Kitaka SB, Kiguli S, Greenhouse B, Ssewanyana I, Kamya MR, Briggs J. Seroprevalence of SARS-CoV-2 and risk factors for infection among children in Uganda: a serial cross-sectional study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.09.24308673. [PMID: 38947039 PMCID: PMC11213087 DOI: 10.1101/2024.06.09.24308673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Background Understanding COVID-19's impact on children is vital for public health policy, yet age-specific data is scarce, especially in Uganda. This study examines SARS-CoV-2 seroprevalence and risk factors among Ugandan children at two timepoints, along with COVID-19-related knowledge and practices in households, including adult vaccination status. Methods Baseline surveys were conducted in 12 communities from April to May 2021 (post-Alpha wave) and follow-up surveys in 32 communities from November 2021 to March 2022 (Omicron wave). Household questionnaires and blood samples were collected to test for malaria by microscopy and for SARS-CoV-2 using a Luminex assay. Seroprevalence was estimated at both the survey and community level. Mixed-effects logistic regression models assessed the association between individual and household factors and SARS-CoV-2 seropositivity in children, adjusting for household clustering. Results More households reported disruptions in daily life at baseline compared to follow-up, though economic impacts lingered. By the follow-up survey, 52.7% of adults had received at least one COVID-19 vaccine dose. Overall seroprevalence in children was higher at follow-up compared to baseline (71.6% versus 19.2%, p < 0.001). Seroprevalence in children ranged across communities from 6-37% at baseline and 50-90% at follow-up. At baseline, children from the poorest households were more likely to be infected. Increasing age remained the only consistent risk factor for SARS-CoV-2 seroconversion at both timepoints. Conclusions Results indicate that a larger number of children were infected by the Delta and Omicron waves of COVID-19 compared to the Alpha wave. This study is the largest seroprevalence survey in children in Uganda, providing evidence that most children were infected with SARS-CoV-2 before the vaccine was widely available to pediatric populations. Pediatric infections were vastly underreported by case counts, highlighting the importance of seroprevalence surveys in assessing disease burden when testing and reporting rates are limited and many cases are mild or asymptomatic.
Collapse
Affiliation(s)
- Irene Bagala
- Makerere University College of Health Sciences, Kampala, Uganda
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | | | - Gloria Cuu
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Thomas Katairo
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Isaiah Nabende
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | - Martha Nassali
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | | | - Joaniter Nankabirwa
- Makerere University College of Health Sciences, Kampala, Uganda
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | - Sarah Kiguli
- Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Isaac Ssewanyana
- Infectious Diseases Research Collaboration, Kampala, Uganda
- Central Public Health Laboratory, Butabika, Uganda
| | - Moses R Kamya
- Makerere University College of Health Sciences, Kampala, Uganda
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | |
Collapse
|
16
|
Dimopoulou D, Charakida M, Marmarinos A, Karaviti D, Avgeris M, Gourgiotis D, Tsolia MN. SARS-CoV-2 Antibody Kinetics in Unvaccinated Hospitalized Children With COVID-19. Pediatr Infect Dis J 2024; 43:536-542. [PMID: 38372544 DOI: 10.1097/inf.0000000000004301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
BACKGROUND Antibody levels decline a few months post-acute COVID-19, but humoral memory persists in adults. Age and disease severity may affect antibody responses. This study aims to evaluate the presence and durability of antibody responses in children with COVID-19. METHODS A prospective, single-center study, involving unvaccinated children 0-16 years of age who were hospitalized with COVID-19 between October 2020 and December 2021, was conducted. Serological testing for anti-Spike severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG and neutralizing antibodies was performed at diagnosis and at 1-, 3-, 6- and 12-months post-infection. RESULTS A total of 65 immunocompetent children were enrolled [mean age (±SD): 6.7 (±6.4) years; males: 56.9%]. At 3 months, 40/44 (91%) children were seropositive; seropositivity persisted in 22/26 (85%) children at 6 months and in 10/12 (83%) children at 12 months. There was no evidence that age was modifying the prediction of variance of SARS-CoV-2 IgG levels. In contrast, SARS-CoV-2 IgG levels varied with time and disease severity. The association with time was non-linear, so that with increasing time there was a significant reduction in SARS-CoV-2 IgG levels [coef, 0.044 (95% confidence interval {CI}: 0.061-0.028), P < 0.001]. For each increment of time, the higher disease severity group was associated with 0.9 lower SARS-CoV-2 IgG levels. Everyone varied from the average effect of time with an SD of 0.01, suggesting that individuals may have different trajectories across time. CONCLUSION Disease severity, but not age, influences antibody titers among children hospitalized with COVID-19. SARS-CoV-2 infection induces durable seroconversion in these children with detectable IgG levels at 1 year after infection.
Collapse
Affiliation(s)
| | | | - Antonios Marmarinos
- Laboratory of Clinical Biochemistry-Molecular Diagnostics, Second Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens, Greece
| | | | - Margaritis Avgeris
- Laboratory of Clinical Biochemistry-Molecular Diagnostics, Second Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens, Greece
| | - Dimitrios Gourgiotis
- Laboratory of Clinical Biochemistry-Molecular Diagnostics, Second Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens, Greece
| | | |
Collapse
|
17
|
Mentor G, Farrar DS, Di Chiara C, Dufour MSK, Valois S, Taillefer S, Drouin O, Renaud C, Kakkar F. The Effect of Age and Comorbidities: Children vs. Adults in Their Response to SARS-CoV-2 Infection. Viruses 2024; 16:801. [PMID: 38793682 PMCID: PMC11126068 DOI: 10.3390/v16050801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/09/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
While children have experienced less severe coronavirus disease (COVID-19) after SARS-CoV-2 infection than adults, the cause of this remains unclear. The objective of this study was to describe the humoral immune response to COVID-19 in child vs. adult household contacts, and to identify predictors of the response over time. In this prospective cohort study, children with a positive SARS-CoV-2 polymerase chain reaction (PCR) test (index case) were recruited along with their adult household contacts. Serum IgG antibodies against SARS-CoV-2 S1/S2 spike proteins were compared between children and adults at 6 and 12 months after infection. A total of 91 participants (37 adults and 54 children) from 36 families were enrolled. Overall, 78 (85.7%) participants were seropositive for anti-S1/S2 IgG antibody at 6 months following infection; this was higher in children than in adults (92.6% vs. 75.7%) (p = 0.05). Significant predictors of a lack of SARS-CoV-2 seropositivity were age ≥ 25 vs. < 12 years (odds ratio [OR] = 0.23, p = 0.04), presence of comorbidities (vs. none, adjusted OR = 0.23, p = 0.03), and immunosuppression (vs. immunocompetent, adjusted OR = 0.17, p = 0.02).
Collapse
Affiliation(s)
- Girlande Mentor
- CHU Sainte-Justine, Département de Pédiatrie, Faculté de Médecine, Université de Montréal, Montreal, QC H3T 1C5, Canada; (G.M.); (O.D.)
| | - Daniel S. Farrar
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 1E8, Canada (C.D.C.)
| | - Costanza Di Chiara
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 1E8, Canada (C.D.C.)
- Division of Infectious Diseases, The Hospital for Sick Children, Toronto, ON M5G 1E8, Canada
| | - Mi-Suk Kang Dufour
- Unité de Recherche Clinique Appliqué, Centre de Recherche du CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada;
| | - Silvie Valois
- Centre D’infectiologie Mère-Enfant, Centre de Recherche du CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (S.V.)
| | - Suzanne Taillefer
- Centre D’infectiologie Mère-Enfant, Centre de Recherche du CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (S.V.)
| | - Olivier Drouin
- CHU Sainte-Justine, Département de Pédiatrie, Faculté de Médecine, Université de Montréal, Montreal, QC H3T 1C5, Canada; (G.M.); (O.D.)
| | - Christian Renaud
- Département de Microbiologie et Immunologie, Faculté de Médecine, Université de Montréal, Montreal, QC H3T 1C5, Canada;
| | - Fatima Kakkar
- CHU Sainte-Justine, Département de Pédiatrie, Faculté de Médecine, Université de Montréal, Montreal, QC H3T 1C5, Canada; (G.M.); (O.D.)
- Centre D’infectiologie Mère-Enfant, Centre de Recherche du CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (S.V.)
| |
Collapse
|
18
|
Qaqish A, Abbas MM, Alkhateeb M, Al-Tamimi M, Mustafa M, Al-Shudifat AE, Tarawneh S, Dawoud R, Mryyian A, Al-Ajaleen M. Anti_spike and anti_nucleocapsid IgG responses to SARS-CoV-2 in children of Jordan. Heliyon 2024; 10:e30631. [PMID: 38765100 PMCID: PMC11101777 DOI: 10.1016/j.heliyon.2024.e30631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 04/30/2024] [Accepted: 05/01/2024] [Indexed: 05/21/2024] Open
Abstract
Background It is proven that children have significantly milder COVID-19 disease compared to adults. Various immunological characteristics influence this age-related difference in protection against COVID-19. Pediatric COVID-19 in Jordan is extremely under reported. Objectives The primary goal of this work is to identify the anti_S and anti_N antibody responses in a random group of children in Jordan and compare it to that of naturally infected-unvaccinated adults. Methods 151 unvaccinated children, 4 days to 18 years old, were screened for anti_S and anti_N antibodies. History of COVID-19 infection or exposure to infection and symptom severity were reported by parents on a special questionnaire. Results 78.9 % and 65.3 % of participants were seropositive for anti_S IgG and anti_N Abs, respectively. There was a remarkable association between age and anti_S IgG and anti_N IgG antibody titers, as children aged 12 years or older had increased anti_S IgG titers (mean = 19.3 BAU/mL) compared to younger groups (means of 10.15, 9.24, 7.91 BAU/mL for age groups 6-12, 1-6, less than 1 year, respectively). Gender did not show a statistically important role in anti_S and anti_N IgG seropositivity rates or titers. Children displayed significantly elevated anti_S titers (mean = 13.23 BAU/mL) compared to naturally infected adults (mean = 9.72 BAU/mL), in contrast, adults' anti_N titers (mean = 39.64 U/mL) were significantly higher compared to those of children (mean = 10.77 U/mL). Conclusions The current work provides evidence of distinctly robust and persistent humoral immunity displayed by high anti_S and anti_N IgG in children, even >12 months post-infection. Age was the only factor that had a significant statistical impact on anti_S and anti_N Ab levels among the pediatric group in this study. Children exhibited significantly higher anti_S titers than naturally infected adults. In contrast, adults' anti_N titers were significantly higher. Such information can assist direct pediatric SARS-CoV-2 immunization programs, with implications for creating age-targeted strategies for diagnostic and population protection measures.
Collapse
Affiliation(s)
- Arwa Qaqish
- Department of Biology and Biotechnology, Faculty of Science, The Hashemite University, Zarqa, Jordan
- Department of Cellular Therapy and Applied Genomics, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Manal Mohammad Abbas
- Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman, Jordan
| | - Mohammad Alkhateeb
- Department of Internal Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Mohammad Al-Tamimi
- Department of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Minas Mustafa
- Department of Medical Laboratory Sciences, Faculty of Applied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Abdel-Ellah Al-Shudifat
- Department of Internal and Family Medicine, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Shahd Tarawneh
- Department of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Rand Dawoud
- Institute for Family Health, King Hussein Foundation, Amman, Jordan
| | - Amel Mryyian
- Department of Pediatrics, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Mu'ath Al-Ajaleen
- Department of Biology and Biotechnology, Faculty of Science, The Hashemite University, Zarqa, Jordan
| |
Collapse
|
19
|
Partey FD, Obiri D, Bonney EY, Pobee ANA, Damptey IK, Ennuson K, Akwetea-Foli J, Nuokpem FY, Courtin D, Kusi KA, Mensah BA. Efficient transplacental transfer of SARS-CoV-2 antibodies between naturally exposed mothers and infants in Accra, Ghana. Sci Rep 2024; 14:10772. [PMID: 38730052 PMCID: PMC11087586 DOI: 10.1038/s41598-024-61496-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/06/2024] [Indexed: 05/12/2024] Open
Abstract
We aimed to determine SARS-CoV-2 antibody seropositivity among pregnant women and the transplacental transfer efficiency of SARS-CoV-2-specific antibodies relative to malaria antibodies among SARS-CoV-2 seropositive mother-cord pairs. This cross-sectional study was conducted in Accra, Ghana, from March to May 2022. Antigen- specific IgG antibodies against SARS-CoV-2 (nucleoprotein and spike-receptor binding domain) and malarial antigens (circumsporozoite protein and merozoite surface protein 3) in maternal and cord plasma were measured by ELISA. Plasma from both vaccinated and unvaccinated pregnant women were tested for neutralizing antibodies using commercial kit. Of the unvaccinated pregnant women tested, 58.12% at antenatal clinics and 55.56% at the delivery wards were seropositive for both SARS-CoV-2 nucleoprotein and RBD antibodies. Anti-SARS-CoV-2 antibodies in cord samples correlated with maternal antibody levels (N antigen rs = 0.7155, p < 0.001; RBD rs = 0.8693, p < 0.001). Transplacental transfer of SARS-CoV-2 nucleoprotein antibodies was comparable to circumsporozoite protein antibodies (p = 0.9999) but both were higher than transfer rates of merozoite surface protein 3 antibodies (p < 0.001). SARS-CoV-2 IgG seropositivity among pregnant women in Accra is high with a boost of SARS-CoV-2 RBD-specific IgG in vaccinated women. Transplacental transfer of anti-SARS-CoV-2 and malarial antibodies was efficient, supporting vaccination of mothers as a strategy to protect infants against SARS-CoV-2.
Collapse
Affiliation(s)
- Frederica D Partey
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, P.O BOX LG 581, Legon, Accra, Ghana
| | - Dorotheah Obiri
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, P.O BOX LG 581, Legon, Accra, Ghana
| | - Evelyn Yayra Bonney
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, P.O BOX LG 581, Legon, Accra, Ghana
| | - Abigail Naa Adjorkor Pobee
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, P.O BOX LG 581, Legon, Accra, Ghana
| | - Isaac Kumi Damptey
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, P.O BOX LG 581, Legon, Accra, Ghana
| | - Keren Ennuson
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, P.O BOX LG 581, Legon, Accra, Ghana
| | - Jayln Akwetea-Foli
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, P.O BOX LG 581, Legon, Accra, Ghana
| | | | - David Courtin
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, P.O BOX LG 581, Legon, Accra, Ghana
- Université Paris Cité, IRD, MERIT, 75006, Paris, France
| | - Kwadwo A Kusi
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, P.O BOX LG 581, Legon, Accra, Ghana
| | - Benedicta A Mensah
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, P.O BOX LG 581, Legon, Accra, Ghana.
| |
Collapse
|
20
|
Dimopoulou D, Sotiri D, Kousi D, Loulou G, Raptaki K, Neofytou A, Dasoula F, Tampouratzi M, Koloi A, Eleftheriou E, Vergadi E, Papadimitriou E, Zorbadaki I, Mavridi A, Miliordos K, Steletou E, Strempela M, Fragkou PC, Spoulou V, Michos A, Gkentzi D, Papaevangelou V, Ladomenou F, Grivea I, Syrogiannopoulos G, Galanakis E, Zaoutis T, Tryfinopoulou K, Tsolia MN. SARS-CoV-2 seroprevalence among children in Greece during Omicron variant period. Eur J Pediatr 2024; 183:2491-2499. [PMID: 38478132 DOI: 10.1007/s00431-024-05486-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/05/2024] [Accepted: 02/13/2024] [Indexed: 04/23/2024]
Abstract
The Omicron variant is associated with increased transmissibility, but evidence about the impact of Omicron in seropositivity of children is limited. This study aims to evaluate SARS-CoV-2 seroprevalence in children during the different variants' subperiods. A prospective multicenter seroprevalence study was conducted in 7 University public hospitals in Greece from November 2021 to August 2022 (3 subperiods: November 2021-February 2022, March 2022-May 2022, June 2022-August 2022). Children from different age groups, admitted to the hospital or examined in outpatient clinics for reasons other than COVID-19 were enrolled. Neutralizing antibodies (Nabs), anti-Spike (anti-S) and anti-nucleocapsid (anti-N) SARS-CoV-2 IgG in serum were evaluated. A total of 2127 children (males:57,2%; median age:4,8years) were enrolled. Anti-N IgG seropositivity increased from 17,8% in the first sub-period to 40,7% in the second sub-period and then decreased in the third sub-period (36,7%). Anti-S IgG seropositivity appeared to have an increasing trend over the study period, starting from 34,8% and reaching 80,7%. Children aged 1-4 years old have significantly higher anti-N IgG titers compared to children aged 0-1 years old (p < 0,001). Infants have significantly lower anti-S IgG titers compared to all other age groups (p < 0,001). Immunocompromised children and infants have the lowest seropositivity for NAbs.Conclusions During the Omicron period, seropositivity significantly increased, as a result of higher transmissibility. Neonates and infants have lower antibody titers compared to other age groups, while young children aged 1-4 years old present higher antibody titers, suggesting that this age group may mount a higher antibody response. Continuous surveillance seroprevalence studies are needed in children, in order to identify the true extent of SARS-CoV-2 and guide the planning of adequate public health measures.
Collapse
Affiliation(s)
- Dimitra Dimopoulou
- Second Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens, 'P. and A. Kyriakou' Children's Hospital, Thivon and Leivadias, Athens, 30601, Greece
| | - Despoina Sotiri
- Central Public Health Laboratory, Hellenic Centre for Diseases Control and Prevention, Athens, Greece
| | - Dimitra Kousi
- Center for Clinical Epidemiology and Outcomes Research (CLEO), Athens, 15451, Greece
| | - Garyfallia Loulou
- Central Public Health Laboratory, Hellenic Centre for Diseases Control and Prevention, Athens, Greece
| | - Kalliopi Raptaki
- Central Public Health Laboratory, Hellenic Centre for Diseases Control and Prevention, Athens, Greece
| | - Ariadni Neofytou
- Second Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens, 'P. and A. Kyriakou' Children's Hospital, Thivon and Leivadias, Athens, 30601, Greece
| | - Foteini Dasoula
- Second Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens, 'P. and A. Kyriakou' Children's Hospital, Thivon and Leivadias, Athens, 30601, Greece
| | - Maria Tampouratzi
- Second Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens, 'P. and A. Kyriakou' Children's Hospital, Thivon and Leivadias, Athens, 30601, Greece
| | - Athina Koloi
- Second Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens, 'P. and A. Kyriakou' Children's Hospital, Thivon and Leivadias, Athens, 30601, Greece
| | - Eirini Eleftheriou
- Second Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens, 'P. and A. Kyriakou' Children's Hospital, Thivon and Leivadias, Athens, 30601, Greece
| | - Eleni Vergadi
- School of Medicine, Department of Paediatrics, University General Hospital of Heraklion, University of Crete, Heraklion, Greece
| | - Eleni Papadimitriou
- School of Health Sciences, Faculty of Medicine, Department of Paediatrics, University General Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Irini Zorbadaki
- Department of Pediatrics, Venizeleion General Hospital, Heraklion, Greece
| | - Artemis Mavridi
- Attikon University Hospital, National and Kapodistrian University of Athens, Third Department of Paediatrics, Athens, Greece
| | | | - Evangelia Steletou
- Medical School, Department of Paediatrics, University of Patras, Patras, Greece
| | - Maria Strempela
- First Department of Paediatrics, Aghia Sophia' Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Paraskevi C Fragkou
- First Department of Critical Care Medicine and Pulmonary Services, Evangelismos Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Vassiliki Spoulou
- First Department of Paediatrics, Aghia Sophia' Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Michos
- First Department of Paediatrics, Aghia Sophia' Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Despoina Gkentzi
- Medical School, Department of Paediatrics, University of Patras, Patras, Greece
| | - Vassiliki Papaevangelou
- Attikon University Hospital, National and Kapodistrian University of Athens, Third Department of Paediatrics, Athens, Greece
| | - Fani Ladomenou
- Department of Pediatrics, Venizeleion General Hospital, Heraklion, Greece
| | - Ioanna Grivea
- School of Health Sciences, Faculty of Medicine, Department of Paediatrics, University General Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - George Syrogiannopoulos
- School of Health Sciences, Faculty of Medicine, Department of Paediatrics, University General Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Emmanouil Galanakis
- School of Medicine, Department of Paediatrics, University General Hospital of Heraklion, University of Crete, Heraklion, Greece
| | - Theoklis Zaoutis
- Second Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens, 'P. and A. Kyriakou' Children's Hospital, Thivon and Leivadias, Athens, 30601, Greece
| | - Kyriaki Tryfinopoulou
- Central Public Health Laboratory, Hellenic Centre for Diseases Control and Prevention, Athens, Greece
| | - Maria N Tsolia
- Second Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens, 'P. and A. Kyriakou' Children's Hospital, Thivon and Leivadias, Athens, 30601, Greece.
| |
Collapse
|
21
|
Sariol A, Vickers MA, Christensen SM, Weiskopf D, Sette A, Norris AW, Tansey MJ, Pinnaro CT, Perlman S. Monovalent SARS-CoV-2 mRNA Vaccine Does not Boost Omicron-Specific Immune Response in Diabetic and Control Pediatric Patients. J Infect Dis 2024; 229:1059-1067. [PMID: 37624979 PMCID: PMC11011175 DOI: 10.1093/infdis/jiad366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/21/2023] [Accepted: 08/22/2023] [Indexed: 08/27/2023] Open
Abstract
While the immunogenicity of SARS-CoV-2 vaccines has been well described in adults, pediatric populations have been less studied. In particular, children with type 1 diabetes are generally at elevated risk for more severe disease after infections, but are understudied in terms of COVID-19 and SARS-CoV-2 vaccine responses. We investigated the immunogenicity of COVID-19 mRNA vaccinations in 35 children with type 1 diabetes (T1D) and 23 controls and found that these children develop levels of SARS-CoV-2 neutralizing antibody titers and spike protein-specific T cells comparable to nondiabetic children. However, in comparing the neutralizing antibody responses in children who received 2 doses of mRNA vaccines (24 T1D; 14 controls) with those who received a third, booster dose (11 T1D; 9 controls), we found that the booster dose increased neutralizing antibody titers against ancestral SARS-CoV-2 strains but, unexpectedly, not Omicron lineage variants. In contrast, boosting enhanced Omicron variant neutralizing antibody titers in adults.
Collapse
Affiliation(s)
- Alan Sariol
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, USA
| | - Molly A Vickers
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, USA
| | - Shannon M Christensen
- Department of Pediatrics-Endocrinology and Diabetes, University of Iowa, Iowa City, Iowa, USA
| | - Daniela Weiskopf
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, California, USA
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, California, USA
| | - Andrew W Norris
- Department of Pediatrics-Endocrinology and Diabetes, University of Iowa, Iowa City, Iowa, USA
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa, USA
| | - Michael J Tansey
- Department of Pediatrics-Endocrinology and Diabetes, University of Iowa, Iowa City, Iowa, USA
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa, USA
| | - Catherina T Pinnaro
- Department of Pediatrics-Endocrinology and Diabetes, University of Iowa, Iowa City, Iowa, USA
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa, USA
| | - Stanley Perlman
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, USA
| |
Collapse
|
22
|
Sun YK, Wang C, Lin PQ, Hu L, Ye J, Gao ZG, Lin R, Li HM, Shu Q, Huang LS, Tan LH. Severe pediatric COVID-19: a review from the clinical and immunopathophysiological perspectives. World J Pediatr 2024; 20:307-324. [PMID: 38321331 PMCID: PMC11052880 DOI: 10.1007/s12519-023-00790-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/14/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) tends to have mild presentations in children. However, severe and critical cases do arise in the pediatric population with debilitating systemic impacts and can be fatal at times, meriting further attention from clinicians. Meanwhile, the intricate interactions between the pathogen virulence factors and host defense mechanisms are believed to play indispensable roles in severe COVID-19 pathophysiology but remain incompletely understood. DATA SOURCES A comprehensive literature review was conducted for pertinent publications by reviewers independently using the PubMed, Embase, and Wanfang databases. Searched keywords included "COVID-19 in children", "severe pediatric COVID-19", and "critical illness in children with COVID-19". RESULTS Risks of developing severe COVID-19 in children escalate with increasing numbers of co-morbidities and an unvaccinated status. Acute respiratory distress stress and necrotizing pneumonia are prominent pulmonary manifestations, while various forms of cardiovascular and neurological involvement may also be seen. Multiple immunological processes are implicated in the host response to COVID-19 including the type I interferon and inflammasome pathways, whose dysregulation in severe and critical diseases translates into adverse clinical manifestations. Multisystem inflammatory syndrome in children (MIS-C), a potentially life-threatening immune-mediated condition chronologically associated with COVID-19 exposure, denotes another scientific and clinical conundrum that exemplifies the complexity of pediatric immunity. Despite the considerable dissimilarities between the pediatric and adult immune systems, clinical trials dedicated to children are lacking and current management recommendations are largely adapted from adult guidelines. CONCLUSIONS Severe pediatric COVID-19 can affect multiple organ systems. The dysregulated immune pathways in severe COVID-19 shape the disease course, epitomize the vast functional diversity of the pediatric immune system and highlight the immunophenotypical differences between children and adults. Consequently, further research may be warranted to adequately address them in pediatric-specific clinical practice guidelines.
Collapse
Affiliation(s)
- Yi-Kan Sun
- Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310030, China
| | - Can Wang
- Surgical Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Pei-Quan Lin
- Surgical Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Lei Hu
- Surgical Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Jing Ye
- Surgical Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Zhi-Gang Gao
- Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Ru Lin
- Department of Cardiopulmonary and Extracorporeal Life Support, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Hao-Min Li
- Clinical Data Center, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Qiang Shu
- Department of Cardiac Surgery, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
- National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Li-Su Huang
- National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
- Department of Infectious Diseases, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
| | - Lin-Hua Tan
- Surgical Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
| |
Collapse
|
23
|
Ikeda S, Mitsuishi H. Influence of mothers' stress on their infants' stress level: A preliminary study. Health Psychol Res 2024; 12:93908. [PMID: 38504672 PMCID: PMC10950203 DOI: 10.52965/001c.93908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/09/2023] [Indexed: 03/21/2024] Open
Abstract
Background In a previous study, mothers' stress was demonstrated to affect the stress of their infants. However, stress is a multi-layered concept, and there is a lack of studies on the type of stress that influences infant stress. Objective This study examined how various types of mothers' stress influence their infants' stress by measuring stress that emanates from COVID-19, child rearing, and stress levels based on speech and cortisol in saliva. Methods This study was conducted in two phases, and the stress of 21 mother-infant dyad were evaluated using questionnaires, participants' saliva, and voice recording. Results The results demonstrated that maternal stress increased infant stress, rearing stress decreased infant stress, and COVID-19 stress did not affect infant stress. Furthermore, there was no relationship between stress measured using questionnaires and stress measured using saliva, indicating that these factors independently affect infant stress. Conclusion It is clear that stress is multi-layered and that it is necessary to grasp each of the various stresses and their relationship appropriately.
Collapse
Affiliation(s)
| | - Hisashi Mitsuishi
- Faculty of Health and Medical Sciences Kyoto University of Advanced Science
| |
Collapse
|
24
|
Chee SHY, Bégué RE. SARS-CoV-2 Serology and Severity of MIS-C: A Case Series. Pediatr Infect Dis J 2024; 43:e114. [PMID: 38241638 DOI: 10.1097/inf.0000000000004191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Affiliation(s)
- Shareen H Y Chee
- Department of Pediatrics, University of Hawai'i, Honolulu, Hawai'i
| | - Rodolfo E Bégué
- Department of Pediatrics, University of Hawai'iKapi'olani Medical Center for Women and Children, Honolulu, Hawai'i
| |
Collapse
|
25
|
La Vecchia G, Del Buono MG, Bonaventura A, Vecchiè A, Moroni F, Cartella I, Saponara G, Campbell MJ, Dagna L, Ammirati E, Sanna T, Abbate A. Cardiac Involvement in Patients With Multisystem Inflammatory Syndrome in Adults. J Am Heart Assoc 2024; 13:e032143. [PMID: 38348793 PMCID: PMC11010102 DOI: 10.1161/jaha.123.032143] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 12/20/2023] [Indexed: 02/21/2024]
Abstract
Multisystemic inflammatory syndrome in adults is a hyperinflammatory condition following (within 4-12 weeks) SARS-CoV-2 infection. Here, the dysregulation of the immune system leads to a multiorgan involvement often affecting the heart. Cardiac involvement in multisystemic inflammatory syndrome in adults has been described mainly in young men without other comorbidities and may present with different clinical scenarios, including acute heart failure, life-threatening arrhythmias, pericarditis, and myocarditis, with a nonnegligible risk of mortality (up to 7% of all cases). The heterogeneity of its clinical features and the absence of a clear case definition make the differential diagnosis with other postinfectious (eg, infective myocarditis) and hyperinflammatory diseases (eg, adult Still disease and macrophage activation syndrome) challenging. Moreover, the evidence on the efficacy of specific treatments targeting the hyperinflammatory response underlying this clinical condition (eg, glucocorticoids, immunoglobulins, and other immunomodulatory agents) is sparse and not supported by randomized clinical trials. In this review article, we aim to provide an overview of the clinical features and the diagnostic workup of multisystemic inflammatory syndrome in adults with cardiac involvement, highlighting the possible pathogenetic mechanisms and the therapeutic management, along with remaining knowledge gaps in this field.
Collapse
Affiliation(s)
- Giulia La Vecchia
- Department of Cardiovascular and Pulmonary SciencesCatholic University of the Sacred HeartRomeItaly
- Center of Excellence in Cardiovascular SciencesIsola Tiberina Hospital Gemelli IsolaRomeItaly
- Department of Cardiovascular MedicineFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Marco Giuseppe Del Buono
- Department of Cardiovascular and Pulmonary SciencesCatholic University of the Sacred HeartRomeItaly
- Department of Cardiovascular MedicineFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Aldo Bonaventura
- S.C. Medicina Generale 1Medical Center, Ospedale di Circolo e Fondazione Macchi, Department of Internal Medicine, ASST Sette LaghiVareseItaly
| | - Alessandra Vecchiè
- S.C. Medicina Generale 1Medical Center, Ospedale di Circolo e Fondazione Macchi, Department of Internal Medicine, ASST Sette LaghiVareseItaly
| | - Francesco Moroni
- Robert M. Berne Cardiovascular Research Center and Division of Cardiovascular Medicine, Department of Medicine, Heart and Vascular CenterUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Iside Cartella
- Department of Cardiology, De Gasperis Cardio Center, ASST GrandeOspedale Metropolitano NiguardaMilanItaly
| | - Gianluigi Saponara
- Department of Cardiovascular MedicineFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Michael J. Campbell
- Division of Pediatric Cardiology, Department of PediatricsDuke University Medical Center2301 Erwin Road, DUMC Box 3127DurhamNCUSA
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare DiseasesIRCCS San Raffaele Hospital, Vita‐Salute San Raffaele UniversityMilanItaly
| | - Enrico Ammirati
- Department of Cardiology, De Gasperis Cardio Center, ASST GrandeOspedale Metropolitano NiguardaMilanItaly
| | - Tommaso Sanna
- Department of Cardiovascular and Pulmonary SciencesCatholic University of the Sacred HeartRomeItaly
- Department of Cardiovascular MedicineFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Antonio Abbate
- Robert M. Berne Cardiovascular Research Center and Division of Cardiovascular Medicine, Department of Medicine, Heart and Vascular CenterUniversity of VirginiaCharlottesvilleVirginiaUSA
| |
Collapse
|
26
|
Luo C, Chen W, Cai J, He Y. The mechanisms of milder clinical symptoms of COVID-19 in children compared to adults. Ital J Pediatr 2024; 50:28. [PMID: 38355623 PMCID: PMC10865718 DOI: 10.1186/s13052-024-01587-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/07/2024] [Indexed: 02/16/2024] Open
Abstract
In stark contrast to adult patients, children who contract Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) typically manifest milder symptoms or remain asymptomatic. However, the precise underlying mechanisms of this pathogenesis remain elusive. In this review, we primarily retrospect the clinical characteristics of SARS-CoV-2 infection in children, and explore the factors that may contribute to the typically milder clinical presentation in pediatric Coronavirus Disease 2019 (COVID-19) patients compare with adults patients with COVID-19. The pathophysiological mechanisms that mitigate lung injury in children are as follows: the expression level of ACE2 receptor in children is lower; the binding affinity between ACE2 receptors and viral spike proteins in children was weaker; children have strong pre-activated innate immune response and appropriate adaptive immune response; children have more natural lymphocytes; children with COVID-19 can produce higher levels of IgM, IgG and interferon; children infected with SARS-CoV-2 can produce lower levels of IL-6 and IL-10; children have fewer underlying diseases and the lower risk of worsening COVID-19; children are usually exposed to other respiratory viruses and have an enhanced cross-reactive immunity. Comprehending the relative contributions of these processes to the protective phenotype in the developing lungs can help in the diagnosis, treatment and research pertaining to children with COVID-19.
Collapse
Affiliation(s)
- Caiyin Luo
- Department of Pharmacy, the First Affiliated Hospital of Guangzhou Medical University, 28 Qiaozhong Middle Road, Liwan District, 510120, Guangzhou, China
| | - Wanwen Chen
- Department of Pharmacy, the First Affiliated Hospital of Guangzhou Medical University, 28 Qiaozhong Middle Road, Liwan District, 510120, Guangzhou, China
| | - Junying Cai
- Department of Pharmacy, the First Affiliated Hospital of Guangzhou Medical University, 28 Qiaozhong Middle Road, Liwan District, 510120, Guangzhou, China
| | - Yuwen He
- Department of Pharmacy, the First Affiliated Hospital of Guangzhou Medical University, 28 Qiaozhong Middle Road, Liwan District, 510120, Guangzhou, China.
| |
Collapse
|
27
|
Zong K, Yuan P, Wang R, Luo Q, Yang Y, Zhang X, Song Q, Du H, Gao C, Song J, Zhan W, Zhang M, Wang Y, Lin Q, Yao H, Xie B, Han J. Characteristics of innate, humoral and cellular immunity in children with non-severe SARS-CoV-2 infection. J Infect 2024; 88:158-166. [PMID: 38101522 DOI: 10.1016/j.jinf.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/25/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023]
Abstract
The symptoms of children infected with SARS-CoV-2 are mainly asymptomatic, mild, moderate, and a few severe cases. To understand the immune response characteristics of children infected with SARS-COV-2 who do not develop severe cases, 82 children infected with the SARS-CoV-2 delta strain were recruited in this study. Our results showed that high levels of IgG, IgM, and neutralization antibodies appeared in children infected with SARS-CoV-2. SARS-CoV-2 induced upregulation of both pro-inflammatory factors including TNF-α and anti-inflammatory factors including IL-4 and IL-13 in the children, even IL-10. The expression of INF-α in infected children also showed a significant increase compared to healthy children. However, IL-6, one of the important inflammatory factors, did not show an increase in infected children. It is worth noting that a large number of chemokines reduced in the SARS-CoV-2-infected children. Subsequently, TCR Repertoire, TCRβ bias, and preferential usage were analyzed on data of TCR next-generation sequencing from 8 SARS-CoV-2-infected children and 8 healthy controls. We found a significant decrease in TCR clonal diversity and a significant increase in TCR clonal expansion in SARS-CoV-2-infected children compared to healthy children. The most frequent V and J genes in SARS-CoV-2 children were TRBV28 and TRBJ2-1. The most frequently VβJ gene pairing in SARS-CoV-2 infected children was TRBV20-1-TRBJ2-1. The strong antiviral antibody levels, low expression of key pro-inflammatory factors, significant elevation of anti-inflammatory factors, and downregulation of many chemokines jointly determine that SARS-CoV-2-infected children rarely develop severe cases. Overall, our findings shed a light on the immune response of non-severe children infected with SARS-CoV-2.
Collapse
Affiliation(s)
- Kexin Zong
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Beijing 102206, China
| | - Ping Yuan
- Fujian Provincial Key Laboratory of Zoonosis Research (Fujian Center for Disease Control and Prevention); The Practice Base on the School of Public Health, Fujian Medical University, Fuzhou, Fujian 350011, China
| | - Ruifang Wang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Beijing 102206, China
| | - Qin Luo
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Beijing 102206, China
| | - Yanqing Yang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Beijing 102206, China
| | - Xiaohong Zhang
- Fujian Provincial Key Laboratory of Zoonosis Research (Fujian Center for Disease Control and Prevention); The Practice Base on the School of Public Health, Fujian Medical University, Fuzhou, Fujian 350011, China
| | - Qinqin Song
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Beijing 102206, China
| | - Haijun Du
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Beijing 102206, China
| | - Chen Gao
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Beijing 102206, China
| | - Juan Song
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Beijing 102206, China
| | - Weihua Zhan
- Putian Center for Disease Control and Prevention, Putian, Fujian 351106, China
| | - Mengjie Zhang
- Putian Center for Disease Control and Prevention, Putian, Fujian 351106, China
| | - Yanhai Wang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Beijing 102206, China
| | - Qunying Lin
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Putian University, Putian, Fujian 351100, China
| | - Hailan Yao
- Department of Biochemistry & Immunology, Capital Institute of Pediatrics, YaBao Rd, Beijing 100020, China.
| | - Baosong Xie
- Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital; Fujian Shengli Medical College, Fujian Medical University, Fuzhou, Fujian 350001, China.
| | - Jun Han
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Beijing 102206, China.
| |
Collapse
|
28
|
Rajamanickam A, Nathella PK, Venkataraman A, Chandrasekaran P, Rajendraprasath S, Devaleenal BD, Pandiarajan AN, Krishnakumar G, Venkat Ramanan P, Babu S. Elucidating systemic immune responses to acute and convalescent SARS-CoV-2 infection in children and elderly individuals. Immun Inflamm Dis 2024; 12:e1167. [PMID: 38415923 PMCID: PMC10832318 DOI: 10.1002/iid3.1167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 12/29/2023] [Accepted: 01/12/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), a causative pathogen of the COVID-19 pandemic, affects all age groups. However, various studies have shown that COVID-19 presentation and severity vary considerably with age. We, therefore, wanted to examine the differences between the immune responses of children with COVID-19 and elderly COVID-19 individuals. METHODS We analyzed cytokines, chemokines, growth factors, and acute phase proteins in acute and convalescent COVID-19 children and the elderly with acute and convalescent COVID-19. RESULTS We show that most of the pro-inflammatory cytokines (interferon [IFN]γ, interleukin [IL]-2, tumor necrosis factor-α [TNFα], IL-1α, IFNα, IFNβ, IL-6, IL-12, IL-3, IL-7, IL-1Ra, IL-13, and IL-10), chemokines (CCL4, CCL11, CCL19, CXCL1, CXCL2, CXCL8, and CXL10), growth factors (vascular endothelial growth factor and CD40L) and acute phase proteins (C-reactive protein, serum amyloid P, and haptoglobin) were decreased in children with acute COVID 19 as compared with elderly individuals. In contrast, children with acute COVID-19 exhibited elevated levels of cytokines- IL-1β, IL-33, IL-4, IL-5, and IL-25, growth factors-fibroblast growth factor-2, platelet- derived growth factors-BB, and transforming growth factorα as compared with elderly individuals. Similar, differences were manifest in children and elderly with convalescent COVID-19. CONCLUSION Thus, COVID-19 children are characterized by distinct cytokine/chemokine/growth factor/acute phase protein markers that are markedly different from elderly COVID-19 individuals.
Collapse
Affiliation(s)
- Anuradha Rajamanickam
- Department of ICERNational Institutes of Health‐National Institute for Research in Tuberculosis—International Center for Excellence in ResearchChennaiIndia
| | - Pavan Kumar Nathella
- Department of ImmunologyICMR−National Institute for Research in TuberculosisChennaiIndia
| | - Aishwarya Venkataraman
- Department of Clinical ResearchICMR−National Institute for Research in TuberculosisChennaiIndia
| | | | | | - Bella D. Devaleenal
- Department of Clinical ResearchICMR−National Institute for Research in TuberculosisChennaiIndia
| | - Arul Nancy Pandiarajan
- Department of ICERNational Institutes of Health‐National Institute for Research in Tuberculosis—International Center for Excellence in ResearchChennaiIndia
| | - Gowshika Krishnakumar
- Department of PaediatricsSri Ramachandra Institute of Higher Education & ResearchChennaiIndia
| | | | - Subash Babu
- Department of ICERNational Institutes of Health‐National Institute for Research in Tuberculosis—International Center for Excellence in ResearchChennaiIndia
- Laboratory of Parasitic DiseasesNational Institute of Allergy and Infectious Diseases, National Institutes of HealthBethesdaMarylandUSA
| |
Collapse
|
29
|
Kim M, Cheng WA, Congrave-Wilson Z, Marentes Ruiz CJ, Turner L, Mendieta S, Jumarang J, Del Valle J, Lee Y, Fabrizio T, Allen EK, Thomas PG, Webby R, Gordon A, Pannaraj PS. Comparisons of Pediatric and Adult SARS-CoV-2-Specific Antibodies up to 6 Months after Infection, Vaccination, or Hybrid Immunity. J Pediatric Infect Dis Soc 2024; 13:91-99. [PMID: 38016076 PMCID: PMC10824260 DOI: 10.1093/jpids/piad107] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/27/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Characterization of longitudinal SARS-CoV-2-specific antibody responses in children following infection and vaccination is needed to inform SARS-CoV-2 vaccine policy decisions for children, which may differ from adults. METHODS We enrolled individuals at the time of SARS-CoV-2 infection or vaccination for longitudinal serological testing and compared SARS-CoV-2-spike-specific IgG and neutralization activity in children and adults stratified by infection and vaccination status using enzyme-linked immunosorbent and virus neutralization assays. RESULTS Between June 2020 and December 2022, we collected sera from 669 participants aged 40 days to 55 years, including 330 unvaccinated individuals with laboratory-confirmed SARS-CoV-2 infection, 180 vaccinated SARS-CoV-2-naïve individuals, and 159 vaccinated previously infected individuals. Half (n = 330, 49.3%) were children. SARS-CoV-2-specific IgG and neutralization activity in children < 12 years old in response to infection persisted at higher levels than those of adults through at least 6 months (spike-specific IgG levels, 2.05 [95% CI: 1.4-3.1] times higher than adults; neutralizing activity, median 88.8 vs 75.2%, respectively, p = .04). In addition, all pediatric participants had significantly higher IgG levels compared with adults at 6 months following infection or vaccination, regardless of prior infection status. Vaccine-induced SARS-CoV-2-specific IgG responses in previously infected individuals persisted at higher levels than those from infection alone at 6 months (median AUC, children 5-11 years old, 9115 vs 368; adolescents 3613 vs 475; adults 1956 vs 263, all p < .001). CONCLUSIONS These data demonstrate the robust and persistent immunologic response of SARS-CoV-2 vaccination in children and emphasize the benefit of vaccination after SARS-CoV-2 infection.
Collapse
Affiliation(s)
- Minjun Kim
- Division of Infectious Diseases, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
| | - Wesley A Cheng
- Division of Infectious Diseases, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
| | - Zion Congrave-Wilson
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | | | - Lauren Turner
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | - Shirley Mendieta
- Division of Infectious Diseases, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
| | - Jaycee Jumarang
- Division of Infectious Diseases, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
| | - Jennifer Del Valle
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | - Yesun Lee
- Division of Infectious Diseases, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
| | - Thomas Fabrizio
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, TN, USA
| | - E Kaitlynn Allen
- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Paul G Thomas
- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Richard Webby
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, TN, USA
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Pia S Pannaraj
- Division of Infectious Diseases, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
- Division of Infectious Diseases, Rady Children’s Hospital, San Diego, CA, USA
| |
Collapse
|
30
|
Goryaynov S, Gurova O. Effect of Platform Type on Clinical Efficacy of SARS-CoV-2 Vaccines in Prime Vaccination Settings: A Systematic Review and Meta-Regression of Randomized Controlled Trials. Vaccines (Basel) 2024; 12:130. [PMID: 38400114 PMCID: PMC10892687 DOI: 10.3390/vaccines12020130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/14/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024] Open
Abstract
This systematic review investigated the association between platform type and the clinical efficacy of SARS-CoV-2 vaccines using the meta-regression of randomized controlled trials to compare the rates of the first appearance of symptomatic COVID-19 on the platforms. The trial search was conducted using PubMed, ClinicalTrials.gov, and the EU Clinical Trials Register. The main selection criteria included: non-active control, immunocompetent individuals without previous vaccination, and a low risk of bias. The platform effect was summarized with an incidence rate ratio (IRR) and a 95% confidence interval for every platform category against the reference. IRR was obtained by random-effect meta-regression with adjustment for confounding by effect modifiers. The analysis was conducted in per-protocol (PP) and modified intention-to-treat (mITT) sets. Six vaccine types with 35 trials were included. Vector vaccines were a reference category. In the PP set, rates of symptomatic COVID-19 on mRNA and protein subunit vaccines were significantly lower than on the vector: IRR = 0.30 [0.19; 0.46], p = 0.001 and 0.63 [0.46; 0.86], p = 0.012, respectively. There was no difference for inactivated and virus-like particle vaccines compared to the vector: IRR = 0.98 [0.71; 1.36], p = 0.913 and 0.70 [0.41; 1.20], p = 0.197, respectively. The rate of cases on DNA vaccines was significantly higher than that on the vector: IRR = 2.58 [1.17; 5.68], p = 0.034. Results for the mITT set were consistent. Platform type is an effect modifier of the clinical efficacy of SARS-CoV-2 vaccines.
Collapse
Affiliation(s)
| | - Olesya Gurova
- Department of Endocrinology No. 1, N.V. Sklifosovsky Institute of Clinical Medicine, Sechenov First Moscow State Medical University, 119435 Moscow, Russia;
| |
Collapse
|
31
|
Röltgen K, Boyd SD. Antibody and B Cell Responses to SARS-CoV-2 Infection and Vaccination: The End of the Beginning. ANNUAL REVIEW OF PATHOLOGY 2024; 19:69-97. [PMID: 37738512 DOI: 10.1146/annurev-pathmechdis-031521-042754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
As the COVID-19 pandemic has evolved during the past years, interactions between human immune systems, rapidly mutating and selected SARS-CoV-2 viral variants, and effective vaccines have complicated the landscape of individual immunological histories. Here, we review some key findings for antibody and B cell-mediated immunity, including responses to the highly mutated omicron variants; immunological imprinting and other impacts of successive viral antigenic variant exposures on antibody and B cell memory; responses in secondary lymphoid and mucosal tissues and non-neutralizing antibody-mediated immunity; responses in populations vulnerable to severe disease such as those with cancer, immunodeficiencies, and other comorbidities, as well as populations showing apparent resistance to severe disease such as many African populations; and evidence of antibody involvement in postacute sequelae of infection or long COVID. Despite the initial phase of the pandemic ending, human populations will continue to face challenges presented by this unpredictable virus.
Collapse
Affiliation(s)
- Katharina Röltgen
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Scott D Boyd
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA;
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, California, USA
| |
Collapse
|
32
|
周 彬, 黄 育, 洪 少, 焦 富, 谢 凯. [Multisystem inflammatory syndrome in children in the context of coronavirus disease 2019 pandemic]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2024; 26:98-102. [PMID: 38269467 PMCID: PMC10817736 DOI: 10.7499/j.issn.1008-8830.2306093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/04/2023] [Indexed: 01/26/2024]
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a complex syndrome characterized by multi-organ involvement that has emerged in the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak. The clinical presentation of MIS-C is similar to Kawasaki disease but predominantly presents with fever and gastrointestinal symptoms, and severe cases can involve toxic shock and cardiac dysfunction. Epidemiological findings indicate that the majority of MIS-C patients test positive for SARS-CoV-2 antibodies. The pathogenesis and pathophysiology of MIS-C remain unclear, though immune dysregulation following SARS-CoV-2 infection is considered a major contributing factor. Current treatment approaches for MIS-C primarily involve intravenous immunoglobulin therapy and symptomatic supportive care. This review article provides a comprehensive overview of the definition, epidemiology, pathogenesis, clinical presentation, diagnosis, treatment, and prognosis of MIS-C.
Collapse
Affiliation(s)
| | | | | | | | - 凯生 谢
- 中国医药大学儿童医院结构性/先天性心脏病及超音波中心,台湾台中
| |
Collapse
|
33
|
Hu W, Liu X, Lu X, Zhang D, Liu S, Gu X, Liu D, Sun J, Zhou T, Li X, Gao Y, Zhao Y, Cui G, Zhang S. Immunogenicity, safety and consistency of seven lots of an inactivated COVID-19 vaccine in healthy children and adolescents: a randomized, double-blind, controlled, phase IV clinical trial. Front Immunol 2024; 14:1320352. [PMID: 38250072 PMCID: PMC10796506 DOI: 10.3389/fimmu.2023.1320352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/12/2023] [Indexed: 01/23/2024] Open
Abstract
Background CoronaVac has been authorized worldwide for preventing coronavirus disease 2019. Information on the safety, immunogenicity and consistency of different lots and workshops of CoronaVac is presented here. Methods In this randomized, double-blind, phase IV clinical trial in healthy children and adolescents aged 3-17 years, we aimed to assess the lot-to-lot and workshop-to-workshop consistency, as well as immunogenicity and safety of seven lots of commercial-scale CoronaVac from three workshops. Eligible participants were enrolled into three age cohorts (3-5, 6-11 and 12-17 years). Within each cohort, participants were randomly assigned to seven groups to receive two doses of CoronaVac, with four weeks apart. Serum samples were collected before the first dose and 28 days after the second dose for neutralizing antibody testing. The primary objective was to evaluate the consistency of immune response among different lots within workshop 2 or 3, as well as among different workshops. The primary endpoint was geometric mean titer (GMT) of neutralizing antibody at 28 days after full-course vaccination. Results Between July 27th and November 19th, 2021, a total of 2,520 eligible participants were enrolled. Results showed that 95% confidence intervals (CIs) of GMT ratios for all comparative groups among different lots or workshops were within the equivalence criteria of [0.67, 1.5]. The GMT and seroconversion rate for all participants were 126.42 (95%CI: 121.82, 131.19) and 99.86% (95%CI: 99.59%, 99.97%) at 28 days after two-dose vaccination. The incidences of adverse reactions were similar among seven lots, and most adverse reactions were mild in Grade 1, with no serious adverse event. Conclusion CoronaVac is well-tolerated and can elicit a good immune response among children and adolescents. Lot-to-lot consistency results indicate stable manufacturing of commercial-scale CoronaVac.
Collapse
Affiliation(s)
- Weijun Hu
- Institute of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China
| | - Xiaoyu Liu
- Institute of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China
| | - Xi Lu
- Medical Affairs Department, Sinovac Biotech Co., Ltd., Beijing, China
| | - Dan Zhang
- Institute of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China
| | - Shuo Liu
- Clinical Research and Development Center, Sinovac Biotech Co., Ltd., Beijing, China
| | - Xianjin Gu
- Department of Immunization Program, Yanliang District Center for Disease Control and Prevention, Xi’an, China
| | - Dan Liu
- Department of Immunization Program, Yanliang District Center for Disease Control and Prevention, Xi’an, China
| | - Jianwen Sun
- Medical Affairs Department, Sinovac Life Sciences Co., Ltd., Beijing, China
| | - Tiantian Zhou
- Institute of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China
| | - Xinge Li
- Clinical Research and Development Center, Sinovac Biotech Co., Ltd., Beijing, China
| | - Yongjun Gao
- Medical Affairs Department, Sinovac Biotech Co., Ltd., Beijing, China
| | - Yanwei Zhao
- Medical Affairs Department, Sinovac Life Sciences Co., Ltd., Beijing, China
| | - Guoliang Cui
- Quality Assurance Department, Sinovac Life Sciences Co., Ltd., Beijing, China
| | - Shaobai Zhang
- Institute of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China
| |
Collapse
|
34
|
Ghosh A, Goyal K, Singh R, Lakshmi PVM, Kaur R, Kumar V, Muralidharan J, Puri GD, Ram J, Singh MP. High prevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibodies among unvaccinated children of Chandigarh, Northwest India, in a household-based paediatric serosurvey post-second wave of pandemic (June to July 2021). Public Health 2023; 225:160-167. [PMID: 37931485 DOI: 10.1016/j.puhe.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/05/2023] [Accepted: 10/04/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVE Current national severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination policy covers children aged >12 years. Unvaccinated, uninfected children remain susceptible to SARS-CoV-2 and play a role in community transmission, as paediatric infection is mostly mild or asymptomatic. To estimate the proportion of susceptible children in a community for public health measures, there is a need to assess the extent of natural infection. STUDY DESIGN We performed a cross-sectional household serosurvey of SARS-CoV-2 antibodies in unvaccinated children aged between 6 and 18 years after the second COVID-19 wave. METHODS Anti-SARS-CoV-2 immunoglobin G (IgG) testing in serum was done using chemiluminescence immunoassay. We used a logistic regression model to investigate predicted factors of seropositivity. RESULTS We observed a high prevalence (weighted average: 68.3%) of anti-SARS-CoV-2 IgG in 2700 enrolled children. Logistic regression for predictors of IgG seropositivity showed lower odds in households with completely vaccinated adults (adjusted odds ratio [OR]: 0.43, 95% confidence interval [CI]: 0.26-0.71, P = 0.0011) compared with households with unvaccinated adults. Other factors for low seropositivity included frontline workers as family members (adjusted OR: 0.69, 95% CI: 0.52-0.91, P = 0.0091) and non-crowded households (adjusted OR: 0.74, 95% CI: 0.61-0.89, P = 0.0019). CONCLUSION A high SARS-CoV-2 IgG prevalence in unvaccinated children was indicative of previous exposure to potentially infected contacts. This implies in-person academic activities for children can be continued during future community transmission. Comparatively lower seropositivity in children of completely vaccinated households or frontline workers suggests decreased transmission due to vaccination-induced immunity of family members. Vaccination will still be required in these children to maintain protective IgG levels, particularly in low seroprevalence groups.
Collapse
Affiliation(s)
- A Ghosh
- Department of Virology, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - K Goyal
- Department of Virology, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - R Singh
- Department of Community Medicine & School of Public Health, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - P V M Lakshmi
- Department of Community Medicine & School of Public Health, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - R Kaur
- Department of Virology, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - V Kumar
- Department of Virology, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - J Muralidharan
- Advanced Pediatric Centre, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - G D Puri
- Department of Anaesthesiology & Critical Care, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - J Ram
- Department of Ophthalmology, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - M P Singh
- Department of Virology, Post-graduate Institute of Medical Education & Research, Chandigarh, India.
| |
Collapse
|
35
|
Pillay A, Yeola A, Tea F, Denkova M, Houston S, Burrell R, Merheb V, Lee FXZ, Lopez JA, Moran L, Jadhav A, Sterling K, Lai CL, Vitagliano TL, Aggarwal A, Catchpoole D, Wood N, Phan TG, Nanan R, Hsu P, Turville SG, Britton PN, Brilot F. Infection and Vaccine Induced Spike Antibody Responses Against SARS-CoV-2 Variants of Concern in COVID-19-Naïve Children and Adults. J Clin Immunol 2023; 43:1706-1723. [PMID: 37405544 PMCID: PMC10661752 DOI: 10.1007/s10875-023-01540-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/19/2023] [Indexed: 07/06/2023]
Abstract
Although a more efficient adaptive humoral immune response has been proposed to underlie the usually favorable outcome of pediatric COVID-19, the breadth of viral and vaccine cross-reactivity toward the ever-mutating Spike protein among variants of concern (VOCs) has not yet been compared between children and adults. We assessed antibodies to conformational Spike in COVID-19-naïve children and adults vaccinated by BNT162b2 and ChAdOx1, and naturally infected with SARS-CoV-2 Early Clade, Delta, and Omicron. Sera were analyzed against Spike including naturally occurring VOCs Alpha, Beta, Gamma, Delta, and Omicron BA.1, BA.2, BA.5, BQ.1.1, BA2.75.2, and XBB.1, and variants of interest Epsilon, Kappa, Eta, D.2, and artificial mutant Spikes. There was no notable difference between breadth and longevity of antibody against VOCs in children and adults. Vaccinated individuals displayed similar immunoreactivity profiles across variants compared with naturally infected individuals. Delta-infected patients had an enhanced cross-reactivity toward Delta and earlier VOCs compared to patients infected by Early Clade SARS-CoV-2. Although Omicron BA.1, BA.2, BA.5, BQ.1.1, BA2.75.2, and XBB.1 antibody titers were generated after Omicron infection, cross-reactive binding against Omicron subvariants was reduced across all infection, immunization, and age groups. Some mutations, such as 498R and 501Y, epistatically combined to enhance cross-reactive binding, but could not fully compensate for antibody-evasive mutations within the Omicron subvariants tested. Our results reveal important molecular features central to the generation of high antibody titers and broad immunoreactivity that should be considered in future vaccine design and global serosurveillance in the context of limited vaccine boosters available to the pediatric population.
Collapse
Affiliation(s)
- Aleha Pillay
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Avani Yeola
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Fiona Tea
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Martina Denkova
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Samuel Houston
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Rebecca Burrell
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Vera Merheb
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Fiona X Z Lee
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Joseph A Lopez
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Lilly Moran
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
- National Center for Immunisation Research and Surveillance, the Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
| | - Ajay Jadhav
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
- National Center for Immunisation Research and Surveillance, the Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
| | - Katrina Sterling
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
- National Center for Immunisation Research and Surveillance, the Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
| | - Catherine L Lai
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Tennille L Vitagliano
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Anupriya Aggarwal
- The Kirby Institute, The University of New South Wales, Sydney, New South Wales, Australia
| | - Dan Catchpoole
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Nicholas Wood
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
- National Center for Immunisation Research and Surveillance, the Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
| | - Tri Giang Phan
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- St Vincent's Healthcare Clinical Campus, School of Clinical Medicine, Faculty of Medicine and Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - Ralph Nanan
- Charles Perkins Center and Sydney Medical School Nepean, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Peter Hsu
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
- Department of Allergy and Immunology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Stuart G Turville
- The Kirby Institute, The University of New South Wales, Sydney, New South Wales, Australia
| | - Philip N Britton
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
- Sydney Institute for Infectious Disease, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Fabienne Brilot
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia.
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
- Sydney Institute for Infectious Disease, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.
| |
Collapse
|
36
|
Bamber HN, Kim JJ, Reynolds BC, Afzaal J, Lunn AJ, Tighe PJ, Irving WL, Tarr AW. Increasing SARS-CoV-2 seroprevalence among UK pediatric patients on dialysis and kidney transplantation between January 2020 and August 2021. Pediatr Nephrol 2023; 38:3745-3755. [PMID: 37261514 PMCID: PMC10233184 DOI: 10.1007/s00467-023-05983-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/29/2023] [Accepted: 04/07/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) was officially declared a pandemic by the World Health Organisation (WHO) on 11 March 2020, as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread rapidly across the world. We investigated the seroprevalence of anti-SARS-CoV-2 antibodies in pediatric patients on dialysis or kidney transplantation in the UK. METHODS Excess sera samples were obtained prospectively during outpatient visits or haemodialysis sessions and analysed using a custom immunoassay calibrated with population age-matched healthy controls. Two large pediatric centres contributed samples. RESULTS In total, 520 sera from 145 patients (16 peritoneal dialysis, 16 haemodialysis, 113 transplantation) were analysed cross-sectionally from January 2020 until August 2021. No anti-SARS-CoV-2 antibody positive samples were detected in 2020 when lockdown and enhanced social distancing measures were enacted. Thereafter, the proportion of positive samples increased from 5% (January 2021) to 32% (August 2021) following the emergence of the Alpha variant. Taking all patients, 32/145 (22%) were seropositive, including 8/32 (25%) with prior laboratory-confirmed SARS-CoV-2 infection and 12/32 (38%) post-vaccination (one of whom was also infected after vaccination). The remaining 13 (41%) seropositive patients had no known stimulus, representing subclinical cases. Antibody binding signals were comparable across patient ages and dialysis versus transplantation and highest against full-length spike protein versus spike subunit-1 and nucleocapsid protein. CONCLUSIONS Anti-SARS-CoV-2 seroprevalence was low in 2020 and increased in early 2021. Serological surveillance complements nucleic acid detection and antigen testing to build a greater picture of the epidemiology of COVID-19 and is therefore important to guide public health responses. A higher resolution version of the Graphical abstract is available as Supplementary information.
Collapse
Affiliation(s)
- Holly N Bamber
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Jon Jin Kim
- Department of Paediatric Nephrology, Nottingham University Hospitals, Nottingham, UK
- Centre for Kidney Research and Innovation, University of Nottingham, Nottingham, UK
| | - Ben C Reynolds
- Department of Paediatric Nephrology, Royal Hospital for Children, Glasgow, UK
| | - Javairiya Afzaal
- Department of Paediatric Nephrology, Nottingham University Hospitals, Nottingham, UK
| | - Andrew J Lunn
- Department of Paediatric Nephrology, Nottingham University Hospitals, Nottingham, UK
| | - Patrick J Tighe
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - William L Irving
- School of Life Sciences, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
- Wolfson Centre for Global Virus Research, The University of Nottingham, Nottingham, UK
- Microbiology, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Alexander W Tarr
- School of Life Sciences, University of Nottingham, Nottingham, UK.
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK.
- Wolfson Centre for Global Virus Research, The University of Nottingham, Nottingham, UK.
- Microbiology, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
| |
Collapse
|
37
|
Andargie TE, Roznik K, Redekar N, Hill T, Zhou W, Apalara Z, Kong H, Gordon O, Meda R, Park W, Johnston TS, Wang Y, Brady S, Ji H, Yanovski JA, Jang MK, Lee CM, Karaba AH, Cox AL, Agbor-Enoh S. Cell-free DNA reveals distinct pathology of multisystem inflammatory syndrome in children. J Clin Invest 2023; 133:e171729. [PMID: 37651206 PMCID: PMC10617770 DOI: 10.1172/jci171729] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/29/2023] [Indexed: 09/02/2023] Open
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a rare but life-threatening hyperinflammatory condition induced by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes pediatric COVID-19 (pCOVID-19). The relationship of the systemic tissue injury to the pathophysiology of MIS-C is poorly defined. We leveraged the high sensitivity of epigenomics analyses of plasma cell-free DNA (cfDNA) and plasma cytokine measurements to identify the spectrum of tissue injury and glean mechanistic insights. Compared with pediatric healthy controls (pHCs) and patients with pCOVID-19, patients with MIS-C had higher levels of cfDNA primarily derived from innate immune cells, megakaryocyte-erythroid precursor cells, and nonhematopoietic tissues such as hepatocytes, cardiac myocytes, and kidney cells. Nonhematopoietic tissue cfDNA levels demonstrated significant interindividual variability, consistent with the heterogenous clinical presentation of MIS-C. In contrast, adaptive immune cell-derived cfDNA levels were comparable in MIS-C and pCOVID-19 patients. Indeed, the cfDNA of innate immune cells in patients with MIS-C correlated with the levels of innate immune inflammatory cytokines and nonhematopoietic tissue-derived cfDNA, suggesting a primarily innate immunity-mediated response to account for the multisystem pathology. These data provide insight into the pathogenesis of MIS-C and support the value of cfDNA as a sensitive biomarker to map tissue injury in MIS-C and likely other multiorgan inflammatory conditions.
Collapse
Affiliation(s)
- Temesgen E. Andargie
- Genomic Research Alliance for Transplantation (GRAfT) and Laboratory of Applied Precision Omics, National Heart, Lung, and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA. GFAfT is detailed in Supplemental Acknowledgments
- Department of Biology, Howard University, Washington DC, USA
| | - Katerina Roznik
- Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA
| | - Neelam Redekar
- Integrated Data Sciences Section, Research Technologies Branch, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA
| | - Tom Hill
- Integrated Data Sciences Section, Research Technologies Branch, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA
| | - Weiqiang Zhou
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Zainab Apalara
- Genomic Research Alliance for Transplantation (GRAfT) and Laboratory of Applied Precision Omics, National Heart, Lung, and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA. GFAfT is detailed in Supplemental Acknowledgments
| | - Hyesik Kong
- Genomic Research Alliance for Transplantation (GRAfT) and Laboratory of Applied Precision Omics, National Heart, Lung, and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA. GFAfT is detailed in Supplemental Acknowledgments
| | - Oren Gordon
- Infectious Diseases Unit, Department of Pediatrics, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Rohan Meda
- Genomic Research Alliance for Transplantation (GRAfT) and Laboratory of Applied Precision Omics, National Heart, Lung, and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA. GFAfT is detailed in Supplemental Acknowledgments
| | - Woojin Park
- Genomic Research Alliance for Transplantation (GRAfT) and Laboratory of Applied Precision Omics, National Heart, Lung, and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA. GFAfT is detailed in Supplemental Acknowledgments
| | - Trevor S. Johnston
- Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA
| | - Yi Wang
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sheila Brady
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda, Maryland, USA
| | - Hongkai Ji
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda, Maryland, USA
| | - Moon K. Jang
- Genomic Research Alliance for Transplantation (GRAfT) and Laboratory of Applied Precision Omics, National Heart, Lung, and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA. GFAfT is detailed in Supplemental Acknowledgments
| | - Clarence M. Lee
- Department of Biology, Howard University, Washington DC, USA
| | - Andrew H. Karaba
- Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA
| | - Andrea L. Cox
- Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA
| | - Sean Agbor-Enoh
- Genomic Research Alliance for Transplantation (GRAfT) and Laboratory of Applied Precision Omics, National Heart, Lung, and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA. GFAfT is detailed in Supplemental Acknowledgments
- Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
38
|
Fernández Villalobos NV, Marsall P, Torres Páez JC, Strömpl J, Gruber J, Lotto Batista M, Pohl D, Concha G, Frickmann H, de la Hoz Restrepo FP, Schneiderhan-Marra N, Krause G, Dulovic A, Strengert M, Kann S. Humoral immune response to SARS-CoV-2 and endemic coronaviruses in urban and indigenous children in Colombia. COMMUNICATIONS MEDICINE 2023; 3:151. [PMID: 37864073 PMCID: PMC10589283 DOI: 10.1038/s43856-023-00376-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/29/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Although anti-SARS-CoV-2 humoral immune responses and epidemiology have been extensively studied, data gaps remain for certain populations such as indigenous people or children especially in low- and middle-income countries. To address this gap, we evaluated SARS-CoV-2 seroprevalence and humoral immunity towards the parental B.1 strain, local SARS-CoV-2 variants, and endemic coronaviruses in children from Colombia from March to April 2021. METHODS We performed a cross-sectional seroprevalence study with 80 children from Bogotá and expanded our analysis by comparing results with an independent observational study of 82 children from the Wiwa community living in the north-eastern Colombian territories. Antibody IgG titers towards SARS-CoV-2 and the endemic coronaviruses as well as ACE2 binding inhibition as a proxy for neutralization towards several SARS-CoV-2 variants were analyzed using two multiplex-based immunoassays. RESULTS While we find seroprevalence estimates of 21.3% in children from Bogotá, seroprevalence is higher with 34.1% in Wiwa children. We observe a robust induction of antibodies towards the surface-exposed spike protein, its S1-, S2- and receptor-binding-subdomains in all SARS-CoV-2 seropositive children. Only nucleocapsid-specific IgG is significantly lower in the indigenous participants. ACE2 binding inhibition is low for all SARS-CoV-2 variants examined. We observe a dominance of NL63 S1 IgG levels in urban and indigenous children which suggests an early exposure to this respiratory virus independent of living conditions and geographic location. SARS-CoV-2 seropositivity does not correlate with antibody levels towards any of the four endemic coronaviruses indicating the absence of cross-protective immunity. CONCLUSIONS Overall, antibody titers, but in particular ACE2 binding inhibition are low within Colombian samples, requiring further investigation to determine any potential clinical significance.
Collapse
Affiliation(s)
| | - Patrick Marsall
- Multiplex Immunoassays, NMI Natural and Medical Sciences Institute at the University of Tübingen (NMI), Reutlingen, Germany
| | - Johanna Carolina Torres Páez
- Department of Epidemiology, PhD Programme, Helmholtz Centre for Infection Research (HZI), Braunschweig-Hannover, Germany
| | - Julia Strömpl
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
| | - Jens Gruber
- Multiplex Immunoassays, NMI Natural and Medical Sciences Institute at the University of Tübingen (NMI), Reutlingen, Germany
| | - Martín Lotto Batista
- Department of Epidemiology, PhD Programme, Helmholtz Centre for Infection Research (HZI), Braunschweig-Hannover, Germany
- Global Health Resilience, Barcelona Supercomputing Center (BSC), Barcelona, Spain
| | - Daria Pohl
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
| | - Gustavo Concha
- Organization Wiwa Yugumaiun Bunkauanarrua Tayrona (OWYBT), Department Health Advocacy, Valledupar, Colombia
| | - Hagen Frickmann
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, Hamburg, Germany
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany
| | | | - Nicole Schneiderhan-Marra
- Multiplex Immunoassays, NMI Natural and Medical Sciences Institute at the University of Tübingen (NMI), Reutlingen, Germany
| | - Gérard Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
- German Centre for Infection Research (DZIF), Braunschweig-Hannover, Germany
- TWINCORE, Centre for Experimental and Clinical Infection Research, a joint venture of the Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany
| | - Alex Dulovic
- Multiplex Immunoassays, NMI Natural and Medical Sciences Institute at the University of Tübingen (NMI), Reutlingen, Germany
| | - Monika Strengert
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany.
- TWINCORE, Centre for Experimental and Clinical Infection Research, a joint venture of the Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany.
| | - Simone Kann
- Medical Mission Institute, Würzburg, Germany
| |
Collapse
|
39
|
Burns MD, Bartsch YC, Davis JP, Boribong BP, Loiselle M, Kang J, Kane AS, Edlow AG, Fasano A, Alter G, Yonker LM. Long-term humoral signatures following acute pediatric COVID-19 and Multisystem Inflammatory Syndrome in Children. Pediatr Res 2023; 94:1327-1334. [PMID: 37173406 PMCID: PMC10176275 DOI: 10.1038/s41390-023-02627-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/21/2023] [Accepted: 03/30/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Although most children experience mild symptoms during acute SARS-CoV-2 infection, some develop the severe post-COVID-19 complication, Multisystem Inflammatory Syndrome in Children (MIS-C). While acute presentations of COVID-19 and MIS-C have been well immunophenotyped, little is known about the lasting immune profile in children after acute illness. METHODS Children 2 months-20 years of age presenting with either acute COVID-19 (n = 9) or MIS-C (n = 12) were enrolled in a Pediatric COVID-19 Biorepository at a single medical center. We deeply profiled humoral immune responses and circulating cytokines following pediatric COVID-19 and MIS-C. RESULTS Twenty-one children and young adults provided blood samples at both acute presentation and 6-month follow-up (mean: 6.5 months; standard deviation: 1.77 months). Pro-inflammatory cytokine elevations resolved after both acute COVID-19 and MIS-C. Humoral profiles continue to mature after acute COVID-19, displaying decreasing IgM and increasing IgG over time, as well as stronger effector functions, including antibody-dependent monocyte activation. In contrast, MIS-C immune signatures, especially anti-Spike IgG1, diminished over time. CONCLUSIONS Here, we show the mature immune signature after pediatric COVID-19 and MIS-C, displaying resolving inflammation with recalibration of the humoral responses. These humoral profiles highlight immune activation and vulnerabilities over time in these pediatric post-infectious cohorts. IMPACT The pediatric immune profile matures after both COVID-19 and MIS-C, suggesting a diversified anti-SARS-CoV-2 antibody response after resolution of acute illness. While pro-inflammatory cytokine responses resolve in the months following acute infection in both conditions, antibody-activated responses remain relatively heightened in convalescent COVID-19. These data may inform long-term immunoprotection from reinfection in children with past SARS-CoV-2 infections or MIS-C.
Collapse
Affiliation(s)
- Madeleine D Burns
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Yannic C Bartsch
- Harvard Medical School, Boston, MA, USA
- Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
| | - Jameson P Davis
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Brittany P Boribong
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Maggie Loiselle
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Jaewon Kang
- Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
| | - Abigail S Kane
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Andrea G Edlow
- Harvard Medical School, Boston, MA, USA
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA
- Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA, USA
| | - Alessio Fasano
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Galit Alter
- Harvard Medical School, Boston, MA, USA
- Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
| | - Lael M Yonker
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA, USA.
- Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
40
|
Takahashi T, Ai T, Saito K, Nojiri S, Takahashi M, Igawa G, Yamamoto T, Khasawneh A, Paran FJ, Takei S, Horiuchi Y, Kanno T, Tobiume M, Hiki M, Wakita M, Miida T, Okuzawa A, Suzuki T, Takahashi K, Naito T, Tabe Y. Assessment of antibody dynamics and neutralizing activity using serological assay after SARS-CoV-2 infection and vaccination. PLoS One 2023; 18:e0291670. [PMID: 37725623 PMCID: PMC10508622 DOI: 10.1371/journal.pone.0291670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 09/01/2023] [Indexed: 09/21/2023] Open
Abstract
The COVID-19 antibody test was developed to investigate the humoral immune response to SARS-CoV-2 infection. In this study, we examined whether S antibody titers measured using the anti-SARS-CoV-2 IgG II Quant assay (S-IgG), a high-throughput test method, reflects the neutralizing capacity acquired after SARS-CoV-2 infection or vaccination. To assess the antibody dynamics and neutralizing potency, we utilized a total of 457 serum samples from 253 individuals: 325 samples from 128 COVID-19 patients including 136 samples from 29 severe/critical cases (Group S), 155 samples from 71 mild/moderate cases (Group M), and 132 samples from 132 health care workers (HCWs) who have received 2 doses of the BNT162b2 vaccinations. The authentic virus neutralization assay, the surrogate virus neutralizing antibody test (sVNT), and the Anti-N SARS-CoV-2 IgG assay (N-IgG) have been performed along with the S-IgG. The S-IgG correlated well with the neutralizing activity detected by the authentic virus neutralization assay (0.8904. of Spearman's rho value, p < 0.0001) and sVNT (0.9206. of Spearman's rho value, p < 0.0001). However, 4 samples (2.3%) of S-IgG and 8 samples (4.5%) of sVNT were inconsistent with negative results for neutralizing activity of the authentic virus neutralization assay. The kinetics of the SARS-CoV-2 neutralizing antibodies and anti-S IgG in severe cases were faster than the mild cases. All the HCWs elicited anti-S IgG titer after the second vaccination. However, the HCWs with history of COVID-19 or positive N-IgG elicited higher anti-S IgG titers than those who did not have it previously. Furthermore, it is difficult to predict the risk of breakthrough infection from anti-S IgG or sVNT antibody titers in HCWs after the second vaccination. Our data shows that the use of anti-S IgG titers as direct quantitative markers of neutralizing capacity is limited. Thus, antibody tests should be carefully interpreted when used as serological markers for diagnosis, treatment, and prophylaxis of COVID-19.
Collapse
Affiliation(s)
- Toshihiro Takahashi
- Department of Clinical Laboratory, Juntendo University Hospital, Tokyo, Japan
| | - Tomohiko Ai
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kaori Saito
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shuko Nojiri
- Medical Technology Innovation Center, Juntendo University, Tokyo, Japan
| | - Maika Takahashi
- Department of Clinical Laboratory, Juntendo University Hospital, Tokyo, Japan
| | - Gene Igawa
- Department of Clinical Laboratory, Juntendo University Hospital, Tokyo, Japan
| | - Takamasa Yamamoto
- Department of Clinical Laboratory, Juntendo University Hospital, Tokyo, Japan
| | - Abdullah Khasawneh
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Faith Jessica Paran
- Department of Research Support Utilizing Bioresource Bank, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Satomi Takei
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuki Horiuchi
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takayuki Kanno
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Minoru Tobiume
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Makoto Hiki
- Department of Emergency Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Cardiovascular Biology and Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Mitsuru Wakita
- Department of Clinical Laboratory, Juntendo University Hospital, Tokyo, Japan
| | - Takashi Miida
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Atsushi Okuzawa
- Department of Research Support Utilizing Bioresource Bank, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Coloproctological Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tadaki Suzuki
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazuhisa Takahashi
- Department of Research Support Utilizing Bioresource Bank, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Toshio Naito
- Department of Research Support Utilizing Bioresource Bank, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of General Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoko Tabe
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Research Support Utilizing Bioresource Bank, Juntendo University Graduate School of Medicine, Tokyo, Japan
| |
Collapse
|
41
|
Oyeniran SJ, Wang H, Everhart K, Mack K, Harvey K, Leber AL. Performance comparison of three commercial tests for the detection of SARS-CoV-2 antibodies in a common set of pediatric samples. J Immunol Methods 2023; 520:113536. [PMID: 37567470 DOI: 10.1016/j.jim.2023.113536] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/26/2023] [Accepted: 08/08/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND Serologic testing for SARS CoV-2 is useful for detection of past infection and assisting in diagnosis of post-COVID-19 syndromes such as MIS-C. Immune responses to SARS-CoV-2 infection in children differ from adults but most antibody performance studies are limited to adults. OBJECTIVE The objective of this study was to compare three commercial SARS-CoV-2 antibody kits in a common set of children being evaluated for SARS-CoV-2 infection. METHODS Three SARS-CoV-2 antibody tests: Abbott anti-nucleocapsid (N) IgG (AA), Epitope Diagnostics anti-N IgG (EDI) and EUROIMMUN anti-S1 Spike IgG (EU) were compared against two references: 1) RT-PCR and 2) consensus IgG (consIgG). RESULTS All three tests had a sensitivity <53% compared to RT-PCR, with EU outperforming EDI (p = 0.03). When all samples were compared to consIgG, positive percent agreement was comparable (AA-90%, EU- 98% and EDI- 88%) but EDI had significantly better negative percent agreement than EU (p = 0.009). No difference in test performance was observed using either reference when samples were collected ≥15 days post-symptom onset (PSO). CONCLUSIONS Our findings suggest good performance of commercial SARS-CoV-2 IgG assays in pediatric patients with samples collected ≥15 days PSO. Additional studies investigating antibody response and assay performance in children are warranted.
Collapse
Affiliation(s)
- Sophonie J Oyeniran
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH 43205, United States of America; Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States of America.
| | - Huanyu Wang
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH 43205, United States of America; Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States of America
| | - Kathy Everhart
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH 43205, United States of America
| | - Kathy Mack
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH 43205, United States of America
| | - Kevin Harvey
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH 43205, United States of America
| | - Amy L Leber
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH 43205, United States of America; Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States of America
| |
Collapse
|
42
|
Kaufmann C, Morris M, Gombolay GY. Antibody response to SARS-CoV-2 vaccination or infection in a prospective cohort of children with neuroinflammatory diseases. Eur J Paediatr Neurol 2023; 46:30-34. [PMID: 37399703 PMCID: PMC10307668 DOI: 10.1016/j.ejpn.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 06/25/2023] [Accepted: 06/28/2023] [Indexed: 07/05/2023]
Abstract
INTRODUCTION Immune medications affect antibody responses to SARS-CoV-2 vaccination in adults with neuroinflammatory disorders, but little is known about antibody responses in children with neuroinflammation and on immune treatments. Here we measure antibody levels in response to SARS-CoV-2 vaccination in children receiving anti-CD20 monoclonal antibodies, or fingolimod. METHODS Children under 18 years of age with pediatric-onset neuroinflammatory disorders who received at least two mRNA vaccines were included. Plasma samples were assayed for SARS-CoV-2 antibodies (spike, spike receptor binding domain-RBD, nucleocapsid) and neutralization antibodies. RESULTS Seventeen participants with pediatric onset neuroinflammatory diseases were included: 12 multiple sclerosis, one neuromyelitis optica spectrum disorder, two MOG-associated disease, and two autoimmune encephalitis. Fourteen were on medications (11 on CD20 monoclonal antibodies-mAbs, one on fingolimod, one on steroids, one on intravenous immunoglobulin) and three were untreated. Nine patients also had pre-vaccination samples available. All participants had seropositivity to spike or spike RBD antibodies except for those receiving CD20 mAbs. However, this proportion was higher in children than in an adult MS patient cohort. The most significant contributor to antibody levels was duration of DMT. CONCLUSION SARS-CoV-2 antibodies are decreased in children on CD20 monoclonal antibodies than on other treatments. Treatment duration associated with vaccination responses.
Collapse
Affiliation(s)
| | - Morgan Morris
- Emory University School of Medicine, Department of Pediatrics, Division of Neurology, Atlanta, GA, USA
| | - Grace Y Gombolay
- Emory University School of Medicine, Department of Pediatrics, Division of Neurology, Atlanta, GA, USA; Children's Healthcare of Atlanta, Division of Neurology, Atlanta, GA, USA.
| |
Collapse
|
43
|
Monzen K, Watanabe T, Okabe T, Sekino H, Nakagami H, Morishita R. Acquisition of Humoral Immune Responses in Convalescent Japanese People with SARS-CoV-2 (COVID-19) Infection in 2021. Viruses 2023; 15:1842. [PMID: 37766249 PMCID: PMC10536507 DOI: 10.3390/v15091842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
We investigated humoral immune responses in 222 unvaccinated Japanese people after recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in 2021. Anti-spike-protein IgG antibody levels and neutralizing antibody titers were measured in serum samples obtained within 20-180 days after diagnosis. The geometric mean of antibody titers was 1555 ELU/mL (95% confidence interval (CI) = 1257-1923), and the neutralizing activity (50% inhibitory dilution) was 253 (95% CI = 204-313). The antibody titer and neutralizing activity both increased with increasing disease severity, and both values were approximately fourfold higher for hospitalized patients than for non-hospitalized patients. However, these differences were smaller in older patients. The humoral immune response, which increased with increasing disease severity, gradually decreased over time after SARS-CoV-2 infection. Most patients with mild or moderate symptoms sustained neutralizing activity for up to 180 days after the infection; the decay of the neutralizing activity in the asymptomatic patients was rather faster than in the other groups. Around 11.7% (26/222) of patients had very low neutralizing activity, and half of these were aged in their 20s. Our study's results show the importance of measuring the neutralizing activity to confirm the immune status and to estimate the timing of vaccines.
Collapse
Affiliation(s)
- Koshiro Monzen
- Shinjuku Tsurukame Clinic, 2-11-15 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
| | - Takanori Watanabe
- Uehonmachi Watanabe Clinic, 1-15 Uenomiya-cho, Tennoji-ku, Osaka 543-0037, Osaka, Japan
| | - Toshihiro Okabe
- Ueda Hospital, 1-7-1 Inazu-cho, Toyonaka 561-0854, Osaka, Japan
| | - Hisakuni Sekino
- Sekino Hospital, 3-28-3 Ikebukuro, Toshima-ku, Tokyo 171-0014, Japan
| | - Hironori Nakagami
- Department of Health Development and Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka, Suita 565-0871, Osaka, Japan
| | - Ryuichi Morishita
- Department of Clinical Gene Therapy, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka, Suita 565-0871, Osaka, Japan
| |
Collapse
|
44
|
Stoddard CI, Sung K, Yaffe ZA, Weight H, Beaudoin-Bussières G, Galloway J, Gantt S, Adhiambo J, Begnel ER, Ojee E, Slyker J, Wamalwa D, Kinuthia J, Finzi A, Matsen FA, Lehman DA, Overbaugh J. Elevated binding and functional antibody responses to SARS-CoV-2 in infants versus mothers. Nat Commun 2023; 14:4864. [PMID: 37567924 PMCID: PMC10421871 DOI: 10.1038/s41467-023-40554-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
Infant antibody responses to viral infection can differ from those in adults. However, data on the specificity and function of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in infants, and direct comparisons between infants and adults are limited. Here, we characterize antibody binding and functionality against Wuhan-Hu-1 (B lineage) strain SARS-CoV-2 in convalescent plasma from 36 postpartum women and 14 of their infants infected with SARS-CoV-2 from a vaccine-naïve prospective cohort in Nairobi, Kenya. We find significantly higher antibody titers against SARS-CoV-2 Spike, receptor binding domain and N-terminal domain, and Spike-expressing cell-surface staining levels in infants versus mothers. Plasma antibodies from mothers and infants bind to similar regions of the Spike S2 subunit, including the fusion peptide (FP) and stem helix-heptad repeat 2. However, infants display higher antibody levels and more consistent antibody escape pathways in the FP region compared to mothers. Finally, infants have significantly higher levels of antibody-dependent cellular cytotoxicity (ADCC), though, surprisingly, Spike pseudovirus neutralization titers between infants and mothers are similar. These results suggest infants develop distinct SARS-CoV-2 binding and functional antibody activities and reveal age-related differences in humoral immunity to SARS-CoV-2 infection that could be relevant to protection and COVID-19 disease outcomes.
Collapse
Affiliation(s)
| | - Kevin Sung
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Zak A Yaffe
- Human Biology Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Medical Scientist Training Program, University of Washington, Seattle, WA, USA
| | - Haidyn Weight
- Human Biology Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Guillaume Beaudoin-Bussières
- Centre de Recherche du CHUM, Université de Montréal, Montreal, QC, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC, Canada
| | - Jared Galloway
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Soren Gantt
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche du CHU Sainte-Justine, Université de Montréal, Montreal, QC, Canada
| | - Judith Adhiambo
- Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Emily R Begnel
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Ednah Ojee
- Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Jennifer Slyker
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Dalton Wamalwa
- Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - John Kinuthia
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Research and Programs, Kenyatta National Hospital, Nairobi, Kenya
| | - Andrés Finzi
- Centre de Recherche du CHUM, Université de Montréal, Montreal, QC, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC, Canada
| | - Frederick A Matsen
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - Dara A Lehman
- Human Biology Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
- Department of Global Health, University of Washington, Seattle, WA, USA.
| | - Julie Overbaugh
- Human Biology Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
| |
Collapse
|
45
|
Hamad Saied M, van der Griend L, van Straalen JW, Wulffraat NM, Vastert S, Jansen MHA. The protective effect of COVID-19 vaccines on developing multisystem inflammatory syndrome in children (MIS-C): a systematic literature review and meta-analysis. Pediatr Rheumatol Online J 2023; 21:80. [PMID: 37550719 PMCID: PMC10405572 DOI: 10.1186/s12969-023-00848-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 06/18/2023] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVE To review whether the current COVID-19 vaccines can prevent the occurrence of multisystem inflammatory syndrome in children (MIS-C) and adolescents. METHODS A systematic literature review and meta-analysis were performed. The data were abstracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Primary outcome was the efficacy of COVID-19 vaccination in preventing MIS-C development. The search was performed in PubMed and Embase. RESULTS The review yielded 13 studies, which were included for critical appraisal and data extraction. The available studies showed a reduced incidence of MIS-C after mRNA COVID-19 vaccination in children aged 12-18 years. Four studies were eligible for meta-analysis and the pooled odds ratio for MIS-C in vaccinated children compared to unvaccinated children was 0.04 (95% confidence interval: 0.03-0.06). Additionally, the risk of MIS-C as an adverse effect of vaccination was much lower compared to the risk of MIS-C post-infection. CONCLUSIONS Our systematic review highlights the current available evidence on the efficacy of COVID-19 vaccination in preventing MIS-C. The published studies so far - mainly conducted during the Delta wave - indicate that (original strain) COVID-19 mRNA vaccines in children are safe and associated with significantly less development of MIS-C. These findings further reinforce the recommendation for COVID-19 vaccination in children, which should be promoted and largely supported.
Collapse
Affiliation(s)
- Mohamad Hamad Saied
- Department of Paediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, P.O. box 85090, Utrecht, 3508 AB, The Netherlands.
- Department of Pediatrics, Carmel Medical Center, Technion Faculty of Medicine, Haifa, Israel.
| | | | - Joeri W van Straalen
- Department of Paediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, P.O. box 85090, Utrecht, 3508 AB, The Netherlands
| | - Nico M Wulffraat
- Department of Paediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, P.O. box 85090, Utrecht, 3508 AB, The Netherlands
| | - Sebastiaan Vastert
- Department of Paediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, P.O. box 85090, Utrecht, 3508 AB, The Netherlands
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marc H A Jansen
- Department of Paediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, P.O. box 85090, Utrecht, 3508 AB, The Netherlands
| |
Collapse
|
46
|
Rybkina K, Bell JN, Bradley MC, Wohlbold T, Scafuro M, Meng W, Korenberg RC, Davis-Porada J, Anderson BR, Weller RJ, Milner JD, Moscona A, Porotto M, Luning Prak ET, Pethe K, Connors TJ, Farber DL. SARS-CoV-2 infection and recovery in children: Distinct T cell responses in MIS-C compared to COVID-19. J Exp Med 2023; 220:e20221518. [PMID: 37133746 PMCID: PMC10163842 DOI: 10.1084/jem.20221518] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 02/09/2023] [Accepted: 04/07/2023] [Indexed: 05/04/2023] Open
Abstract
SARS-CoV-2 infection for most children results in mild or minimal symptoms, though in rare cases severe disease can develop, including a multisystem inflammatory syndrome (MIS-C) with myocarditis. Here, we present longitudinal profiling of immune responses during acute disease and following recovery in children who developed MIS-C, relative to children who experienced more typical symptoms of COVID-19. T cells in acute MIS-C exhibited transient signatures of activation, inflammation, and tissue residency which correlated with cardiac disease severity, while T cells in acute COVID-19 upregulated markers of follicular helper T cells for promoting antibody production. The resultant memory immune response in recovery showed increased frequencies of virus-specific memory T cells with pro-inflammatory functions in children with prior MIS-C compared to COVID-19 while both cohorts generated comparable antibody responses. Together our results reveal distinct effector and memory T cell responses in pediatric SARS-CoV-2 infection delineated by clinical syndrome, and a potential role for tissue-derived T cells in the immune pathology of systemic disease.
Collapse
Affiliation(s)
- Ksenia Rybkina
- Department of Microbiology and Immunology, Columbia University Irving Medical Center, New York, NY, USA
| | - Joseph N. Bell
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Marissa C. Bradley
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Teddy Wohlbold
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Marika Scafuro
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Wenzhao Meng
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca C. Korenberg
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Julia Davis-Porada
- Department of Microbiology and Immunology, Columbia University Irving Medical Center, New York, NY, USA
| | - Brett R. Anderson
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Rachel J. Weller
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Joshua D. Milner
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Anne Moscona
- Department of Microbiology and Immunology, Columbia University Irving Medical Center, New York, NY, USA
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Matteo Porotto
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Eline T. Luning Prak
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kalpana Pethe
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Thomas J. Connors
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Donna L. Farber
- Department of Microbiology and Immunology, Columbia University Irving Medical Center, New York, NY, USA
- Department of Surgery, Columbia Irving University Medical Center, New York, NY, USA
| |
Collapse
|
47
|
Blanquart F, Abad C, Ambroise J, Bernard M, Débarre F, Giannoli JM, Rey T, Vieillefond V. Temporal, age, and geographical variation in vaccine efficacy against infection by the Delta and Omicron variants in the community in France, December 2021 to March 2022. Int J Infect Dis 2023; 133:89-96. [PMID: 37182550 PMCID: PMC10176971 DOI: 10.1016/j.ijid.2023.04.410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/29/2023] [Accepted: 04/21/2023] [Indexed: 05/16/2023] Open
Abstract
OBJECTIVES We aimed to quantify how the vaccine efficacy of BNT162b2, messenger RNA-1273, AD26.COV2-S, and ChAdOx1 nCoV-19 against detected infection by the SARS-CoV-2 Delta and Omicron variants varied by time since the last dose, vaccine scheme, age, and geographic areas. METHODS We analyzed 3,261,749 community polymerase chain reaction tests conducted by private laboratories in France from December 2021 to March 2022 with a test-negative design comparing vaccinated to unvaccinated individuals. RESULTS Efficacy against detected infection by Delta was 89% (95% confidence interval, 86-91%) at 2 weeks, down to 59% (56-61%) at 26 weeks and more after the second dose. Efficacy against Omicron was 48% (45-51%) at 2 weeks, down to 4% (2-5%) at 16 weeks after the second dose. A third dose temporarily restored efficacy. Efficacy against Omicron was lower in children and the elderly. Geographical variability in efficacy may reflect variability in the ratio of the number of contacts of vaccinated vs unvaccinated individuals. This ratio ranged from 0 to +50% across departments and correlated with the number of restaurants and bars per inhabitant (beta = 15.0 [0.75-29], P-value = 0.04), places that only vaccinated individuals could access in the study period. CONCLUSION SARS-CoV-2 vaccines conferred low and transient protection against Omicron infection.
Collapse
Affiliation(s)
- François Blanquart
- Centre for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, PSL Research University, Paris, France.
| | - Clémence Abad
- LBM BIOESTEREL-Biogroup-Plateau technique de Mouans-Sartoux, Mouans-Sartoux, France
| | - Joevin Ambroise
- BPO-BIOEPINE-Biogroup-Plateau technique Chocolaterie, Levallois-Perret, France
| | - Mathieu Bernard
- BIOESTEREL - Biogroup - Plateau technique la Bastide, Sanary sur Mer, France
| | - Florence Débarre
- Institute of Ecology and Environmental Sciences of Paris (iEES-Paris, UMR 7618), CNRS, Sorbonne Université, UPEC, IRD, INRAE, Paris, France
| | | | - Thomas Rey
- LBM BIOESTEREL-Biogroup-Plateau technique de Mouans-Sartoux, Mouans-Sartoux, France
| | - Vincent Vieillefond
- BPO-BIOEPINE-Biogroup-Plateau technique Chocolaterie, Levallois-Perret, France
| |
Collapse
|
48
|
Soriano-Arandes A, Brett A, Buonsenso D, Emilsson L, de la Fuente Garcia I, Gkentzi D, Helve O, Kepp KP, Mossberg M, Muka T, Munro A, Papan C, Perramon-Malavez A, Schaltz-Buchholzer F, Smeesters PR, Zimmermann P. Policies on children and schools during the SARS-CoV-2 pandemic in Western Europe. Front Public Health 2023; 11:1175444. [PMID: 37564427 PMCID: PMC10411527 DOI: 10.3389/fpubh.2023.1175444] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/26/2023] [Indexed: 08/12/2023] Open
Abstract
During the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), mitigation policies for children have been a topic of considerable uncertainty and debate. Although some children have co-morbidities which increase their risk for severe coronavirus disease (COVID-19), and complications such as multisystem inflammatory syndrome and long COVID, most children only get mild COVID-19. On the other hand, consistent evidence shows that mass mitigation measures had enormous adverse impacts on children. A central question can thus be posed: What amount of mitigation should children bear, in response to a disease that is disproportionally affecting older people? In this review, we analyze the distinct child versus adult epidemiology, policies, mitigation trade-offs and outcomes in children in Western Europe. The highly heterogenous European policies applied to children compared to adults did not lead to significant measurable differences in outcomes. Remarkably, the relative epidemiological importance of transmission from school-age children to other age groups remains uncertain, with current evidence suggesting that schools often follow, rather than lead, community transmission. Important learning points for future pandemics are summarized.
Collapse
Affiliation(s)
- Antoni Soriano-Arandes
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ana Brett
- Infectious Diseases Unit and Emergency Service, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Milan, Italy
| | - Louise Emilsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Sweden
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Isabel de la Fuente Garcia
- Pediatric Infectious Diseases, National Pediatric Center, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Despoina Gkentzi
- Department of Paediatrics, Patras Medical School, Patras, Greece
| | - Otto Helve
- Department of Health Security, Institute for Health and Welfare, Helsinki, Finland
- Pediatric Research Center, Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Kasper P. Kepp
- Section of Biophysical and Biomedicinal Chemistry, DTU Chemistry, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Maria Mossberg
- Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Taulant Muka
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Epistudia, Bern, Switzerland
| | - Alasdair Munro
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- Faculty of Medicine, Institute of Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Cihan Papan
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany
| | - Aida Perramon-Malavez
- Computational Biology and Complex Systems (BIOCOM-SC) Group, Department of Physics, Universitat Politècnica de Catalunya (UPC·BarcelonaTech), Barcelona, Spain
| | | | - Pierre R. Smeesters
- Department of Pediatrics, University Hospital Brussels, Academic Children’s Hospital Queen Fabiola, Université Libre de Bruxelles, Brussels, Belgium
- Molecular Bacteriology Laboratory, Université Libre de Bruxelles, Brussels, Belgium
| | - Petra Zimmermann
- Department of Community Health, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
- Department of Paediatrics, Fribourg Hospital, Fribourg, Switzerland
| |
Collapse
|
49
|
Fotea S, Ghiciuc CM, Stefanescu G, Cianga AL, Mihai CM, Lupu A, Butnariu LI, Starcea IM, Salaru DL, Mocanu A, Chisnoiu T, Thet AA, Miron L, Lupu VV. Pediatric COVID-19 and Diabetes: An Investigation into the Intersection of Two Pandemics. Diagnostics (Basel) 2023; 13:2436. [PMID: 37510181 PMCID: PMC10378192 DOI: 10.3390/diagnostics13142436] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a complex infectious disease caused by the SARS-CoV-2 virus, and it currently represents a worldwide public health emergency. The pediatric population is less prone to develop severe COVID-19 infection, but children presenting underlying medical conditions, such as diabetes mellitus, are thought to be at increased risk of developing more severe forms of COVID-19. Diabetic children face new challenges when infected with SARS-CoV-2. On one hand, the glycemic values become substantially more difficult to manage as COVID-19 is a predisposing factor for hyperglycemia. On the other hand, alongside other risk factors, high glycemic values are incriminated in modulating immune and inflammatory responses, leading to potentially severe COVID-19 cases in the pediatric population. Also, there are hypotheses of SARS-CoV-2 being diabetogenic itself, but this information is still to be confirmed. Furthermore, it is reported that there was a noticeable increase in the number of cases of new-onset type 2 diabetes among the pediatric population, and the complications in these patients with COVID-19 include the risk of developing autoimmune diseases under the influence of stress. Additionally, children with diabetes mellitus are confronted with lifestyle changes dictated by the pandemic, which can potentially lead to the onset or exacerbation of a potential underlying anxiety disorder or depression. Since the literature contains a series of unknowns related to the impact of COVID-19 in both types of diabetes in children, the purpose of our work is to bring together the data obtained so far and to identify potential knowledge gaps and areas for future investigation regarding COVID-19 and the onset of diabetes type 1 or type 2 among the pediatric population.
Collapse
Affiliation(s)
- Silvia Fotea
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania
| | - Cristina Mihaela Ghiciuc
- Pharmacology, Clinical Pharmacology and Algeziology, Department of Morpho-Functional Sciences II, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Gabriela Stefanescu
- I-st Medical Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Anca Lavinia Cianga
- Mother and Child Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Cristina Maria Mihai
- Pediatrics, Faculty of General Medicine, Ovidius University, 900470 Constanta, Romania
| | - Ancuta Lupu
- Mother and Child Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Lacramioara Ionela Butnariu
- Mother and Child Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Iuliana Magdalena Starcea
- Mother and Child Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Delia Lidia Salaru
- Faculty of General Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Adriana Mocanu
- Mother and Child Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Tatiana Chisnoiu
- Pediatrics, Faculty of General Medicine, Ovidius University, 900470 Constanta, Romania
| | - Aye Aung Thet
- Faculty of General Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Lucian Miron
- III-rd Medical Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Vasile Valeriu Lupu
- Mother and Child Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| |
Collapse
|
50
|
Rick AM, Lentscher A, Xu L, Wilkins MS, Nasser A, Tuttle DJ, Megli C, Marques ETA, McElroy AK, Williams JV, Martin JM. Impact of maternal SARS-CoV-2 booster vaccination on blood and breastmilk antibodies. PLoS One 2023; 18:e0287103. [PMID: 37310982 PMCID: PMC10263312 DOI: 10.1371/journal.pone.0287103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/30/2023] [Indexed: 06/15/2023] Open
Abstract
Maternal COVID-19 vaccination could protect infants who are ineligible for vaccine through antibody transfer during pregnancy and lactation. We measured the quantity and durability of SARS-CoV-2 antibodies in human milk and infant blood before and after maternal booster vaccination. Prospective cohort of lactating women immunized with primary and booster COVID-19 vaccines during pregnancy or lactation and their infants. Milk and blood samples from October 2021 to April 2022 were included. Anti-nucleoprotein (NP) and anti-receptor binding domain (RBD) IgG and IgA in maternal milk and maternal and infant blood were measured and compared longitudinally after maternal booster vaccine. Forty-five lactating women and their infants provided samples. 58% of women were anti-NP negative and 42% were positive on their first blood sample prior to booster vaccine. Anti-RBD IgG and IgA in milk remained significantly increased through 120-170 days after booster vaccine and did not differ by maternal NP status. Anti-RBD IgG and IgA did not increase in infant blood after maternal booster. Of infants born to women vaccinated in pregnancy, 74% still had positive serum anti-RBD IgG measured on average 5 months after delivery. Infant to maternal IgG ratio was highest for infants exposed to maternal primary vaccine during the second trimester compared to third trimester (0.85 versus 0.29; p<0.001). Maternal COVID-19 primary and booster vaccine resulted in robust and long-lasting transplacental and milk antibodies. These antibodies may provide important protection against SARS-CoV-2 during the first six months of life.
Collapse
Affiliation(s)
- Anne-Marie Rick
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Anthony Lentscher
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Lingqing Xu
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
- Center for Vaccine Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Maris S. Wilkins
- Department of Infectious Diseases and Microbiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States of America
| | - Amro Nasser
- Department of Infectious Diseases and Microbiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States of America
| | - Dylan J. Tuttle
- Department of Infectious Diseases and Microbiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States of America
| | - Christina Megli
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
- Magee Womens Research Institute, Pittsburgh, Pennsylvania, United States of America
| | - Ernesto T. A. Marques
- Department of Infectious Diseases and Microbiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States of America
| | - Anita K. McElroy
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
- Center for Vaccine Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - John V. Williams
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Judith M. Martin
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| |
Collapse
|