You are here

Article Text

Article menu
Download PDFPDF
Original research
Seroprevalence of SARS-CoV-2 antibodies in children: a prospective multicentre cohort study
  1. Thomas Waterfield1,2,
  2. Chris Watson1,
  3. Rebecca Moore3,
  4. Kathryn Ferris4,
  5. Claire Tonry1,
  6. Alison Watt5,
  7. Claire McGinn3,
  8. Steven Foster6,
  9. Jennifer Evans7,
  10. Mark David Lyttle8,9,
  11. Shazaad Ahmad10,11,
  12. Shamez Ladhani12,
  13. Michael Corr4,
  14. Lisa McFetridge13,
  15. Hannah Mitchell13,
  16. Kevin Brown14,
  17. Gayatri Amirthalingam15,
  18. Julie-Ann Maney16,
  19. Sharon Christie17
  1. 1 Queen's University Belfast Wellcome-Wolfson Institute for Experimental Medicine, Belfast, UK
  2. 2 Emergency Department, Children's Health Ireland at Temple Street, Dublin D01 YC67, Ireland
  3. 3 General Paediatrics, Royal Belfast Hospital for Sick Children, Belfast, UK
  4. 4 Belfast Health and Social Care Trust, Belfast, UK
  5. 5 Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, UK
  6. 6 Emergency Department, Royal Hospital for Children, Glasgow, UK
  7. 7 Cardiff and Vale University Health Board, Cardiff, UK
  8. 8 Emergency Department, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
  9. 9 Health and Applied Sciences, University of the West of England, Bristol, UK
  10. 10 Department of Virology, Manchester Medical Microbiology Partnership, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK
  11. 11 Manchester Academic Health Science Centre, Manchester, UK
  12. 12 Immunisation and Countermeasures Division, Public Health England, London, UK
  13. 13 Mathematical Sciences Research Centre, Queen's University Belfast, Belfast, UK
  14. 14 Virus Reference Department, Public Health England, Colindale, UK
  15. 15 Immunisation,Hepatitis & Blood Safety Department, Public Health England Immunisation and Countermeasures Division, London, UK
  16. 16 Emergency Department, Royal Belfast Hospital for Sick Children, Belfast, UK
  17. 17 Paediatric Infectious Diseases, Royal Belfast Hospital for Sick Children, Belfast, UK
  1. Correspondence to Dr Thomas Waterfield, Emergency Department, Children's Health Ireland at Temple Street, Dublin D01 YC67, Ireland; thomas.waterfield{at}googlemail.com

Abstract

Background Studies based on molecular testing of oral/nasal swabs underestimate SARS-CoV-2 infection due to issues with test sensitivity, test timing and selection bias. The objective of this study was to report the presence of SARS-CoV-2 antibodies, consistent with previous infection.

Design This multicentre observational cohort study, conducted between 16 April to 3 July 2020 at 5 UK sites, recruited children of healthcare workers, aged 2–15 years. Participants provided blood samples for SARS-CoV-2 antibody testing and data were gathered regarding unwell contacts and symptoms.

Results 1007 participants were enrolled, and 992 were included in the final analysis. The median age of participants was 10·1 years. There were 68 (6.9%) participants with positive SARS-CoV-2 antibody tests indicative of previous SARS-CoV-2 infection. Of these, 34/68 (50%) reported no symptoms prior to testing. The presence of antibodies and the mean antibody titre was not influenced by age. Following multivariable analysis four independent variables were identified as significantly associated with SARS-CoV-2 seropositivity: known infected household contact OR=10.9 (95% CI 6.1 to 19.6); fatigue OR=16.8 (95% CI 5.5 to 51.9); gastrointestinal symptoms OR=6.6 (95% CI 3.0 to 13.8); and changes in sense of smell or taste OR=10.0 (95% CI 2.4 to 11.4).

Discussion Children demonstrated similar antibody titres in response to SARS-CoV-2 irrespective of age. Fatigue, gastrointestinal symptoms and changes in sense of smell or taste were the symptoms most strongly associated with SARS-CoV-2 antibody positivity.

Trial registration number NCT0434740.

  • virology
  • epidemiology

Data availability statement

Data are available in a public, open access repository. All of the individual participant data collected during this study will be available (including data dictionaries) on the Queen’s University Belfast database within 3 months of completion of the study.

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/archdischild-2020-320558

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    Data are available in a public, open access repository. All of the individual participant data collected during this study will be available (including data dictionaries) on the Queen’s University Belfast database within 3 months of completion of the study.

    View Full Text

    Footnotes

    • Twitter @mdlyttle, @shamezladhani, @julieannmaney

    • Correction notice This paper has been amended since it was published online. The end of the abstract originally refered to SARS-CoV-1 instead of SARS-CoV-2.

    • Contributors TW, CW, SL and SC conceived the study idea. TW, CW, SL, SC, RM, KF, CM, SF, JE, MDL, SA, MC, LM, HM and J-AM contributed to the design of the study. TW coordinated the running of the study including data management and site training. MC wrote the study protocol. MDL designed the electronic CRFs. RM coordinated and led the PPI group. SC, KF, SF, JE, SA and SL were site leads. CT, CW, GA, KB and AW were responsible for performing laboratory testing. LM and HM provided statistical expertise and performed the statistical analysis. All authors contributed to the writing of the manuscript.

    • Funding This work was supported by HSC R&D Division, Public Health Agency Ref: COM/5596/20. This funding source had no role in the design of this study and will not have any role during its execution, analyses, interpretation of the data or decision to submit the result.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.