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.
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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.
Patient consent for publication Not required.
Ethics approval Ethical approval was obtained from the London - Chelsea Research Ethics Committee (REC Reference - 20/HRA/1731) and the Belfast Health & Social Care Trust Research Governance (Reference 19147TW-SW).
Provenance and peer review Not commissioned; externally peer reviewed.
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.
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