瑞士中小学生队列研究的血清阳性率在地区、学校和班级之间的差异：基线测量结果。
Variation in SARS-CoV-2 seroprevalence across districts, schools and classes: baseline measurements from a cohort of primary and secondary school children in Switzerland.
机构信息
Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland.
Institute of Medical Virology, University of Zurich, Zurich, Switzerland.
出版信息
BMJ Open. 2021 Jul 26;11(7):e047483. doi: 10.1136/bmjopen-2020-047483.
OBJECTIVES
To determine the variation in SARS-CoV-2 seroprevalence in school children and the relationship with self-reported symptoms.
DESIGN
Baseline measurements of a longitudinal cohort study () from June to July 2020.
SETTING
55 schools stratified by district in the canton of Zurich, Switzerland.
PARTICIPANTS
2585 children (1339 girls; median age: 11 years, age range: 6-16 years), attending grades 1-2, 4-5 and 7-8.
MAIN OUTCOME MEASURES
Variation in seroprevalence of SARS-CoV-2 in children across 12 cantonal districts, schools and grades, assessed using Luminex-based test of four epitopes for IgG, IgA and IgM (Antibody Coronavirus Assay,ABCORA 2.0). Clustering of cases within classes. Association of seropositivity and symptoms. Comparison with seroprevalence in adult population, assessed using Luminex-based test of IgG and IgA (Sensitive Anti-SARS-CoV-2 Spike Trimer Immunoglobulin Serological test).
RESULTS
Overall seroprevalence was 2.8% (95% CI 1.5% to 4.1%), ranging from 1.0% to 4.5% across districts. Seroprevalence in grades 1-2 was 3.8% (95% CI 2.0% to 6.1%), in grades 4-5 was 2.4% (95% CI 1.1% to 4.2%) and in grades 7-8 was 1.5% (95% CI 0.5% to 3.0%). At least one seropositive child was present in 36 of 55 (65%) schools and in 44 (34%) of 131 classes where ≥5 children and ≥50% of children within the class were tested. 73% of children reported COVID-19-compatible symptoms since January 2020, with the same frequency in seropositive and seronegative children for all symptoms. Seroprevalence of children and adults was similar (3.2%, 95% credible interval (CrI) 1.7% to 5.0% vs 3.6%, 95% CrI 1.7% to 5.4%). The ratio of confirmed SARS-CoV-2 cumulative incidence-to-seropositive cases was 1:89 in children and 1:12 in adults.
CONCLUSIONS
SARS-CoV-2 seroprevalence was low in children and similar to that in adults by the end of June 2020. Very low ratio of diagnosed-to-seropositive children was observed. We did not detect clustering of SARS-CoV-2-seropositive children within classes, but the follow-up of this study will shed more light on transmission within schools.
TRIAL REGISTRATION NUMBER
NCT04448717.
目的
确定 SARS-CoV-2 血清阳性率在学龄儿童中的变化及其与自我报告症状的关系。
设计
2020 年 6 月至 7 月进行的一项纵向队列研究的基线测量。
地点
瑞士苏黎世州按区分层的 55 所学校。
参与者
2585 名儿童（1339 名女孩；中位年龄：11 岁，年龄范围：6-16 岁），分别就读于 1-2 年级、4-5 年级和 7-8 年级。
主要观察指标
使用基于 Luminex 的针对 IgG、IgA 和 IgM 的四个表位的检测方法（冠状病毒抗体测定，ABCORA 2.0）评估 SARS-CoV-2 在 12 个州辖区、学校和年级的儿童中的血清阳性率变化。病例在班级内的聚类。血清阳性与症状的关系。与基于 Luminex 的 IgG 和 IgA 检测（敏感抗 SARS-CoV-2 刺突三聚体免疫球蛋白血清学检测）评估的成人人群中的血清阳性率进行比较。
结果
总体血清阳性率为 2.8%（95%CI1.5%至 4.1%），各地区血清阳性率为 1.0%至 4.5%。1-2 年级的血清阳性率为 3.8%（95%CI2.0%至 6.1%），4-5 年级为 2.4%（95%CI1.1%至 4.2%），7-8 年级为 1.5%（95%CI0.5%至 3.0%）。在 55 所（65%）学校和 131 个（34%）班级中至少有一名血清阳性儿童，这些班级中≥5 名儿童和≥50%的儿童接受了检测。自 2020 年 1 月以来，73%的儿童报告有 COVID-19 症状，所有症状的血清阳性和阴性儿童的频率相同。儿童和成人的血清阳性率相似（3.2%，95%可信区间[CrI]1.7%至 5.0%与 3.6%，95% CrI 1.7%至 5.4%）。儿童确诊 SARS-CoV-2 累积发病率与血清阳性病例的比值为 1:89，成人的比值为 1:12。
结论
2020 年 6 月底，儿童的 SARS-CoV-2 血清阳性率较低，与成人相似。确诊的儿童与血清阳性儿童的比例非常低。我们没有检测到 SARS-CoV-2 血清阳性儿童在班级内的聚集，但本研究的随访将进一步揭示学校内的传播情况。
临床试验注册号
NCT04448717。
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