Laub Otto, Leipold Georg, Toncheva Antoaneta A, Peterhoff David, Einhauser Sebastian, Neckermann Patrick, Borchers Natascha, Santos-Valente Elisangela, Kheiroddin Parastoo, Buntrock-Döpke Heike, Laub Sarah, Schöberl Patricia, Schweiger-Kabesch Andrea, Ewald Dominik, Horn Michael, Niggel Jakob, Ambrosch Andreas, Überla Klaus, Gerling Stephan, Brandstetter Susanne, Wagner Ralf, Kabesch Michael
Pediatric Office Laub, Rosenheim, Germany.
Pediatric Office Dr. Leipold, Regensburg, Germany.
Front Pediatr. 2021 Oct 4;9:678937. doi: 10.3389/fped.2021.678937. eCollection 2021.
Children and youth are affected rather mildly in the acute phase of COVID-19 and thus, SARS-CoV-2 infection infection may easily be overlooked. In the light of current discussions on the vaccinations of children it seems necessary to better identify children who are immune against SARS-CoV-2 due to a previous infection and to better understand COVID-19 related immune reactions in children. In a cross-sectional design, children aged 1-17 were recruited through primary care pediatricians for the study (a) randomly, if they had an appointment for a regular health check-up or (b) if parents and children volunteered and actively wanted to participate in the study. Symptoms were recorded and two antibody tests were performed in parallel directed against S (in house test) and N (Roche Elecsys) viral proteins. In children with antibody response in either test, neutralization activity was determined. We identified antibodies against SARS-CoV-2 in 162 of 2,832 eligible children (5.7%) between end of May and end of July 2020 in three, in part strongly affected regions of Bavaria in the first wave of the pandemic. Approximately 60% of antibody positive children ( = 97) showed high levels (>97th percentile) of antibodies against N-protein, and for the S-protein, similar results were found. Sufficient neutralizing activity was detected for only 135 antibody positive children (86%), irrespective of age and sex. Initial COVID-19 symptoms were unspecific in children except for the loss of smell and taste and unrelated to antibody responses or neutralization capacity. Approximately 30% of PCR positive children did not show seroconversion in our small subsample in which PCR tests were performed. Symptoms of SARS-CoV-2 infections are unspecific in children and antibody responses show a dichotomous structure with strong responses in many and no detectable antibodies in PCR positive children and missing neutralization activity in a relevant proportion of the young population.
儿童和青少年在新冠病毒病（COVID-19）急性期受影响相对较轻，因此，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染可能很容易被忽视。鉴于目前关于儿童疫苗接种的讨论，似乎有必要更好地识别因既往感染而对SARS-CoV-2具有免疫力的儿童，并更好地了解儿童中与COVID-19相关的免疫反应。在一项横断面研究中，通过初级保健儿科医生招募了1至17岁的儿童参与该研究：（a）如果他们预约了常规健康检查，则随机招募；（b）如果父母和孩子自愿并积极希望参与研究。记录症状，并同时进行两项针对S蛋白（内部检测）和N蛋白（罗氏电化学发光免疫分析）的抗体检测。在两项检测中任一项有抗体反应的儿童中，测定中和活性。在2020年5月底至7月底期间，我们在巴伐利亚州第一波疫情中三个部分受影响严重的地区，从2832名符合条件的儿童中识别出162名（5.7%）有抗SARS-CoV-2抗体。大约60%的抗体阳性儿童（=97名）显示出针对N蛋白的高水平抗体（>第97百分位数），对于S蛋白，也发现了类似结果。无论年龄和性别，仅在135名抗体阳性儿童（86%）中检测到足够的中和活性。除嗅觉和味觉丧失外，儿童最初的COVID-19症状不具特异性，且与抗体反应或中和能力无关。在我们进行PCR检测的小亚组中，约30%的PCR阳性儿童未出现血清转化。SARS-CoV-2感染的症状在儿童中不具特异性，抗体反应呈现二分结构，许多儿童有强烈反应，PCR阳性儿童中无可检测到的抗体，且相当一部分年轻人群缺乏中和活性。
