Department of Children's Oncology and Hematology, Uppsala University Hospital, Uppsala, Sweden.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Pediatr Blood Cancer. 2022 Oct;69(10):e29773. doi: 10.1002/pbc.29773. Epub 2022 May 25.
Children develop symptomatic coronavirus disease 2019 (COVID-19) more rarely than adults upon infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Pediatric oncology and hematology patients may be at increased risk of severe COVID-19 due to their underlying disease or treatment. We investigated COVID-19 and seroprevalence of anti-SARS-CoV-2 antibodies, respectively, in a Swedish cohort of pediatric oncology and hematology patients.
Patients (n = 136) were recruited between June 2020 and September 2021 at Uppsala University Children's Hospital, Sweden. Up to six consecutive blood samples per patient were analyzed for wild-type anti-S1 IgM and IgG antibodies (including after vaccination, n = 4). Clinical data on COVID-19 (including polymerase chain reaction [PCR] test results) were collected from electronic medical records. A questionnaire was completed at recruitment.
A cumulative seroprevalence (IgM and IgG) of 33% (45/136 patients, 95% confidence interval: 25%-41%) was observed in this patient cohort, of whom 66% (90/136 patients) were under severe immunosuppressive treatment during the study period. Increasing patient age (p = .037) and PCR test results (p < .002) were associated with seropositivity in nonvaccinated cases. Most seropositive, nonvaccinated cases (32/43, 74%) were never PCR-verified for SARS-CoV-2 infection. Of the 13 patients with PCR-verified infection, nine (69%) reported mild disease. A majority (63%) reported continued school attendance during the pandemic.
Swedish pediatric oncology and hematology patients developed antibodies against SARS-CoV-2, despite their diagnosis and/or treatment, and the observed seroprevalence was similar to that in national pediatric outpatients. PCR-verified cases underestimate the true incidence of COVID-19 in this patient cohort.
儿童在感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）后，出现有症状的 2019 冠状病毒病（COVID-19）的频率比成年人低。由于自身疾病或治疗，儿科肿瘤学和血液学患者可能有发生严重 COVID-19 的风险增加。我们分别在瑞典的儿科肿瘤学和血液学患者队列中调查了 COVID-19 和抗 SARS-CoV-2 抗体的血清阳性率。
2020 年 6 月至 2021 年 9 月，在瑞典乌普萨拉大学儿童医院招募了患者（n=136）。对每个患者最多连续 6 份血样进行了野生型抗 S1 IgM 和 IgG 抗体分析（包括接种疫苗后，n=4）。从电子病历中收集了 COVID-19 的临床数据（包括聚合酶链反应[PCR]检测结果）。在招募时完成了一份问卷。
在该患者队列中观察到累积血清阳性率（IgM 和 IgG）为 33%（45/136 例患者，95%置信区间：25%-41%），其中 66%（90/136 例患者）在研究期间接受严重免疫抑制治疗。患者年龄增加（p=0.037）和 PCR 检测结果（p<0.002）与非接种疫苗情况下的血清阳性相关。大多数血清阳性、非接种疫苗的病例（32/43，74%）从未通过 PCR 验证 SARS-CoV-2 感染。在 13 例经 PCR 证实感染的患者中，9 例（69%）报告为轻症。大多数（63%）报告在大流行期间继续上学。
尽管瑞典儿科肿瘤学和血液学患者有诊断和/或治疗，但仍产生了针对 SARS-CoV-2 的抗体，观察到的血清阳性率与全国儿科门诊患者相似。PCR 检测病例低估了该患者队列中 COVID-19 的真实发病率。
