Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan; Division of Pediatric Infectious Diseases, Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
Division of Pediatric Infectious Diseases, Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
J Microbiol Immunol Infect. 2024 Aug;57(4):546-553. doi: 10.1016/j.jmii.2024.05.003. Epub 2024 May 11.
COVID-19 poses risks and leads to complications for vulnerable populations, including children. Unreported cases of COVID-19 among children hinder our understanding of the true disease burden. In this study, we aimed to investigate the proportion of children who report no prior infection to SARS-CoV-2 but who nevertheless exhibit serological evidence of prior infection.
Between November 2022 and February 2023, we recruited children and adolescents under 19 years of age who lacked a prior history of SARS-CoV-2 infection. Participants underwent SARS-CoV-2 antibody testing to assess the presence of IgG antibodies specific to nucleocapsid (N) and spike (S) proteins. Demographic and contact information were also collected.
Among 260 COVID-19-free children, the overall anti-N antibody positivity rate, which varied across age groups (4%-25%), was 9.2% (24/260). Contact with individuals who were positive for COVID-19, particularly the children's mothers, significantly increased the likelihood of antibody positivity. The median age of the 34 children who remained unvaccinated against COVID-19 was lower than that of the children who were vaccinated (6.5 vs. 9 years; p < 0.001). Until January 2024, the overall infection rate was 41.9% (99/236) among children who were negative for anti-N antibodies, irrespective of vaccination status or the presence of chronic disease.
We discovered previously undisclosed cases of SARS-CoV-2 infection among children. The risk of seropositivity increases substantially with household contact. Regarding children who report no prior exposure to COVID-19, clinicians must remain vigilant, as SARS-CoV-2 remains a concern.
COVID-19 对包括儿童在内的弱势群体构成风险并导致并发症。未报告的儿童 COVID-19 病例阻碍了我们对真实疾病负担的了解。在这项研究中，我们旨在调查报告没有先前感染 SARS-CoV-2 但具有先前感染血清学证据的儿童比例。
在 2022 年 11 月至 2023 年 2 月期间，我们招募了 19 岁以下且没有先前 SARS-CoV-2 感染史的儿童和青少年。参与者接受 SARS-CoV-2 抗体检测，以评估针对核衣壳 (N) 和刺突 (S) 蛋白的 IgG 抗体的存在。还收集了人口统计学和接触信息。
在 260 名无 COVID-19 的儿童中，总体抗-N 抗体阳性率（在不同年龄组为 4%-25%）为 9.2%（24/260）。与 COVID-19 阳性者接触，特别是儿童的母亲，显著增加了抗体阳性的可能性。34 名未接种 COVID-19 疫苗的儿童的中位年龄低于接种疫苗的儿童（6.5 岁与 9 岁；p<0.001）。截至 2024 年 1 月，在抗-N 抗体阴性的儿童中，无论疫苗接种状况或是否存在慢性疾病，整体感染率为 41.9%（99/236）。
我们发现了以前未公开的儿童 SARS-CoV-2 感染病例。与家庭接触密切相关，血清阳性风险大大增加。对于报告没有先前 COVID-19 暴露的儿童，临床医生必须保持警惕，因为 SARS-CoV-2 仍然是一个关注点。
