Messiah Sarah E, Abbas Rhiana, Bergqvist Emma, Kohl Harold W, Swartz Michael D, Talebi Yashar, Sabharwal Rachit, Han Haoting, Valerio-Shewmaker Melissa A, DeSantis Stacia M, Yaseen Ashraf, Gandhi Henal A, Amavisca Ximena Flandes, Ross Jessica A, Padilla Lindsay N, Gonzalez Michael O, Wu Leqing, Silberman Mark A, Lakey David, Shuford Jennifer A, Pont Stephen J, Boerwinkle Eric
Department of Epidemiology, UTHealth Houston School of Public Health, Dallas, TX, United States.
Center for Pediatric Population Health, UTHealth Houston School of Public Health, Dallas, TX, United States.
Front Pediatr. 2024 Aug 15;12:1393321. doi: 10.3389/fped.2024.1393321. eCollection 2024.
Understanding the distinct immunologic responses to SARS-CoV-2 infection among pediatric populations is pivotal in navigating the COVID-19 pandemic and informing future public health strategies. This study aimed to identify factors associated with heightened antibody responses in children and adolescents to identify potential unique immune dynamics in this population.
Data collected between July and December 2023 from the Texas Coronavirus Antibody REsponse Survey (Texas CARES), a statewide prospective population-based antibody survey among 1-to-19-year-old participants, were analyzed. Each participant had the following data available for analysis: (1) Roche Elecsys® Anti-SARS-CoV-2 Immunoassay for Nucleocapsid protein antibodies (Roche N-test), (2) qualitative and semi-quantitative detection of antibodies to the SARS CoV-2 spike protein receptor binding domain (Roche S-test), and (3) self-reported antigen/PCR COVID-19 test results, vaccination, and health status. Statistical analysis identified associations between participant characteristics and spike antibody quartile group.
The analytical sample consisted of 411 participants (mean age 12.2 years, 50.6% female). Spike antibody values ranged from a low of 6.3 U/ml in the lowest quartile to a maximum of 203,132.0 U/ml in the highest quartile in the aggregate sample. Older age at test date (OR = 1.22, 95% CI: 1.12, 1.35, < .001) and vaccination status (primary series/partially vaccinated, one or multiple boosters) showed significantly higher odds of being in the highest spike antibody quartile compared to younger age and unvaccinated status. Conversely, fewer days since the last immunity challenge showed decreased odds (OR = 0.98, 95% CI: 0.96, 0.99, = 0.002) of being in the highest spike antibody quartile vs. more days since last immunity challenge. Additionally, one out of every three COVID-19 infections were asymptomatic.
Older age, duration since the last immunity challenge (vaccine or infection), and vaccination status were associated with heightened spike antibody responses, highlighting the nuanced immune dynamics in the pediatric population. A significant proportion of children/adolescents continue to have asymptomatic infection, which has important public health implications.
了解儿科人群对SARS-CoV-2感染的不同免疫反应对于应对新冠疫情和制定未来公共卫生策略至关重要。本研究旨在确定与儿童和青少年抗体反应增强相关的因素，以识别该人群潜在的独特免疫动态。
分析了2023年7月至12月期间从德克萨斯州冠状病毒抗体反应调查（Texas CARES）收集的数据，这是一项针对1至19岁参与者的全州前瞻性基于人群的抗体调查。每位参与者有以下可供分析的数据：（1）罗氏电化学发光法检测抗SARS-CoV-2核衣壳蛋白抗体（罗氏N检测），（2）对SARS-CoV-2刺突蛋白受体结合域抗体的定性和半定量检测（罗氏S检测），以及（3）自我报告的抗原/PCR新冠检测结果、疫苗接种情况和健康状况。统计分析确定了参与者特征与刺突抗体四分位数组之间的关联。
分析样本包括411名参与者（平均年龄12.2岁，50.6%为女性）。在总体样本中，刺突抗体值范围从最低四分位数的6.3 U/ml到最高四分位数的203,132.0 U/ml。检测日期年龄较大（比值比[OR]=1.22，95%置信区间[CI]：1.12，1.35，P<0.001）和疫苗接种状态（初次系列/部分接种、一剂或多剂加强针）与处于最高刺突抗体四分位数的几率显著高于年龄较小和未接种疫苗的状态。相反，自上次免疫挑战以来的天数越少，处于最高刺突抗体四分位数的几率越低（OR=0.98，95%CI：0.96，0.99，P=0.002），而自上次免疫挑战以来的天数越多则反之。此外，每三例新冠感染中有一例无症状。
年龄较大、自上次免疫挑战（疫苗接种或感染）以来的持续时间以及疫苗接种状态与刺突抗体反应增强相关，突出了儿科人群中细微的免疫动态。相当比例的儿童/青少年继续有无症状感染，这具有重要的公共卫生意义。
