Adler Amanda L, Waghmare Alpana, Lacombe Kirsten, Dickerson Jane A, L Greninger Alexander, Briggs Hagen Melissa, Pringle Kimberly, Fairlie Tarayn, Midgely Claire M, Englund Janet A
Seattle Children's Research Institute, Seattle, Washington, USA.
Department of Pediatrics, University of Washington, Seattle, Washington, USA.
Microbiol Spectr. 2025 Apr;13(4):e0262524. doi: 10.1128/spectrum.02625-24. Epub 2025 Mar 10.
Seroprevalence studies play an important role in estimating the number of children infected with SARS-CoV-2. We report SARS-CoV-2 seroprevalence in children seeking medical care for any reason at a free-standing pediatric hospital in Seattle, WA over a 2.5-year period and four distinct pandemic waves. We randomly selected residual serum samples from children and young adults seeking medical care as inpatients and outpatients at Seattle Children's Hospital between June 2020 and December 2022 to test for the presence of anti-nucleocapsid (N) antibodies. Samples were categorized into four distinct pandemic waves based on Washington State epidemiology: Wave 1 (June 2020-October 2020), Wave 2 (November 2020-June 2021), Wave 3 (July 2021-November 2021), and Wave 4 (December 2021-December 2022). Patient characteristics and COVID-19 vaccine status were obtained, and zip codes were used to ascertain the Social Vulnerability Index (SVI). Multivariable Poisson regression models with robust variance estimates were used to examine the relationship between patient characteristics and anti-N-positivity for each wave. Among 8,040 samples from 7,102 patients included in the analyses, seroprevalence rose from 2.4% (95% CI, 2.0%-3.1%) in Wave 1 to 25.5% (95% CI 23.3%-27.8%) in Wave 4 (following the Omicron surge). High SVI, Hispanic ethnicity, or use of government insurance was associated with increased anti-N positivity in most waves. We observed a steady increase in anti-N seroprevalence followed by a sharp increase after the Omicron surge in early 2022. Our data demonstrate the burden of COVID-19 on specific groups with health disparities within our region throughout the pandemic.IMPORTANCEOur results highlight the importance of seropositivity studies as essential tools to provide information on the incidence and prevalence of SARS-CoV-2 seropositivity. Our results also reinforce other reports demonstrating the inequitable burden of COVID-19 on groups with health disparities and that this inequitable burden continued to persist throughout the pandemic, even in a region with high adherence to COVID-19 mitigation efforts. It also highlights SVI's value in identifying communities that must be part of pandemic research, and public health and vaccination strategies.
血清流行率研究在估计感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的儿童数量方面发挥着重要作用。我们报告了在华盛顿州西雅图一家独立儿童医院，2.5年期间及四个不同疫情波次中，因任何原因寻求医疗护理的儿童的SARS-CoV-2血清流行率。我们从2020年6月至2022年12月期间在西雅图儿童医院作为住院患者和门诊患者寻求医疗护理的儿童和年轻人中随机选取残留血清样本，以检测抗核衣壳（N）抗体的存在。根据华盛顿州的流行病学情况，样本被分为四个不同的疫情波次：第1波（2020年6月至2020年10月）、第2波（2020年11月至2021年6月）、第3波（2021年7月至2021年11月）和第4波（2021年12月至2022年12月）。获取了患者特征和新冠病毒疫苗接种状况，并使用邮政编码来确定社会脆弱性指数（SVI）。使用具有稳健方差估计的多变量泊松回归模型来检验每个波次中患者特征与抗N阳性之间的关系。在纳入分析的来自7102名患者的8040份样本中，血清流行率从第1波的2.4%（95%置信区间，2.0%-3.1%）上升至第4波的25.5%（95%置信区间，23.3%-27.8%）（在奥密克戎激增之后）。在大多数波次中，高SVI、西班牙裔种族或使用政府保险与抗N阳性增加相关。我们观察到抗N血清流行率稳步上升，随后在2022年初奥密克戎激增后急剧上升。我们的数据证明了在整个疫情期间，新冠病毒对我们地区内存在健康差异的特定群体造成的负担。重要性我们的结果强调了血清阳性研究作为提供SARS-CoV-2血清阳性发病率和流行率信息的重要工具的重要性。我们的结果还强化了其他报告，这些报告表明新冠病毒对存在健康差异的群体造成了不公平的负担，并且这种不公平的负担在整个疫情期间持续存在，即使在一个高度遵守新冠病毒缓解措施的地区也是如此。它还突出了SVI在识别必须成为疫情研究、公共卫生和疫苗接种策略一部分的社区方面的价值。
