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Published on: February 16, 2022
Longitudinal Rise in Seroprevalence of SARS-CoV-2 Infections in Children in Western Germany-A Blind Spot in
Folke Brinkmann1, Hans H Diebner2, Chantal Matenar1
1University Children's Hospital, Ruhr-University Bochum, 44791 Bochum, Germany.
Insights
SARS-CoV-2 infections in children are significantly underestimated, with seroprevalence revealing much higher rates than PCR tests. Many pediatric infections are asymptomatic, highlighting children
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Immunology
Background:
- Asymptomatic and oligosymptomatic infections often lead to underestimation of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) spread in children and adolescents.
- Seroprevalence studies are crucial for understanding the true burden of "silent" infections and assessing transmission dynamics in pediatric populations.
Purpose of the Study:
- To determine the seroprevalence and seroconversion rates of SARS-CoV-2 in children and adolescents in the Ruhr region.
- To compare seroprevalence data with officially registered PCR-based infection rates.
- To investigate the role of children and adolescents in household SARS-CoV-2 transmission.
Main Methods:
- A longitudinal seroprevalence study involving 2045 children and their parents from the Ruhr region.
- Analysis of seroconversion rates over the study period.
- Comparison of symptomatic recall versus serological evidence of infection.
Main Results:
- Seroconversion rates in children increased from 0.5% to 8% during the study, indicating infection rates 3-4 times higher than officially reported PCR rates.
- 59% of infected children were asymptomatic, with only 41% recalling symptoms.
- In 51% of infected children, at least one parent also showed SARS-CoV-2 antibodies, suggesting significant household transmission.
Conclusions:
- The actual prevalence of SARS-CoV-2 infections in children and adolescents is substantially higher than indicated by official case numbers.
- Asymptomatic transmission plays a significant role in the spread of SARS-CoV-2 among pediatric populations.
- Close contact within households represents a high-risk scenario for SARS-CoV-2 infection among children and their families.
Abstract:
SARS-CoV-2 infection rates in children and adolescents are often underestimated due to asymptomatic or oligosymptomatic infections. Seroprevalence studies can reveal the magnitude of "silent" infections in this age group and help to assess the risk of infection for children but also their role in spreading the disease. In total, 2045 children and their parents from the Ruhr region were finally included after the exclusion of drop-outs. Seroconversion rates among children of all age groups increased from 0.5% to 8% during the study period and were about three to fourfold higher than the officially registered PCR-based infection rates. Only 41% recalled symptoms of infection; 59% were asymptomatic. In 51% of the infected children, at least one parent also developed SARS-CoV-2 antibodies. Depending on local incidences, the rates of seroconversion rose to different levels during the study period. Although the dynamics of infection within the study cohort mirrors local incidence, the figure of SARS-CoV-2 infections in children and adolescents appears to be high. Reported contact with SARS-CoV-2-infected individuals in the same household carries a high risk of infection.
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