Seroprevalence of SARS-CoV-2 in self-reported COVID-19-free children

Hsiao-Lun Huang1, Chun-Yi Lu2, Yun-Chung Liu2

  • 1Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan; Division of Pediatric Infectious Diseases, Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.

Insights

Many children have undetected COVID-19 (SARS-CoV-2) infections, with serological evidence revealing prior exposure. Household contact, especially with mothers, significantly increases the risk of infection in children.

Area of Science:

  • Pediatric Infectious Diseases
  • Immunology
  • Epidemiology

Background:

  • COVID-19 (Coronavirus disease 2019) presents significant risks to children.
  • Undetected cases of SARS-CoV-2 (Severe acute respiratory syndrome-related coronavirus 2) infection in children complicate disease burden assessment.
  • This study addresses the gap in understanding asymptomatic or unreported pediatric infections.

Purpose of the Study:

  • To determine the proportion of children with serological evidence of prior SARS-CoV-2 infection despite reporting no previous diagnosis.
  • To identify risk factors associated with seropositivity in children.

Main Methods:

  • Recruitment of children under 19 years old with no reported history of SARS-CoV-2 infection (November 2022 - February 2023).
  • SARS-CoV-2 antibody testing for IgG antibodies against nucleocapsid (N) and spike (S) proteins.
  • Collection of demographic and household contact information.

Main Results:

  • Overall anti-N antibody positivity was 9.2% (24/260) in children reporting no prior infection, with rates varying by age (4%-25%).
  • Household contact, particularly with mothers, significantly elevated the likelihood of antibody positivity.
  • The cumulative infection rate reached 41.9% by January 2024 for children initially negative for anti-N antibodies.

Conclusions:

  • Previously undisclosed SARS-CoV-2 infections are common in children.
  • Household transmission is a major driver of pediatric COVID-19 seropositivity.
  • Clinicians should maintain vigilance for SARS-CoV-2 in children, even those without reported prior exposure.
Abstract

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