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Serum ACE2 and Anti-MMR Antibody Profiles in Pediatric Patients with and without SARS-CoV-2 Infection
Zohre Labbani-Motlagh1,2, Zohreh Nozarian3, Mohammad Taghi Haghi Ashtiani4
1Infectious Diseases Research Center, Aja University of Medical Sciences, Tehran, Iran
Background:
Coronavirus Disease 2019 (COVID-19) typically manifests with milder symptoms and lower mortality rates in children when compared to adults.
Objective:
To investigate potential mechanisms underlying this age-related protection, we examined whether serum levels of angiotensin-converting enzyme 2 (ACE2) and IgG antibody titers against Measles, Mumps, and Rubella (MMR) vaccines are associated with susceptibility to SARS-CoV-2 infection in the pediatric population.
Methods:
In this case-control study, conducted before the introduction of mass COVID-19 vaccination, we enrolled children aged 1-15 years. The cases were hospitalized children with confirmed COVID-19, while the control group consisted of outpatients with non-infectious, non-immunodeficient conditions and no documented history of COVID-19. The COVID-19 status was confirmed using RT-PCR. Serum levels of ACE2 and anti-MMR IgG antibodies were assessed using ELISA.
Results:
Eighty-three patients including 39 cases with COVID-19 infection and 44 controls were enrolled in this study. The median serum ACE2 levels were 3.6 in COVID-19 cases and 3.8 ng/mL in control cases (P=0.440). Similarly, antibody levels against Mumps (P=0.788), Measles (P=0.281), and Rubella (P=0.083) did not differ significantly between the groups, although Rubella seropositivity was more frequent in COVID-19 cases than in controls (P=0.039).
Conclusion:
Our findings did not support a significant association between serum ACE2 levels or MMR antibody titers and protection against COVID-19 in children. The higher prevalence of Rubella seropositivity among infected cases may suggest possible cross-reactivity, but causal relationships could not be established in this study.
Insights
This study found no significant link between ACE2 levels or MMR vaccine antibody titers and protection against COVID-19 in children. Further research is needed to understand potential cross-reactivity with Rubella.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Virology
Background:
- Coronavirus Disease 2019 (COVID-19) presents with generally milder symptoms and lower mortality in children compared to adults.
- Investigating age-related protection mechanisms against SARS-CoV-2 in pediatric populations is crucial.
Purpose of the Study:
- To determine if serum angiotensin-converting enzyme 2 (ACE2) levels and IgG antibody titers against Measles, Mumps, and Rubella (MMR) vaccines are associated with SARS-CoV-2 susceptibility in children.
- To explore potential immunological factors contributing to differential COVID-19 severity in pediatric cases.
Main Methods:
- A case-control study involving 83 children (aged 1-15 years) before widespread COVID-19 vaccination.
- Cases were hospitalized children with confirmed COVID-19 (RT-PCR); controls were outpatients without infectious or immunodeficient conditions.
- Serum ACE2 levels and anti-MMR IgG antibody titers were quantified using ELISA.
Main Results:
- No significant differences in median serum ACE2 levels were observed between COVID-19 cases and controls.
- Antibody levels against Mumps, Measles, and Rubella did not significantly differ between groups.
- A higher prevalence of Rubella seropositivity was noted in COVID-19 cases compared to controls (P=0.039).
Conclusions:
- Serum ACE2 levels and MMR antibody titers were not significantly associated with protection against COVID-19 in the pediatric cohort.
- The increased Rubella seropositivity in cases may indicate possible cross-reactivity, but a causal link remains unestablished.
- Further investigation is warranted to elucidate the immunological underpinnings of pediatric COVID-19 resilience.
