Quantitative SARS-CoV-2 Serology in Children With Multisystem Inflammatory Syndrome (MIS-C).

Autor:	Rostad CA; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia.; Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta and School of Medicine, Emory University, Atlanta, Georgia; and., Chahroudi A; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia.; Emory Vaccine Center and.; Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta and School of Medicine, Emory University, Atlanta, Georgia; and., Mantus G; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia.; Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta and School of Medicine, Emory University, Atlanta, Georgia; and., Lapp SA; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia.; Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta and School of Medicine, Emory University, Atlanta, Georgia; and., Teherani M; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia.; Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta and School of Medicine, Emory University, Atlanta, Georgia; and., Macoy L; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia.; Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta and School of Medicine, Emory University, Atlanta, Georgia; and., Tarquinio KM; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia., Basu RK; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia., Kao C; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia.; Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta and School of Medicine, Emory University, Atlanta, Georgia; and., Linam WM; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia.; Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta and School of Medicine, Emory University, Atlanta, Georgia; and., Zimmerman MG; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia.; Yerkes National Primate Research Center, Emory University, Atlanta, Georgia.; Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta and School of Medicine, Emory University, Atlanta, Georgia; and., Shi PY; Departments of Biochemistry and Molecular Biology and., Menachery VD; Microbiology and Immunology, The University of Texas Medical Branch, Galveston, Texas., Oster ME; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia., Edupuganti S; Department of Medicine, School of Medicine and., Anderson EJ; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia.; Department of Medicine, School of Medicine and.; Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta and School of Medicine, Emory University, Atlanta, Georgia; and., Suthar MS; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia.; Emory Vaccine Center and.; Yerkes National Primate Research Center, Emory University, Atlanta, Georgia.; Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta and School of Medicine, Emory University, Atlanta, Georgia; and., Wrammert J; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia.; Emory Vaccine Center and.; Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta and School of Medicine, Emory University, Atlanta, Georgia; and., Jaggi P; Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia; preeti.jaggi@emory.edu.; Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta and School of Medicine, Emory University, Atlanta, Georgia; and.
Jazyk:	angličtina
Zdroj:	Pediatrics [Pediatrics] 2020 Dec; Vol. 146 (6). Date of Electronic Publication: 2020 Sep 02.
DOI:	10.1542/peds.2020-018242
Abstrakt:	Objectives: We aimed to measure severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological responses in children hospitalized with multisystem inflammatory syndrome in children (MIS-C) compared with those with coronavirus disease 2019 (COVID-19), those with Kawasaki disease (KD), and hospitalized pediatric controls. Methods: From March 17, 2020, to May 26, 2020, we prospectively identified hospitalized children with MIS-C ( n = 10), symptomatic COVID-19 ( n = 10), and KD ( n = 5) and hospitalized controls ( n = 4) at Children's Healthcare of Atlanta. With institutional review board approval, we obtained prospective and residual blood samples from these children and measured SARS-CoV-2 spike receptor-binding domain (RBD) immunoglobulin M and immunoglobulin G (IgG), full-length spike IgG, and nucleocapsid protein antibodies using quantitative enzyme-linked immunosorbent assays and SARS-CoV-2 neutralizing antibodies using live-virus focus-reduction neutralization assays. We statistically compared the log-transformed antibody titers among groups and performed linear regression analyses. Results: All children with MIS-C had high titers of SARS-CoV-2 RBD IgG antibodies, which correlated with full-length spike IgG antibodies ( R 2 = 0.956; P < .001), nucleocapsid protein antibodies ( R 2 = 0.846; P < .001), and neutralizing antibodies ( R 2 = 0.667; P < .001). Children with MIS-C had significantly higher SARS-CoV-2 RBD IgG antibody titers (geometric mean titer 6800; 95% confidence interval 3495-13 231) than children with COVID-19 (geometric mean titer 626; 95% confidence interval 251-1563; P < .001), children with KD (geometric mean titer 124; 95% confidence interval 91-170; P < .001), and hospitalized controls (geometric mean titer 85; P < .001). All children with MIS-C also had detectable RBD immunoglobulin M antibodies, indicating recent SARS-CoV-2 infection. RBD IgG titers correlated with the erythrocyte sedimentation rate ( R 2 = 0.512; P < .046) and with hospital ( R 2 = 0.548; P = .014) and ICU lengths of stay ( R 2 = 0.590; P = .010). Conclusions: Quantitative SARS-CoV-2 serology may have a role in establishing the diagnosis of MIS-C, distinguishing it from similar clinical entities, and stratifying risk for adverse outcomes. Competing Interests: POTENTIAL CONFLICT OF INTEREST: Dr Anderson has received personal fees from AbbVie and Pfizer for consulting; Dr Rostad receives royalties unrelated to this article to Emory University from Meissa Vaccines, Inc; Drs Anderson and Rostad’s institution receives funds to conduct clinical research unrelated to this article from MedImmune, Regeneron, PaxVax, Pfizer, GlaxoSmithKline, Merck, Novavax, Sanofi-Pasteur, and Micron; Drs Menachery and Shi coinvented the reverse genetics system used to generate the live severe acute respiratory syndrome coronavirus 2 virus described in this article (a patent has been applied for this technology, and it has been licensed for commercial use); the other authors have indicated they have no potential conflicts of interest to disclose (Copyright © 2020 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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