Quantitative SARS-CoV-2 Serology in Children With Multisystem Inflammatory Syndrome (MIS-C)
| Autor: | Lisa Macoy, Pei Yong Shi, Stacey A. Lapp, Carol M. Kao, Christina A. Rostad, Mehul S. Suthar, Evan J. Anderson, Rajit K. Basu, W Matthew Linam, Matthew G. Zimmerman, Mehgan Teherani, Matthew E. Oster, Srilatha Edupuganti, Grace Mantus, Ann Chahroudi, Jens Wrammert, Vineet D. Menachery, Keiko M. Tarquinio, Preeti Jaggi |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Adolescent Blood Sedimentation Mucocutaneous Lymph Node Syndrome Antibodies Viral Immunoglobulin G COVID-19 Serological Testing Serology Diagnosis Differential Young Adult 03 medical and health sciences 0302 clinical medicine Neutralization Tests 030225 pediatrics Coronavirus Nucleocapsid Proteins Humans Medicine Prospective Studies Child biology SARS-CoV-2 business.industry Infant Newborn Antibody titer Case-control study COVID-19 Infant Length of Stay Phosphoproteins medicine.disease Antibodies Neutralizing Systemic Inflammatory Response Syndrome Hospitalization Titer Immunoglobulin M Case-Control Studies Child Preschool Spike Glycoprotein Coronavirus Pediatrics Perinatology and Child Health Immunology biology.protein Regression Analysis Female Kawasaki disease Antibody business |
| Zdroj: | Pediatrics. 146 |
| ISSN: | 1098-4275 0031-4005 |
| Popis: | 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 (R2 = 0.956; P < .001), nucleocapsid protein antibodies (R2 = 0.846; P < .001), and neutralizing antibodies (R2 = 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 (R2 = 0.512; P < .046) and with hospital (R2 = 0.548; P = .014) and ICU lengths of stay (R2 = 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. |
| Databáze: | OpenAIRE |
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