Symptoms, SARS-CoV-2 Antibodies, and Neutralization Capacity in a Cross Sectional-Population of German Children

URN to cite this document:: urn:nbn:de:bvb:355-epub-493748
DOI to cite this document:: 10.5283/epub.49374

Laub, Otto ; Leipold, Georg ; Toncheva, Antoaneta A.

; Peterhoff, David ; Einhauser, Sebastian

; Neckermann, Patrick ; Borchers, Natascha S. ; Santos-Valente, Elisangela ; Kheiroddin, Parastoo ; Buntrock-Döpke, Heike ; Laub, Sarah ; Schöberl, Patricia ; Schweiger-Kabesch, Andrea ; Ewald, Dominik ; Horn, Michael ; Niggel, Jakob ; Ambrosch, Andreas ; Überla, Klaus ; Gerling, Stephan ; Brandstetter, Susanne ; Wagner, Ralf ; Kabesch, Michael

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Date of publication of this fulltext: 26 Oct 2021 14:29

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Background: Children and youth are affected rather mildly in the acute phase of COVID-19 and thus, SARS-CoV-2 infection infection may easily be overlooked. In the light of current discussions on the vaccinations of children it seems necessary to better identify children who are immune against SARS-CoV-2 due to a previous infection and to better understand COVID-19 related immune reactions in children. Methods: In a cross-sectional design, children aged 1-17 were recruited through primary care pediatricians for the study (a) randomly, if they had an appointment for a regular health check-up or (b) if parents and children volunteered and actively wanted to participate in the study. Symptoms were recorded and two antibody tests were performed in parallel directed against S (in house test) and N (Roche Elecsys) viral proteins. In children with antibody response in either test, neutralization activity was determined. Results: We identified antibodies against SARS-CoV-2 in 162 of 2,832 eligible children (5.7%) between end of May and end of July 2020 in three, in part strongly affected regions of Bavaria in the first wave of the pandemic. Approximately 60% of antibody positive children (n = 97) showed high levels (>97th percentile) of antibodies against N-protein, and for the S-protein, similar results were found. Sufficient neutralizing activity was detected for only 135 antibody positive children (86%), irrespective of age and sex. Initial COVID-19 symptoms were unspecific in children except for the loss of smell and taste and unrelated to antibody responses or neutralization capacity. Approximately 30% of PCR positive children did not show seroconversion in our small subsample in which PCR tests were performed. Conclusions: Symptoms of SARS-CoV-2 infections are unspecific in children and antibody responses show a dichotomous structure with strong responses in many and no detectable antibodies in PCR positive children and missing neutralization activity in a relevant proportion of the young population.

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