A public health antibody screening indicates a 6-fold higher SARS-CoV-2 exposure rate than reported cases in children

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Item Type:	Article
Title:	A public health antibody screening indicates a 6-fold higher SARS-CoV-2 exposure rate than reported cases in children
Creators Name:	Hippich, M., Holthaus, L., Assfalg, R., Zapardiel Gonzalo, J.M., Kapfelsperger, H., Heigermoser, M., Haupt, F., Ewald, D.A., Welzhofer, T.C., Marcus, B.A., Heck, S., Koelln, A., Stock, J., Voss, F., Secchi, M., Piemonti, L., de la Rosa, K., Protzer, U., Boehmer, M., Achenbach, P., Lampasona, V., Bonifacio, E. and Ziegler, A.G.
Abstract:	BACKGROUND: Antibody responses to virus reflect exposure and potential protection. METHODS: We developed a highly specific and sensitive approach to measuring antibodies against SARS-CoV-2 for population-scale immune surveillance. Antibody positivity was defined as a dual-positive response against both the receptor binding domain and nucleocapsid proteins of SARS-CoV-2. Antibodies were measured by immuno-precipitation assays in capillary blood from 15,771 children aged 1 to 18 years living in Bavaria, Germany, and participating in a public health type 1 diabetes screening program (Clinicaltrials.gov NCT04039945), in 1,916 dried blood spots from neonates in a Bavarian screening study (Clinicaltrials.gov NCT03316261), and in 75 SARS-CoV-2 positive individuals. Virus positive incidence was obtained from Bavarian health authority data. FINDINGS: Dual-antibody positivity was detected in none of 3887 children in 2019 (100% specificity) and 73 of 75 SARS-CoV-2 positive individuals (97.3% sensitivity). Antibody surveillance in children during 2020 resulted in frequencies of 0.08% in January to March, 0.61% in April, 0.74% in May, 1.13% in June and 0.91% in July. Antibody prevalence from April 2020 was six-fold higher than the incidence of authority-reported cases (156 per 100,000 children), showed marked variation between the seven Bavarian regions (P<0.0001), and was not associated with age or sex. Transmission in children with virus-positive family members was 35%; 47% of positive children were asymptomatic. No association with type 1 diabetes autoimmunity was observed. Antibody frequency in newborns was 0.47%. CONCLUSION: We demonstrate the value of population-based screening programs for pandemic monitoring.
Keywords:	SARS-CoV-2 Antibody, Seroprevalence, Receptor Binding Domain RBD, Nucleocapsid Antigen, Public Health Screening
Source:	Med
ISSN:	2666-6359
Publisher:	Cell Press
Volume:	2
Number:	2
Page Range:	149-163
Date:	12 February 2021
Additional Information:	Copyright © 2020 Elsevier Inc. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
Official Publication:	https://doi.org/10.1016/j.medj.2020.10.003
External Fulltext:	View full text on PubMed Central
PubMed:	View item in PubMed

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