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Quantitative SARS-CoV-2 Serology in Children With Multisystem Inflammatory Syndrome (MIS-C).
Pediatrics. 2020 12; 146(6)Ped

Abstract

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.

Authors+Show Affiliations

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.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.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.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.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.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.Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia.Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia.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.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.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.Departments of Biochemistry and Molecular Biology and.Microbiology and Immunology, The University of Texas Medical Branch, Galveston, Texas.Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia.Department of Medicine, School of Medicine and.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.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.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.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.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32879033

Citation

Rostad, Christina A., et al. "Quantitative SARS-CoV-2 Serology in Children With Multisystem Inflammatory Syndrome (MIS-C)." Pediatrics, vol. 146, no. 6, 2020.
Rostad CA, Chahroudi A, Mantus G, et al. Quantitative SARS-CoV-2 Serology in Children With Multisystem Inflammatory Syndrome (MIS-C). Pediatrics. 2020;146(6).
Rostad, C. A., Chahroudi, A., Mantus, G., Lapp, S. A., Teherani, M., Macoy, L., Tarquinio, K. M., Basu, R. K., Kao, C., Linam, W. M., Zimmerman, M. G., Shi, P. Y., Menachery, V. D., Oster, M. E., Edupuganti, S., Anderson, E. J., Suthar, M. S., Wrammert, J., & Jaggi, P. (2020). Quantitative SARS-CoV-2 Serology in Children With Multisystem Inflammatory Syndrome (MIS-C). Pediatrics, 146(6). https://doi.org/10.1542/peds.2020-018242
Rostad CA, et al. Quantitative SARS-CoV-2 Serology in Children With Multisystem Inflammatory Syndrome (MIS-C). Pediatrics. 2020;146(6) PubMed PMID: 32879033.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quantitative SARS-CoV-2 Serology in Children With Multisystem Inflammatory Syndrome (MIS-C). AU - Rostad,Christina A, AU - Chahroudi,Ann, AU - Mantus,Grace, AU - Lapp,Stacey A, AU - Teherani,Mehgan, AU - Macoy,Lisa, AU - Tarquinio,Keiko M, AU - Basu,Rajit K, AU - Kao,Carol, AU - Linam,W Matthew, AU - Zimmerman,Matthew G, AU - Shi,Pei-Yong, AU - Menachery,Vineet D, AU - Oster,Matthew E, AU - Edupuganti,Srilatha, AU - Anderson,Evan J, AU - Suthar,Mehul S, AU - Wrammert,Jens, AU - Jaggi,Preeti, Y1 - 2020/09/02/ PY - 2020/08/27/accepted PY - 2020/9/4/pubmed PY - 2020/9/4/medline PY - 2020/9/4/entrez JF - Pediatrics JO - Pediatrics VL - 146 IS - 6 N2 - 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. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/32879033/Quantitative_SARS_CoV_2_Serology_in_Children_With_Multisystem_Inflammatory_Syndrome__MIS_C__ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=32879033 DB - PRIME DP - Unbound Medicine ER -