A Public Health Antibody Screening Indicates a 6-Fold Higher SARS-CoV-2 Exposure Rate than Reported Cases in Children

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Markus Hippich - (Author)
  • Lisa Holthaus - (Author)
  • Robin Assfalg - (Author)
  • Jose Zapardiel-Gonzalo - (Author)
  • Heidi Kapfelsperger - (Author)
  • Martin Heigermoser - (Author)
  • Florian Haupt - (Author)
  • Dominik A. Ewald - (Author)
  • Tiziana C. Welzhofer - (Author)
  • Benjamin A. Marcus - (Author)
  • Susanne Heck - (Author)
  • Annika Koelln - (Author)
  • Joanna Stock - (Author)
  • Franziska Voss - (Author)
  • Massimiliano Secchi - (Author)
  • Lorenzo Piemonti - (Author)
  • Kathrin de la Rosa - (Author)
  • Ulrike Protzer - (Author)
  • Merle Boehmer - (Author)
  • Peter Achenbach - (Author)
  • Vito Lampasona - (Author)
  • Ezio Bonifacio - , Chair of Preclinical stem cell therapy and diabetes, Center for Regenerative Therapies Dresden (Author)
  • Anette-Gabriele Ziegler - (Author)

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 immunoprecipitation 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 the Bavarian health authority data. Findings: Dual-antibody positivity was detected in none of the 3,887 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 6-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%. Conclusions: We demonstrate the value of population-based screening programs for pandemic monitoring. Funding: The work was supported by funding from the BMBF (FKZ01KX1818).

Details

Original languageEnglish
Pages (from-to)149-163.e4
JournalMED
Volume2
Issue number2
Publication statusPublished - 12 Feb 2021
Peer-reviewedYes

External IDs

Scopus 85108569853
ORCID /0000-0002-8704-4713/work/141544342

Keywords

Research priority areas of TU Dresden

Sustainable Development Goals

Library keywords