Seroprevalence of SARS-CoV-2 infection in pediatric patients in a tertiary care hospital setting

Ploy Pattanakitsakul; Chanya Pongpatipat; Chavachol Setthaudom; Mongkol Kunakorn; Thiantip Sahakijpicharn; Anannit Visudtibhan; Nopporn Apiwattanakul; Surapat Assawawiroonhakarn; Uthen Pandee; Chonnamet Techasaensiri; Sophida Boonsathorn; Sujittra Chaisavaneeyakorn

doi:10.1371/journal.pone.0310860

Seroprevalence of SARS-CoV-2 infection in pediatric patients in a tertiary care hospital setting

Ploy Pattanakitsakul
, Chanya Pongpatipat
, Chavachol Setthaudom
, Mongkol Kunakorn
, Thiantip Sahakijpicharn
, Anannit Visudtibhan
, Nopporn Apiwattanakul
, Surapat Assawawiroonhakarn
, Uthen Pandee
, Chonnamet Techasaensiri
, Sophida Boonsathorn
, Sujittra Chaisavaneeyakorn

Faculty of Medicine Ramathibodi Hospital, Mahidol University
Chiangmai Ram Hospital
Ramathibodi Hospital

Research output: Contribution to journal › Article › peer-review

Abstract

Globally, cases of children’s coronavirus disease 2019 (COVID-19) have been reported since the pandemic started. Most children have an asymptomatic or mild infection. Therefore, the incidence rate of COVID-19 in children might have been underestimated. This study aimed to determine (1) the seroprevalence (and seroconversion rates) of COVID-19, including associated risk factors, in pediatric patients visiting hospitals; and (2) the immunological responses to COVID-19. This was a prospective, cross-sectional study. Patients aged 0–18 years who visited the hospital from September 2020 to February 2022 were included. Demographic, clinical, and laboratory data were reviewed. A total of 1,443 pediatric patients were enrolled. Of these, 323 (22.6%) had a history of COVID-19. In the pre-Delta period, the seroprevalence increased from 4.1% to 70.6% in all included patients and from 0.5% to 10% in patients without a known history of COVID-19 compared with the Delta-Omicron period. The seroconversion rate was 6.8% (19 per 100 person-years) in pediatric patients with COVID-19. Risk factors for COVID-19 seropositivity were respiratory symptoms, being in an outpatient department setting, and infection during the Delta-Omicron period. Exposure to household members with confirmed COVID-19 was a risk factor for seropositivity and seroconversion. Infection during the Delta-Omicron period and testing conducted >2 weeks after the onset of symptoms was associated with spike immunoglobulin (Ig) M and spike and nucleocapsid IgG, respectively. High nucleocapsid IgG levels were associated with pneumonia in pediatric patients with COVID-19. Pediatric patients exposed to household members with COVID-19 and respiratory symptoms should be tested for COVID-19. Nucleocapsid IgG can be used as a surrogate marker to identify patients who may have experienced pneumonia from COVID-19 and as a screening tool for the COVID-19 outbreak, regardless of COVID-19 vaccination status.

Original language	English
Article number	e0310860
Journal	PLoS ONE
Volume	19
Issue number	9
DOIs	https://doi.org/10.1371/journal.pone.0310860
Publication status	Published - Sept 2024

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Access to Document

10.1371/journal.pone.0310860

Cite this

Pattanakitsakul, P., Pongpatipat, C., Setthaudom, C., Kunakorn, M., Sahakijpicharn, T., Visudtibhan, A., Apiwattanakul, N., Assawawiroonhakarn, S., Pandee, U., Techasaensiri, C., Boonsathorn, S., & Chaisavaneeyakorn, S. (2024). Seroprevalence of SARS-CoV-2 infection in pediatric patients in a tertiary care hospital setting. PLoS ONE, 19(9), Article e0310860. https://doi.org/10.1371/journal.pone.0310860

@article{337e2c0ebd054132a9f9d434cf3ef052,

title = "Seroprevalence of SARS-CoV-2 infection in pediatric patients in a tertiary care hospital setting",

abstract = "Globally, cases of children{\textquoteright}s coronavirus disease 2019 (COVID-19) have been reported since the pandemic started. Most children have an asymptomatic or mild infection. Therefore, the incidence rate of COVID-19 in children might have been underestimated. This study aimed to determine (1) the seroprevalence (and seroconversion rates) of COVID-19, including associated risk factors, in pediatric patients visiting hospitals; and (2) the immunological responses to COVID-19. This was a prospective, cross-sectional study. Patients aged 0–18 years who visited the hospital from September 2020 to February 2022 were included. Demographic, clinical, and laboratory data were reviewed. A total of 1,443 pediatric patients were enrolled. Of these, 323 (22.6\%) had a history of COVID-19. In the pre-Delta period, the seroprevalence increased from 4.1\% to 70.6\% in all included patients and from 0.5\% to 10\% in patients without a known history of COVID-19 compared with the Delta-Omicron period. The seroconversion rate was 6.8\% (19 per 100 person-years) in pediatric patients with COVID-19. Risk factors for COVID-19 seropositivity were respiratory symptoms, being in an outpatient department setting, and infection during the Delta-Omicron period. Exposure to household members with confirmed COVID-19 was a risk factor for seropositivity and seroconversion. Infection during the Delta-Omicron period and testing conducted >2 weeks after the onset of symptoms was associated with spike immunoglobulin (Ig) M and spike and nucleocapsid IgG, respectively. High nucleocapsid IgG levels were associated with pneumonia in pediatric patients with COVID-19. Pediatric patients exposed to household members with COVID-19 and respiratory symptoms should be tested for COVID-19. Nucleocapsid IgG can be used as a surrogate marker to identify patients who may have experienced pneumonia from COVID-19 and as a screening tool for the COVID-19 outbreak, regardless of COVID-19 vaccination status.",

author = "Ploy Pattanakitsakul and Chanya Pongpatipat and Chavachol Setthaudom and Mongkol Kunakorn and Thiantip Sahakijpicharn and Anannit Visudtibhan and Nopporn Apiwattanakul and Surapat Assawawiroonhakarn and Uthen Pandee and Chonnamet Techasaensiri and Sophida Boonsathorn and Sujittra Chaisavaneeyakorn",

note = "Publisher Copyright: : {\textcopyright} 2024 Pattanakitsakul et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2024",

month = sep,

doi = "10.1371/journal.pone.0310860",

language = "English",

volume = "19",

journal = "PLoS ONE",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "9",

}

Pattanakitsakul, P, Pongpatipat, C, Setthaudom, C, Kunakorn, M, Sahakijpicharn, T, Visudtibhan, A, Apiwattanakul, N , Assawawiroonhakarn, S , Pandee, U , Techasaensiri, C , Boonsathorn, S & Chaisavaneeyakorn, S 2024, 'Seroprevalence of SARS-CoV-2 infection in pediatric patients in a tertiary care hospital setting', PLoS ONE, vol. 19, no. 9, e0310860. https://doi.org/10.1371/journal.pone.0310860

TY - JOUR

T1 - Seroprevalence of SARS-CoV-2 infection in pediatric patients in a tertiary care hospital setting

AU - Pattanakitsakul, Ploy

AU - Pongpatipat, Chanya

AU - Setthaudom, Chavachol

AU - Kunakorn, Mongkol

AU - Sahakijpicharn, Thiantip

AU - Visudtibhan, Anannit

AU - Apiwattanakul, Nopporn

AU - Assawawiroonhakarn, Surapat

AU - Pandee, Uthen

AU - Techasaensiri, Chonnamet

AU - Boonsathorn, Sophida

AU - Chaisavaneeyakorn, Sujittra

N1 - Publisher Copyright: : © 2024 Pattanakitsakul et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2024/9

Y1 - 2024/9

N2 - Globally, cases of children’s coronavirus disease 2019 (COVID-19) have been reported since the pandemic started. Most children have an asymptomatic or mild infection. Therefore, the incidence rate of COVID-19 in children might have been underestimated. This study aimed to determine (1) the seroprevalence (and seroconversion rates) of COVID-19, including associated risk factors, in pediatric patients visiting hospitals; and (2) the immunological responses to COVID-19. This was a prospective, cross-sectional study. Patients aged 0–18 years who visited the hospital from September 2020 to February 2022 were included. Demographic, clinical, and laboratory data were reviewed. A total of 1,443 pediatric patients were enrolled. Of these, 323 (22.6%) had a history of COVID-19. In the pre-Delta period, the seroprevalence increased from 4.1% to 70.6% in all included patients and from 0.5% to 10% in patients without a known history of COVID-19 compared with the Delta-Omicron period. The seroconversion rate was 6.8% (19 per 100 person-years) in pediatric patients with COVID-19. Risk factors for COVID-19 seropositivity were respiratory symptoms, being in an outpatient department setting, and infection during the Delta-Omicron period. Exposure to household members with confirmed COVID-19 was a risk factor for seropositivity and seroconversion. Infection during the Delta-Omicron period and testing conducted >2 weeks after the onset of symptoms was associated with spike immunoglobulin (Ig) M and spike and nucleocapsid IgG, respectively. High nucleocapsid IgG levels were associated with pneumonia in pediatric patients with COVID-19. Pediatric patients exposed to household members with COVID-19 and respiratory symptoms should be tested for COVID-19. Nucleocapsid IgG can be used as a surrogate marker to identify patients who may have experienced pneumonia from COVID-19 and as a screening tool for the COVID-19 outbreak, regardless of COVID-19 vaccination status.

AB - Globally, cases of children’s coronavirus disease 2019 (COVID-19) have been reported since the pandemic started. Most children have an asymptomatic or mild infection. Therefore, the incidence rate of COVID-19 in children might have been underestimated. This study aimed to determine (1) the seroprevalence (and seroconversion rates) of COVID-19, including associated risk factors, in pediatric patients visiting hospitals; and (2) the immunological responses to COVID-19. This was a prospective, cross-sectional study. Patients aged 0–18 years who visited the hospital from September 2020 to February 2022 were included. Demographic, clinical, and laboratory data were reviewed. A total of 1,443 pediatric patients were enrolled. Of these, 323 (22.6%) had a history of COVID-19. In the pre-Delta period, the seroprevalence increased from 4.1% to 70.6% in all included patients and from 0.5% to 10% in patients without a known history of COVID-19 compared with the Delta-Omicron period. The seroconversion rate was 6.8% (19 per 100 person-years) in pediatric patients with COVID-19. Risk factors for COVID-19 seropositivity were respiratory symptoms, being in an outpatient department setting, and infection during the Delta-Omicron period. Exposure to household members with confirmed COVID-19 was a risk factor for seropositivity and seroconversion. Infection during the Delta-Omicron period and testing conducted >2 weeks after the onset of symptoms was associated with spike immunoglobulin (Ig) M and spike and nucleocapsid IgG, respectively. High nucleocapsid IgG levels were associated with pneumonia in pediatric patients with COVID-19. Pediatric patients exposed to household members with COVID-19 and respiratory symptoms should be tested for COVID-19. Nucleocapsid IgG can be used as a surrogate marker to identify patients who may have experienced pneumonia from COVID-19 and as a screening tool for the COVID-19 outbreak, regardless of COVID-19 vaccination status.

UR - https://www.scopus.com/pages/publications/85204883065

U2 - 10.1371/journal.pone.0310860

DO - 10.1371/journal.pone.0310860

M3 - Article

C2 - 39316628

AN - SCOPUS:85204883065

SN - 1932-6203

VL - 19

JO - PLoS ONE

JF - PLoS ONE

IS - 9

M1 - e0310860

ER -

Seroprevalence of SARS-CoV-2 infection in pediatric patients in a tertiary care hospital setting

Abstract

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this