Antibodies Against SARS-CoV-2 in Unvaccinated Children Hospitalized with COVID-19: An Observational Cohort Study of Pre-Omicron and Omicron Variants Era

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2024 Feb 23

PMID 38394318

Authors

Rattapon Uppala

Phanthila Sitthikarnkha

Kiatichai Faksri

Pope Kosalaraksa

Leelawadee Techasatian

Nattakarn Tantawarak

Sysavanh Nanthavongsa

Affiliations

Soon will be listed here.

Abstract

Purpose: This study aimed to investigate the antibodies against SARS-CoV-2 in children hospitalized due to COVID-19 during the era of pre-Omicron and Omicron variants.

Methods: This was a retrospective observational study conducted at a tertiary academic medical center in Thailand between June 2021 and August 2022. We collected the data of children aged under 18-year who were hospitalized from SARS-CoV-2 infection. After hospital discharge, we scheduled clinical follow-up 60 to 90 days post-infection clinical follow-up. We measured antibodies against SARS-CoV-2 anti-spike protein receptor-binding domain in the serum during a follow-up visit and compared the mean difference of antibody levels between children infected with COVID-19 during the pre-Omicron and Omicron eras.

Results: A total of 119 children enrolled into the study. There were 58 and 61 children hospitalized due to COVID-19 during pre-Omicron and Omicron era, respectively. The median (interquartile range, IQR) of SARS-CoV-2 antibodies in all cases was 206.1 (87.9-424.1) U/mL at follow-up. Children infected during pre-Omicron had SARS-CoV-2 antibody levels at follow-up higher than children infected during Omicron era [mean difference 292.57 U/mL, 95% CI 53.85-531.28, p = 0.017). There was no difference in SARS-CoV-2 antibody levels between the children based on gender, age, co-morbidities, chest radiograph classification, or diagnosis.

Conclusions: The antibodies response to SARS-CoV-2 infection was weaker during the Omicron era than previous variant of concern. Immunization strategies and policies should be implemented in children even if they had been previously infected.

References

Zuiani A, Wesemann D . Antibody Dynamics and Durability in Coronavirus Disease-19. Clin Lab Med. 2022; 42(1):85-96. PMC: 8563365. DOI: 10.1016/j.cll.2021.10.004. View

Al-Sadeq D, Shurrab F, Ismail A, Humaira Amanullah F, Thomas S, Aldewik N . Comparison of antibody immune responses between BNT162b2 and mRNA-1273 SARS-CoV-2 vaccines in naïve and previously infected individuals. J Travel Med. 2021; 28(8). PMC: 8754698. DOI: 10.1093/jtm/taab190. View

Kopanja S, Gattinger P, Schmidthaler K, Sieber J, Niepodziana K, Schlederer T . Characterization of the antibody response to SARS-CoV-2 in a mildly affected pediatric population. Pediatr Allergy Immunol. 2022; 33(2):e13737. PMC: 9115525. DOI: 10.1111/pai.13737. View

Takei S, Ai T, Yamamoto T, Igawa G, Kanno T, Tobiume M . Performance evaluation of the Roche Elecsys® Anti-SARS-CoV-2 immunoassays by comparison with neutralizing antibodies and clinical assessment. PLoS One. 2022; 17(9):e0274181. PMC: 9477342. DOI: 10.1371/journal.pone.0274181. View

da Costa C, de Freitas C, Alves C, Lameira J . Assessment of mutations on RBD in the Spike protein of SARS-CoV-2 Alpha, Delta and Omicron variants. Sci Rep. 2022; 12(1):8540. PMC: 9121086. DOI: 10.1038/s41598-022-12479-9. View

Martinez Chamorro E, Diez Tascon A, Ibanez Sanz L, Ossaba Velez S, Borruel Nacenta S . Radiologic diagnosis of patients with COVID-19. Radiologia (Engl Ed). 2020; 63(1):56-73. PMC: 7685043. DOI: 10.1016/j.rx.2020.11.001. View

Woodruff R, Campbell A, Taylor C, Chai S, Kawasaki B, Meek J . Risk Factors for Severe COVID-19 in Children. Pediatrics. 2021; 149(1). PMC: 9213563. DOI: 10.1542/peds.2021-053418. View

Speiser D, Bachmann M . COVID-19: Mechanisms of Vaccination and Immunity. Vaccines (Basel). 2020; 8(3). PMC: 7564472. DOI: 10.3390/vaccines8030404. View

Wrenn J, Pakala S, Vestal G, Shilts M, Brown H, Bowen S . COVID-19 severity from Omicron and Delta SARS-CoV-2 variants. Influenza Other Respir Viruses. 2022; 16(5):832-836. PMC: 9111734. DOI: 10.1111/irv.12982. View

10.

Sadeghalvad M, Mansourabadi A, Noori M, Nejadghaderi S, Masoomikarimi M, Alimohammadi M . Recent developments in SARS-CoV-2 vaccines: A systematic review of the current studies. Rev Med Virol. 2022; 33(1):e2359. PMC: 9348268. DOI: 10.1002/rmv.2359. View

11.

Buonsenso D, Cusenza F, Passadore L, Bonanno F, De Guido C, Esposito S . Duration of immunity to SARS-CoV-2 in children after natural infection or vaccination in the omicron and pre-omicron era: A systematic review of clinical and immunological studies. Front Immunol. 2023; 13:1024924. PMC: 9874918. DOI: 10.3389/fimmu.2022.1024924. View

12.

Roltgen K, Boyd S . Antibody and B cell responses to SARS-CoV-2 infection and vaccination. Cell Host Microbe. 2021; 29(7):1063-1075. PMC: 8233571. DOI: 10.1016/j.chom.2021.06.009. View

13.

Chen S, Guan F, Candotti F, Benlagha K, Camara N, Herrada A . The role of B cells in COVID-19 infection and vaccination. Front Immunol. 2022; 13:988536. PMC: 9468879. DOI: 10.3389/fimmu.2022.988536. View

14.

Riester E, Findeisen P, Hegel J, Kabesch M, Ambrosch A, Rank C . Performance evaluation of the Roche Elecsys Anti-SARS-CoV-2 S immunoassay. J Virol Methods. 2021; 297:114271. PMC: 8393518. DOI: 10.1016/j.jviromet.2021.114271. View

15.

Molloy E, Nakra N, Gale C, Dimitriades V, Lakshminrusimha S . Multisystem inflammatory syndrome in children (MIS-C) and neonates (MIS-N) associated with COVID-19: optimizing definition and management. Pediatr Res. 2022; 93(6):1499-1508. PMC: 9436161. DOI: 10.1038/s41390-022-02263-w. View

16.

Naranbhai V, Nathan A, Kaseke C, Berrios C, Khatri A, Choi S . T cell reactivity to the SARS-CoV-2 Omicron variant is preserved in most but not all individuals. Cell. 2022; 185(6):1041-1051.e6. PMC: 8810349. DOI: 10.1016/j.cell.2022.01.029. View

17.

Fisler G, Izard S, Shah S, Lewis D, Kainth M, Hagmann S . Characteristics and risk factors associated with critical illness in pediatric COVID-19. Ann Intensive Care. 2020; 10(1):171. PMC: 7749393. DOI: 10.1186/s13613-020-00790-5. View

18.

Satdhabudha A, Chaiyakulsil C, Uppala R, Niyomkarn W, Tovichien P, Norasettekul V . Development and validation of the predictive score for pediatric COVID-19 pneumonia: A nationwide, multicenter study. PLoS One. 2022; 17(8):e0273842. PMC: 9423652. DOI: 10.1371/journal.pone.0273842. View

19.

Ravichandran S, Tang J, Grubbs G, Lee Y, Pourhashemi S, Hussaini L . SARS-CoV-2 immune repertoire in MIS-C and pediatric COVID-19. Nat Immunol. 2021; 22(11):1452-1464. DOI: 10.1038/s41590-021-01051-8. View

20.

Kim L, Whitaker M, OHalloran A, Kambhampati A, Chai S, Reingold A . Hospitalization Rates and Characteristics of Children Aged <18 Years Hospitalized with Laboratory-Confirmed COVID-19 - COVID-NET, 14 States, March 1-July 25, 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(32):1081-1088. PMC: 7440125. DOI: 10.15585/mmwr.mm6932e3. View