Prevalence of SARS-CoV-2 Infection in Children and Their Parents in Southwest Germany
Top Cited Papers
- 1 June 2021
- journal article
- research article
- Published by American Medical Association (AMA) in JAMA Pediatrics
- Vol. 175 (6), 586-593
- https://doi.org/10.1001/jamapediatrics.2021.0001
Abstract
IMPORTANCE School and daycare closures were enforced as measures to confine the novel coronavirus disease 2019 (COVID-19) pandemic, based on the assumption that young children may play a key role in severe acute respiratory coronavirus 2 (SARS-CoV-2) spread. Given the grave consequences of contact restrictions for children, a better understanding of their contribution to the COVID-19 pandemic is of great importance. OBJECTIVE To describe the rate of SARS-CoV-2 infections and the seroprevalence of SARS-CoV-2 antibodies in children aged 1 to 10 years, compared with a corresponding parent of each child, in a population-based sample. DESIGN, SETTING, AND PARTICIPANTS This large-scale, multicenter, cross-sectional investigation (the COVID-19 BaWu study) enrolled children aged 1 to 10 years and a corresponding parent between April 22 and May 15, 2020, in southwest Germany. EXPOSURES Potential exposure to SARS-CoV-2. MAIN OUTCOMES AND MEASURES The main outcomes were infection and seroprevalence of SARS-CoV-2. Participants were tested for SARS-CoV-2 RNA from nasopharyngeal swabs by reverse transcription-polymerase chain reaction and SARS-CoV-2 specific IgG antibodies in serum by enzyme-linked immunosorbent assays and immunofluorescence tests. Discordant results were clarified by electrochemiluminescence immunoassays, a second enzyme-linked immunosorbent assay, or an in-house Luminex-based assay. RESULTS This study included 4964 participants: 2482 children (median age, 6 [range, 1-10] years; 1265 boys [51.0%]) and 2482 parents (median age, 40 [range, 23-66] years; 615 men [24.8%]). Two participants (0.04%) tested positive for SARS-CoV-2 RNA. The estimated SARS-CoV-2 seroprevalence was low in parents (1.8% [95% CI, 1.2-2.4%]) and 3-fold lower in children (0.6% [95% CI, 0.3-1.0%]). Among 56 families with at least 1 child or parent with seropositivity, the combination of a parent with seropositivity and a corresponding child with seronegativity was 4.3 (95% CI, 1.19-15.52) times higher than the combination of a parent who was seronegative and a corresponding child with seropositivity. We observed virus-neutralizing activity for 66 of 70 IgG-positive serum samples (94.3%). CONCLUSIONS AND RELEVANCE In this cross-sectional study, the spread of SARS-CoV-2 infection during a period of lockdown in southwest Germany was particularly low in children aged 1 to 10 years. Accordingly, it is unlikely that children have boosted the pandemic. This SARS-CoV-2 prevalence study, which appears to be the largest focusing on children, is instructive for how ad hoc mass testing provides the basis for rational political decision-making in a pandemic.This publication has 34 references indexed in Scilit:
- Epidemiology of COVID-19 Among Children in ChinaPEDIATRICS, 2020
- An interactive web-based dashboard to track COVID-19 in real timeThe Lancet Infectious Diseases, 2020
- [The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China].2020
- Increased Risk of Noninfluenza Respiratory Virus Infections Associated With Receipt of Inactivated Influenza VaccineClinical Infectious Diseases, 2012
- Estimating the impact of school closure on influenza transmission from Sentinel dataNature, 2008
- Social Contacts and Mixing Patterns Relevant to the Spread of Infectious DiseasesPLoS Medicine, 2008
- Herd immunity in adults against influenza-related illnesses with use of the trivalent-live attenuated influenza vaccine (CAIV-T) in childrenVaccine, 2005
- Risk factors of influenza transmission in households.2004
- Epidemiology, transmission dynamics and control of SARS: the 2002–2003 epidemicPhilosophical Transactions B, 2004
- Risk factors of influenza transmission in householdsInternational Congress Series, 2004