Affordable Access

deepdyve-link
Publisher Website

Pediatric SARS-CoV-2: Clinical Presentation, Infectivity, and Immune Responses.

Authors
  • Yonker, Lael M1
  • Neilan, Anne M2
  • Bartsch, Yannic3
  • Patel, Ankit B4
  • Regan, James5
  • Arya, Puneeta6
  • Gootkind, Elizabeth7
  • Park, Grace7
  • Hardcastle, Margot7
  • St John, Anita7
  • Appleman, Lori7
  • Chiu, Michelle L6
  • Fialkowski, Allison8
  • De la Flor, Denis9
  • Lima, Rosiane9
  • Bordt, Evan A6
  • Yockey, Laura J10
  • D'Avino, Paolo11
  • Fischinger, Stephanie12
  • Shui, Jessica E6
  • And 10 more
  • 1 Massachusetts General Hospital, Mucosal Immunology and Biology Research Center, Boston, MA; Massachusetts General Hospital, Department of Pediatrics, Boston, MA; Harvard Medical School, Boston, MA. Electronic address: [email protected]
  • 2 Massachusetts General Hospital, Department of Pediatrics, Boston, MA; Massachusetts General Hospital, Department of Internal Medicine, Boston, MA; Harvard Medical School, Boston, MA.
  • 3 Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard, Harvard Medical School, Cambridge, MA; Harvard Medical School, Boston, MA.
  • 4 Brigham and Women's Hospital, Department of Medicine, Renal Division, Boston, MA; Harvard Medical School, Boston, MA.
  • 5 Brigham and Women's Hospital, Department of Infectious Diseases, Boston, MA.
  • 6 Massachusetts General Hospital, Department of Pediatrics, Boston, MA; Harvard Medical School, Boston, MA.
  • 7 Massachusetts General Hospital, Department of Pediatrics, Boston, MA.
  • 8 Harvard Medical School, Boston, MA.
  • 9 Massachusetts General Hospital, Mucosal Immunology and Biology Research Center, Boston, MA; Massachusetts General Hospital, Department of Pediatrics, Boston, MA.
  • 10 Massachusetts General Hospital, Department of Internal Medicine, Boston, MA; Massachusetts General Hospital, Vincent Center for Reproductive Biology, Boston, MA.
  • 11 Massachusetts General Hospital, Mucosal Immunology and Biology Research Center, Boston, MA.
  • 12 Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard, Harvard Medical School, Cambridge, MA.
  • 13 Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard, Harvard Medical School, Cambridge, MA; Brigham and Women's Hospital, Department of Infectious Diseases, Boston, MA; Harvard Medical School, Boston, MA.
  • 14 Massachusetts General Hospital, Department of Pediatrics, Boston, MA; Massachusetts General Hospital, Department of Internal Medicine, Boston, MA; Harvard Medical School, Boston, MA; Harvard T.H. Chan School of Public Health, Boston, MA.
  • 15 Massachusetts General Hospital, Department of Internal Medicine, Boston, MA; Harvard Medical School, Boston, MA.
  • 16 Massachusetts General Hospital, Center for Engineering in Medicine, Department of Surgery, Boston, MA; Harvard Medical School, Boston, MA.
  • 17 Massachusetts General Hospital Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Boston, MA; Massachusetts General Hospital, Vincent Center for Reproductive Biology, Boston, MA; Harvard Medical School, Boston, MA.
  • 18 Massachusetts General Hospital, Vincent Center for Reproductive Biology, Boston, MA; Harvard Medical School, Boston, MA.
  • 19 Brigham and Women's Hospital, Department of Infectious Diseases, Boston, MA; Harvard Medical School, Boston, MA.
  • 20 Massachusetts General Hospital, Mucosal Immunology and Biology Research Center, Boston, MA; Massachusetts General Hospital, Department of Pediatrics, Boston, MA; Harvard Medical School, Boston, MA.
Type
Published Article
Journal
The Journal of pediatrics
Publication Date
Aug 18, 2020
Identifiers
DOI: 10.1016/j.jpeds.2020.08.037
PMID: 32827525
Source
Medline
Language
English
License
Unknown

Abstract

Data sharing: The data obtained as part of this study are available from the corresponding author upon reasonable request. As schools plan for re-opening, understanding the potential role children play in the coronavirus infectious disease 2019 (COVID-19) pandemic and the factors that drive severe illness in children is critical. Children ages 0-22 years with suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection presenting to urgent care clinics or being hospitalized for confirmed/suspected SARS-CoV-2 infection or multisystem inflammatory syndrome in children (MIS-C) at Massachusetts General Hospital (MGH) were offered enrollment in the MGH Pediatric COVID-19 Biorepository. Enrolled children provided nasopharyngeal, oropharyngeal, and/or blood specimens. SARS-CoV-2 viral load, ACE2 RNA levels, and serology for SARS-CoV-2 were quantified. A total of 192 children (mean age 10.2 +/- 7 years) were enrolled. Forty-nine children (26%) were diagnosed with acute SARS-CoV-2 infection; an additional 18 children (9%) met criteria for MIS-C. Only 25 (51%) of children with acute SARS-CoV-2 infection presented with fever; symptoms of SARS-CoV-2 infection, if present, were non-specific. Nasopharyngeal viral load was highest in children in the first 2 days of symptoms, significantly higher than hospitalized adults with severe disease (P = .002). Age did not impact viral load, but younger children had lower ACE2 expression (P=0.004). IgM and IgG to the receptor binding domain (RBD) of the SARS-CoV-2 spike protein were increased in severe MIS-C (P<0.001), with dysregulated humoral responses observed. This study reveals that children may be a potential source of contagion in the SARS-CoV-2 pandemic in spite of milder disease or lack of symptoms, and immune dysregulation is implicated in severe post-infectious MIS-C. Copyright © 2020 Elsevier Inc. All rights reserved.

Report this publication

Statistics

Seen <100 times