Abstract

Backgrounds:

School closures were enforced as measures to restrain the COVID-19 pandemic, based on the assumption that young children may play a key role in SARS-CoV-2 spread. The purpose of this study is to estimate the prevalence of SARS-CoV-2 IgG antibodies in children and a corresponding parent, to provide evidence for the potential underdiagnosis of COVID-19, in order to improve surveillance and to estimate the prevalence of asymptomatic or subclinical COVID-19 cases.

Methods

A prospective multicenter study was conducted between March and May 2021 in Greece. Pediatric patients and their parents admitted to the hospital or examined in outpatient clinics for other reasons were tested for anti-Spike SARS-CoV-2 specific IgG antibodies in serum by Chemiluminescent Magnetic Microparticle Immunoassay (CMIA). Participants with current COVID-19 infection or being vaccinated for SARS-CoV-2 were excluded. A questionnaire about clinical and demographic data was completed.

Results:

This study included 329 participants: 166 children [median age:11 years (IQR:8); 87 males (52.4%)] and 163 parents [median age:43 years (IQR:9); 47 males (28.8%)]. The overall estimated SARS-CoV-2 seroprevalence was 6.7% in parents and 7.2% in children. Among 18 families with >1 child or parent with seropositivity, the combination of a seropositive parent and a corresponding seronegative child was 38.9%, the combination of a seronegative parent and a corresponding seropositive child was 33.3% and the combination of a seropositive child and a corresponding seropositive parent was 27.8%.

Conclusions/Learning Points:

In this seroprevalence study, the spread of SARS-CoV-2 infection during a period of lockdown in Greece was particularly low in children and comparable to adults most likely due to intrafamilial transmission. Accordingly, it is unlikely that children have boosted virus transmission. The study findings may be useful for decisions regarding containment measures during the pandemic.

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