SARS-CoV-2 Antigenemia is Associated With Pneumonia in Children But Lacks Sensitivity to Diagnose Acute Infection.
Journal
The Pediatric infectious disease journal
ISSN: 1532-0987
Titre abrégé: Pediatr Infect Dis J
Pays: United States
ID NLM: 8701858
Informations de publication
Date de publication:
01 02 2023
01 02 2023
Historique:
entrez:
13
1
2023
pubmed:
14
1
2023
medline:
18
1
2023
Statut:
ppublish
Résumé
Nucleocapsid antigenemia in adults has demonstrated high sensitivity and specificity for acute infection, and antigen burden is associated with disease severity. Data regarding SARS-CoV-2 antigenemia in children are limited. We retrospectively analyzed blood plasma specimens from hospitalized children with COVID-19 or MIS-C. Nucleocapsid and spike were measured using ultrasensitive immunoassays. We detected nucleocapsid antigenemia in 62% (50/81) and spike antigenemia in 27% (21/79) of children with acute COVID-19 but 0% (0/26) and 15% (4/26) with MIS-C from March 2020-March 2021. Higher nucleocapsid levels were associated with radiographic infiltrates and respiratory symptoms in children with COVID-19. Antigenemia lacks the sensitivity to diagnose acute infection in children but is associated with signs and symptoms of lower respiratory tract involvement. Further study into the mechanism of antigenemia, its association with specific organ involvement, and the role of antigenemia in the pathogenesis of COVID-19 is warranted.
Sections du résumé
BACKGROUND
Nucleocapsid antigenemia in adults has demonstrated high sensitivity and specificity for acute infection, and antigen burden is associated with disease severity. Data regarding SARS-CoV-2 antigenemia in children are limited.
METHODS
We retrospectively analyzed blood plasma specimens from hospitalized children with COVID-19 or MIS-C. Nucleocapsid and spike were measured using ultrasensitive immunoassays.
RESULTS
We detected nucleocapsid antigenemia in 62% (50/81) and spike antigenemia in 27% (21/79) of children with acute COVID-19 but 0% (0/26) and 15% (4/26) with MIS-C from March 2020-March 2021. Higher nucleocapsid levels were associated with radiographic infiltrates and respiratory symptoms in children with COVID-19.
CONCLUSIONS
Antigenemia lacks the sensitivity to diagnose acute infection in children but is associated with signs and symptoms of lower respiratory tract involvement. Further study into the mechanism of antigenemia, its association with specific organ involvement, and the role of antigenemia in the pathogenesis of COVID-19 is warranted.
Identifiants
pubmed: 36638399
doi: 10.1097/INF.0000000000003779
pii: 00006454-202302000-00010
pmc: PMC9838602
doi:
Substances chimiques
Antibodies, Viral
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
130-135Subventions
Organisme : NIGMS NIH HHS
ID : T32 GM142617
Pays : United States
Organisme : NIBIB NIH HHS
ID : U54 EB027690
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002378
Pays : United States
Organisme : NIAID NIH HHS
ID : F30 AI152342
Pays : United States
Organisme : NHLBI NIH HHS
ID : T32 HL069769
Pays : United States
Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
CAR’s institution has received funds to conduct clinical research unrelated to this manuscript from BioFire Inc, GSK, MedImmune, Micron, Janssen, Merck, Moderna, Novavax, PaxVax, Pfizer, Regeneron, Sanofi-Pasteur. She is co-inventor of patented RSV vaccine technology unrelated to this manuscript, which has been licensed to Meissa Vaccines, Inc. EJA has consulted for Pfizer, Sanofi Pasteur, Janssen, and Medscape, and his institution receives funds to conduct clinical research unrelated to this manuscript from MedImmune, Regeneron, PaxVax, Pfizer, GSK, Merck, Sanofi-Pasteur, Janssen, and Micron. He also serves on a safety monitoring board for Kentucky BioProcessing, Inc. and Sanofi Pasteur. His institution has also received funding from NIH to conduct clinical trials of Moderna and Janssen COVID-19 vaccines. GLD, HPV, KRVH, KM, AL, MAP, LH, SRS, JDR, and WAL report no conflicts of interest.
Références
Hingrat QL, Visseaux B, Laouenan C, et al. Detection of SARS-CoV-2 N-antigen in blood during acute COVID-19 provides a sensitive new marker and new testing alternatives. Clin Microbiol Infect. 2020;27:789.e1–789.e5.
Zhang Y, Ong CM, Yun C, et al. Diagnostic value of nucleocapsid protein in blood for SARS-CoV-2 infection. Clin Chem. 2021;68:240–248.
Ogata AF, Maley AM, Wu C, et al. Ultra-sensitive serial profiling of SARS-CoV-2 antigens and antibodies in plasma to understand disease progression in COVID-19 Patients with severe disease. Clin Chem. 2020;66:1562.
Wang H, Hogan CA, Verghese M, et al. SARS-CoV-2 nucleocapsid plasma antigen for diagnosis and monitoring of COVID-19. Clin Chem. 2021;68:204–213.
Verkerke HP, Damhorst GL, Graciaa DS, et al. Nucleocapsid antigenemia is a marker of acute SARS-CoV-2 infection. J Infect Dis. 2022;226:1577–1587.
Yonker LM, Gilboa T, Ogata AF, et al. Multisystem inflammatory syndrome in children is driven by zonulin-dependent loss of gut mucosal barrier. J Clin Investig. 2021;131:e149633.
Sigal GB, Novak T, Mathew A, et al. Measurement of SARS-CoV-2 antigens in plasma of pediatric patients with acute COVID-19 or MIS-C using an ultrasensitive and quantitative immunoassay. Clin Infect Dis. 2022;75:1351–1358.
CDC. Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19). 2021. Available at: https://emergency.cdc.gov/han/2020/han00432.asp . Accessed December 14, 2021.
World Health Organization. Novel coronavirus COVID-19 therapeutic trial synopsis. WHO R&D Blueprint. 2020:12.
Harris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–381.
Harris PA, Taylor R, Minor BL, et al.; REDCap Consortium. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019;95:103208.
Quanterix. Simoa® SARS CoV‐2 N Protein Advantage Kit HD‐X Data Sheet. Available at: https://www.quanterix.com/wp-content/uploads/2020/12/SARS-CoV-2-N-Protein-Advantage-Data-Sheet-for-HD-X.pdf . Accessed June 2, 2022.
R-PLEX SARS-CoV-2 Spike. Available at: https://www.mesoscale.com/~/media/files/data%20sheets/r-plex%20sars-cov-2%20spike.pdf . Accessed July 18, 2022.
Shane AL, Sato AI, Kao C, et al. A pediatric infectious diseases perspective of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and novel coronavirus disease 2019 (COVID-19) in children. J Pediatric Infect Dis Soc. 2020;9:596–608.
Bogunovic D, Merad M. Children and SARS-CoV-2. Cell Host Microbe. 2021;29:1040–1042.
V’Kovski P, Kratzel A, Steiner S, et al. Coronavirus biology and replication: implications for SARS-CoV-2. Nat Rev Microbiol. 2021;19:155–170.
Chou J, Thomas PG, Randolph AG. Immunology of SARS-CoV-2 infection in children. Nat Immunol. 2022;23:177–185.
Williams PCM, Howard-Jones AR, Hsu P, et al. SARS-CoV-2 in children: spectrum of disease, transmission and immunopathological underpinnings. Pathology. 2020;52:801–808.