Dynamics of Reverse Transcription-Polymerase Chain Reaction and Serologic Test Results in Children with SARS-CoV-2 Infection

• Published in: The Journal of pediatrics Vol. 241; pp. 126 - 132.e3
• Main Authors: Tagarro, Alfredo, Sanz-Santaeufemia, Francisco José, Grasa, Carlos, Cobos, Elena, Yebra, Julia, Alonso-Cadenas, Jose Antonio, Baquero-Artigao, Fernando, Mesa-Guzmán, Juan Miguel, Pérez-Seoane, Beatriz, Calvo, Cristina, Herreros, María Luisa, Epalza, Cristina, Melendo, Susana, Dominguez-Rodriguez, Sara, Vidal, Paula, Pacheco, Mónica, Ballesteros, Alvaro, Bernardino, María, Villanueva-Medina, Sara, Rodríguez-Molino, Paula, Miragaya Castro, Sandra, Rivière, Jacques, Garcés, Rosa, Santiago, Begoña, Fumadó, Victoria, Urretavizcaya-Martínez, María, García-García, María Luz, Penín, María, Cava, Fernando, Sáez, Elena, Iglesias-Bouzas, María Isabel, Herrero, Blanca, Reinoso, Teresa de Jesús, Moraleda, Cinta
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2022
• Subjects: Adolescent; Child; Child, Preschool; children; COVID-19; COVID-19 - diagnosis; COVID-19 - epidemiology; COVID-19 - immunology; COVID-19 Nucleic Acid Testing; COVID-19 Serological Testing; dynamics; Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Kaplan-Meier Estimate; Male; Original; Registries; Reverse Transcriptase Polymerase Chain Reaction; RT-PCR; SARS-CoV-2; Seroconversion; Seroepidemiologic Studies; serology; Spain - epidemiology; Time Factors; Spain; COVID-19; Ct; SARS-CoV-2; dynamics; MIS-C; EPICO-AEP; seroconversion; children; RT-PCR; serology; IgG
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2021.09.029

To determine the time to reverse transcription-polymerase chain reaction (RT-PCR) negativity after the first positive RT-PCR test, factors associated with longer time to RT-PCR negativity, proportion of children seroconverting after proven severe acute respiratory syndrome coronavirus 2 infection, and factors associated with the lack of seroconversion. The Epidemiological Study of Coronavirus in Children of the Spanish Society of Pediatrics is a multicenter study conducted in Spanish children to assess the characteristics of coronavirus disease 2019. In a subset of patients, 3 serial RT-PCR tests on nasopharyngeal swab specimens were performed after the first RT-PCR test, and immunoglobulin G serology for severe acute respiratory syndrome coronavirus 2 antibodies was performed in the acute and follow-up (<14 and ≥14 days after diagnosis) phase. In total, 324 patients were included in the study. The median time to RT-PCR negativity was 17 days (IQR, 8-29 days), and 35% of patients remained positive more than 4 weeks after the first RT-PCR test. The probability of RT-PCR negativity did not differ across groups defined by sex, disease severity, immunosuppressive drugs, or clinical phenotype. Globally, 24% of children failed to seroconvert after infection. Seroconversion was associated with hospitalization, persistence of RT-PCR positivity, and days of fever. Time to RT-PCR negativity was long, regardless of the severity of symptoms or other patient features. This finding should be considered when interpreting RT-PCR results in a child with symptoms, especially those with mild symptoms. Seroprevalence and postimmunization studies should consider that 11 in 4 infected children fail to seroconvert.