BREAKING! COVID-19 Pediatrics: Study Shows That Kids Can Have The SARS-Cov-2 Coronavirus And The Antibodies Simultaneously
: Researchers from the Children’s National Hospital in Washington DC in a new study on the kinetics of viral clearance and antibody production across age groups in SARS-CoV-2 infected children found that the virus and the corresponding antibodies can co-exists simultaneously raisng lots of questions and possible implications.
The study is available on a preprint format and has already been peer-reviewed and was meant to be published in the Journal of Pediatrics today but as of publication time of this article, the unproductive staff at the journal have yet to put in online. The preprint version however is available on the link below. https://www.medrxiv.org/content/10.1101/2020.08.06.20162446v1
As a result of so much uncertainties around how children spread COVID-19, the study team from Children's National Hospital set out to improve the understanding of how long it takes pediatric patients with the virus to clear it from their systems, and at what point they start to make antibodies that work against the coronavirus.
Lead author of the study Dr Burak Bahar, M.D., and director of Laboratory Informatics at Children's National told Thailand Medical News, "With most viruses, when you start to detect antibodies, you will not be able to detect the virus anymore. But with COVID-19, we're seeing both. This means children still have the potential to transmit the virus even if antibodies are detected
Dr Bahar further added that the next phase of research will be to test if the SARS-CoV-2 coronavirus that is present alongside the antibodies can be transmitted to other individuals. It also remains unknown if antibodies correlate with immunity, and how long antibodies and potential protection from reinfection last.
This research also assessed the timing of viral clearance and immunologic response.
The study findings showed that the median time from viral positivity to negativity, when the virus can no longer be detected, was 25 days. The median time to seropositivity, or the presence of antibodies in the blood, was 18 days, while the median time to reach adequate levels of neutralizing antibodies was 36 days.
It should be noted that neutralizing antibodies are important in potentially protecting a person from re-infection of the same virus.
The research utilized a retrospective analysis of 6,369 children tested for SARS-CoV-2, the virus that causes COVID-19, and 215 patients who underwent antibody testing at Children's National between March 13, 2020, and June 21, 2020.
From out of the 215 patients, 33 had co-testing for both the virus and antibodies during their disease course. Nine of the 33 showed presence of antibodies in their blood while also later testing positive for the virus.
Importantly, the study team found patients 6 through 15 years old took a longer time to clear the virus (median of 32 days) compared to patients 16 through 22 years old (median of 18 days). Females in the 6-15 age group also took longer to clear the virus than males (median of 44 days for females compared to median
of 25.5 days for males).
Even though there is emerging data regarding this timing in adults with COVID-19, there is far less data when it comes to the pediatric population.
The study also demonstrated that IgG class antibodies directed against S1 and S2 glycoproteins could be detected in blood samples of children before viral clearance. Previous studies revealed that antibodies bound to the RBD epitope of SARS-CoV-2’s S1 glycoprotein are able to disrupt the virus-ACE2 interaction, thus blocking viral entry into human cells and enabling neutralizing capacity to the antibodies. While the RBD is located on the S1 subunit, the S2 subunit plays a crucial role in membrane fusion of the virus by conformation changes. It was previously hypothesized for SARS-CoV that multiple antibodies targeting different epitopes might act synergistically.
The study findings being gathered by Children's National researchers and scientists around the world are critical to helping understand the unique impact on children and their role in viral transmission.
Dr Bahar added, "The takeaway here is that we can't let our guard down just because a child has antibodies or is no longer showing symptoms. The continued role of good hygiene and social distancing remains critical."
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