Assessment of SARS-CoV-2 infection by Reverse transcription-PCR and serology in the Paris area: a cross-sectional study

Robert Cohen, Camille Jung, Naim Ouldali, Aurelie Sellam, Christophe Batard, Fabienne Cahn-Sellem, Annie Elbez, Alain Wollner, Olivier Romain, François Corrard, Said Aberrane, Nathalie Soismier, Rita Creidy, Mounira Smati-Lafarge, Odile Launay, Stéphane Béchet, Emmanuelle Varon, Corinne Levy, Robert Cohen, Camille Jung, Naim Ouldali, Aurelie Sellam, Christophe Batard, Fabienne Cahn-Sellem, Annie Elbez, Alain Wollner, Olivier Romain, François Corrard, Said Aberrane, Nathalie Soismier, Rita Creidy, Mounira Smati-Lafarge, Odile Launay, Stéphane Béchet, Emmanuelle Varon, Corinne Levy

Abstract

Background: Several studies indicated that children seem to be less frequently infected with SARS-CoV-2 and are potentially less contagious than adults. To examine the spread of SARS-CoV-2, we combined both Reverse transcription-PCR testing and serology in children in the most affected region in France, Paris, during the COVID-19 epidemic.

Methods: From 14 April 2020 to 12 May 2020, we conducted a cross-sectional, prospective, multicentre study. Healthy controls and pauci-symptomatic children from birth to age 15 years were enrolled by 27 ambulatory paediatricians. A nasopharyngeal swab was taken for detection of SARS-CoV-2 by Reverse transcription-PCR and a microsample of blood for micromethod serology.

Results: Among the 605 children, 322 (53.2%) were asymptomatic and 283 (46.8%) were symptomatic. Reverse transcription-PCR and serology results were positive for 11 (1.8%) and 65 (10.7%) children, respectively, with no significant difference between asymptomatic and pauci-symptomatic children. Only three children were Reverse transcription-PCR-positive without any antibody response detected. The frequency of Reverse transcription-PCR SARS-CoV-2 positivity was significantly higher for children with positive than negative serology results (12.3% vs 0.6%, p<0.001). Contact with a person with confirmed COVID-19 increased the odds of Reverse transcription-PCR positivity (OR 7.8, 95% CI 1.5 to 40.7) and serology positivity (OR 15.1, 95% CI 6.6 to 34.6).

Conclusion: In an area heavily affected by COVID-19, after the peak of the first epidemic wave and during the lockdown, the rate of children with Reverse transcription-PCR SARS-CoV-2 positivity was very low (1.8%), but that of serology positivity was higher (10.7%). Most children with positive Reverse transcription-PCR results also had positive serology results.

Trial registration number: NCT04318431.

Keywords: epidemiology; virology.

Conflict of interest statement

Competing interests: RC, CL and EV received personal fees and non-financial support from Pfizer. RC reports personal fees from Merck, GSK, Sanofi and AstraZeneca outside the submitted work. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Number of children enrolled and total hospitalisation during the first COVID-19 epidemic wave in the Paris area.

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