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Prevalence of SARS-CoV-2 Infection in Children and Their Parents in Southwest Germany

28 Pages Posted: 30 Aug 2020

See all articles by Burkhard Toenshoff

Burkhard Toenshoff

Heidelberg University - Department of Pediatrics I

Barbara Müller

Heidelberg University - Department of Infectious Diseases

Roland Elling

University of Freiburg - Center for Pediatrics and Adolescent Medicine

Hanna Renk

University of Tuebingen - Children's Hospital

Peter Meissner

affiliation not provided to SSRN

Hartmut Hengel

University of Freiburg - Faculty of Medicine

Sven F. Garbade

Heidelberg University - Dietmar-Hopp Metabolic Center

Meinhard Kieser

affiliation not provided to SSRN

Kathrin Jeltsch

Heidelberg University - Division of Child Neurology and Metabolic Disorders

Jürgen Grulich-Henn

affiliation not provided to SSRN

Julia Euler

affiliation not provided to SSRN

Maximilian Stich

Heidelberg University - Department of Pediatrics I

Kristine Chobanyan-Jürgens

affiliation not provided to SSRN

Maria Zernickel

Ulm University - Department of Pediatrics and Adolescent Medicine

Aleš Janda

Ulm University - Department of Pediatrics and Adolescent Medicine

Lena Wölfe

affiliation not provided to SSRN

Thomas Stamminger

Ulm University - Institute of Virology

Thomas Iftner

University of Tuebingen - Institute for Medical Virology and Epidemiology of Viral Diseases

Tina Ganzenmueller

University of Tuebingen - Institute for Medical Virology and Epidemiology of Viral Diseases

Tessa Görne

affiliation not provided to SSRN

Vibor Laketa

German Center for Infection Research (DZIF)

Sylvia Olberg

affiliation not provided to SSRN

Anna Plasczyczca

affiliation not provided to SSRN

Mirko Cortese

Heidelberg University - Department of Infectious Diseases

Constantin Pape

affiliation not provided to SSRN

Roman Remme

affiliation not provided to SSRN

Daniela Huzly

University of Freiburg - Institute of Virology

Marcus Panning

affiliation not provided to SSRN

Sebastian Weigang

University of Freiburg - Faculty of Medicine

Sebastian Giese

affiliation not provided to SSRN

Kevin Ciminski

affiliation not provided to SSRN

Jakob Ankerhold

affiliation not provided to SSRN

Georg Kochs

University of Freiburg - Faculty of Medicine

Martin Schwemmle

University of Freiburg - Institute of Virology

Rupert Handgretinger

University Children's Hospital Tübingen - General Paediatrics, Oncology/Haematology

Charlotte M. Niemeyer

affiliation not provided to SSRN

Corinna Engel

University of Tuebingen - Center for Pediatric Clinical Studies

Winfried V. Kern

University of Freiburg - Division of Infectious Diseases

Georg Friedrich Hoffmann

Heidelberg University - Division of Child Neurology and Metabolic Disorders

Axel Franz

Center for Doctoral Studies in Business, Graduate School of Economic & Social Sciences, University of Mannheim

Philipp Henneke

University of Freiburg - Center for Pediatrics and Adolescent Medicine

Klaus-Michael Debatin

Ulm University - Department of Pediatrics and Adolescent Medicine

Hans-Georg Kräusslich

Heidelberg University - Department of Infectious Diseases

More...

Abstract

Background: School and day-care closures were enforced as measures to confine the COVID-19 pandemic based on the assumption that young children may play a key role in SARS-CoV-2 spreading. However, infection prevalence in children under 10 years of age is not very well analysed.

Methods: The COVID-19 BaWü study is a large-scale multicentre cross-sectional investigation of children aged 1–10 years and one of their parents, both not diagnosed with COVID-19 before, in southwest Germany. We tested for SARS-CoV-2 RNA from nasopharyngeal swabs by RT-PCR and for SARS-CoV-2 specific IgG antibodies in serum by ELISA and immunofluorescence. Discordant results were clarified by ECLIA, a second ELISA or an in-house Luminex-based assay. We used mixed effects logistic regression to estimate the seroprevalence and to analyse the association between SARS-CoV-2 seropositivity and covariates.

Findings: Between April 22nd and May 15th, 2020, we enrolled 4964 subjects, 2482 children and 2482 corresponding parents. 0•04% tested positive for SARS-CoV-2 RNA. The estimated SARS-CoV-2 seroprevalence was low in parents (1•8%; 95% CI, 1•2–2•4%) and 3-fold lower in children (0•6%; 95% CI, 0•3–1•0%). We observed virus-neutralizing activity for 66 of 70 IgG-positive sera (94•3%).

Interpretation: The spread of SARS-CoV-2 infection during a period of lock-down in southwest Germany was particularly low in children aged 1–10 years. Accordingly, it is unlikely that children have boosted the pandemic. This largest reported SARS-CoV-2 prevalence study focussing on children is instructive for how ad hoc mass testing provides the basis for rational political decision making in a pandemic setting.

Funding: Grant from the Federal State of Baden-Württemberg, Germany

Declaration of Interests: All authors state no conflict of interest.

Ethics Approval Statement: The study protocol was approved by the independent Ethics committees of each centre. The study was conducted according to the Declaration of Helsinki. Written informed consent was obtained from all parents/guardians, with assent from children when appropriate for their age.

Keywords: SARS-CoV-2 infection, prevalence, children, parents, southwest Germany, SARS-CoV-2 specific IgG antibodies, SARS-CoV-2 seroprevalence

Suggested Citation

Toenshoff, Burkhard and Müller, Barbara and Elling, Roland and Renk, Hanna and Meissner, Peter and Hengel, Hartmut and Garbade, Sven F. and Kieser, Meinhard and Jeltsch, Kathrin and Grulich-Henn, Jürgen and Euler, Julia and Stich, Maximilian and Chobanyan-Jürgens, Kristine and Zernickel, Maria and Janda, Aleš and Wölfe, Lena and Stamminger, Thomas and Iftner, Thomas and Ganzenmueller, Tina and Görne, Tessa and Laketa, Vibor and Olberg, Sylvia and Plasczyczca, Anna and Cortese, Mirko and Pape, Constantin and Remme, Roman and Huzly, Daniela and Panning, Marcus and Weigang, Sebastian and Giese, Sebastian and Ciminski, Kevin and Ankerhold, Jakob and Kochs, Georg and Schwemmle, Martin and Handgretinger, Rupert and Niemeyer, Charlotte M. and Engel, Corinna and Kern, Winfried V. and Hoffmann, Georg Friedrich and Franz, Axel and Henneke, Philipp and Debatin, Klaus-Michael and Kräusslich, Hans-Georg, Prevalence of SARS-CoV-2 Infection in Children and Their Parents in Southwest Germany. Available at SSRN: https://ssrn.com/abstract=3668418 or http://dx.doi.org/10.2139/ssrn.3668418

Burkhard Toenshoff (Contact Author)

Heidelberg University - Department of Pediatrics I ( email )

Heidelberg
Germany

Barbara Müller

Heidelberg University - Department of Infectious Diseases ( email )

Germany

Roland Elling

University of Freiburg - Center for Pediatrics and Adolescent Medicine ( email )

Freiburg
Germany

Hanna Renk

University of Tuebingen - Children's Hospital ( email )

Calwer Straße 7
Tübingen, D-72076
Germany

Peter Meissner

affiliation not provided to SSRN

No Address Available

Hartmut Hengel

University of Freiburg - Faculty of Medicine ( email )

Fahnenbergplatz
Freiburg, D-79085
Germany

Sven F. Garbade

Heidelberg University - Dietmar-Hopp Metabolic Center ( email )

Germany

Meinhard Kieser

affiliation not provided to SSRN

No Address Available

Kathrin Jeltsch

Heidelberg University - Division of Child Neurology and Metabolic Disorders ( email )

Heidelberg
Germany

Jürgen Grulich-Henn

affiliation not provided to SSRN

No Address Available

Julia Euler

affiliation not provided to SSRN

No Address Available

Maximilian Stich

Heidelberg University - Department of Pediatrics I ( email )

Heidelberg
Germany

Kristine Chobanyan-Jürgens

affiliation not provided to SSRN

No Address Available

Maria Zernickel

Ulm University - Department of Pediatrics and Adolescent Medicine ( email )

Albert-Einstein-Alee 11
Ulm, D-89081
Germany

Aleš Janda

Ulm University - Department of Pediatrics and Adolescent Medicine ( email )

Albert-Einstein-Alee 11
Ulm, D-89081
Germany

Lena Wölfe

affiliation not provided to SSRN

No Address Available

Thomas Stamminger

Ulm University - Institute of Virology ( email )

Ulm
Germany

Thomas Iftner

University of Tuebingen - Institute for Medical Virology and Epidemiology of Viral Diseases

Tina Ganzenmueller

University of Tuebingen - Institute for Medical Virology and Epidemiology of Viral Diseases ( email )

Tübingen
Germany

Tessa Görne

affiliation not provided to SSRN

No Address Available

Vibor Laketa

German Center for Infection Research (DZIF) ( email )

Inhoffenstraße 7
Braunschweig, 738124
Germany

Sylvia Olberg

affiliation not provided to SSRN

No Address Available

Anna Plasczyczca

affiliation not provided to SSRN

No Address Available

Mirko Cortese

Heidelberg University - Department of Infectious Diseases ( email )

Germany

Constantin Pape

affiliation not provided to SSRN

No Address Available

Roman Remme

affiliation not provided to SSRN

No Address Available

Daniela Huzly

University of Freiburg - Institute of Virology ( email )

Freiburg
Germany

Marcus Panning

affiliation not provided to SSRN

Sebastian Weigang

University of Freiburg - Faculty of Medicine ( email )

Fahnenbergplatz
Freiburg, D-79085
Germany

Sebastian Giese

affiliation not provided to SSRN

No Address Available

Kevin Ciminski

affiliation not provided to SSRN

No Address Available

Jakob Ankerhold

affiliation not provided to SSRN

No Address Available

Georg Kochs

University of Freiburg - Faculty of Medicine ( email )

Fahnenbergplatz
Freiburg, D-79085
Germany

Martin Schwemmle

University of Freiburg - Institute of Virology

Rupert Handgretinger

University Children's Hospital Tübingen - General Paediatrics, Oncology/Haematology

Hoppe-Seyler-Str. 1
Tübingen, 72076
Germany

Charlotte M. Niemeyer

affiliation not provided to SSRN

No Address Available

Corinna Engel

University of Tuebingen - Center for Pediatric Clinical Studies

Tübingen
Germany

Winfried V. Kern

University of Freiburg - Division of Infectious Diseases ( email )

Georg Friedrich Hoffmann

Heidelberg University - Division of Child Neurology and Metabolic Disorders ( email )

Heidelberg
Germany

Axel Franz

Center for Doctoral Studies in Business, Graduate School of Economic & Social Sciences, University of Mannheim ( email )

Schloss
Mannheim, 68131
Germany

Philipp Henneke

University of Freiburg - Center for Pediatrics and Adolescent Medicine ( email )

Freiburg
Germany

Klaus-Michael Debatin

Ulm University - Department of Pediatrics and Adolescent Medicine ( email )

Albert-Einstein-Alee 11
Ulm, D-89081
Germany

Hans-Georg Kräusslich

Heidelberg University - Department of Infectious Diseases ( email )

Germany

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