Pediatric Infection-Induced SARS-CoV-2 Seroprevalence Estimation Using Commercial Laboratory Specimens: How Representative Is It of the General U.S. Pediatric Population?

20 Pages Posted: 4 May 2022

See all articles by Kristie E. N. Clarke

Kristie E. N. Clarke

Centers for Disease Control and Prevention - COVID-19 Response

Yun Kim

ICF

Jeff Jones

Centers for Disease Control and Prevention - COVID-19 Response

Adam Lee

ICF

Yangyang Deng

ICF

Elise Nycz

Government of the United States of America - CDC COVID-19 Response

Ronaldo Iachan

ICF

Adi Gundlapalli

Centers for Disease Control and Prevention - COVID-19 Response

Adam Macneil

Government of the United States of America - Centers for Disease Control and Prevention (CDC)

Aron J. Hall

Government of the United States of America - Centers for Disease Control and Prevention (CDC)

Date Written: April 26, 2022

Abstract

Background and Objectives
Since August 2020, a national U.S. study has estimated infection-induced SARS-CoV-2 seroprevalence. Because this study uses sera collected by commercial laboratories and most children do not require frequent laboratory testing, we investigated the representativeness of U.S. pediatric seroprevalence estimates.

Methods
Repeated, cross-sectional, convenience samples of residual commercial laboratory sera from 52 U.S. jurisdictions were assayed for infection-induced SARS-CoV-2 antibodies monthly from September 2021 to February 2022. Seroprevalence estimates for pediatric specimens associated with ICD-10-CM codes and laboratory orders likely to represent well-child care were compared with estimates for other pediatric specimens, which may include more children with frequent health monitoring needs, by multivariate logistic analyses.

Results
Pediatric SARS-CoV-2 seroprevalence increased substantially over the study period, reaching 68% (95% CI: 63-72%) among children aged 1-4 years, 77% (95% CI: 75-79%) among children aged 5-11 years, and 74% (95% CI: 73-75%) among adolescents aged 12-17 years by February 2022. On multivariate analysis, pediatric patients with well child ICD-10 codes were more likely to test seropositive than other pediatric patients aged 1-17 years (aPR 1.04; 95% CI 1.02-1.07); children aged 9-11 years without hyperlipidemia whose specimen was associated with a standard lipid screening were more likely to test seropositive for infection-induced antibodies than those whose specimen was drawn for another type of test (1.05; 1.02-1.08).

Conclusions
Although differences in SARS-CoV-2 seroprevalence between children obtaining well-child care and other care types were statistically significant, these differences were small. Thus, national seroprevalence study pediatric estimates are likely to approximate infection-induced SARS-CoV-2 seroprevalence in the U.S. pediatric population.

Note:
Funding Information: No external funding sources

Conflict of Interests: None of the authors have any conflicts of interest to disclose.

Ethical Approval: Reviewed by CDC and was conducted consistent with applicable federal law and CDC policy.

Keywords: SARS-CoV-2,COVID-19, seroprevalence, antibody, anti-nucleocapsid

JEL Classification: I18, I10

Suggested Citation

Clarke, Kristie E. N. and Kim, Yun and Jones, Jeff and Lee, Adam and Deng, Yangyang and Nycz, Elise and Iachan, Ronaldo and Gundlapalli, Adi and MacNeil, Adam and Hall, Aron J., Pediatric Infection-Induced SARS-CoV-2 Seroprevalence Estimation Using Commercial Laboratory Specimens: How Representative Is It of the General U.S. Pediatric Population? (April 26, 2022). Available at SSRN: https://ssrn.com/abstract=4092074 or http://dx.doi.org/10.2139/ssrn.4092074

Kristie E. N. Clarke (Contact Author)

Centers for Disease Control and Prevention - COVID-19 Response ( email )

Atlanta, GA
United States

Yun Kim

ICF ( email )

3 Corporate Square
Atlanta, GA
United States

Jeff Jones

Centers for Disease Control and Prevention - COVID-19 Response

Adam Lee

ICF ( email )

3 Corporate Square
Atlanta, GA
United States

Yangyang Deng

ICF ( email )

3 Corporate Square
Atlanta, GA
United States

Elise Nycz

Government of the United States of America - CDC COVID-19 Response ( email )

Atlanta, GA
United States

Ronaldo Iachan

ICF ( email )

3 Corporate Square
Atlanta, GA
United States

Adi Gundlapalli

Centers for Disease Control and Prevention - COVID-19 Response ( email )

Atlanta, GA
United States

Adam MacNeil

Government of the United States of America - Centers for Disease Control and Prevention (CDC) ( email )

Aron J. Hall

Government of the United States of America - Centers for Disease Control and Prevention (CDC) ( email )

Do you have a job opening that you would like to promote on SSRN?

Paper statistics

Downloads
704
Abstract Views
2,899
rank
51,992
PlumX Metrics