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
Date Written: April 26, 2022
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.
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.
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).
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.
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: Suggested Citation