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Seroprevalence and Clinical Characteristics of SARS-CoV-2 Infection in Children with Cystic Fibrosis
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  • Georgene Hergenroeder,
  • Anna Faino,
  • Jonathan Cogen,
  • Alan Genatossio,
  • Sharon McNamara,
  • Michael Pascual,
  • Rafael Hernandez
Georgene Hergenroeder
Seattle Children's Hospital
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Anna Faino
Seattle Children's Research Institute
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Jonathan Cogen
Seattle Children's Hospital
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Alan Genatossio
Seattle Children's Hospital
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Sharon McNamara
Seattle Children's Hospital
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Michael Pascual
Seattle Children's Hospital
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Rafael Hernandez
Seattle Children's Hospital

Corresponding Author:[email protected]

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Abstract

Background: People with cystic fibrosis (PwCF) have chronic lung disease and may be at increased risk of COVID-19-related morbidity and mortality. This study aimed to determine seroprevalence and clinical characteristics of SARS-CoV-2 infection in children with CF, and to assess antibody responses following SARS-CoV-2 infection or vaccination. Methods: Children and adolescents with CF followed at Seattle Children’s Hospital were enrolled between July 20, 2020 and February 28, 2021. SARS-CoV-2 serostatus was determined on enrollment, at 6 and 11 months (+/-2 months) for nucleocapsid and spike IgG. Participants completed intake and weekly surveys inquiring about SARS-CoV-2 exposures, viral/respiratory illnesses, and symptoms. Results: Of 125 PwCF enrolled, 14 (11%) had positive SARS-CoV-2 antibodies consistent with recent or past infection. Seropositive participants were more likely to identify as Hispanic (29% vs 8%, p=0.04) and have pulmonary exacerbations requiring oral antibiotics in the year prior (71% vs 41%, p = 0.04). Five seropositive individuals (35.7%) were asymptomatic, while six (42.9%) reported mild symptoms, primarily cough and nasal congestion. Anti-spike protein IgG levels were approximately 10-fold higher in participants following vaccination compared with participants who had natural infection alone (p < 0.0001) and resembled levels previously reported in the general population. Conclusions: A majority of PwCF have mild or no symptoms of SARS-CoV-2 making it difficult to distinguish from baseline respiratory symptoms. Hispanic PwCF may be disproportionately impacted, consistent with racial and ethnic COVID-19 disparities among the general US population. Vaccination in PwCF generated antibody responses similar to those previously reported in the general population.
21 Mar 2023Submitted to Pediatric Pulmonology
21 Mar 2023Submission Checks Completed
21 Mar 2023Assigned to Editor
21 Mar 2023Review(s) Completed, Editorial Evaluation Pending
24 Mar 2023Reviewer(s) Assigned
21 May 2023Editorial Decision: Accept