Abstract

BackgroundThe seroprevalence of SARS-CoV-2 infection has been studied in immunocompetent children. However, data in the pediatric kidney transplant population (PKT) are lacking.MethodsUsing two commercial immunoassays that measured IgG antibodies against SARS-CoV-2 spike protein and IgG against the nucleocapsid (N) protein, we screened 72 PKT recipients who attended the outpatient clinic for routine blood work. The majority of patients with positive serology underwent an additional serology test at least once during subsequent clinical follow-up. Patients were confirmed to have SARS-CoV-2 infection if they had two positive tests.ResultsEight patients out of the 72 screened (11.1%) had positive results for SARS-CoV-2 IgG antibodies in both serological tests. Of those who tested positive, 4 had positive SARS-CoV-2 PCR results before screening. All patients were asymptomatic or had a history of mild symptoms. All tested patients had persistently positive antibodies at a median follow-up time of 75 days (IQR, 44.5, 86.5 days). One patient had a positive PCR test at 75 days and a positive serology test at 120 days post infection.ConclusionThe seroprevalence of SARS-CoV-2 was relatively high (11.1%) in our population. Although all patients were asymptomatic or mildly symptomatic, they mounted a strong humoral immune response that persisted for a few months despite being on triple immunosuppressants. These findings have positive implications regarding vaccination efficacy in this group.

Highlights

  • The coronavirus disease 2019 (COVID-19) pandemic is considered a public health emergency

  • In the early days of the pandemic, COVID-19 was thought to be more severe among immunocompromised patients

  • Of the 72 pediatric kidney transplant (PKT) patients screened by serological testing for SARS-CoV-2, 12.5% (9 of 72) were found to have positive SARS-CoV2 IgG in at least one test

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Summary

Introduction

The coronavirus disease 2019 (COVID-19) pandemic is considered a public health emergency. The fear of more severe disease has limited kidney transplant surgeries to those that are urgent and has led to the closure of many living transplant programs [3], including ours. This perceived risk in transplant patients is an extrapolation of data from other viruses. There is emerging evidence that immunosuppressed children exhibit mild disease [5,6,7]. This mild disease course could be explained. Data in the pediatric kidney transplant population (PKT) are lacking

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