Increasing SARS-CoV-2 seroprevalence among UK pediatric patients on dialysis and kidney transplantation between January 2020 and August 2021

Bamber, Holly N.; Kim, Jon Jin; Reynolds, Ben C.; Afzaal, Javairiya; Lunn, Andrew J.; Tighe, Patrick J.; Irving, William L.; Tarr, Alexander W.

Abstract

Background
Coronavirus disease 2019 (COVID-19) was officially declared a pandemic by the World Health Organisation (WHO) on 11 March 2020, as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread rapidly across the world. We investigated the seroprevalence of anti-SARS-CoV-2 antibodies in pediatric patients on dialysis or kidney transplantation in the UK.

Methods
Excess sera samples were obtained prospectively during outpatient visits or haemodialysis sessions and analysed using a custom immunoassay calibrated with population age-matched healthy controls. Two large pediatric centres contributed samples.

Results
In total, 520 sera from 145 patients (16 peritoneal dialysis, 16 haemodialysis, 113 transplantation) were analysed cross-sectionally from January 2020 until August 2021. No anti-SARS-CoV-2 antibody positive samples were detected in 2020 when lockdown and enhanced social distancing measures were enacted. Thereafter, the proportion of positive samples increased from 5% (January 2021) to 32% (August 2021) following the emergence of the Alpha variant. Taking all patients, 32/145 (22%) were seropositive, including 8/32 (25%) with prior laboratory-confirmed SARS-CoV-2 infection and 12/32 (38%) post-vaccination (one of whom was also infected after vaccination). The remaining 13 (41%) seropositive patients had no known stimulus, representing subclinical cases. Antibody binding signals were comparable across patient ages and dialysis versus transplantation and highest against full-length spike protein versus spike subunit-1 and nucleocapsid protein.

Conclusions
Anti-SARS-CoV-2 seroprevalence was low in 2020 and increased in early 2021. Serological surveillance complements nucleic acid detection and antigen testing to build a greater picture of the epidemiology of COVID-19 and is therefore important to guide public health responses.

Citation

Bamber, H. N., Kim, J. J., Reynolds, B. C., Afzaal, J., Lunn, A. J., Tighe, P. J., …Tarr, A. W. (2023). Increasing SARS-CoV-2 seroprevalence among UK pediatric patients on dialysis and kidney transplantation between January 2020 and August 2021. Pediatric Nephrology, 38, 3745-3755. https://doi.org/10.1007/s00467-023-05983-1

• Journal Article Type: Article
• Acceptance Date: Apr 7, 2023
• Online Publication Date: Jun 1, 2023
• Publication Date: 2023-11
• Deposit Date: Jul 29, 2023
• Publicly Available Date: Aug 1, 2023
• Journal: Pediatric Nephrology
• Print ISSN: 0931-041X
• Electronic ISSN: 1432-198X
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 38
• Pages: 3745-3755
• DOI: https://doi.org/10.1007/s00467-023-05983-1
• Keywords: Antibodies; Dialysis; Kidney replacement therapy; SARS-CoV-2; Seroprevalence
• Public URL: https://nottingham-repository.worktribe.com/output/21378142
• Publisher URL: https://link.springer.com/article/10.1007/s00467-023-05983-1