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., Irving, W. L., & 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