M. Hippich, Lisa Holthaus, R. Assfalg, J. Zapardiel-Gonzalo, Heidi Kapfelsperger, Martin Heigermoser, F. Haupt, Dominik A Ewald, Tiziana C. Welzhofer, Benjamin A. Marcus, S. Heck, Annika Koelln, Joanna Stock, Franziska Voß, M. Secchi, L. Piemonti, Kathrin de la Rosa, U. Protzer, Merle Boehmer, P. Achenbach, V. Lampasona, E. Bonifacio, A. Ziegler
Med, 2020
Background Antibody responses to virus reflect exposure and potential protection. Methods We developed a highly specific and sensitive approach to measuring antibodies against SARS-CoV-2 for population-scale immune surveillance. Antibody positivity was defined as a dual-positive response against both the receptor binding domain and nucleocapsid proteins of SARS-CoV-2. Antibodies were measured by immuno-precipitation assays in capillary blood from 15,771 children aged 1 to 18 years living in Bavaria, Germany, and participating in a public health type 1 diabetes screening program (Clinicaltrials.gov NCT04039945), in 1,916 dried blood spots from neonates in a Bavarian screening study (Clinicaltrials.gov NCT03316261), and in 75 SARS-CoV-2 positive individuals. Virus positive incidence was obtained from Bavarian health authority data. Findings. Dual-antibody positivity was detected in none of 3887 children in 2019 (100% specificity) and 73 of 75 SARS-CoV-2 positive individuals (97.3% sensitivity). Antibody surveillance in children during 2020 resulted in frequencies of 0.08% in January to March, 0.61% in April, 0.74% in May, 1.13% in June and 0.91% in July. Antibody prevalence from April 2020 was six-fold higher than the incidence of authority-reported cases (156 per 100,000 children), showed marked variation between the seven Bavarian regions (P<0.0001), and was not associated with age or sex. Transmission in children with virus-positive family members was 35%; 47% of positive children were asymptomatic. No association with type 1 diabetes autoimmunity was observed. Antibody frequency in newborns was 0.47%. Conclusion We demonstrate the value of population-based screening programs for pandemic monitoring. Funding. The work was supported by funding from the BMBF (FKZ01KX1818).
Cited by 41 publications.
Field of study: Medicine