Leveraging serologic testing to identify children at risk for post-acute sequelae of SARS-CoV-2 infection: An electronic health record-based cohort study from the RECOVER Program
Mejias, A; Schuchard, J; Rao, S; et al., The Journal of Pediatrics
Published
June 2023
Journal
The Journal of Pediatrics
Abstract
Using an electronic health record-based algorithm, we identified children with Coronavirus disease 2019 (COVID-19) based exclusively on serologic testing between March 2020 and April 2022. Compared with the 131 537 polymerase chain reaction-positive children, the 2714 serology-positive children were more likely to be inpatients (24% vs 2%), to have a chronic condition (37% vs 24%), and to have a diagnosis of multisystem inflammatory syndrome in children (23% vs <1%). Identification of children who could have been asymptomatic or paucisymptomatic and not tested is critical to define the burden of post-acute sequelae of severe acute respiratory syndrome coronavirus 2 infection in children.
Authors
Asuncion Mejias, Julia Schuchard, Suchitra Rao, Tellen D Bennett, Ravi Jhaveri, Deepika Thacker, L Charles Bailey, Dimitri A Christakis, Nathan M Pajor, Hanieh Razzaghi, Christopher B Forrest, Grace M Lee
Keywords
COVID-19 serology; PEDSnet; anti-N antibodies; anti-S antibodies; chronic COVID-19 syndrome; late sequelae of COVID-19; long COVID; long-haul COVID-19; long-term COVID-19; post-acute COVID-19; post-acute sequelae of COVID-19; post-acute sequelae of SARS-CoV-2 infection; post–COVID-19 syndrome
Short Summary
To find another way to know if children had COVID, researchers compared health records of 2 groups of children: children who only had a positive antibody test and children who had a positive PCR test. A positive antibody test means a child had COVID in the past, had the COVID vaccine, or both. A positive PCR test means a child currently has COVID. Researchers used data from children’s hospitals in the National Pediatric Learning Health System (PEDSnet) network.
Antibody tests found 2,714 children who had COVID and didn’t have a positive PCR test or COVID vaccine. If researchers used only PCR tests, they wouldn’t have known these children had COVID. Knowing if children had COVID is the first step to know their risk of Long COVID and if symptoms could be related to Long COVID.