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-19, 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-19 in the past, had the COVID-19 vaccine, or both. A positive PCR test means a child currently has COVID-19. 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-19 and didn’t have a positive PCR test or COVID-19 vaccine. If researchers used only PCR tests, they wouldn’t have known these children had COVID-19. Knowing if children had COVID-19 is the first step to know their risk of Long COVID and if symptoms could be related to Long COVID.