@article{9b3cf55e50004ffcac730b9e64dbc1e2,
title = "Serological identification of SARS-CoV-2 infections among children visiting a hospital during the initial Seattle outbreak",
abstract = "Children are strikingly underrepresented in COVID-19 case counts. In the United States, children represent 22% of the population but only 1.7% of confirmed SARS-CoV-2 cases as of April 2, 2020. One possibility is that symptom-based viral testing is less likely to identify infected children, since they often experience milder disease than adults. Here, to better assess the frequency of pediatric SARS-CoV-2 infection, we serologically screen 1,775 residual samples from Seattle Children{\textquoteright}s Hospital collected from 1,076 children seeking medical care during March and April of 2020. Only one child was seropositive in March, but seven were seropositive in April for a period seroprevalence of ≈1%. Most seropositive children (6/8) were not suspected of having had COVID-19. The sera of seropositive children have neutralizing activity, including one that neutralized at a dilution > 1:18,000. Therefore, an increasing number of children seeking medical care were infected by SARS-CoV-2 during the early Seattle outbreak despite few positive viral tests.",
author = "Dingens, {Adam S.} and Crawford, {Katharine H.D.} and Amanda Adler and Steele, {Sarah L.} and Kirsten Lacombe and Rachel Eguia and Fatima Amanat and Walls, {Alexandra C.} and Wolf, {Caitlin R.} and Michael Murphy and Deleah Pettie and Lauren Carter and Xuan Qin and King, {Neil P.} and David Veesler and Florian Krammer and Dickerson, {Jane A.} and Chu, {Helen Y.} and Englund, {Janet A.} and Bloom, {Jesse D.}",
note = "Funding Information: We are grateful to all study participants for contributing samples. We also thank Abigail Powell, Peter Rupert, and Roland Strong for sharing antigens, Elizabeth Ahearn for laboratory management at Seattle Children{\textquoteright}s Hospital, and Mike Famulare and Alex Greninger for helpful comments on this paper. This work was supported by the NIAID/ NIH (R01AI141707 and R01AI140891 to J.D.B., HHSN272201700059C to D.V., and F30AI149928 to K.H.D.C.), the NIMGS/NIH (R01GM120553 to D.V.), the Bill & Melinda Gates Foundation (OPP1156262 to N.P.K.), a Pew Biomedical Scholars Award (to D.V.), and Burroughs Wellcome Investigators in the Pathogenesis of Infectious Diseases awards (to D.V. and J.D.B.). J.D.B. is an investigator of the Howard Hughes Medical Institute. Work in the Krammer laboratory was partially supported by the NIAID Centers of Excellence for Influenza Research and Surveillance (CEIRS) contract HHSN272201400008C, Collaborative Influenza Vaccine Innovation Centers (CIVIC) contract 75N93019C00051, and philanthropic donations. Publisher Copyright: {\textcopyright} 2020, The Author(s).",
year = "2020",
month = dec,
day = "1",
doi = "10.1038/s41467-020-18178-1",
language = "English",
volume = "11",
journal = "Nature Communications",
issn = "2041-1723",
publisher = "Nature Publishing Group",
number = "1",
}