Key Points Question Are the quantity and quality of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) different among children, adolescents, and young adults? Findings In this cross-sectional study evaluating 31 426 SARS-CoV-2 antibody tests performed between April 9 and August 31, 2020, immunoglobin G levels were found to vary in different age groups, despite similar seroprevalence in the pediatric and adult patient populations. SARS-CoV-2 immunoglobin G and total antibody levels, neutralizing activity, and avidity exhibited negative correlations with age in patients aged 1 to 24 years. Meaning This analysis revealed distinct antibody responses in different age groups, suggesting that age-targeted strategies for disease screening and management as well as vaccine development may be warranted. This cross-sectional study investigates the association of age with the quantity and quality of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody responses. Importance Accumulating evidence suggests that children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are more likely to manifest mild symptoms and are at a lower risk of developing severe respiratory disease compared with adults. It remains unknown how the immune response in children differs from that of adolescents and adults. Objective To investigate the association of age with the quantity and quality of SARS-CoV-2 antibody responses. Design, Setting, and Participants This cross-sectional study used 31 426 SARS-CoV-2 antibody test results from pediatric and adult patients. Data were collected from a New York City hospital from April 9 to August 31, 2020. The semiquantitative immunoglobin (Ig) G levels were compared between 85 pediatric and 3648 adult patients. Further analysis of SARS-CoV-2 antibody profiles was performed on sera from 126 patients aged 1 to 24 years. Main Outcomes and Measures SARS-CoV-2 antibody positivity rates and IgG levels were evaluated in patients from a wide range of age groups (1-102 years). SARS-CoV-2 IgG level, total antibody (TAb) level, surrogate neutralizing antibody (SNAb) activity, and antibody binding avidity were compared between children (aged 1-10 years), adolescents (aged 11-18 years), and young adults (aged 19-24 years). Results Among 31 426 antibody test results (19 797 [63.0%] female patients), with 1194 pediatric patients (mean [SD] age, 11.0 [5.3] years) and 30 232 adult patients (mean [SD] age, 49.2 [17.1] years), the seroprevalence in the pediatric (197 [16.5%; 95% CI, 14.4%-18.7%]) and adult (5630 [18.6%; 95% CI, 18.2%-19.1%]) patient populations was similar. The SARS-CoV-2 IgG level showed a negative correlation with age in the pediatric population ( r = −0.45, P < .001) and a moderate but positive correlation with age in adults ( r = 0.24, P < .001). Patients aged 19 to 30 years exhibited the lowest IgG levels (eg, aged 25-30 years vs 1-10 years: 99 [44-180] relative fluorescence units [RFU] vs 443 [188-851] RFU). In the subset cohort aged 1 to 24 years, IgG, TAb, SNAb and avidity were negatively correlated with age (eg, IgG: r = −0.51; P < .001). Children exhibited higher median (IQR) IgG levels, TAb levels, and SNAb activity compared with adolescents (eg, IgG levels: 473 [233-656] RFU vs 191 [82-349] RFU; P < .001) and young adults (eg, IgG levels: 473 [233-656] RFU vs 85 [38-150] RFU; P < .001). Adolescents also exhibited higher median (IQR) TAb levels, IgG levels, and SNAb activity than young adults (eg, TAb levels: 961 [290-2074] RFU vs 370 [125-697]; P = .006). In addition, children had higher antibody binding avidity compared with young adults, but the difference was not significant. Conclusions and Relevance The results of this study suggest that SARS-CoV-2 viral specific antibody response profiles are distinct in different age groups. Age-targeted strategies for disease screening and management as well as vaccine development may be warranted.
【초록키워드】 severe acute respiratory syndrome coronavirus 2, neutralizing antibody, SARS-CoV-2, IgG, Vaccine development, coronavirus, immune response, antibody, cross-sectional, pediatric, children, hospital, Antibody Response, Seroprevalence, severe acute respiratory syndrome Coronavirus, New York City, Adults, Neutralizing activity, Cohort, Antibody responses, Antibody binding, cross-sectional study, SARS-CoV-2 antibody, SARS-CoV-2 antibody test, antibody tests, sera, management, Respiratory disease, Patient, Adolescent, age, Antibody test, avidity, group, disease, moderate, patients, SARS-CoV-2 IgG, mild symptoms, association, Evidence, Analysis, acute respiratory syndrome, Pediatric patient, not significant, Mild symptom, 95% CI, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, profile, quantity, positive correlation, SARS-CoV-2 antibody tests, severe respiratory disease, IgG levels, lower risk, measure, SARS-CoV-2 antibody responses, Female patients, participant, negative correlation, finding, patient population, responses, objective, populations, setting, antibody test result, SARS-CoV-2 viral, lowest, relative fluorescence units, SNAb, Result, performed, collected, addition, evaluated, was performed, exhibited, median, correlated, groups, subset, Importance, adolescents and adults, IgG level, IQR, Point, relative fluorescence unit, Relevance, RFU, 【제목키워드】 SARS-CoV-2, response,