Undiagnosed COVID-19 in households with a child with mitochondrial disease.
Undiagnosed COVID-19 in households with a child with mitochondrial disease.
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有线粒体疾病儿童的家庭中未确诊的 COVID-19。
DOI：
10.1101/2022.03.21.22272358
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
McGuire,PeterJ
中科院分区：
文献类型：
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作者：
Gordon-Lipkin,ElizaM;Marcum,Christopher;Kruk,Shannon;Thompson,Elizabeth;Kelly,SophieEM;Kalish,Heather;Sadtler,Kaitlyn;McGuire,PeterJ
背景新冠肺炎大流行对医学脆弱人群的影响尚未得到很好的描述，这些人群患严重疾病和后遗症的风险更高。病毒感染是线粒体疾病儿童发病的主要原因，而新冠肺炎大流行为研究这一易感人群提供了机会。方法在有线粒体疾病儿童(N=22)的家庭(N=20)中进行方便抽样的横断面血清学研究。样本(N=83)在家中使用微量采样设备采集并运往调查人员。采用双抗体夹心酶联免疫吸附试验检测SARS-CoV-2核衣壳抗体、刺突蛋白抗体和受体结合区抗体。结果临床诊断为SARS-CoV-2感染者占4.8%，SARS-CoV-2抗体阳性占75.9%。大多数样本对SPEKE或RBD呈IgM阳性(70%)，表明感染是最近发生的。这意味着所有20个家庭都显示出至少有一名家庭成员感染了病毒。对于患有MTD的儿童，91%的儿童有SARS-CoV-2抗体，在评估时没有任何不良后果。对于新近感染的儿童(仅限IgM+)，血清学数据表明家庭成员是来源。结论在2020-2021年冬季大流行期间，在有MTD儿童的家庭中，COVID-19高度流行，未被诊断。在第一波大流行中，患有MTD的儿童对SARS-CoV-2感染的耐受性良好，这可能是因为家庭坚持疾控中心关于降低风险的建议。
BackgroundThe impact of the COVID-19 pandemic on medically fragile populations, who are at higher risk of severe illness and sequelae, has not been well characterized. Viral infection is a major cause of morbidity in children with mitochondrial disease (MtD), and the COVID-19 pandemic represents an opportunity to study this vulnerable population.MethodsA convenience sampling cross-sectional serology study was conducted (October 2020 to June 2021) in households (N = 20) containing a child with MtD (N = 22). Samples (N = 83) were collected in the home using a microsampling apparatus and shipped to investigators. Antibodies against SARS-CoV-2 nucleocapsid (IgG), spike protein (IgG, IgM, IgA), and receptor binding domain (IgG, IgM, IgA) were determined by enzyme linked immunosorbent assay.ResultsWhile only 4.8% of participants were clinically diagnosed for SARS-CoV-2 infection, 75.9% of study participants were seropositive for SARS-CoV-2 antibodies. Most samples were IgM positive for spike or RBD (70%), indicating that infection was recent. This translated to all 20 families showing evidence of infection in at least one household member. For the children with MtD, 91% had antibodies against SARS-CoV-2 and had not experienced any adverse outcomes at the time of assessment. For children with recent infections (IgM+ only), serologic data suggest household members as a source.ConclusionsCOVID-19 was highly prevalent and undiagnosed in households with a child with MtD through the 2020–2021 winter wave of the pandemic. In this first major wave, children with MtD tolerated SARS-CoV-2 infection well, potentially due to household adherence to CDC recommendations for risk mitigation.