Leveraging Serology Testing to Identify Children at Risk for Post-Acute Sequelae of SARS-CoV-2 Infection: An EHR-based Cohort Study from the RECOVER Program
| dc.contributor | National Institutes of Health |
| dc.contributor.author | Mejias, Asuncion |
| dc.contributor.other | St. Jude Children's Research Hospital |
| dc.date.accessioned | 2024-11-18T21:07:17Z |
| dc.description | The impact of post-acute sequelae of SARS-CoV-2 infection (PASC) in children is underrecognized. We developed an EHR-based algorithm across eight pediatric institutions to identify children with COVID-19 based on serology testing from 3/2020 through 4/2022 who had not been identified by PCR. Overall, serology tests were used 100-fold less than PCR. Seroprevalence of IgG anti-nucleocapsid antibodies remained stable, while rates of positive IgG anti-spike antibodies increased in teenagers after COVID-19 vaccine approval. Through data harmonization and after excluding 1,410 serology test results that may have been influenced by vaccines, we identified 2,714 children that were COVID-19 positive exclusively by serology. These patients were frequently tested as inpatients (24% vs. 2%), had chronic conditions more frequently (37% vs 24%), and a MIS-C diagnosis (23% vs. less than 1%) compared with PCR-positive children. Identification of children that could have been paucisymptomatic, not tested, or missed is critical to define the burden of PASC in children. |
| dc.description.abstract | Study using an electronic health record–based algorithm to identify 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 less than 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. |
| dc.identifier.uri | https://pedsnet.org/metadata/handle/20.500.14642/891 |
| dc.publisher | PEDSnet |
| dc.relation.isreferencedby | Mejias A, Schuchard J, Rao S, Bennett TD, Jhaveri R, et al. 2023. "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." _The Journal of Pediatrics_. Volume 257. 113358, ISSN 0022-3476 <br>DOI: [10.1016/j.jpeds.2023.02.005](doi.org/10.1016/j.jpeds.2023.02.005) |
| dc.rights | a CC-BY 4.0 Attribution license. |
| dc.rights.uri | https://creativecommons.org/licenses/by-sa/4.0/ |
| dc.subject | PEDSnet Study |
| dc.subject.mesh | COVID-19 |
| dc.subject.mesh | SARS-CoV-2 |
| dc.subject.mesh | COVID-19 Serological Testing |
| dc.subject.mesh | Coronavirus Infections |
| dc.subject.mesh | Pneumonia, Viral |
| dc.subject.mesh | COVID-19 Testing |
| dc.subject.mesh | Serologic Tests |
| dc.title | Leveraging Serology Testing to Identify Children at Risk for Post-Acute Sequelae of SARS-CoV-2 Infection: An EHR-based Cohort Study from the RECOVER Program |
| dc.title.alternative | A Y1 Q2 RECOVER program deliverable. |
| dspace.entity.type | Study |
| local.admin.note | National Institutes of Health (NIH) Agreement OT2HL161847-01 as part of the Researching COVID to Enhance Recovery (RECOVER) program of research. |
| local.subject.flat | PEDSnet Data Source |
| local.subject.flat | Federally Funded Research |
| project.startDate | 2023 |
| relation.isStudyOfStudy | 4932bc8c-1f72-44ad-aeeb-b7922e38fad3 |
| relation.isStudyOfStudy.latestForDiscovery | 4932bc8c-1f72-44ad-aeeb-b7922e38fad3 |