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Epidemiology
Original research
Assessment of SARS-CoV-2 infection by Reverse transcription-PCR and serology in the Paris area: a cross-sectional study
  1. Robert Cohen1,2,3,4,
  2. Camille Jung2,5,
  3. Naim Ouldali3,
  4. Aurelie Sellam6,
  5. Christophe Batard3,
  6. Fabienne Cahn-Sellem4,
  7. Annie Elbez3,
  8. Alain Wollner3,
  9. Olivier Romain3,
  10. François Corrard3,
  11. Said Aberrane7,
  12. Nathalie Soismier7,
  13. Rita Creidy7,
  14. Mounira Smati-Lafarge7,
  15. Odile Launay8,
  16. Stéphane Béchet3,
  17. Emmanuelle Varon7,
  18. Corinne Levy2,3,4,5
  1. 1Paediatric Department, Centre Hospitalier Intercommunal de Créteil, Creteil, Île-de-France, France
  2. 2Université Paris Est, IMRB-GRC GEMINI, Créteil, France
  3. 3ACTIV, Creteil, France
  4. 4AFPA, Paris, France
  5. 5Centre Hospitalier Intercommunal de Creteil, Creteil, Île-de-France, France
  6. 6Seine Saint Denis, Hôpital Jean Verdier, Bondy, France
  7. 7Microbiology, Centre Hospitalier Intercommunal de Créteil, Creteil, Île-de-France, France
  8. 8Hôpital Cochin, Paris, Île-de-France, France
  1. Correspondence to Dr Corinne Levy; corinne.levy{at}activ-france.fr

Abstract

Background Several studies indicated that children seem to be less frequently infected with SARS-CoV-2 and are potentially less contagious than adults. To examine the spread of SARS-CoV-2, we combined both Reverse transcription-PCR testing and serology in children in the most affected region in France, Paris, during the COVID-19 epidemic.

Methods From 14 April 2020 to 12 May 2020, we conducted a cross-sectional, prospective, multicentre study. Healthy controls and pauci-symptomatic children from birth to age 15 years were enrolled by 27 ambulatory paediatricians. A nasopharyngeal swab was taken for detection of SARS-CoV-2 by Reverse transcription-PCR and a microsample of blood for micromethod serology.

Results Among the 605 children, 322 (53.2%) were asymptomatic and 283 (46.8%) were symptomatic. Reverse transcription-PCR and serology results were positive for 11 (1.8%) and 65 (10.7%) children, respectively, with no significant difference between asymptomatic and pauci-symptomatic children. Only three children were Reverse transcription-PCR-positive without any antibody response detected. The frequency of Reverse transcription-PCR SARS-CoV-2 positivity was significantly higher for children with positive than negative serology results (12.3% vs 0.6%, p<0.001). Contact with a person with confirmed COVID-19 increased the odds of Reverse transcription-PCR positivity (OR 7.8, 95% CI 1.5 to 40.7) and serology positivity (OR 15.1, 95% CI 6.6 to 34.6).

Conclusion In an area heavily affected by COVID-19, after the peak of the first epidemic wave and during the lockdown, the rate of children with Reverse transcription-PCR SARS-CoV-2 positivity was very low (1.8%), but that of serology positivity was higher (10.7%). Most children with positive Reverse transcription-PCR results also had positive serology results.

Trial registration number NCT04318431.

  • epidemiology
  • virology
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjpo-2020-000887

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    Footnotes

    • Contributors RC, CL, NO, CJ, OL and EV designed the study. RC, CL, NO, CJ, OL, AS, CB, AE, FC, FC-S, AW, OR and EV analysed and interpreted the data and drafted the article. SB and CL performed the statistical analysis. EV, SA, NS, RC and MS-L performed the microbiological analysis. All authors revised and approved the manuscript.

    • Funding This work was supported by the French Ministry of Health DGOS PHRC regional IDF 2020 number AOR20095.

    • Competing interests RC, CL and EV received personal fees and non-financial support from Pfizer. RC reports personal fees from Merck, GSK, Sanofi and AstraZeneca outside the submitted work. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

    • Patient consent for publication Not required.

    • Ethics approval The study protocol was approved by an ethics committee (CPP IDF IX no. 08–022). Parents of all infants and children provided written informed consent.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request. Deidentified data available upon reasonable request after signed DTA.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.