Predictors of Severe Acute Respiratory Syndrome Coronavirus 2 Seropositivity Before Coronavirus Disease 2019 Vaccination Among Children 0-4 Years and Their Household Members in the SEARCh Study

Maria Garcia Quesada, Marissa K. Hetrich, Scott Zeger, Jayati Sharma, Yu Bin Na, Vic Veguilla, Ruth A. Karron, Fatimah S. Dawood, Maria D. Knoll, Christine Council-Dibitetto, Tina Ghasri, Amanda Gormley, Milena Gatto, Kristi Herbert, Maria Jordan, Karen Loehr, Jason Morsell, Jennifer Oliva, Jocelyn San Mateo, Elizabeth SchappellKhadija Smith, Kimberli Wanionek, Cathleen Weadon, Paula Williams-Soro, Suzanne Woods

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Estimates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence in young children and risk factors for seropositivity are scarce. Using data from a prospective cohort study of households during the pre-coronavirus disease 2019 (COVID-19) vaccine period, we estimated SARS-CoV-2 seroprevalence by age and evaluated risk factors for SARS-CoV-2 seropositivity. Methods: The SARS-CoV-2 Epidemiology and Response in Children (SEARCh) study enrolled 175 Maryland households (690 participants) with ≥1 child aged 0-4 years during November 2020-March 2021; individuals vaccinated against COVID-19 were ineligible. At enrollment, participants completed questionnaires about sociodemographic and health status and work, school, and daycare attendance. Participants were tested for SARS-CoV-2 antibodies in sera. Logistic regression models with generalized estimating equations (GEE) to account for correlation within households assessed predictors of individual- and household-level SARS-CoV-2 seropositivity. Results: Of 681 (98.7%) participants with enrollment serology results, 55 (8.1%; 95% confidence interval [CI], 6.3%-10.4%) participants from 21 (12.0%) households were seropositive for SARS-CoV-2. Among seropositive participants, fewer children than adults reported being tested for SARS-CoV-2 infection before enrollment (odds ratio [OR] = 0.23; 95% CI,. 06-.73). Seropositivity was similar by age (GEE OR vs 0-4 years: 1.19 for 5-17 years, 1.36 for adults; P =. 16) and was significantly higher among adults working outside the home (GEE adjusted OR = 2.2; 95% CI, 1.1-4.4) but not among children attending daycare or school. Conclusions: Before study enrollment, children and adults in this cohort had similar rates of SARS-CoV-2 infection as measured by serology. An adult household member working outside the home increased a household's odds of SARS-CoV-2 infection, whereas a child attending daycare or school in person did not.

Original languageEnglish (US)
Article numberofac507
JournalOpen Forum Infectious Diseases
Volume9
Issue number10
DOIs
StatePublished - Oct 1 2022

Keywords

  • COVID-19
  • children
  • household transmission
  • risk factors
  • seroprevalence

ASJC Scopus subject areas

  • Infectious Diseases
  • Oncology

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