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J Med Virol . SARS-CoV-2 nucleocapsid antigen in plasma of children hospitalized for COVID-19 or with incidental detection of SARS-CoV-2 infection

tetano

Editor, Senior Moderator
J Med Virol


. 2024 Jan;96(1):e29358.
doi: 10.1002/jmv.29358. SARS-CoV-2 nucleocapsid antigen in plasma of children hospitalized for COVID-19 or with incidental detection of SARS-CoV-2 infection

Nicolas Capelli[SUP] 1 2 [/SUP], Léa Domitien Payet[SUP] 1 2 [/SUP], Carmen Alcocer Cordellat[SUP] 1 2 [/SUP], Amandine Pisoni[SUP] 1 2 [/SUP], Ilka Engelmann[SUP] 1 2 [/SUP], Philippe Van de Perre[SUP] 1 2 [/SUP], Eric Jeziorski[SUP] 1 3 [/SUP], Edouard Tuaillon[SUP] 1 2 [/SUP]



Affiliations
Abstract

In hospitalized children, SARS-CoV-2 infection can present as either a primary reason for admission (patients admitted for COVID-19) or an incidental finding during follow-up (patients admitted with COVID-19). We conducted a nested case-control study within a cohort of pediatric patients with confirmed SARS-CoV-2 infection, to investigate the concentration of plasma nucleocapsid antigen (N-Ag) in children admitted for COVID-19 or with COVID-19. While reverse transcriptase polymerase chain reaction Ct values in nasopharyngeal swab were similar between the two groups, children admitted for COVID-19 had a higher rate of detectable N-Ag (12/18 (60.7%) versus 6/18 (33.3%), p = 0.0455) and a higher concentration of N-Ag (medians: 19.51 g/mL vs. 1.08 pg/mL, p = 0.0105). In children hospitalized for COVID-19, the youngest had higher concentration of N-Ag (r = -0.74, p = 0.0004). We also observed a lower prevalence of detectable spike antibodies in children hospitalized for COVID-19 compared to those hospitalized for other medical reasons (3/15 [20%] vs. 13/16 [81.25%], respectively, p = < 0.0011), but similar rates of IgG nucleocapsid antibodies (5/14 [35.7%] vs. 6/17 [35.3%], respectively, p = 0.99). Our findings indicate that N-Ag is associated with COVID-19-related hospitalizations in pediatric patients, and less frequently detected in children tested positive for SARS-CoV-2 but hospitalized for another medical reason. Further studies are needed to confirm the value of N-Ag in identifying COVID-19 disease infections in which SARS-CoV-2 is the main pathogen responsible for symptoms.

Keywords: COVID-19; SARS-CoV-2; antigenemia; nucleocapsid; pediatrics; spike.

 
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