Evidence map›Paper›PMID 34909787›Full record

ArticlemedRxiv : the preprint server for health sciences2021

Measurement of SARS-CoV-2 antigens in plasma of pediatric patients with acute COVID-19 or MIS-C using an ultrasensitive and quantitative immunoassay.

George B Sigal, Tanya Novak, Anu Mathew, Janet Chou, Yubo Zhang, Navaratnam Manjula, Predeepthi Bathala, Jessica Joe, Nikhil Padmanabhan, Daniel Romero and 20 more

Open access · greenAbstract readPreprint
PubMed Full text at PMC Publisher
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 9 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

30 authors at 17 institutions in 1 country.

George B SigalMeso Scale Diagnostics, LLC., Rockville, MD, USA.
Tanya NovakDepartment of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Department of Anesthesia, Harvard Medical School, Boston, MA, USA.
Anu MathewMeso Scale Diagnostics, LLC., Rockville, MD, USA.
Janet ChouDepartment of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
Yubo ZhangInstitutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, MA, USA.
Navaratnam ManjulaMeso Scale Diagnostics, LLC., Rockville, MD, USA.
Predeepthi BathalaMeso Scale Diagnostics, LLC., Rockville, MD, USA.
Jessica JoeMeso Scale Diagnostics, LLC., Rockville, MD, USA.
Nikhil PadmanabhanMeso Scale Diagnostics, LLC., Rockville, MD, USA.
Daniel RomeroMeso Scale Diagnostics, LLC., Rockville, MD, USA.
Gabriella Allegri-MachadoDepartment of Laboratory Medicine, Boston Children's Hospital, Boston, MA USA.
Jill JoergerDepartment of Laboratory Medicine, Boston Children's Hospital, Boston, MA USA.
Laura L LoftisDivision of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Stephanie P SchwartzDepartment of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, NC, USA.
Tracie C WalkerDepartment of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, NC, USA.
Julie C FitzgeraldDivision of Critical Care, Department of Anesthesiology and Critical Care, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Keiko M TarquinioDivision of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Matt S ZinterDepartment of Pediatrics, Divisions of Critical Care and Bone Marrow Transplantation, University of California, San Francisco, San Francisco, CA, USA.
Jennifer E SchusterDivision of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City MO, USA.
Natasha B HalasaDivision of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
Melissa L CullimoreDepartment of Pediatrics, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
Aline B MadduxDepartment of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.
Mary A StaatDepartment of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Katherine IrbySection of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, AR, USA.
Heidi R FloriDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor, MI, USA.
Bria M CoatesDivision of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
Hillary CrandallDivision of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
Shira J GertzDivision of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ, USA.
Adrienne G RandolphDepartment of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Department of Anesthesia, Harvard Medical School, Boston, MA, USA.
Nira R PollockDepartment of Laboratory Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
Boston Children's Hospital · USMeso Scale Discovery (United States) · USUniversity of North Carolina at Chapel Hill · USArkansas Children's Hospital · USBaylor College of Medicine · USChildren's Hospital Colorado · USChildren's Mercy Hospital · USCincinnati Children's Hospital Medical Center · USEmory University · USNorthwestern University · USSaint Barnabas Medical Center · USUniversity of California, San Francisco · USUniversity of Michigan · USUniversity of Nebraska Medical Center · USUniversity of Pennsylvania · USUniversity of Utah · USVanderbilt University Medical Center · US

Funding

Pediatric septic acute kidney injury: personalizing antibiotic dosing through understanding acute kidney injury risk factors and biomarker profilesK23DK119463 · NIDDK · CHILDREN'S HOSP OF PHILADELPHIA · PI FITZGERALD, JULIE C. HOLLOWS · 2020 to 2024
$810k
NIDDK NIH HHS K23 DK119463
6 · The paper itself

Abstract

backgroundDetection of SARS-CoV-2 antigens in blood has high sensitivity in adults with acute COVID-19, but sensitivity in pediatric patients is unclear. Recent data suggest that persistent SARS-CoV-2 spike antigenemia may contribute to multisystem inflammatory syndrome in children (MIS-C). We quantified SARS-CoV-2 nucleocapsid (N) and spike (S) antigens in blood of pediatric patients with either acute COVID-19 or MIS-C using ultrasensitive immunoassays (Meso Scale Discovery).

methodsPlasma was collected from inpatients (<21 years) enrolled across 15 hospitals in 15 US states. Acute COVID-19 patients (n=36) had a range of disease severity and positive nasopharyngeal SARS-CoV-2 RT-PCR within 24 hours of blood collection. Patients with MIS-C (n=53) met CDC criteria and tested positive for SARS-CoV-2 (RT-PCR or serology). Controls were patients pre-COVID-19 (n=67) or within 24h of negative RT-PCR (n=43).

resultsSpecificities of N and S assays were 95-97% and 100%, respectively. In acute COVID-19 patients, N/S plasma assays had 89%/64% sensitivity, respectively; sensitivity in patients with concurrent nasopharyngeal swab cycle threshold (Ct) ≤ 35 were 93%/63%. Antigen concentrations ranged from 1.28-3,844 pg/mL (N) and 1.65-1,071 pg/mL (S) and correlated with disease severity. In MIS-C, antigens were detected in 3/53 (5.7%) samples (3 N-positive: 1.7, 1.9, 121.1 pg/mL; 1 S-positive: 2.3 pg/mL); the patient with highest N had positive nasopharyngeal RT-PCR (Ct 22.3) concurrent with blood draw.

conclusionsUltrasensitive blood SARS-CoV-2 antigen measurement has high diagnostic yield in children with acute COVID-19. Antigens were undetectable in most MIS-C patients, suggesting that persistent antigenemia is not a common contributor to MIS-C pathogenesis. KEY POINTS: In a U.S. pediatric cohort tested with ultrasensitive immunoassays, SARS-CoV-2 nucleocapsid antigens were detectable in most patients with acute COVID-19, and spike antigens were commonly detectable. Both antigens were undetectable in almost all MIS-C patients.

Identifiers

PMID34909787
PMCPMC8669854
OpenAlexW4200588467

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.