{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T01:30:14Z","timestamp":1772155814233,"version":"3.50.1"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T00:00:00Z","timestamp":1611878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"The CHILDS Trust Medical Research Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Children usually present with minimal or no symptoms of COVID-19 infection. Antibody responses to SARS-CoV-2 in children from low- and middle-income countries (LMIC) have not been well described. We describe the prevalence of anti-SARS-CoV-2 antibodies and clinical phenotype of seropositive children admitted to a tertiary children\u2019s hospital in South India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To determine the seropositivity and describe the clinical characteristics of COVID-19 infection amongst hospitalised children, we performed a prospective clinical data collection and blood sampling of children admitted to Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India over 4\u2009months of the COVID-19 pandemic. In seropositive children, we compared antibody titres between children with and without PIMS-TS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 463 children, 91 (19.6%) were seropositive. The median (range) age of seropositive children was 5\u2009years (1\u2009month\u201317\u2009years). Clinical presentation was consistent with Paediatric inflammatory multisystem syndrome associated or related with SARS-CoV-2 infection (PIMS-TS) in 48% (44\/91) of seropositive children. The median (range) antibody titre was 54.8 (11.1\u2013170.9) AU\/ml among all seropositive children. The median antibody titre among the children with PIMS-TS (60.3\u2009AU\/mL) was significantly (p\u2009=\u20090.01) higher when compared to the children without PIMS-TS (54.8\u2009AU\/mL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We describe the antibody responses to SARS-CoV-2 amongst hospitalised children in a LMIC tertiary children\u2019s hospital. Almost half of the seropositive children had PIMS-TS. Antibody levels may be helpful in the diagnosis and disease stratification of PIMS-TS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LAY SUMMARY<\/jats:title>\n                    <jats:p>Children usually present with minimal or no symptoms of COVID-19 infection. However, Multisystem Inflammatory Syndrome in Children (MIS-C) or Paediatric inflammatory multisystem syndrome associated or related with SARS-CoV-2 infection (PIMS-TS) has emerged as a distinctive paediatric illness related to SARS-CoV-2. Recently, antibody testing for SARS-CoV-2 is being used increasingly as a diagnostic test for PIMS-TS. However, data on the antibody responses to SARS-CoV-2 in children are sparse. We, therefore, attempted to identify the seropositivity and describe the clinical spectrum of COVID-19 infection amongst infants and children getting hospitalised in a children\u2019s hospital in south India. Nearly one-fifth of the hospitalised children tested serology positive over 4\u2009months. Antibody levels in children with PIMS-TS were significantly higher in comparison to the other two groups (acute COVID-19 infection and children without PIMS-TS). Results from our study suggest that all children are at risk of COVID-19 infection though they may present with mild illness or no symptoms. We also observed that antibody testing may have a possible role in diagnosis of PIMS-TS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/tropej\/fmab015","type":"journal-article","created":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T01:55:44Z","timestamp":1613613344000},"source":"Crossref","is-referenced-by-count":14,"title":["Correlation of SARS-CoV-2 Serology and Clinical Phenotype Amongst Hospitalised Children in a Tertiary Children\u2019s Hospital in India"],"prefix":"10.1093","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7360-9736","authenticated-orcid":false,"given":"Aishwarya","family":"Venkataraman","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Balasubramanian","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sulochana","family":"Putilibai","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Lakshan Raj","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumanth","family":"Amperayani","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Senthilnathan","sequence":"additional","affiliation":[{"name":"The CHILDS Trust Medical Research Foundation (CTMRF), Chennai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anand","family":"Manoharan","sequence":"additional","affiliation":[{"name":"The CHILDS Trust Medical Research Foundation (CTMRF), Chennai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arokia","family":"Sophi","sequence":"additional","affiliation":[{"name":"Department of Paediatric Nursing, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Amutha","sequence":"additional","affiliation":[{"name":"Department of Paediatric Nursing, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalaimaran","family":"Sadasivam","sequence":"additional","affiliation":[{"name":"Department of Paediatric Intensive Care Unit, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8152-2155","authenticated-orcid":false,"given":"Anu","family":"Goenka","sequence":"additional","affiliation":[{"name":"School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK"},{"name":"Paediatric Immunology & Infectious Diseases, Bristol Royal Hospital for Children, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A V","family":"Ramanan","sequence":"additional","affiliation":[{"name":"Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK"},{"name":"Translational Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,3,9]]},"reference":[{"key":"2021031106502712500_fmab015-B1","doi-asserted-by":"crossref","first-page":"100433","DOI":"10.1016\/j.eclinm.2020.100433","article-title":"COVID-19 in 7780 pediatric patients: a systematic review","volume":"24","author":"Hoang","year":"2020","journal-title":"EClinicalMedicine"},{"key":"2021031106502712500_fmab015-B2","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1111\/apa.15270","article-title":"Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults","volume":"109","author":"Ludvigsson","year":"2020","journal-title":"Acta Paediatr"},{"key":"2021031106502712500_fmab015-B3","first-page":"1","article-title":"Age-specific mortality and immunity patterns of SARS-CoV-2","volume":"2","author":"O\u2019Driscoll","year":"2020","journal-title":"Nature"},{"key":"2021031106502712500_fmab015-B4","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1016\/S0140-6736(20)31094-1","article-title":"Hyperinflammatory shock in children during COVID-19 pandemic","volume":"395","author":"Riphagen","year":"2020","journal-title":"Lancet"},{"key":"2021031106502712500_fmab015-B5","first-page":"1","article-title":"Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2","author":"Whittaker","year":"2020","journal-title":"J Am Med Assoc"},{"key":"2021031106502712500_fmab015-B6","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1056\/NEJMoa2021680","article-title":"Multisystem inflammatory syndrome in U.S. children and adolescents","volume":"383","author":"Feldstein","year":"2020","journal-title":"N Engl J Med"},{"key":"2021031106502712500_fmab015-B7","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1007\/s13312-020-2025-1","article-title":"Epidemiological and clinical profile of pediatric inflammatory multisystem syndrome\u2014temporally associated with SARS-CoV-2 (PIMS-TS) in Indian children","volume":"57","author":"Dhanalakshmi","year":"2020","journal-title":"Indian Pediatr"},{"key":"2021031106502712500_fmab015-B8","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/S0140-6736(20)31304-0","article-title":"Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Geneva, Switzerland (SEROCoV-POP): a population-based study","volume":"396","author":"Stringhini","year":"2020","journal-title":"Lancet"},{"key":"2021031106502712500_fmab015-B9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41467-020-18178-1","article-title":"Serological identification of SARS-CoV-2 infections among children visiting a hospital during the initial Seattle outbreak","volume":"11","author":"Dingens","year":"2020","journal-title":"Nat Commun"},{"key":"2021031106502712500_fmab015-B10","author":"Valentini","year":"2020"},{"key":"2021031106502712500_fmab015-B11","author":"Dietrich","year":"2020"},{"key":"2021031106502712500_fmab015-B12","doi-asserted-by":"crossref","DOI":"10.1136\/archdischild-2020-320558","article-title":"Seroprevalence of SARS-CoV-2 antibodies in children: a prospective multicentre cohort study","author":"Waterfield","year":"2020","journal-title":"Arch Dis Child"},{"key":"2021031106502712500_fmab015-B13","article-title":"Antibody responses to SARS-CoV2 are distinct in children with MIS-C compared to adults with COVID-19","author":"Weisberg","year":"2020","journal-title":"medRxiv"},{"key":"2021031106502712500_fmab015-B14","article-title":"SARS-CoV-2 antibody responses in children with MIS-C and mild and severe COVID-19","author":"Anderson","year":"2020","journal-title":"medRxiv"},{"key":"2021031106502712500_fmab015-B15","doi-asserted-by":"crossref","first-page":"e2020018242","DOI":"10.1542\/peds.2020-018242","article-title":"Quantitative SARS-CoV-2 serology in children with multisystem inflammatory syndrome (MIS-C)","volume":"146","author":"Rostad","year":"2020","journal-title":"Pediatrics"},{"key":"2021031106502712500_fmab015-B16","first-page":"1","article-title":"List of IgG ELISA\/CLIA kits for COVID-19 validated by ICMR identified validation centres","author":"ICMR","year":"2020","journal-title":"Icmr"},{"key":"2021031106502712500_fmab015-B17","author":"Guidance document on appropriate management of suspect or confirmed cases of COVID-19"},{"key":"2021031106502712500_fmab015-B18","author":"RCPCH","year":"2020"},{"key":"2021031106502712500_fmab015-B19","article-title":"COVID-19 antibody seroprevalence in Santa Clara County, California","author":"Bendavid","year":"2020","journal-title":"medRxiv"},{"key":"2021031106502712500_fmab015-B20","article-title":"Estimation of seroprevalence of novel coronavirus disease (COVID-19) using preserved serum at an outpatient setting in Kobe, Japan: a cross-sectional study","author":"Doi","year":"2020","journal-title":"medRxiv"},{"key":"2021031106502712500_fmab015-B21","author":"Greater Chennai Corporation Coronavirus Disease"},{"key":"2021031106502712500_fmab015-B22","author":"Press Information Bureau Government of India"},{"key":"2021031106502712500_fmab015-B23","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1001\/jamapediatrics.2020.4095","article-title":"Prevalence of SARS-CoV-2 infection in children without symptoms of coronavirus disease 2019","volume":"175","author":"Sola","year":"2021","journal-title":"JAMA Pediatr"},{"key":"2021031106502712500_fmab015-B24","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.clinbiochem.2020.08.009","article-title":"High clinical performance and quantitative assessment of antibody kinetics using a dual recognition assay for the detection of SARS-CoV-2 IgM and IgG antibodies","volume":"86","author":"Mairesse","year":"2020","journal-title":"Clin Biochem"}],"container-title":["Journal of Tropical Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/tropej\/article-pdf\/67\/1\/fmab015\/36522914\/fmab015.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/tropej\/article-pdf\/67\/1\/fmab015\/36522914\/fmab015.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T02:53:52Z","timestamp":1615431232000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/tropej\/article\/doi\/10.1093\/tropej\/fmab015\/6163018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,29]]},"references-count":24,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1,29]]}},"URL":"https:\/\/doi.org\/10.1093\/tropej\/fmab015","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2021.01.29.21250660","asserted-by":"object"}]},"ISSN":["0142-6338","1465-3664"],"issn-type":[{"value":"0142-6338","type":"print"},{"value":"1465-3664","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,2,1]]},"published":{"date-parts":[[2021,1,29]]},"article-number":"fmab015"}}