J Korean Med Sci.  2022 Nov;37(44):e314. 10.3346/jkms.2022.37.e314.

The Seroprevalence of SARS-CoV-2 in Children During Early COVID-19 Pandemic in Korea: A Nationwide, Population-Based Study

Affiliations
  • 1Department of Pediatrics, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Korea
  • 2Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea
  • 3Department of Diagnostic Immunology, Seegene Medical Foundation, Seoul, Korea
  • 4Department of Pediatrics, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea

Abstract

Background
Coronavirus disease 2019 (COVID-19) is often asymptomatic and associated with mild clinical symptoms in children. Social distancing measures have led to a relatively small number of confirmed COVID-19 cases in Korea than in other countries in the earlier pandemic phase. Previous seroprevalence studies in Korean adults before the introduction of COVID-19 vaccination campaign have shown a low antibody positivity rate. However, data on COVID-19 seroprevalence in Korean children remained scarce. In this study, we assessed the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children in Korea.
Methods
Between December 2020 and March 2021, stratified serum samples were collected from children aged 0–18 years in 17 different regions across the country. The SARS-CoV-2 antibody test was conducted using an electro-chemiluminescence immunoassay (ECLIA) to detect the antibodies against nucleocapsid antigens of SARS-CoV-2. Samples that tested positive using the ECLIA were reflexed to an additional plaque reduction neutralization test (PRNT) for SARS-CoV-2.
Results
A total of 1,887 samples were collected. Excluding 21 samples collected from regional medical centers, 1,866 samples were included in the final analysis. Two samples (0.11%) were positive for the antibodies against nucleocapsid antigens of SARS-CoV-2. Both samples were shown to have neutralizing antibodies for SARS-CoV-2 via PRNT.
Conclusion
After 1 year since the start of COVID-19 pandemic, the seroprevalence of SARSCoV-2 among Korean children was 0.11%, which was lower than the adults (0.52%) in another study conducted during a similar period. In the early stages of the COVID-19 pandemic, the seroprevalence of SARS-CoV-2 in Korea was lower than those of other countries, which was presumed to be the consequence of a very strong social distancing measures.

Keyword

SARS-CoV-2; COVID-19 Antibodies; Seroprevalence; Child

Figure

  • Fig. 1 Number of daily confirmed cases of COVID-19 as of March 31, 2021. Study samples were collected from December 24, 2020, to March 31, 2021.COVID-19 = coronavirus disease 2019.

  • Fig. 2 Regional and age distribution of study participants. (A) Map of cities and province with number of samples collected. (B) Number of samples stratified by participant age.


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