SARS-CoV-2 acquisition and immune pathogenesis among school-aged learners in four diverse schools

Dan M. Cooper; Michael Z. Zulu; Allen Jankeel; Izabela Coimbra Ibraim; Jessica Ardo; Kirsten Kasper; Diana Stephens; Andria Meyer; Annamarie Stehli; Curt Condon; Mary E. Londoño; Casey M. Schreiber; Nanette V. Lopez; Ricky L. Camplain; Michael Weiss; Charles Golden; Shlomit Radom-Aizik; Bernadette Boden-Albala; Clayton Chau; Ilhem Messaoudi; Erlinda R. Ulloa

doi:10.1038/s41390-021-01660-x

SARS-CoV-2 acquisition and immune pathogenesis among school-aged learners in four diverse schools

Dan M. Cooper, Michael Z. Zulu, Allen Jankeel, Izabela Coimbra Ibraim, Jessica Ardo, Kirsten Kasper, Diana Stephens, Andria Meyer, Annamarie Stehli, Curt Condon, Mary E. Londoño, Casey M. Schreiber, Nanette V. Lopez, Ricky L. Camplain, Michael Weiss, Charles Golden, Shlomit Radom-Aizik, Bernadette Boden-Albala, Clayton Chau, Ilhem MessaoudiErlinda R. Ulloa

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Background: Understanding SARS-CoV-2 infection in children is necessary to reopen schools safely. Methods: We measured SARS-CoV-2 infection in 320 learners [10.5 ± 2.1 (sd); 7–17 y.o.] at four diverse schools with either remote or on-site learning. Schools A and B served low-income Hispanic learners; school C served many special-needs learners, and all provided predominantly remote instruction. School D served middle- and upper-income learners, with predominantly on-site instruction. Testing occurred in the fall (2020), and 6–8 weeks later during the fall-winter surge (notable for a tenfold increase in COVID-19 cases). Immune responses and mitigation fidelity were also measured. Results: We found SARS-CoV-2 infections in 17 learners only during the surge. School A (97% remote learners) had the highest infection (10/70, 14.3%, p < 0.01) and IgG positivity rates (13/66, 19.7%). School D (93% on-site learners) had the lowest infection and IgG positivity rates (1/63, 1.6%). Mitigation compliance [physical distancing (mean 87.4%) and face-covering (91.3%)] was remarkably high at all schools. Documented SARS-CoV-2-infected learners had neutralizing antibodies (94.7%), robust IFN-γ + T cell responses, and reduced monocytes. Conclusions: Schools can implement successful mitigation strategies across a wide range of student diversity. Despite asymptomatic to mild SARS-CoV-2 infection, children generate robust humoral and cellular immune responses. Impact: Successful COVID-19 mitigation was implemented across a diverse range of schools.School-associated SARS-CoV-2 infections reflect regional rates rather than remote or on-site learning.Seropositive school-aged children with asymptomatic to mild SARS-CoV-2 infections generate robust humoral and cellular immunity.

Original language	English
Pages (from-to)	1073-1080
Number of pages	8
Journal	Pediatric Research
Volume	90
Issue number	5
DOIs	https://doi.org/10.1038/s41390-021-01660-x
State	Published - Nov 2021

Bibliographical note

Publisher Copyright:
© 2021, The Author(s).

Funding

NIH NCATS UCI Clinical and Translational Science Award UL1 TR001414; R01AI142841; R21AI143301; Orange County Health Care Agency Research Fund; UCI COVID-19 Research Fund; Support was provided in part by the Robert Wood Johnson Foundation and the National Institute of Allergy and Infectious Diseases, NIH (K08 AI151253-01) to E.R.U.

Funders	Funder number
UCI COVID-19 Research Fund
National Institutes of Health (NIH)	K08 AI151253-01
National Institute of Allergy and Infectious Diseases	R01AI142841, R21AI143301
Robert Wood Johnson Foundation
National Center for Advancing Translational Sciences (NCATS)	UL1TR001414

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health

Access to Document

10.1038/s41390-021-01660-x

Cite this

Cooper, D. M., Zulu, M. Z., Jankeel, A., Ibraim, I. C., Ardo, J., Kasper, K., Stephens, D., Meyer, A., Stehli, A., Condon, C., Londoño, M. E., Schreiber, C. M., Lopez, N. V., Camplain, R. L., Weiss, M., Golden, C., Radom-Aizik, S., Boden-Albala, B., Chau, C., ... Ulloa, E. R. (2021). SARS-CoV-2 acquisition and immune pathogenesis among school-aged learners in four diverse schools. Pediatric Research, 90(5), 1073-1080. https://doi.org/10.1038/s41390-021-01660-x

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title = "SARS-CoV-2 acquisition and immune pathogenesis among school-aged learners in four diverse schools",

abstract = "Background: Understanding SARS-CoV-2 infection in children is necessary to reopen schools safely. Methods: We measured SARS-CoV-2 infection in 320 learners [10.5 ± 2.1 (sd); 7–17 y.o.] at four diverse schools with either remote or on-site learning. Schools A and B served low-income Hispanic learners; school C served many special-needs learners, and all provided predominantly remote instruction. School D served middle- and upper-income learners, with predominantly on-site instruction. Testing occurred in the fall (2020), and 6–8 weeks later during the fall-winter surge (notable for a tenfold increase in COVID-19 cases). Immune responses and mitigation fidelity were also measured. Results: We found SARS-CoV-2 infections in 17 learners only during the surge. School A (97\% remote learners) had the highest infection (10/70, 14.3\%, p < 0.01) and IgG positivity rates (13/66, 19.7\%). School D (93\% on-site learners) had the lowest infection and IgG positivity rates (1/63, 1.6\%). Mitigation compliance [physical distancing (mean 87.4\%) and face-covering (91.3\%)] was remarkably high at all schools. Documented SARS-CoV-2-infected learners had neutralizing antibodies (94.7\%), robust IFN-γ + T cell responses, and reduced monocytes. Conclusions: Schools can implement successful mitigation strategies across a wide range of student diversity. Despite asymptomatic to mild SARS-CoV-2 infection, children generate robust humoral and cellular immune responses. Impact: Successful COVID-19 mitigation was implemented across a diverse range of schools.School-associated SARS-CoV-2 infections reflect regional rates rather than remote or on-site learning.Seropositive school-aged children with asymptomatic to mild SARS-CoV-2 infections generate robust humoral and cellular immunity.",

author = "Cooper, \{Dan M.\} and Zulu, \{Michael Z.\} and Allen Jankeel and Ibraim, \{Izabela Coimbra\} and Jessica Ardo and Kirsten Kasper and Diana Stephens and Andria Meyer and Annamarie Stehli and Curt Condon and Londo{\~n}o, \{Mary E.\} and Schreiber, \{Casey M.\} and Lopez, \{Nanette V.\} and Camplain, \{Ricky L.\} and Michael Weiss and Charles Golden and Shlomit Radom-Aizik and Bernadette Boden-Albala and Clayton Chau and Ilhem Messaoudi and Ulloa, \{Erlinda R.\}",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = nov,

doi = "10.1038/s41390-021-01660-x",

language = "English",

volume = "90",

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Cooper, DM, Zulu, MZ, Jankeel, A, Ibraim, IC, Ardo, J, Kasper, K, Stephens, D, Meyer, A, Stehli, A, Condon, C, Londoño, ME, Schreiber, CM, Lopez, NV, Camplain, RL, Weiss, M, Golden, C, Radom-Aizik, S, Boden-Albala, B, Chau, C, Messaoudi, I & Ulloa, ER 2021, 'SARS-CoV-2 acquisition and immune pathogenesis among school-aged learners in four diverse schools', Pediatric Research, vol. 90, no. 5, pp. 1073-1080. https://doi.org/10.1038/s41390-021-01660-x

TY - JOUR

T1 - SARS-CoV-2 acquisition and immune pathogenesis among school-aged learners in four diverse schools

AU - Cooper, Dan M.

AU - Zulu, Michael Z.

AU - Jankeel, Allen

AU - Ibraim, Izabela Coimbra

AU - Ardo, Jessica

AU - Kasper, Kirsten

AU - Stephens, Diana

AU - Meyer, Andria

AU - Stehli, Annamarie

AU - Condon, Curt

AU - Londoño, Mary E.

AU - Schreiber, Casey M.

AU - Lopez, Nanette V.

AU - Camplain, Ricky L.

AU - Weiss, Michael

AU - Golden, Charles

AU - Radom-Aizik, Shlomit

AU - Boden-Albala, Bernadette

AU - Chau, Clayton

AU - Messaoudi, Ilhem

AU - Ulloa, Erlinda R.

PY - 2021/11

Y1 - 2021/11

N2 - Background: Understanding SARS-CoV-2 infection in children is necessary to reopen schools safely. Methods: We measured SARS-CoV-2 infection in 320 learners [10.5 ± 2.1 (sd); 7–17 y.o.] at four diverse schools with either remote or on-site learning. Schools A and B served low-income Hispanic learners; school C served many special-needs learners, and all provided predominantly remote instruction. School D served middle- and upper-income learners, with predominantly on-site instruction. Testing occurred in the fall (2020), and 6–8 weeks later during the fall-winter surge (notable for a tenfold increase in COVID-19 cases). Immune responses and mitigation fidelity were also measured. Results: We found SARS-CoV-2 infections in 17 learners only during the surge. School A (97% remote learners) had the highest infection (10/70, 14.3%, p < 0.01) and IgG positivity rates (13/66, 19.7%). School D (93% on-site learners) had the lowest infection and IgG positivity rates (1/63, 1.6%). Mitigation compliance [physical distancing (mean 87.4%) and face-covering (91.3%)] was remarkably high at all schools. Documented SARS-CoV-2-infected learners had neutralizing antibodies (94.7%), robust IFN-γ + T cell responses, and reduced monocytes. Conclusions: Schools can implement successful mitigation strategies across a wide range of student diversity. Despite asymptomatic to mild SARS-CoV-2 infection, children generate robust humoral and cellular immune responses. Impact: Successful COVID-19 mitigation was implemented across a diverse range of schools.School-associated SARS-CoV-2 infections reflect regional rates rather than remote or on-site learning.Seropositive school-aged children with asymptomatic to mild SARS-CoV-2 infections generate robust humoral and cellular immunity.

AB - Background: Understanding SARS-CoV-2 infection in children is necessary to reopen schools safely. Methods: We measured SARS-CoV-2 infection in 320 learners [10.5 ± 2.1 (sd); 7–17 y.o.] at four diverse schools with either remote or on-site learning. Schools A and B served low-income Hispanic learners; school C served many special-needs learners, and all provided predominantly remote instruction. School D served middle- and upper-income learners, with predominantly on-site instruction. Testing occurred in the fall (2020), and 6–8 weeks later during the fall-winter surge (notable for a tenfold increase in COVID-19 cases). Immune responses and mitigation fidelity were also measured. Results: We found SARS-CoV-2 infections in 17 learners only during the surge. School A (97% remote learners) had the highest infection (10/70, 14.3%, p < 0.01) and IgG positivity rates (13/66, 19.7%). School D (93% on-site learners) had the lowest infection and IgG positivity rates (1/63, 1.6%). Mitigation compliance [physical distancing (mean 87.4%) and face-covering (91.3%)] was remarkably high at all schools. Documented SARS-CoV-2-infected learners had neutralizing antibodies (94.7%), robust IFN-γ + T cell responses, and reduced monocytes. Conclusions: Schools can implement successful mitigation strategies across a wide range of student diversity. Despite asymptomatic to mild SARS-CoV-2 infection, children generate robust humoral and cellular immune responses. Impact: Successful COVID-19 mitigation was implemented across a diverse range of schools.School-associated SARS-CoV-2 infections reflect regional rates rather than remote or on-site learning.Seropositive school-aged children with asymptomatic to mild SARS-CoV-2 infections generate robust humoral and cellular immunity.

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SARS-CoV-2 acquisition and immune pathogenesis among school-aged learners in four diverse schools

Abstract

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