Key result
SARS-CoV-2 seroprevalence reaches ~76% in households with pediatric mitochondrial disease despite rare clinical diagnosis.
Why the study?
The impact of the COVID-19 pandemic on medically fragile populations was not well characterized, and viral infection is a major cause of morbidity in children with mitochondrial disease.
Cross-Sectional (n=83)
COVID-19 was highly prevalent but largely undiagnosed in households with children with mitochondrial disease, who appeared to tolerate the infection well.
High undiagnosed SARS-CoV-2 exposure in MtD households warrants continued vigilance; leaves open whether mitigation or host factors explain tolerance, requiring prospective confirmation.
Background The impact of the COVID-19 pandemic on medically fragile populations, who are at higher risk of severe illness and sequelae, has not been well characterized. Viral infection is a major cause of morbidity in children with mitochondrial disease (MtD), and the COVID-19 pandemic represents an opportunity to study this vulnerable population. Methods A convenience sampling cross-sectional serology study was conducted (October 2020 to June 2021) in households (N = 20) containing a child with MtD (N = 22). Samples (N = 83) were collected in the home using a microsampling apparatus and shipped to investigators. Antibodies against SARS-CoV-2 nucleocapsid (IgG), spike protein (IgG, IgM, IgA), and receptor binding domain (IgG, IgM, IgA) were determined by enzyme linked immunosorbent assay. Results While only 4.8% of participants were clinically diagnosed for SARS-CoV-2 infection, 75.9% of study participants were seropositive for SARS-CoV-2 antibodies. Most samples were IgM positive for spike or RBD (70%), indicating that infection was recent. This translated to all 20 families showing evidence of infection in at least one household member. For the children with MtD, 91% had antibodies against SARS-CoV-2 and had not experienced any adverse outcomes at the time of assessment. For children with recent infections (IgM + only), serologic data suggest household members as a source. Conclusions COVID-19 was highly prevalent and undiagnosed in households with a child with MtD through the 2020-2021 winter wave of the pandemic. In this first major wave, children with MtD tolerated SARS-CoV-2 infection well, potentially due to household adherence to CDC recommendations for risk mitigation. Funding This study was funded by the Intramural Research Program of the National Institutes of Health (HG200381-03). Clinical trial number NCT04419870
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Gordon‐Lipkin et al. (2022) conducted a cross-sectional in Mitochondrial disease and COVID-19 (n=83). SARS-CoV-2 exposure was evaluated on SARS-CoV-2 seropositivity. SARS-CoV-2 seropositivity was highly prevalent (75.9%) in households with a child with mitochondrial disease, despite only 4.8% having a clinical diagnosis.
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