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Article: False-positive SARS-CoV-2 serology in 3 children with Kawasaki disease

TitleFalse-positive SARS-CoV-2 serology in 3 children with Kawasaki disease
Authors
KeywordsCOVID-19
Kawasaki disease
Serology
Chinese
False positive
Issue Date2020
Citation
Diagnostic Microbiology and Infectious Disease, 2020, v. 98, n. 3, article no. 115141 How to Cite?
AbstractBackground: Kawasaki disease (KD) is an acute febrile and eruptive disease with systemic vasculitis predominantly affecting young East Asian children. Recent reports showed that children with KD-like disease from KD low prevalence regions had positive SARS-CoV-2 serology despite a negative SARS-CoV-2 polymerase chain reaction (PCR) in respiratory samples. Objectives: To describe 3 pediatric Kawasaki Disease patients with false positive SARS-CoV-2 serology. Study design: We retrospectively recruited children with KD diagnosed during the COVID-19 outbreak in Hong Kong. Clinical characteristics and laboratory test results including SARS-CoV-2 PCR results were retrieved. We performed a microparticle-based immunoassay for the detection of IgG against nucleoprotein (NP) and spike protein receptor binding domain (RBD), and a microneutralization assay for the detection of neutralizing antibodies. Results: Three Chinese children with typical KD were identified. They had no epidemiological links with COVID-19 patients and tested negative for SARS-CoV-2 NPA PCR. They were treated with IVIG and aspirin, and were discharged without complications. Subsequently 2 of them were tested positive against anti-RBD and anti-NP antibodies and 1 was tested positive against anti- RBD antibodies. However, microneutralization assay showed that neutralizing antibodies were absent, suggesting a false-positive IgG result. Conclusion: Detection of neutralizing antibodies is recommended to confirm previous SARS-CoV-2 infection in IgG-positive but PCR-negative patients.
Persistent Identifierhttp://hdl.handle.net/10722/285873
ISSN
2023 Impact Factor: 2.1
2023 SCImago Journal Rankings: 0.626
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorTo, KKW-
dc.contributor.authorChua, GT-
dc.contributor.authorKwok, KL-
dc.contributor.authorWong, JSC-
dc.contributor.authorAu, DCY-
dc.contributor.authorLam, YY-
dc.contributor.authorWong, WHS-
dc.contributor.authorHo, MHK-
dc.contributor.authorChan, GCF-
dc.contributor.authorChui, CSL-
dc.contributor.authorLi, X-
dc.contributor.authorTung, KTS-
dc.contributor.authorWong, RS-
dc.contributor.authorTso, WWY-
dc.contributor.authorWong, ICK-
dc.contributor.authorWong, CSM-
dc.contributor.authorFong, CHY-
dc.contributor.authorChan, KH-
dc.contributor.authorYuen, KY-
dc.contributor.authorIp, P-
dc.contributor.authorKwan, MYW-
dc.date.accessioned2020-08-18T04:56:52Z-
dc.date.available2020-08-18T04:56:52Z-
dc.date.issued2020-
dc.identifier.citationDiagnostic Microbiology and Infectious Disease, 2020, v. 98, n. 3, article no. 115141-
dc.identifier.issn0732-8893-
dc.identifier.urihttp://hdl.handle.net/10722/285873-
dc.description.abstractBackground: Kawasaki disease (KD) is an acute febrile and eruptive disease with systemic vasculitis predominantly affecting young East Asian children. Recent reports showed that children with KD-like disease from KD low prevalence regions had positive SARS-CoV-2 serology despite a negative SARS-CoV-2 polymerase chain reaction (PCR) in respiratory samples. Objectives: To describe 3 pediatric Kawasaki Disease patients with false positive SARS-CoV-2 serology. Study design: We retrospectively recruited children with KD diagnosed during the COVID-19 outbreak in Hong Kong. Clinical characteristics and laboratory test results including SARS-CoV-2 PCR results were retrieved. We performed a microparticle-based immunoassay for the detection of IgG against nucleoprotein (NP) and spike protein receptor binding domain (RBD), and a microneutralization assay for the detection of neutralizing antibodies. Results: Three Chinese children with typical KD were identified. They had no epidemiological links with COVID-19 patients and tested negative for SARS-CoV-2 NPA PCR. They were treated with IVIG and aspirin, and were discharged without complications. Subsequently 2 of them were tested positive against anti-RBD and anti-NP antibodies and 1 was tested positive against anti- RBD antibodies. However, microneutralization assay showed that neutralizing antibodies were absent, suggesting a false-positive IgG result. Conclusion: Detection of neutralizing antibodies is recommended to confirm previous SARS-CoV-2 infection in IgG-positive but PCR-negative patients.-
dc.languageeng-
dc.relation.ispartofDiagnostic Microbiology and Infectious Disease-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectCOVID-19-
dc.subjectKawasaki disease-
dc.subjectSerology-
dc.subjectChinese-
dc.subjectFalse positive-
dc.titleFalse-positive SARS-CoV-2 serology in 3 children with Kawasaki disease-
dc.typeArticle-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1016/j.diagmicrobio.2020.115141-
dc.identifier.pmid32795776-
dc.identifier.pmcidPMC7366972-
dc.identifier.scopuseid_2-s2.0-85089244602-
dc.identifier.hkuros316024-
dc.identifier.volume98-
dc.identifier.issue3-
dc.identifier.spagearticle no. 115141-
dc.identifier.epagearticle no. 115141-
dc.identifier.eissn1879-0070-
dc.identifier.isiWOS:000579794400012-
dc.identifier.issnl0732-8893-

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