Seroprevalence of SARS-COV-2 antibodies among school-age children in the Swabi district of Pakistan

OBJECTIVES: To determine the seroprevalence of SARS-CoV-2 antibodies (IgM, IgG) in school-age children and identify the predominant symptoms in seropositive children in the Swabi district of Khyber Pakhtunkhwa, Pakistan. METHODS: This descriptive cross-sectional study was conducted from November 2020 to May 2021. Blood samples from 246 randomly selected children (aged 5-16 years) in Swabi district of Pakistan were analyzed using ELISA. The study focused on the general pediatric population, excluding those over 16 years, with chronic illnesses, or whose parents declined participation. Data was collected through a structured questionnaire. RESULTS: Among 246 participants, 5 (2.03%) individuals tested positive for IgM and 58 (23.6%) for IgG antibodies, totaling 63 (25.6%) participants with both IgM and IgG antibodies. Mean age of seropositive and seronegative children was 11.2 +/- 3.0 and 10.3 +/- 2.98 years respectively (p=0.030). Out of 63 seropositive children, 51 (80.96%) were symptomatic, and 12 (19.04%) were asymptomatic. Common symptoms among seropositive individuals included fever (98.0%, n=50/51), cough (88.02%, n=45/51), sore throat (78.4%, n=40/51), coryza (66.7%, n=34/51), myalgia (60.8%, n=31/51), and loss of smell and taste (49.0%, n=25/51). The mean antibody titer was 20.9 +/- 10.41 IU/ml and 13.35 +/- 5.6 IU/ml for symptomatic and asymptomatic individuals respectively (p=0.013). CONCLUSION: In our study, approximately one fourth of the participants tested positive for SARS-CoV-2 antibodies, predominantly IgG. Females exhibited higher seropositivity than males, with a significant association between seropositivity and exposure to confirmed COVID-19 cases. Symptomatic cases comprised 80.95% of seropositive individuals, with predominant symptoms of fever, cough, and sore throat. Symptomatic individuals had a higher mean antibody titer.