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Article ; Online: Brief report

John Mark Wiginton / Jessica L. Maksut / Sarah M. Murray / Jura L. Augustinavicius / Meaghan Kall / Valerie Delpech / Stefan D. Baral

Preventive Medicine Reports, Vol 24, Iss , Pp 101580- (2021)

HIV-related healthcare stigma/discrimination and unmet needs among persons living with HIV in England and Wales

2021

Abstract: We characterized the prevalence of, and estimated associations between, (1) HIV-related healthcare stigma/discrimination and (2) unmet social, mental, and chronic condition healthcare needs among persons living with HIV (PLHIV) in England and Wales. We ... ...

Abstract	We characterized the prevalence of, and estimated associations between, (1) HIV-related healthcare stigma/discrimination and (2) unmet social, mental, and chronic condition healthcare needs among persons living with HIV (PLHIV) in England and Wales. We used data from Positive Voices 2017, a national, cross-sectional probability survey of PLHIV in England and Wales, in which N = 3,475 PLHIV provided complete data on demographic characteristics (control variables; age, ethnicity, gender, sexual identity), HIV-related healthcare stigma/discrimination (exposures; treated differently from other patients, care was refused/delayed, worried about being treated differently, avoided seeking needed care, all due to HIV status), and unmet needs (outcomes; unmet peer support, psychological care, management of chronic health conditions, and isolation help needs). Modified Poisson regression models with log links and robust variance estimators were used to produce prevalence ratios and 95% confidence intervals for unadjusted and adjusted associations between demographic characteristics, HIV-related healthcare stigma/discrimination (individual items and total scale score), and unmet needs variables. Two in five participants (40%) endorsed at least one HIV-related healthcare stigma/discrimination item; and 474 (14%), 428 (12%), 459 (13%), and 501 (14%) reported an unmet peer support, psychological care, chronic health condition management, and isolation help need, respectively. Each HIV-related healthcare stigma/discrimination item and the summed scale score were significantly, positively associated with all four unmet needs variables in unadjusted and adjusted models. Trainings for all healthcare workers in HIV-competent, non-stigmatizing care, as well as the development of engagement and delivery approaches for psychosocial care for PLHIV, are needed.
Keywords	Persons living with HIV ; England ; Wales ; HIV-related healthcare stigma/ discrimination ; Healthcare ; Unmet needs ; Medicine ; R
Subject code	360 ; 310
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Household transmission of COVID-19 cases associated with SARS-CoV-2 delta variant (B.1.617.2)

Hester Allen / Amoolya Vusirikala / Joe Flannagan / Katherine A. Twohig / Asad Zaidi / Dimple Chudasama / Theresa Lamagni / Natalie Groves / Charlie Turner / Christopher Rawlinson / Jamie Lopez-Bernal / Ross Harris / Andre Charlett / Gavin Dabrera / Meaghan Kall

The Lancet Regional Health. Europe, Vol 12, Iss , Pp 100252- (2022)

national case-control study

2022

Abstract: Summary: Background: The SARS-CoV-2 Delta variant (B.1.617.2), first detected in India, has rapidly become the dominant variant in England. Early reports suggest this variant has an increased growth rate suggesting increased transmissibility. This study ... ...

Abstract	Summary: Background: The SARS-CoV-2 Delta variant (B.1.617.2), first detected in India, has rapidly become the dominant variant in England. Early reports suggest this variant has an increased growth rate suggesting increased transmissibility. This study indirectly assessed differences in transmissibility between the emergent Delta variant compared to the previously dominant Alpha variant (B.1.1.7). Methods: A matched case-control study was conducted to estimate the odds of household transmission (≥ 2 cases within 14 days) for Delta variant index cases compared with Alpha cases. Cases were derived from national surveillance data (March to June 2021). One-to-two matching was undertaken on geographical location of residence, time period of testing and property type, and a multivariable conditional logistic regression model was used for analysis. Findings: In total 5,976 genomically sequenced index cases in household clusters were matched to 11,952 sporadic index cases (single case within a household). 43.3% (n=2,586) of cases in household clusters were confirmed Delta variant compared to 40.4% (n= 4,824) of sporadic cases. The odds ratio of household transmission was 1.70 among Delta variant cases (95% CI 1.48-1.95, p <0.001) compared to Alpha cases after adjusting for age, sex, ethnicity, index of multiple deprivation (IMD), number of household contacts and vaccination status of index case. Interpretation: We found evidence of increased household transmission of SARS-CoV-2 Delta variant, potentially explaining its success at displacing Alpha variant as the dominant strain in England. With the Delta variant now having been detected in many countries worldwide, the understanding of the transmissibility of this variant is important for informing infection prevention and control policies internationally.
Keywords	COVID-19 ; SARS-CoV-2 ; variant ; Delta,household ; transmission ; England ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Health system capacity to report on indicators fostering integrated people-centred HIV care

Kelly Safreed-Harmon / Jane Anderson / Natasha Azzopardi-Muscat / Antonella d'Arminio Monforte / Meaghan Kall / Teymur Noori / Kholoud Porter / Jeffrey Lazarus

International Journal of Integrated Care, Vol 19, Iss

findings from six European countries

2019 Volume 4

Abstract: Introduction: Effective antiretroviral treatment has greatly increased life expectancy for people living with HIV (PLHIV). However, PLHIV have higher levels of multimorbidity than the general population. Integrated people-centred health services are ... ...

Abstract	Introduction: Effective antiretroviral treatment has greatly increased life expectancy for people living with HIV (PLHIV). However, PLHIV have higher levels of multimorbidity than the general population. Integrated people-centred health services are needed to effectively manage non-AIDS comorbidities and to achieve good health-related quality of life (HRQoL). This study assesses national health system capacity to monitor indicators that are relevant to the changing focus of HIV care. Methods: Through desk research and expert consultation we determined that health-related concerns for PLHIV in Europe include certain non-AIDS comorbidities, HRQoL, discrimination within health systems and unmet psychosocial needs. We created a 56-item English-language survey to assess whether health systems currently report on these issues as part of routine HIV monitoring or whether they have the capacity to do so. One leading HIV expert completed the survey in each of six countries: Estonia, Italy, the Netherlands, Slovenia, Sweden and Turkey. Data collection took place in April–June 2018. We compiled results in Microsoft Excel and performed descriptive analyses. Results: Bone loss, cardiovascular disease, drug dependence, non-AIDS malignancies and renal disease were reported to be the most comprehensively monitored comorbidities (Table 1). Five countries could potentially report on leading causes of death among PLHIV, while two could potentially report on leading causes of hospital admission (data not shown). Respondents from three countries indicated capacity to report on the HRQoL of PLHIV. Two countries could report on the percentage of PLHIV denied health services because of HIV status, while none appeared to have indicators for monitoring psychosocial service provision. Discussion: National HIV monitoring programmes across study countries have greater capacity to report on some non-AIDS comorbidities than others. The conditions that are most widely monitored may be those for which monitoring could be expanded most easily in ...
Keywords	comorbidities ; health systems monitoring ; hiv ; integrated care ; Medicine (General) ; R5-920
Subject code	360
Language	English
Publishing date	2019-08-01T00:00:00Z
Publisher	Ubiquity Press
Document type	Article ; Online
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Article ; Online: Experience of primary care for people with HIV

Tanvi Rai / Jane Bruton / Meaghan Kall / Richard Ma / Erica Pufall / Sophie Day / Valerie Delpech / Helen Ward

BJGP Open, Vol 3, Iss

a mixed-method analysis

2019 Volume 4

Abstract: Background: Advances in treatment have transformed HIV into a long-term condition (LTC), presenting fresh challenges for health services, HIV specialists, and GPs. Aim: To explore the experience of people living with HIV (PLHIV) regarding consulting ... ...

Abstract	Background: Advances in treatment have transformed HIV into a long-term condition (LTC), presenting fresh challenges for health services, HIV specialists, and GPs. Aim: To explore the experience of people living with HIV (PLHIV) regarding consulting their GPs. Design & setting: A mixed-method analysis using data from two sources: a nationally-representative survey of PLHIV and a qualitative study with London-based PLHIV. Method: Univariate logistic regression was used for quantitative data and framework analysis for qualitative data. Results: The survey had 4422 participants; the qualitative study included 52 participants. In both studies, registration with a GP and HIV status disclosure were high. Similar to general population trends, recent GP use was associated with poor self-rated health status, comorbidities, older age, and lower socioeconomic status. Two-thirds reported a good experience with GPs; a lower proportion felt comfortable asking HIV-related questions. Actual or perceived HIV stigma were consistently associated with poor satisfaction. In the interviews, participants with additional LTCs valued sensitive and consistent support from GPs. Some anticipated, and sometimes experienced, problems relating to HIV status, as well as GPs’ limited experience and time to manage their complex needs. Sometimes they took their own initiative to facilitate coordination and communication. For PLHIV, a ‘good’ GP offered continuity and took time to know and accept them without judgment. Conclusion: The authors suggest clarification of roles and provision of relevant support to build the confidence of PLHIV in GPs and primary care staff to care for them. As the PLHIV population ages, there is a strong need to develop trusting patient–GP relationships and HIV-friendly GP practices.
Keywords	hiv ; hiv infections ; chronic disease ; general practice ; empathy ; patient satisfaction ; social stigma ; surveys and questionnaires ; qualitative research ; Medicine (General) ; R5-920
Subject code	360 ; 310
Language	English
Publishing date	2019-12-01T00:00:00Z
Publisher	Royal College of General Practitioners
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Ability to Monitor National Responses to the HIV Epidemic “Beyond Viral Suppression”

Kelly Safreed-Harmon / Meaghan Kall / Jane Anderson / Natasha Azzopardi-Muscat / Georg M. N. Behrens / Antonella d'Arminio Monforte / Udi Davidovich / Teymur Noori / Jeffrey V. Lazarus

Frontiers in Public Health, Vol

Findings From Six European Countries

2020 Volume 8

Abstract: Objective: With more people living with HIV (PLHIV) ageing into their 50s and beyond in settings where antiretroviral therapy is widely available, non-AIDS comorbidities and health-related quality of life (HRQoL) are becoming major challenges. ... ...

Abstract	Objective: With more people living with HIV (PLHIV) ageing into their 50s and beyond in settings where antiretroviral therapy is widely available, non-AIDS comorbidities and health-related quality of life (HRQoL) are becoming major challenges. Information is needed about whether national HIV monitoring programmes have evolved to reflect the changing focus of HIV care.Methods: We created a 56-item English-language survey to assess whether health systems report on common health-related issues for people with HIV including physical and mental health comorbidities, HRQoL, psychosocial needs, and fertility desires. One expert was identified via purposive sampling in each of six countries (Estonia, Italy, the Netherlands, Slovenia, Sweden, and Turkey) and was asked to participate in the survey.Results: Three respondents reported that the current monitoring systems in their countries do not monitor any of four specified aspects of 10 comorbidities including bone loss, cardiovascular disease, and neurocognitive disorders. Two respondents stated that their countries potentially can report on leading causes of hospital admission among PLHIV, and five on leading cases of death. In three countries, respondents reported that there was the ability to report on the HRQoL of PLHIV. In two countries, respondents provided data on the percentage of PLHIV denied health services because of HIV status in the past 12 months.Conclusions: This study identified areas for potential HIV monitoring improvements in six European countries in relation to comorbidities, HRQoL, discrimination within health systems, and other issues associated with the changing nature of the HIV epidemic. It also indicated that some countries either currently monitor or have the ability to monitor some of these issues. There are opportunities for health information systems in European countries to expand the scope of their HIV monitoring in order to support decision-making about how the long-term health-related needs of PLHIV can best be met.
Keywords	comorbidity ; Europe ; health-related quality of life ; HIV ; indicator ; monitoring ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2020-03-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
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Article ; Online: Emergence of the delta variant and risk of SARS-CoV-2 infection in secondary school students and staff

EClinicalMedicine, Vol 45, Iss , Pp 101319- (2022)

Prospective surveillance in 18 schools, England

2022

Abstract: Summary: Background: The role of educational settings in SARS-CoV-2 infection and transmission remains controversial. We investigated SARS-CoV-2 infection, seroprevalence, and seroconversion rates in secondary schools during the 2020/21 academic year, ... ...

Abstract	Summary: Background: The role of educational settings in SARS-CoV-2 infection and transmission remains controversial. We investigated SARS-CoV-2 infection, seroprevalence, and seroconversion rates in secondary schools during the 2020/21 academic year, which included the emergence of the more transmissible alpha and delta variants, in England. Methods: The UK Health Security Agency (UKHSA) initiated prospective surveillance in 18 urban English secondary schools. Participants had nasal swabs for SARS-CoV-2 RT-PCR and blood sampling for SARS-CoV-2 nucleoprotein and spike protein antibodies at the start (Round 1: September-October 2020) and end (Round 2: December 2020) of the autumn term, when schools reopened after national lockdown was imposed in January 2021 (Round 3: March-April 2021), and end of the academic year (Round 4: May-July 2021). Findings: We enrolled 2314 participants (1277 students, 1037 staff; one participant had missing data for PCR testing). In-school testing identified 31 PCR-positive participants (20 students, 11 staff). Another 247 confirmed cases (112 students, 135 staff) were identified after linkage with national surveillance data, giving an overall positivity rate of 12.0% (278/2313; staff: 14.1%, 146/1037 vs students: 10.3%, 132/1276; p = 0.006). Trends were similar to national infection data. Nucleoprotein-antibody seroprevalence increased for students and staff between Rounds 1 and 3 but were similar between Rounds 3 and 4, when the delta variant was the dominant circulating strain. Overall, Nucleoprotein-antibody seroconversion was 18.4% (137/744) in staff and 18.8% (146/778) in students, while Spike-antibody seroconversion was higher in staff (72.8%, 525/721) than students (21.3%, 163/764) because of vaccination. Interpretation: SARS-CoV-2 infection rates in secondary schools remained low when community infection rates were low, even as the delta variant was emerging in England. Funding: This study was funded by the UK Department of Health and Social Care.
Keywords	Education setting ; COVID-19 ; SARS-CoV-2 ; Teenagers ; Antibody testing ; PCR ; Medicine (General) ; R5-920
Subject code	370
Language	English
Publishing date	2022-03-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
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Article ; Online: Quality of life among people living with HIV in England and the Netherlands

Stephanie Popping, MD, PhD / Meaghan Kall, PhD / Brooke E. Nichols, PhD / Evelien Stempher / Lisbeth Versteegh / David. A.M.C. van de Vijver, PhD / Ard van Sighem / M. Versteegh, PhD / Charles Boucher, MD, PhD / Valerie Delpech, PhD / Annelies Verbon, MD, PhD

The Lancet Regional Health. Europe, Vol 8, Iss , Pp 100177- (2021)

a population-based study

2021

Abstract: Background: HIV is now considered a chronic condition, and people living with HIV, when treated, have a similar life expectancy as compared to the general population. Consequently, improving and ensuring a good health-related quality of life (HrQoL) ... ...

Abstract	Background: HIV is now considered a chronic condition, and people living with HIV, when treated, have a similar life expectancy as compared to the general population. Consequently, improving and ensuring a good health-related quality of life (HrQoL) among people living with HIV (people living with HIV) is increasingly important and has risen on the global agenda in recent years. A ‘fourth 90’ as 90% of people with viral load suppression have a good HrQoL should therefore be adopted alongside the other 90-90-90 targets. This study aims to report the progress on HrQoL as the ‘fourth 90’ and compare against the general population in the Netherlands and England. Methods: In the Netherlands, individuals attending the HIV outpatient clinic of a tertiary hospital were asked to complete the EQ-5D-5L from June 2016 until December 2018. In England, individuals attending one of 73 HIV outpatient clinics were randomly sampled to complete the Positive Voices survey, which included the EQ-5D-5L, from January to September 2017. HrQoL scores were combined with demographic data and compared to general population data. Findings: The EQ-5D-5L was filled-out by 895 people living with HIV in the NL and 4,137 in England. HrQoLutility was 0·85 among Dutch and 0·83 among English people living with HIV. This equated to 98% and 94% of the general population HrQoLutility in the Netherlands and England, respectively. Of the EQ-5D domains, anxiety/depression was mostly affected, with one-third in Dutch (35%) and almost half (47%) of English people living with HIV reporting symptoms. This was higher compared to their respective general populations (21% NL and 31% England). Interpretation: Overall, HrQoLutility for people living with HIV was high in both countries and highly comparable to the general populations Nevertheless, there should be an increased focus on anxiety and depression in the people living with HIV population The EQ-5D-5L proved an easy HrQoL measurement tool and identified areas for improvement by social and behavioural ...
Keywords	HIV ; people living with HIV ; quality of life ; elimination goals ; value-based healthcare ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2021-09-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Secondary attack rates in primary and secondary school bubbles following a confirmed case

Annabel A Powell / Georgina Ireland / Frances Baawuah / Joanne Beckmann / Ifeanyichukwu O Okike / Shazaad Ahmad / Joanna Garstang / Andrew J Brent / Bernadette Brent / Felicity Aiano / James Hargreaves / Sinéad M Langan / Punam Mangtani / Patrick Nguipdop-Djomo / Joanna Sturgess / William Oswald / Katherine Halliday / Emma Rourke / Fiona Dawe /

Zahin Amin-Chowdhury / Meaghan Kall / Maria Zambon / John Poh / Samreen Ijaz / Angie Lackenby / Joanna Elli / Kevin E Brown / Sir Ian Diamond / Mary E Ramsay / Shamez N Ladhani

PLoS ONE, Vol 17, Iss 2, p e

Active, prospective national surveillance, November to December 2020, England.

2022 Volume 0262515

Abstract: Background Following the full re-opening of schools in England and emergence of the SARS-CoV-2 Alpha variant, we investigated the risk of SARS-CoV-2 infection in students and staff who were contacts of a confirmed case in a school bubble (school ... ...

Abstract	Background Following the full re-opening of schools in England and emergence of the SARS-CoV-2 Alpha variant, we investigated the risk of SARS-CoV-2 infection in students and staff who were contacts of a confirmed case in a school bubble (school groupings with limited interactions), along with their household members. Methods Primary and secondary school bubbles were recruited into sKIDsBUBBLE after being sent home to self-isolate following a confirmed case of COVID-19 in the bubble. Bubble participants and their household members were sent home-testing kits comprising nasal swabs for RT-PCR testing and whole genome sequencing, and oral fluid swabs for SARS-CoV-2 antibodies. Results During November-December 2020, 14 bubbles were recruited from 7 schools, including 269 bubble contacts (248 students, 21 staff) and 823 household contacts (524 adults, 299 children). The secondary attack rate was 10.0% (6/60) in primary and 3.9% (4/102) in secondary school students, compared to 6.3% (1/16) and 0% (0/1) among staff, respectively. The incidence rate for household contacts of primary school students was 6.6% (12/183) and 3.7% (1/27) for household contacts of primary school staff. In secondary schools, this was 3.5% (11/317) and 0% (0/1), respectively. Household contacts were more likely to test positive if their bubble contact tested positive although there were new infections among household contacts of uninfected bubble contacts. Interpretation Compared to other institutional settings, the overall risk of secondary infection in school bubbles and their household contacts was low. Our findings are important for developing evidence-based infection prevention guidelines for educational settings.
Keywords	Medicine ; R ; Science ; Q
Subject code	370
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: SARS-CoV-2 infection, antibody positivity and seroconversion rates in staff and students following full reopening of secondary schools in England

Shamez N. Ladhani / Georgina Ireland / Frances Baawuah / Joanne Beckmann / Ifeanyichukwu O. Okike / Shazaad Ahmad / Joanna Garstang / Andrew J. Brent / Bernadette Brent / Jemma Walker / Felicity Aiano / Zahin Amin-Chowdhury / Louise Letley / Jessica Flood / Samuel E.I. Jones / Meaghan Kall / Ray Borrow / Ezra Linley / Maria Zambon /

John Poh / Angie Lackenby / Joanna Ellis / Gayatri Amirthalingam / Kevin E. Brown / Mary E. Ramsay

EClinicalMedicine, Vol 37, Iss , Pp 100948- (2021)

A prospective cohort study, September–December 2020

2021

Abstract: Background: Older children have higher SARS-CoV-2 infection rates than younger children. We investigated SARS-CoV-2 infection, seroprevalence and seroconversion rates in staff and students following the full reopening of all secondary schools in England. ...

Abstract	Background: Older children have higher SARS-CoV-2 infection rates than younger children. We investigated SARS-CoV-2 infection, seroprevalence and seroconversion rates in staff and students following the full reopening of all secondary schools in England. Methods: Public Health England (PHE) invited secondary schools in six regions (East and West London, Hertfordshire, Derbyshire, Manchester and Birmingham) to participate in SARS-CoV-2 surveillance during the 2020/21 academic year. Participants had nasal swabs for RT-PCR and blood samples for SARS-CoV-2 antibodies at the beginning (September 2020) and end (December 2020) of the autumn term. Multivariable logistic regression was used to assess independent risk factors for seropositivity and seroconversion. Findings: Eighteen schools in six regions enrolled 2,209 participants, including 1,189 (53.8%) students and 1,020 (46.2%) staff. SARS-CoV-2 infection rates were not significantly different between students and staff in round one (5/948; [0.53%] vs. 2/876 [0.23%]; p = 0.46) or round two (10/948 [1.05%] vs. 7/886 [0.79%]; p = 0.63), and similar to national prevalence. None of four and 7/15 (47%) sequenced strains in rounds 1 and 2 were the highly transmissible SARS-CoV-2 B.1.1.7 variant. In round 1, antibody seropositivity was higher in students than staff (114/893 [12.8%] vs. 79/861 [9.2%]; p = 0.016), but similar in round 2 (117/893 [13.1%] vs.117/872 [13.3%]; p = 0.85), comparable to local community seroprevalence. Between the two rounds, 8.7% (57/652) staff and 6.6% (36/549) students seroconverted (p = 0.16). Interpretation: In secondary schools, SARS-CoV-2 infection, seropositivity and seroconversion rates were similar in staff and students, and comparable to local community rates. Ongoing surveillance will be important for monitoring the impact of new variants in educational settings.
Keywords	Medicine (General) ; R5-920
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
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Article ; Online: Antibody persistence and neutralising activity in primary school students and staff

Georgina Ireland / Anna Jeffery-Smith / Maria Zambon / Katja Hoschler / Ross Harris / John Poh / Frances Baawuah / Joanne Beckmann / Ifeanyichukwu O Okike / Shazaad Ahmad / Joanna Garstang / Andrew J Brent / Bernadette Brent / Felicity Aiano / Zahin Amin-Chowdhury / Louise Letley / Samuel E I Jones / Meaghan Kall / Monika Patel /

Robin Gopal / Ray Borrow / Ezra Linley / Gayatri Amirthalingam / Kevin E Brown / Mary E Ramsay / Shamez N Ladhani

EClinicalMedicine, Vol 41, Iss , Pp 101150- (2021)

Prospective active surveillance, June to December 2020, England

2021

Abstract: Background: Prospective, longitudinal SARS-CoV-2 sero-surveillance in schools across England was initiated after the first national lockdown, allowing comparison of child and adult antibody responses over time. Methods: Prospective active serological ... ...

Abstract	Background: Prospective, longitudinal SARS-CoV-2 sero-surveillance in schools across England was initiated after the first national lockdown, allowing comparison of child and adult antibody responses over time. Methods: Prospective active serological surveillance in 46 primary schools in England tested for SARS-CoV-2 antibodies during June, July and December 2020. Samples were tested for nucleocapsid (N) and receptor binding domain (RBD) antibodies, to estimate antibody persistence at least 6 months after infection, and for the correlation of N, RBD and live virus neutralising activity. Findings: In June 2020, 1,344 staff and 835 students were tested. Overall, 11.5% (95%CI: 9.4–13.9) and 11.3% (95%CI: 9.2–13.6; p = 0.88) of students had nucleoprotein and RBD antibodies, compared to 15.6% (95%CI: 13.7–17.6) and 15.3% (95%CI: 13.4–17.3; p = 0.83) of staff. Live virus neutralising activity was detected in 79.8% (n = 71/89) of nucleocapsid and 85.5% (71/83) of RBD antibody positive children. RBD antibodies correlated more strongly with neutralising antibodies (rs=0.7527; p<0.0001) than nucleocapsid antibodies (rs=0.3698; p<0.0001). A median of 24.4 weeks later, 58.2% (107/184) participants had nucleocapsid antibody seroreversion, compared to 20.9% (33/158) for RBD (p<0.001). Similar seroreversion rates were observed between staff and students for nucleocapsid (p = 0.26) and RBD-antibodies (p = 0.43). Nucleocapsid and RBD antibody quantitative results were significantly lower in staff compared to students (p = 0.028 and <0.0001 respectively) at baseline, but not at 24 weeks (p = 0.16 and p = 0.37, respectively). Interpretation: The immune response in children following SARS-CoV-2 infection was robust and sustained (>6 months) but further work is required to understand the extent to which this protects against reinfection.
Keywords	School ; Antibody ; SARS-CoV-2 ; Medicine (General) ; R5-920
Subject code	370
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
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