{"doi":"10.1001/jamanetworkopen.2021.4302","title":"Association of Age With SARS-CoV-2 Antibody Response","abstract":"Importance: Accumulating evidence suggests that children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are more likely to manifest mild symptoms and are at a lower risk of developing severe respiratory disease compared with adults. It remains unknown how the immune response in children differs from that of adolescents and adults. Objective: To investigate the association of age with the quantity and quality of SARS-CoV-2 antibody responses. Design, Setting, and Participants: This cross-sectional study used 31 426 SARS-CoV-2 antibody test results from pediatric and adult patients. Data were collected from a New York City hospital from April 9 to August 31, 2020. The semiquantitative immunoglobin (Ig) G levels were compared between 85 pediatric and 3648 adult patients. Further analysis of SARS-CoV-2 antibody profiles was performed on sera from 126 patients aged 1 to 24 years. Main Outcomes and Measures: SARS-CoV-2 antibody positivity rates and IgG levels were evaluated in patients from a wide range of age groups (1-102 years). SARS-CoV-2 IgG level, total antibody (TAb) level, surrogate neutralizing antibody (SNAb) activity, and antibody binding avidity were compared between children (aged 1-10 years), adolescents (aged 11-18 years), and young adults (aged 19-24 years). Results: Among 31 426 antibody test results (19 797 [63.0%] female patients), with 1194 pediatric patients (mean [SD] age, 11.0 [5.3] years) and 30 232 adult patients (mean [SD] age, 49.2 [17.1] years), the seroprevalence in the pediatric (197 [16.5%; 95% CI, 14.4%-18.7%]) and adult (5630 [18.6%; 95% CI, 18.2%-19.1%]) patient populations was similar. The SARS-CoV-2 IgG level showed a negative correlation with age in the pediatric population (r = -0.45, P < .001) and a moderate but positive correlation with age in adults (r = 0.24, P < .001). Patients aged 19 to 30 years exhibited the lowest IgG levels (eg, aged 25-30 years vs 1-10 years: 99 [44-180] relative fluorescence units [RFU] vs 443 [188-851] RFU). In the subset cohort aged 1 to 24 years, IgG, TAb, SNAb and avidity were negatively correlated with age (eg, IgG: r = -0.51; P < .001). Children exhibited higher median (IQR) IgG levels, TAb levels, and SNAb activity compared with adolescents (eg, IgG levels: 473 [233-656] RFU vs 191 [82-349] RFU; P < .001) and young adults (eg, IgG levels: 473 [233-656] RFU vs 85 [38-150] RFU; P < .001). Adolescents also exhibited higher median (IQR) TAb levels, IgG levels, and SNAb activity than young adults (eg, TAb levels: 961 [290-2074] RFU vs 370 [125-697]; P = .006). In addition, children had higher antibody binding avidity compared with young adults, but the difference was not significant. Conclusions and Relevance: The results of this study suggest that SARS-CoV-2 viral specific antibody response profiles are distinct in different age groups. Age-targeted strategies for disease screening and management as well as vaccine development may be warranted.","journal":"JAMA Network Open","year":2021,"id":146114,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":258,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9712,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":537696,"name":"Victoria Costa","orcid":"0000-0003-0859-5291","position":1,"is_corresponding":false},{"id":561970,"name":"Sabrina Racine‐Brzostek","orcid":"0000-0002-6296-6682","position":2,"is_corresponding":false},{"id":620755,"name":"Karen P. Acker","orcid":"0000-0001-6559-5517","position":3,"is_corresponding":false},{"id":561972,"name":"Jim Yee","orcid":"0000-0003-1595-6585","position":4,"is_corresponding":false},{"id":280500,"name":"Zhengming Chen","orcid":"0000-0001-9437-6452","position":5,"is_corresponding":false},{"id":561971,"name":"Mohsen Karbaschi","orcid":"0000-0002-7341-5528","position":6,"is_corresponding":false},{"id":562543,"name":"Robert Zuk","orcid":null,"position":7,"is_corresponding":false},{"id":622288,"name":"Sophie Rand","orcid":null,"position":8,"is_corresponding":false},{"id":622289,"name":"Ashley Sukhu","orcid":null,"position":9,"is_corresponding":false},{"id":249513,"name":"Per Johan Klasse","orcid":"0000-0001-8222-278X","position":10,"is_corresponding":false},{"id":550386,"name":"Melissa M. Cushing","orcid":"0000-0001-8042-1494","position":11,"is_corresponding":false},{"id":308650,"name":"Amy Chadburn","orcid":"0000-0002-9499-8638","position":12,"is_corresponding":false},{"id":561975,"name":"Zhen Zhao","orcid":"0000-0002-9742-5982","position":13,"is_corresponding":false},{"id":561969,"name":"He S. Yang","orcid":"0000-0001-5827-992X","position":0,"is_corresponding":true}],"reference_count":24,"raw_metadata":null,"created_at":"2026-07-18T23:42:18.947086Z","pmid":"33749770","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}