COVID-19: U.S. Antibody Test Results / Multiple Sclerosis & Severe Disease / Illness in Children

By Amy Orciari Herman

Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH

Confirmed cases of COVID-19 worldwide passed 10 million this weekend, with over 500,000 deaths, according to counts from Johns Hopkins University. And in the U.S., Health and Human Services secretary Alex Azar warned that "the window is closing for us to take action and get this under control," CNN reports.

Here are some other recent developments on the pandemic:

U.S. antibody test results: An analysis of SARS-CoV-2 antibody test results from nearly 12,000 serum samples suggests that the COVID-19 burden across the U.S. may be more than 10 times greater than currently reported, the CDC says. Researchers tested samples collected as part of routine or sick care (but unrelated to COVID-19) between March 23 and May 3 from six regions: Connecticut, southern Florida, Missouri, the New York City metro region, Utah, and Washington State's Puget Sound region. In New York City, for example, the estimated seroprevalence (adjusted for test sensitivity and specificity) was 6.93% — 12 times higher than the prevalence based on reported cases. In Missouri, the estimated seroprevalence was 2.65% — 24 times higher than the reported prevalence.

Multiple sclerosis & severe disease: Among patients with multiple sclerosis, independent risk factors for more severe COVID-19 illness (that is, hospitalization or worse course) include obesity, older age, and greater pre-COVID disability, a JAMA Neurology study finds. Disease-modifying therapies, on the other hand, were not associated with increased COVID-19 severity. This, the researchers say, "should reinforce the recommendation of not stopping current [disease-modifying therapies] and not delaying treatment initiation in patients who have higher disease inflammatory activity, risk for relapses, or subsequent disability." The findings were based on a French registry of some 350 patients with MS and confirmed or highly likely COVID-19.

Illness in children: A study of roughly 580 European children with confirmed COVID-19 — 62% of whom were inpatient and 8% of whom were in the ICU — offers insight into factors associated with severe disease in the pediatric population. Some 87% did not require respiratory support at any time, while 4% received mechanical ventilation for a median of 7 days. After multivariable adjustment, the following factors were associated with ICU admission: age younger than 1 month, male sex, preexisting comorbidities, and lower respiratory tract symptoms at admission. Four children, all older than age 10 years, died. Writing in The Lancet Child & Adolescent Health, the researchers note that because their cohort mainly included children seen at hospitals, "the study population is likely to primarily represent individuals at the more severe end of the disease spectrum."