NEW: We know children rarely get sick from the coronavirus. A new study shows that they make a less diverse and weaker set of antibodies than adults do, suggesting that they clear the virus much faster. 1/10

nytimes.com/2020/11/05/hea…
Why, you may ask, would weaker and narrower set of antibodies mean less severe infection? It seems counter-intuitive. But in fact, many studies have shown that the most severely infected people have much higher levels of antibodies. 2/10
In other words, a really strong immune response can be a sign that earlier immune defenses did not work, and can signal an immune system that is desperately trying to gain mastery over the virus — and sometimes failing. 3/10
In children, the smaller immune response may be all that’s required to beat the virus because they dispatch it quickly. And why is that? 4/10
One possibility is that they have strong innate immunity—designed to protect them from the many, many new pathogens they’ll encounter. I wrote about a study supporting this theory a few weeks ago. 5/10

nytimes.com/2020/09/25/hea…
Or it may be that they have some pre-existing immunity from common cold coronaviruses. Or possibly both options contribute. Bottomline: kids clear the virus quickly and don’t need to rely on a heavy-duty antibody response. 6/10
One extremely interesting implication of this study: kids predominantly make IgG antibodies to the spike, S and not to the nucleocapsid, N. And yet: the popular antibody tests made by Roche and Abbott detect only N. 7/10
I wrote about this problem with antibody tests once before, but in the context of N antibodies possibly waning faster than S antibodies. 8/10

nytimes.com/2020/07/26/hea…
If it now turns out that the tests don’t pick up antibodies in kids at all, it has huge implications for seroprevalence studies, not to mention at an individual level for a family trying to determine whether their kid has already been exposed 9/10
A caveat from this study: kids of age 3 to 18. Which we as we now know is too wide a range to call “children”. But it’s a good start nonetheless. 10/10

w/ @DonnaFarber3, @deeptabhattacha @MarilaGennaro and @BrodinPetter

nytimes.com/2020/11/05/hea…

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More from @apoorva_nyc

4 Nov
As of Oct 29, there were at least 835K children infected with the corionavirus (61K in that last week alone.)

That represents 11% of total infections, according to the @AmerAcadPeds
@AmerAcadPeds Latino children are 73% of infected children overall. Of the 1,100 kids with MISC, 41% of children are Latinx, 35% are Black. And this is probably undercounted.
@AmerAcadPeds OTOH, lots of stresses on children from the pandemic and from schools being closed.
Read 4 tweets
4 Nov
All right, here goes, with this latest round of papers and preprints. I don't vouch for the quality of any of them and certainly not the preprints, just noting some interesting and intriguing trends and findings.
1. First on the list is this preprint from many days ago that linked election rallies to an increase in Covid-19 hospitalizations, in one case by 15-fold

medrxiv.org/content/10.110…
2. This one's interesting. We know by now that fomites pose low risk of infection, but this suggests that monitoring surfaces can be a good indicator of level of community spread

medrxiv.org/content/10.110…
Read 11 tweets
3 Nov
How are you all holding up? Shall I tweet out a second set of papers? Or are you too stressed to pay attention?
1. This Lancet Global Health Paper is from a while ago, but really sobering. Estimates that 1.7 billion, or 22% of the world, has at least one underlying condition for Covid risk and 349 mil or 4% are at high risk and would be hospitalized if infected

pubmed.ncbi.nlm.nih.gov/32553130/
2. Really interesting preprint that found that seroprevalence in the slums of Mumbai was a whopping 54% compared with 16% in non-slums. But without the deaths you'd expect with that kind of prevalence

medrxiv.org/content/10.110…
Read 10 tweets
3 Nov
I'm going to tweet out a whole bunch of papers I've been looking at so we all have something to read. READY?

1/x
First, this paper in Blood suggests using T cells from recovered patients as therapies for Covid. Like convalescent plasma therapy but T cells instead of antibodies.

ashpublications.org/blood/article/…
And here's a press release for that T cell paper, in case you're interested: eurekalert.org/pub_releases/2…
Read 11 tweets
28 Oct
The perfect antidote to unwarranted fears about declining antibodies: Solid data showing the opposite. Here's news from Ania Wajnberg @florian_krammer et al that antibodies persist for at least five months. 1/x

science.sciencemag.org/content/early/…
@florian_krammer I've written about earlier data from this team, here in May, showing that most people, regardless of sex, age and severity of illness make decent antibodies: 2/x

nytimes.com/2020/05/07/hea…
@florian_krammer Or here in July, when they reported data from 20,000 people showing the antibodies persist for at least 3 months. 3/x

nytimes.com/2020/07/22/hea…
Read 4 tweets
27 Oct
The headlines, all of a sudden, are everywhere. UK study showed antibodies to the coronavirus decline so we're all doomed. No immunity, no vaccines, no herd immunity.

People, we have enough real things to worry about. Do not worry about this. 1/x

nytimes.com/2020/10/27/hea…
First of all, antibody levels are *supposed* to drop after the infection clears. Imagine if they didn't: Your blood would be a sludge of every type of antibody to every pathogen you've ever encountered. Hence my surprise yesterday at this paper 2/x

In the British study, in 27% of people who were positive at first, they dropped below detection limit. But the test has 84% sensitivity, and we know not everyone makes really high levels of antibodies after coronavirus infection (although nearly everyone makes some) 3/x
Read 9 tweets

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