Shamez Ladhani Profile picture
Jul 31, 2021 8 tweets 4 min read Read on X
1/ Our preprint on #SARSCoV2 infection & transmission in secondary schools following the emergence of the Alpha variant in England is now online

We took multiple blood samples from ~2,000 students/staff for #SARSCoV2 antibodies. Here’s what we found 🧵

👉medrxiv.org/content/10.110…
2/ In England, #Covid19 cases due to the Alpha variant increased rapidly from late Nov 2020, leading to national lockdown in Dec 2020, including school closures. When schools reopened fully in Mar 2021, we took blood samples from 1,895 students & staff in our sKIDsPLUS study
3/ Between December 2020 & March 2021, 5.6% (61/1094) students & 4.4% (35/792) staff had laboratory-confirmed SARS-CoV-2 infection.

Most of these infections were acquired during community peaks in infections rates in December 2020, with a trickle of cases throughout lockdown
4/ Over the same period (median 16 weeks, ~4 mths), 15% (97/656) of students & 10% (59/590) of staff seroconverted (antibody -ve ➡️+ve; captures asymptomatic infections too)

👉 there were 2-3 times as many students/staff with antibody evidence of infection vs PCR-testing alone
5/ The proportion with evidence of previous infection (Nucleoprotein (N) antibody positive) in March 2021 was 36% (370/1018) in students & 32% (245/769) in staff, but was as high as 50% in some London schools
6/ The proportion with spike protein (S) antibodies (due to infection and/or vaccine) was 40% (402/1018) is students & 60% (459/769) in staff, similar to regional community seroprevalence. Staff had higher proportion with Spike protein antibody because of vaccination
7/ For the unbelievers of #SARSCoV2 antibodies as a marker of infection, we used multiple antibody testing platforms & showed that the Roche N and S assays were the most reliable, while the Abbott N assay had uncharacteristically high antibody decay rates over time (assay effect)
8/ To conclude:

By March 2021, 1 in 3 students in urban secondary schools had serological evidence of #SARSCoV2 infection (up to 50% in London)

👉antibody rates likely higher now after Delta variant

👉these findings are important when considering vaccination of teenagers

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More from @ShamezLadhani

Jan 30, 2023
1/ Remember all the media coverage of #omicron causing so much severe #COVID19 in young kids?

We extended our @UKHSA #COVID19 deaths surveillance in kids & found:

ONE #COVID19 fatality per MILLION #Omicron infections in children aged <20 yrs …🧵

👉 sciencedirect.com/science/articl…
2/ We assessed all fatalities within 30 days of a positive #SARSCoV2 test in <20 year-olds during Jan-Mar 2022 when national testing was still available. We collected detailed clinical data from multiple sources to ascertain cause of death for each child
3/ During Jan-Mar 2022, there were 46 deaths within 30 days of a positive #SARSCoV2 test & 11 were due to COVID-19

👉All 11 #COVID19 deaths occurred after primary SARS-CoV-2 infection

👉 8/11 (73%) had underlying comorbidities, including 4 with severe neurodisabilities Image
Read 9 tweets
Dec 30, 2022
1/ This is so mportant - thank you @kerpen for tagging me

The US with all its mitigations, vaccine & booster mandates has the same proportion of kids already exposed to #sarscov2 as the UK, which as been accused of “letting the virus rip”

90.3% (US) vs 86.7% (UK)

…🧵
2/ In England, among 1-17 year-olds, we recently reported that by Sep 2022

➡️ 86.2% (95%CrL 81.1-91.6) had infection-induced #SARSCoV2 N antibodies

➡️ 97.2% (95% CrI 93.7%–98.9%) had #SARSCoV2 S-antibodies (infection and/or vaccine)

👉 journalofinfection.com/article/S0163-…
3/ According to US CDC, #SARSCoV2 antibody seroprevalence in 6m-17y by Sep-Oct 2022 was no different:

➡️ 90.3% (95%CI 89.8-90.8) had infection-induced N antibodies

➡️ 95.9% (95%CI 95.5-96.3) had S-antibodies (infection and/or vaccine)

👉 covid.cdc.gov/covid-data-tra…
Read 5 tweets
Dec 28, 2022
1/ Our @UKHSA paper on paediatric #SARSCoV2 antibody prevalence in England is now published

By Sep 2022, 97.2% of 1-17 year-olds had #SARSCoV2 antibodies

Our findings are critical for future #COVID19 vaccine/booster recommendations for kids

…🧵

👉sciencedirect.com/science/articl…
2/ Methods: We used residual samples from kids aged 1–17 years having a blood test as part of their clinical management in 44 hospital trusts in England. Samples were processed using Roche Elecsys assays for i) nucleocapsid (N) antibodies and ii) spike RBD (S) antibodies
3/ The overall national prevalence estimate of #SARSCoV2 antibody seropositivity in 1-17y, weighted by age & NHS region, based on Spike protein (vaccine or infection) increased from

➡️ 48.5% (95% CrI 40.8%–55.1%) during Sep-Oct 2021
to
➡️ 97.2% (95% CrI 93.7%–98.9%) by Sep 2022 Image
Read 8 tweets
Dec 5, 2022
1/ Our latest paper on longitudinal follow-up of teens with long covid (CLoCk) is a game changer:

Different teens report the same post-covid symptoms at 0, 6m & 12m after their #SARSCoV2 PCR , irrespective of whether they tested + or - for the virus

👉 sciencedirect.com/science/articl…
2/ Method: we followed up 11-17y with a PCR-positive #SARSCoV2 test compared with matched PCR-negative controls for 12 months after their test. The final cohort included 2,909 cases and 2,177 controls
3/ We found that teens reporting a symptom at baseline (PCR-testing) improved by 6m, with new teens reporting the same symptoms at 6m, who then improved by 12m, with new kids reporting the same symptoms at 12m and so on …. you catch the drift .. 👇
Read 9 tweets
Nov 18, 2022
1/ It’s really sad that, when we report that a disease (eg. #covid19) is more severe or fatal in kids with underlying conditions (eg neurodisabilities, immunocompromised), this is taken to mean that such kids are less valued

The truth is exactly the opposite…🧵
2/ It is really important that we identify kids at increased risk of severe outcomes after any condition (eg #COVID19) so we can raise awareness among clinicians, parents & policymakers to be extra vigilant & implement additional strategies protect them 👉journals.plos.org/plosmedicine/a…
3/ When kids with severe neurodisabilities were identified as high-risk in the 1st pandemic wave, the UK recommended #COVID19 vaccines for 12+y kids with severe neurodisabilities as soon as vaccines were licensed in adults - way back in Jan 2021 👉 adc.bmj.com/content/106/12…
Read 7 tweets
Nov 17, 2022
Remember that recent US paper on #covid19 vaccination for 5-11y?

We didn’t agree with the conclusions (h/t @ProfAsmaKhalil)

So, we wrote to @NEJM to explain why US data do NOT support BOOSTERS for kids irrespective of their previous infection status

👉 nejm.org/doi/full/10.10… Image
2/ We pointed out that there was very little difference in protection against omicron infection between vaccinated & previously infected 5-11y, while infection plus 2 vaccine doses might provide slightly better protection after 4 months (79.4% vs 62.9%)

👉nejm.org/doi/full/10.10…
3/ We then pointed out that #COVID19 hospitalizations were v low in 5-11y irrespective of vaccination status (0.3-0.5%), although we still aren’t sure how these were calculated because numerator/denominator in their table give lower percentages (0.1%)🤷🏻‍♂️

👉nejm.org/doi/suppl/10.1…
Read 6 tweets

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