• Diagn. Microbiol. Infect. Dis. · Nov 2020

    False-positive SARS-CoV-2 serology in 3 children with Kawasaki disease.

    • Kelvin Kw To, Gilbert T Chua, Ka Li Kwok, Joshua Sc Wong, Dennis Chi Yu Au, Yuen Yu Lam, Wilfred Hs Wong, Marco Hk Ho, Godfrey Cf Chan, Celine Sl Chui, Xue Li, Keith Ts Tung, Rosa S Wong, Winnie Wy Tso, Ian Ck Wong, Christina Sm Wong, Carol Hy Fong, Kwok Hung Chan, Kwok Yung Yuen, Patrick Ip, and Mike Yw Kwan.
    • Department of Microbiology, Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.
    • Diagn. Microbiol. Infect. Dis. 2020 Nov 1; 98 (3): 115141.

    BackgroundKawasaki disease (KD) is an acute febrile and eruptive disease with systemic vasculitis predominantly affecting young East Asian children. Recent reports showed that children with KD-like disease from KD low prevalence regions had positive SARS-CoV-2 serology despite a negative SARS-CoV-2 polymerase chain reaction (PCR) in respiratory samples.ObjectivesTo describe 3 pediatric Kawasaki Disease patients with false positive SARS-CoV-2 serology.Study DesignWe retrospectively recruited children with KD diagnosed during the COVID-19 outbreak in Hong Kong. Clinical characteristics and laboratory test results including SARS-CoV-2 PCR results were retrieved. We performed a microparticle-based immunoassay for the detection of IgG against nucleoprotein (NP) and spike protein receptor binding domain (RBD), and a microneutralization assay for the detection of neutralizing antibodies.ResultsThree Chinese children with typical KD were identified. They had no epidemiological links with COVID-19 patients and tested negative for SARS-CoV-2 NPA PCR. They were treated with IVIG and aspirin, and were discharged without complications. Subsequently 2 of them were tested positive against anti-RBD and anti-NP antibodies and 1 was tested positive against anti- RBD antibodies. However, microneutralization assay showed that neutralizing antibodies were absent, suggesting a false-positive IgG result.ConclusionDetection of neutralizing antibodies is recommended to confirm previous SARS-CoV-2 infection in IgG-positive but PCR-negative patients.Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.

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