Are SARS‐CoV‐2 IgA antibodies in paediatric patients with chilblain‐like lesions indicative of COVID‐19 asymptomatic or paucisymptomatic infection?
A Diociaiuti, S Giancristoforo, S Terreri, M Corbeddu, C Concato, M Ciofi Degli Atti, G Zambruno, R Carsetti, M El Hachem
Journal of the European Academy of Dermatology and Venereology, doi:10.1111/jdv.16934
was positive in eight cases, borderline in two, and negative in three, including the COVID-19 patient. Overall, serology for S1-specific IgA and IgG in the 30 patients shows that 16 (53.3%) were positive for IgA, whereas IgG was detectable in five (16.6%; Fig. 1f ). We have recently reported that high levels of IgG and IgA can be detected in adult patients with severe COVID-19, while IgA, and to a lower extent IgG, is increased in asymptomatic individuals. 6 As IgA is the most abundant antibody at mucosal sites, a strong local protection may prevent viral spread and damage to the respiratory tract, explaining the lack of symptoms. The ELISA used for the detection of anti-S1 IgG and IgA has been demonstrated to be specific and sensitive. 7, 8 Of note, antibodies against S1 are often neutralizing 9 and may prevent severe disease and further immune responses. 6 Our findings indicate that, similar to asymptomatic adults, paediatric patients would respond to SARS-CoV-2 producing more IgA than IgG. On the other hand, a single patient had detectable IgG against SARS-CoV-2 nucleoprotein. Anti-nucleoprotein IgG is present in the great majority of hospitalized adult patients, but only in one-third of paucisymptomatic individuals, suggesting that disease severity influences the specificity of the antibodies produced. 10 In conclusion, the detection of S1-specific IgA in paediatric patients with chilblain-like lesions strongly points to a previous, mostly asymptomatic SARS-CoV-2 infection with inflammatory sequelae.
Conflicts of interest None to be reported for all authors. A. Diociaiuti, 1,*, † S. Giancristoforo, 1, † S. Terreri, 2 M. Corbeddu, 1 C. Concato, 3 M. Ciofi Degli Atti, 4 G. Zambruno, 5 R. Carsetti, 6, † M. El Hachem 1, †
Conflicts of interest None declared.
References
Andina, Noguera-Morel, Bascuas-Arribas, Chilblains in children in the setting of COVID-19 pandemic, Pediatr Dermatol
Beavis, Matushek, Abeleda, Evaluation of the EUROIM-MUN Anti-SARS-CoV-2 ELISA assay for detection of IgA and IgG antibodies, J Clin Virol
Carsetti, Zaffina, Mortari, Spectrum of innate and adaptive immune response to SARS CoV 2 infection across asymptomatic, mild and severe cases; a longitudinal cohort study, medRxiv,
doi:10.1101/2020.06.22.20137141Caturegli, Materi, Howard, Caturegli, Clinical validity of serum antibodies to SARS-CoV-2: a case-control study, Ann Intern Med
Cleach, Dousset, Assier, Most chilblains observed during the COVID-19 outbreak occur in patients who are negative for COVID-19 on PCR and serology testing, Br J Dermatol
El Hachem, Diociaiuti, Concato, A clinical, histopathological and laboratory study of 19 consecutive Italian paediatric patients with chilblain-like lesions: lights and shadows on the relationship with COVID-19 infection, J Eur Acad Dermatol Venereol
Freeman, Mcmahon, Lipoff, Pernio-like skin lesions associated with COVID-19: a case series of 318 patients from 8 countries, J Am Acad Dermatol
Gebhard, Regitz-Zagrosek, Neuhauser, Morgan, Klein, Impact of sex and gender on COVID-19 outcomes in Europe, Biol Sex Differ
Ghazizadeh, Majd, Richter, Androgen regulates SARS-CoV-2 receptor levels and is associated with severe COVID-19 symptoms in men, bioRxiv,
doi:10.1101/2020.05.12.091082Grzelak, Temmam, Planchais, SARS-CoV-2 serological analysis of COVID-19 hospitalized patients, pauci-symptomatic individuals and blood donors, medRxiv,
doi:10.1101/2020.04.21.20068858Montopoli, Zumerle, Vettor, Androgen-deprivation therapies for prostate cancer and risk of infection by SARS-CoV-2: a populationbased study (N = 4532), Ann Oncol
Salgado, Handler, Schwartz, Shedding light on onychomadesis, Cutis
Seydoux, Homad, Maccamy, Analysis of a SARS-CoV-2-infected individual reveals development of potent neutralizing antibodies with limited somatic mutation, Immunity
Wadman, Sex hormones signal why virus hits men harder, Science
Wambier, Goren, Vaño-Galv An, Androgen sensitivity gateway to COVID-19 disease severity, Drug Dev Res
Wambier, Vaño-Galv An, Mccoy, Androgenetic alopecia present in the majority of hospitalized COVID-19 patients -the "Gabrin sign, J Am Acad Dermatol
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