Sero-prevalence COVID-19 Among Belgian Children
Condition: SARS-CoV-2; SARS-CoV Infection; Covid19
MeSH terms: COVID-19; Severe Acute Respiratory Syndrome
Study type: Observational [Patient Registry]

Summary: 
      Based on studies in China, Iceland, the Netherlands and Italy it seems that children are less
      affected by SARS-CoV-2 infections and play a lesser role in the dissemination of the
      SARS-CoV-2 virus. It is unclear to which extend this is due to lesser exposure or an inherent
      decreased susceptibility to become infected. The low reported number of cases in children can
      be partially explained by the lower testing rates in the pediatric population.

      To get insight in the transmission of SARS-CoV-2 virus in school-aged children it is
      necessary to compile data on infection of SARS-CoV-2 virus in the child and (pre-)adolescent
      population. The main objective of this study is to determine the sero-prevalence and
      sero-conversion of antibodies against SARS-CoV-2 in a sample of school-aged children (primary
      and secondary school) in Belgium at different time points. Additionally this study will gain
      insight in the incidence of SARS-CoV-2, the proportion of asymptomatic infections with
      SARS-CoV-2 and the role of COVID-19 infection in household members. It will give us the
      possibility to investigate potential risk factors for infection.

      The study population includes primary and secondary school children from two predefined age
      groups (8-9 and 13-14 years old). These two groups are chosen because studies have shown more
      pronounced symptoms of infection and disease depending on age and because transmission
      dynamics also vary by age. The study population will be recruited in all Belgian schools
      including Brussels-Capital, Flemish and Walloon Region (including the German speaking
      community).

      The study is a prospective cohort study. In total there will be 3 testing points with 3
      months between each point. The sample size calculation indicated the inclusion of 41 randomly
      selected primary and 41 secondary schools and in each school 20 randomly selected pupils of
      the defined age groups. Parents/legal child caregiver will complete a questionnaire at each
      of the testing points providing basic socio-demographic characteristics (at baseline only)
      and risk-behavior and health characteristics including presence of symptoms during the time
      since the previous testing point (at each of the testing points). The questionnaire will be
      completed through a secured online application during the same week as the child had the
      saliva sample for serological testing taken.

      Saliva samples will be sent to the Sciensano laboratory for serological analysis. The child's
      parent/legal caregiver will be informed of the serological result.

      Study data will guide the Belgian policy makers in their advices to limit circulation of
      SARS-CoV-2 in Belgium and more specifically in their advice on measures for school-age
      children. This data might also be used to guide health authorities that have to decide on
      vaccination strategies once a vaccine is available; to decide whether children should be
      included for vaccination to create herd immunity or not.
    


Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        The study population includes primary and secondary school children from two predefined age
        groups. These two groups are chosen because studies have shown more pronounced symptoms of
        infection and disease depending on age and because transmission dynamics also vary by age.
        Adolescents of 15 year and older will not be included as their symptom patterns resembles
        more disease pathology of adults. Because of pragmatic and practical reasons we will
        include primary school children from the 3rd grade (age 8-9) and secondary schoolchildren
        from the 2nd grade (age 13-14).

        The study sample will be recruited in all Belgian schools including Brussels-Capital, and
        the Flemish and Walloon Regions (including the German speaking community). School
        attendance in this age group is high in Belgium, because of this, recruitment of school-age
        children through schools is acceptable.
      
Keywords: SARS-CoV-2; COVID-19; Children; Belgium; Pandemic 2020