Association between SARS-CoV-2 infection and anti-apolipoprotein A-1 antibodies in children

Vuilleumier N, Pagano S, Lorthe E, Lamour J, Nehme M, Juillard C, Barbe R, Posfay-Barbe KM, Guessous I, Stringhini S; SEROCoV-KIDS study group; L'Huillier AG.

Association between SARS-CoV-2 infection and anti-apolipoprotein A-1 antibody in children. Front Immunol. 2025 Feb 26;16:1521299. doi: 10.3389/fimmu.2025.1521299. PMID: 40079006; PMCID: PMC11897246.

Abstract :

Background and objectives : Autoantibodies to apolipoprotein A-1 (AAA1) are triggered by SARS-CoV-2 infection and predict the persistence of COVID-19 symptoms at one year in adults. However, it is unknown whether this applies to children. We investigated the association between exposure to SARS-CoV-2 and the prevalence of AAA1 in children, as well as the association of AAA1 seropositivity with symptom persistence.

Methods : Anti-SARS-CoV-2 and AAA1 serologies were examined in 1031 participants aged 6 months to 17 years from the prospective SEROCOV-KIDS cohort, recruited between December 2021 and February 2022. Four groups based on SARS-CoV-2 serology were defined: "Infected-unvaccinated (I+/V-)", "Uninfected-vaccinated (I-/V+)", "Infected-vaccinated (I+/V+)" and "Naïve (I-/V-)". The results reported were collected via online questionnaires. Associations with study criteria were assessed by logistic regression.

Results : Overall, seropositivity rates were 71% (736/1031) for anti-RBD, 55% (568/1031) for anti-N and 5.8% (60/1031) for AAA1. AAA1 was inversely associated with age, but not with other characteristics. The I+/V- group had higher median AAA1 levels and more frequent seropositivity (7.9%) than the other groups (p ≤ 0.011), corresponding to a doubled risk of AAA1 seroconversion (Odds Ratio [OR]: 2.11 [95% Confidence Interval (CI): 1.22-3.65]; p = 0.008), unchanged after adjustment for age and sex. AAA1 seropositivity was independently associated with a doubling of the odds of symptom persistence ≥ 4 weeks (p ≤ 0.03) in the overall sample and in infected individuals, but not for ≥ 12 weeks.

Conclusions : Despite the limitations of the study (cross-sectional design, patient-reported outcomes via validated questionnaires), the results indicate that SARS-CoV-2 infection may trigger an AAA1 response in children, which may be independently associated with short-term symptom persistence.

Link to the article in English

This text was automatically translated from French using artificial intelligence