Dynamic surveillance of SARS-CoV-2 shedding and neutralizing antibody in children with COVID-19

Emerg Microbes Infect. 2020 Dec;9(1):1254-1258. doi: 10.1080/22221751.2020.1772677.


Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China and quickly spread globally. In this study, we investigated the characteristics of viral shedding from different sites and the neutralizing antibody (NAb) response during the acute and convalescent phases of nine children with COVID-19. SARS-CoV-2 was detected in their nasopharyngeal swabs (9/9, 100%), stool samples (8/9, 89%), and oropharyngeal swabs (3/9, 33%) but was not detected in their serum and urine samples. The median duration of viral shedding detected in nasopharyngeal swabs, oropharyngeal swabs, and stools was 13, 4, and 43 days respectively, and the maximum duration of viral shedding detected from stools was 46 days after discharge. In children, nasopharyngeal swabs appear to be a more sensitive specimen type for the diagnosis of COVID-19 compared with oropharyngeal swabs. Three of eight patients produced NAbs in the acute phase, and NAbs were detected in all eight patients with convalescent sera. The results of this study provide valuable information for the diagnosis and surveillance of COVID-19 and development of SARS-CoV-2 vaccines for use in children.

Keywords: COVID-19; Children; SARS-CoV-2; neutralizing antibody; viral shedding.

Publication types

  • Letter

MeSH terms

  • Antibodies, Neutralizing / biosynthesis*
  • Antibodies, Neutralizing / blood
  • Betacoronavirus / immunology*
  • Betacoronavirus / isolation & purification*
  • COVID-19
  • Child
  • Child, Preschool
  • Coronavirus Infections / immunology
  • Coronavirus Infections / virology*
  • Feces / virology
  • Female
  • Humans
  • Infant
  • Inhibitory Concentration 50
  • Male
  • Nasopharynx / virology
  • Oropharynx / virology
  • Pandemics
  • Pneumonia, Viral / immunology
  • Pneumonia, Viral / virology*
  • RNA, Viral / analysis
  • SARS-CoV-2
  • Time Factors
  • Virus Shedding*


  • Antibodies, Neutralizing
  • RNA, Viral

Grants and funding

This work was supported by grants specific for Coronavirus disease 2019 from Children’s Hospital of Fudan University (grant number EKXGZX006).