Pediatric SARS-CoV-2 Seroprevalence in Arkansas Over the First Year of the COVID-19 Pandemic

J Pediatric Infect Dis Soc. 2022 Jun 22;11(6):248-256. doi: 10.1093/jpids/piac010.


Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) seroprevalence studies largely focus on adults, but little is known about spread in children. We determined SARS-CoV-2 seroprevalence in children and adolescents from Arkansas over the first year of the coronavirus disease of 2019 (COVID-19) pandemic.

Methods: We tested remnant serum samples from children ages 1-18 years who visited Arkansas hospitals or clinics for non-COVID-19-related reasons from April 2020 through April 2021 for SARS-CoV-2 antibodies. We used univariable and multivariable regression models to determine the association between seropositivity and participant characteristics.

Results: Among 2357 participants, seroprevalence rose from 7.9% in April/May 2020 (95% CI, 4.9-10.9) to 25.0% in April 2021 (95% CI, 21.5-28.5). Hispanic and black children had a higher association with antibody positivity than non-Hispanic and white children, respectively, in multiple sampling periods.

Conclusions: By spring 2021, most children in Arkansas were not infected with SARS-CoV-2. With the emergence of SARS-CoV-2 variants, recognition of long-term effects of COVID-19, and the lack of an authorized pediatric SARS-CoV-2 vaccine at the time, these results highlight the importance of including children in SARS-CoV-2 public health, clinical care, and research strategies.

Keywords: COVID-19; SARS-CoV-2; antibody; child; children; coronavirus; epidemiology; ethnic disparity; racial disparity; serology; serum.

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Viral
  • Arkansas / epidemiology
  • COVID-19 Vaccines
  • COVID-19* / epidemiology
  • Child
  • Child, Preschool
  • Humans
  • Infant
  • Pandemics*
  • SARS-CoV-2
  • Seroepidemiologic Studies


  • Antibodies, Viral
  • COVID-19 Vaccines

Supplementary concepts

  • SARS-CoV-2 variants