Humoral Immune Response to SARS-CoV-2 in Children with Idiopathic Nephrotic Syndrome: A Cross-Sectional Exploratory Study

Ibrahim Sandokji,1,2 Sulaiman Abdullah,1 Mohammed Eskembaji,3 Albaraa A Fallatah,4 Maan Hajjar,4 Faten Almutairi,5 Ahmed Arabi Alarabi,5 Mona Hamza Syrafi,5 Mossab Imery,5 Amer Alshengeti,1 Waleed Mahallawi2,6 1Department of Child and Women’s Health, College of Medicine, Taibah University, Madinah, Saudi Arabia; 2Health and Life Research Center, Taibah University, Madinah, Saudi Arabia; 3Medical Center, Taibah University, Madinah, Saudi Arabia; 4Taibah University College of Medicine, Madinah, Saudi Arabia; 5Maternity and Children Hospital, King Salman bin Abdulaziz Medical City, Madinah, Saudi Arabia; 6Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi ArabiaCorrespondence: Ibrahim Sandokji, Department of Child and Women’s Health, College of Medicine, Taibah University, Madinah, Saudi Arabia, Email [email protected]: Children with idiopathic nephrotic syndrome face a high risk of infections due to an abnormal antibody response. This study aims to evaluate the humoral immunity in children with nephrotic syndrome against SARS-CoV-2.Methods: This cross-sectional study assessed anti-spike SARS-CoV-2 IgG levels in children with nephrotic syndrome and compared them with those in the control group. Data on COVID-19 exposure and vaccination were collected from caregivers. Statistical analyses were performed using appropriate parametric and non-parametric tests, with a significance level set at p < 0.05.Results: Thirty-five children (10 with nephrotic syndrome and 25 controls) were enrolled. Seropositivity rates were 60% in children with nephrotic syndrome versus 32% in controls (p = 0.15). Mean antibody levels were comparable between groups (0.74 ± 0.68 vs 0.89 ± 1.24, p = 0.64), with no statistically significant differences observed in children receiving steroid therapy.Conclusion: The humoral response to COVID-19 was similar in children with idiopathic nephrotic syndrome compared to control children, suggesting that routine vaccination schedules remain appropriate in this group. These findings suggest preserved antibody responses in this population; however, due to the exploratory nature of this study, larger studies are needed before clinical recommendations can be modified.Keywords: immunology, nephrotic syndrome, pediatric nephrology, SARS-CoV-2