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Kamaludeen M, Ranganadin P, Pillai AB, Sugumaran A. Serosurveillance of COVID-19 amongst health care workers in a teaching institution - A prospective cohort study in Puducherry district. J Family Med Prim Care 2024; 13:1917-1921. [PMID: 38948592 PMCID: PMC11213439 DOI: 10.4103/jfmpc.jfmpc_1488_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 07/02/2024] Open
Abstract
Introduction The rapid spread and mutation rate of severe acute respiratory syndrome corona virus (SARS-CoV2) demands continuous monitoring in terms of genomic and serosurvival. The current study is designed to track the seroprevalence of health care workers (HCWs) postvaccination, as they may be more susceptible to contracting the SARS-CoV-2 infection compared to the general population. Objective The objective was to identify the seroprevalence rate for SARS-CoV-2 immunoglobulin G (IgG) antibody (N, S1, S2) amongst HCWs of various levels of exposure working in a tertiary care teaching hospital in Puducherry. Materials and Methods The present study followed a nonprobability consecutive sampling technique, which involved 216 study participants HCWs from the hospital. IgG antibody levels were measured using EUROIMMUNE Anti SARS-COV-2 ELISA KIT (IG g) ELISA at two points: firstly, 2 weeks after the second dose of vaccination, followed by 2 weeks after the booster dose. Results Out of the total 216 participants enrolled in the survey, there were 140 males and 76 females, and the maximum number of candidates studied were in the 41-50 age group. Almost 46.7% of the HCWs who participated in the study were seropositive for SARS-CoV-2 in the case of those who were high-risk exposed, while only 30.4% were amongst those who were low-risk exposed. The proportion of study participants who became seropositive increased considerably after the booster dose (65.7%), from 38.0% when tested three months after infection. Conclusion A significant increase in antibody titres amongst high-risk HCWs postboost vaccination demands continuous monitoring of soluble IgG levels for recommendations of vaccination schedules.
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Affiliation(s)
- Muhamed Kamaludeen
- Assistant Professor, Department of Pulmonary Medicine, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (Deemed-to-be-University), Puducherry, India
| | - Pajanivel Ranganadin
- Professor and HOD, Department of Pulmonary Medicine, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (Deemed-to-be-University), Puducherry, India
| | | | - Arun Sugumaran
- Department of Community Medicine, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (Deemed-to-be-University), Puducherry, India
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2
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Saeed U, Uppal R, Khan AA, Uppal MR, Piracha ZZ, Uppal SR. Analytical assessment of clinical sensitivity and specificities of pharmaceutical rapid SARS-CoV-2 detection nasopharyngeal swab testing kits in Pakistan. BRAZ J BIOL 2024; 84:e265550. [PMID: 38451627 DOI: 10.1590/1519-6984.265550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/28/2022] [Indexed: 03/08/2024] Open
Abstract
Despite of the global unity against COVID-19 pandemic, the threat of SARS-CoV-2 variants on the lives of human being is still not over. SARS-CoV-2 pandemic has urged the need of rapid viral detection at earliest. To cope with gradually expanding scenario of SARS-CoV-2, accurate diagnosis is extremely crucial factor which should be noticed by international health organizations. Limited research followed by sporadic marketing of SARS-CoV-2 rapid pharmaceutical detection kits raises critical questions against quality assurance and quality control measures. Herein we aimed to interrogate effectivity and specificity analysis of SARS-CoV-2 pharmaceutical rapid detection kits (nasopharyngeal swab based) using conventional gold standard triple target real-time polymerase chain reaction (USFDA approved). A cross-sectional study was conducted over 1500 suspected SARS-CoV-2 patients. 100 real time-PCR confirmed patients were evaluated for pharmaceutical RDT kits based upon nasopharyngeal swab based kits. The SARS-CoV-2 nasopharyngeal swab based rapid diagnostic kit (NSP RDTs) analysis showed 78% reactivity. Among real time PCR confirmed negative subjects, 49.3% represented false positivity. The positive predictive analysis revealed 67.82%, while negative predictive values were 64.40%. The NSP RDTs showed limited sensitivities and specificities as compared to gold standard real time PCR. Valid and authentic detection of SARS-CoV-2 is deemed necessary for accurate COVID-19 surveillance across the globe. Current study highlights the potential consequences of inadequate detection of SARS-CoV-2 and emerging novel mutants, compromising vaccine preventable diseases. Current study emphasizes need to wake higher authorities including strategic organizations for designing adequate measures to prevent future SARS-CoV-2 epidemics.
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Affiliation(s)
- U Saeed
- Islamabad Diagnostic Center - IDC, Department of Research and Development, Islamabad, Pakistan
- Foundation University Islamabad Pakistan, Foundation University School of Health Sciences, Clinical and Biomedical Research Center, Islamabad, Pakistan
| | - R Uppal
- Islamabad Diagnostic Center - IDC, Department of Research and Development, Islamabad, Pakistan
| | - A A Khan
- Islamabad Diagnostic Center - IDC, Department of Research and Development, Islamabad, Pakistan
| | - M R Uppal
- Islamabad Diagnostic Center - IDC, Department of Research and Development, Islamabad, Pakistan
| | - Z Z Piracha
- International Center of Medical Sciences Research - ICMSR, Islamabad, Pakistan
- International Center of Medical Sciences Research - ICMSR, Austin, TX, United States of America
- International Center of Medical Sciences Research - ICMSR, Chadwell Health, United Kingdom
| | - S R Uppal
- Islamabad Diagnostic Center - IDC, Department of Research and Development, Islamabad, Pakistan
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3
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Helou M, Zoghbi S, El Osta N, Mina J, Mokhbat J, Husni R. COVID-19 infection and seroconversion rates in healthcare workers in Lebanon: An observational study. Medicine (Baltimore) 2023; 102:e32992. [PMID: 37115042 PMCID: PMC10143398 DOI: 10.1097/md.0000000000032992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 04/29/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) infection is a recent pandemic. Healthcare workers (HCW) are at high risk of acquiring the infection and transmitting it to others. Seroprevalence for COVID-19 among HCW varies between countries, hospitals in the same country and even among different departments in the same hospital. In this study, we aim to determine the prevalence of severe acute respiratory syndrome coronavirus 2 antibodies and the seroconversion among the HCW in our hospital. A total of 203 HCW were included. The rate of conversion to seropositive was 19.7% in total, with a rate of 13.4% in female versus 25% in male. The seropositivity in the House keeping group was 83%, followed by 45% in the COVID Floor while the seropositivity in the Anesthesia was 4% and the Infection Control 0%. The highest seropositivity rate in the COVID floor, and in the intensive care unit was explained by the long time spent with the patients. While in the inhalation team and the anesthesia, the lower rates of seropositivity was due to the N95 mask wearing the whole time. Seropositivity for COVID-19 in HCW is a major public health concern. Policies should be implemented to better protect HCWs.
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Affiliation(s)
- Mariana Helou
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Sanaa Zoghbi
- Division of Infection Control, Lebanese American University Medical Center, Beirut, Lebanon
| | - Nour El Osta
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Jonathan Mina
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Jacques Mokhbat
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Rola Husni
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
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4
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Osman NA, Anwar MM, Singh B, Gupta GK, Rabie AM. A peek behind the curtain in the diagnosis and management of COVID‑19‑Associated Mucormycosis (CAM). J Egypt Public Health Assoc 2023; 98:4. [PMID: 36859556 PMCID: PMC9977480 DOI: 10.1186/s42506-022-00125-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/28/2022] [Indexed: 06/18/2023]
Abstract
Coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM) is responsible for a high mortality rate due to its unique and severe host-pathogen interactions. Critically ill or immunocompromised COVID-19 patients are more prone to suffer from aggressive mycoses. Probable victims include those with uncontrolled diabetes mellitus (DM), metabolic acidosis, prolonged neutropenia, increased ferritin levels, hypoxia, and prolonged hospitalization with/without mechanical ventilators and corticosteroids administration. The current review aims to outline the journey of patients with CAM as well as the advantages and disadvantages of the currently available diagnostic techniques. It also discussed the current status of treatment options and caveats in the management of mucormycosis. Multidisciplinary team, early diagnosis, controlling the predisposing condition(s), complete surgical debridement, effective antifungal therapies (e.g., amphotericin B, isavuconazole, and posaconazole), and implementing antifungal stewardship programs are imperative in CAM cases.
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Affiliation(s)
- Nermin A. Osman
- Biomedical Informatics and Medical Statistics Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Mohammed Moustapha Anwar
- Department of Biotechnology, Institute of Graduate Studies and Research (IGSR), Alexandria University, Alexandria, Egypt
| | | | - Girish K. Gupta
- Department of Pharmaceutical Chemistry, Sri Sai College of Pharmacy, Badhani, Pathankot, 145001 Punjab India
| | - Amgad M. Rabie
- Drug Discovery & Clinical Research Department, Dikernis General Hospital (DGH), Magliss El-Madina Street, Dikernis City, 35744 Dikernis, Dakahlia Governorate Egypt
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5
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Temessadouno FW, Ndong JG, Gignoux E, Coppieters Y, Ba A, Sidibe YD, Daou A, Malou N, Compaore I, Fane T, Simons E, Luquero F, Mills C, Vuti KM, Nkokolo Massamba MH, Guiramand S. Seroprevalence of anti-SARS-CoV-2 antibodies among blood donors from December 2020 to June 2021 in Koutiala district, Mali. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001316. [PMID: 36962828 PMCID: PMC10022217 DOI: 10.1371/journal.pgph.0001316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/09/2022] [Indexed: 01/06/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus associated with coronavirus disease (COVID-19). At the time of the study, little data on the level of exposure of the population in Koutiala district in Mali to SARS-CoV-2 was available. Although blood donors are not representative of the general population, a COVID-19 seroprevalence estimate in this population was intended to assess the extent of community transmission, serve as a health alert system, and help guide the public health response. We measured seroprevalence of anti-SARS-CoV-2 antibodies using NG-Biotech SARS-Cov-2 RDT and ECLIA test between January and June 2020. This is a cross-sectional study of volunteer blood donors aged 18 to 60 years, independent of any previous COVID-19 disease. A stratified analysis of seroprevalence by month of sample collection and a comparison of the results of the NG-Biotech SARS-Cov-2 RDT with those of the ECLIA test was performed. The overall prevalence of antibodies to SARS-Cov-2 virus assessed by the NG-Biotech SARS-Cov-2 RDT was 24.6% (95% CI 21.8-27.4) and by the ECLIA test was 70.2 (95% CI 64.9-75.5). Both estimates remained relatively stable over the study period. We observed SARS-CoV-2 exposure much higher than indicated by case-based surveillance. The national surveillance system, as it was, was not able to detect variations in incidence, and as such, we do not recommend it as an alert system. However, the discrepancy between the results of the rapid test and the ECLIA test shows that further research is required to assess the validity of these test before a more solid conclusion can be drawn it their use in surveillance.
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Affiliation(s)
| | | | | | - Yves Coppieters
- School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | | | | | | | - Nada Malou
- Médecins Sans Frontières, Koutiala, Mali
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El-Moghazy AY, Amaly N, Sun G, Nitin N. Development and clinical evaluation of commercial glucose meter coupled with nanofiber based immuno-platform for self-diagnosis of SARS-CoV-2 in saliva. Talanta 2022. [DOI: 10.1016/j.talanta.2022.124117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Qavi AJ, Wu C, Lloyd M, Zaman MMU, Luan J, Ballman C, Leung DW, Crick SL, Farnsworth CW, Amarasinghe GK. Plasmonic Fluor-Enhanced Antigen Arrays for High-Throughput, Serological Studies of SARS-CoV-2. ACS Infect Dis 2022; 8:1468-1479. [PMID: 35867632 PMCID: PMC9344907 DOI: 10.1021/acsinfecdis.2c00086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Serological testing for acute infection or prior exposure is critical for patient management and coordination of public health decisions during outbreaks. Current methods have several limitations, including variable performance, relatively low analytical and clinical sensitivity, and poor detection due to antigenic drift. Serological methods for SARS-CoV-2 detection for the ongoing COVID-19 pandemic suffer from several of these limitations and serves as a reminder of the critical need for new technologies. Here, we describe the use of ultrabright fluorescent reagents, Plasmonic Fluors, coupled with antigen arrays that address a subset of these limitations. We demonstrate its application using patient samples in SARS-CoV-2 serological assays. In our multiplexed assay, SARS-CoV-2 antigens were spotted into 48-plex arrays within a single well of a 96-well plate and used to evaluate remnant laboratory samples of SARS-CoV-2 positive patients. Signal-readout was performed with Auragent Bioscience's Empower microplate reader, and microarray analysis software. Sample volumes of 1 μL were used. High sensitivity of the Plasmonic Fluors combined with the array format enabled us to profile patient serological response to eight distinct SARS-CoV-2 antigens and evaluate responses to IgG, IgM, and IgA. Sensitivities for SARS-CoV-2 antigens during the symptomatic state ranged between 72.5 and 95.0%, specificity between 62.5 and 100%, and the resulting area under the curve values between 0.76 and 0.97. Together, these results highlight the increased sensitivity for low sample volumes and multiplex capability. These characteristics make Plasmonic Fluor-enhanced antigen arrays an attractive technology for serological studies for the COVID-19 pandemic and beyond.
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Affiliation(s)
- Abraham J. Qavi
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
| | - Chao Wu
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
| | - Matthew Lloyd
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
| | | | - Jingyi Luan
- Auragent
Bioscience, St. Louis, Missouri 63108, United
States
| | - Claire Ballman
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
| | - Daisy W. Leung
- Department
of Internal Medicine, Washington University
School of Medicine, St. Louis, Missouri 63110, United States
| | - Scott L. Crick
- Auragent
Bioscience, St. Louis, Missouri 63108, United
States
| | - Christopher W. Farnsworth
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
| | - Gaya K. Amarasinghe
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
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Pallett SJC, Rayment M, Heskin J, Mazzelli A, Jones R, Mughal N, Randell P, Davies GW, Moore LSP. Early identification of high-risk individuals for monoclonal antibody therapy and prophylaxis is feasible by SARS-CoV-2 anti-spike antibody specific lateral flow assay. Diagn Microbiol Infect Dis 2022; 104:115788. [PMID: 36084423 PMCID: PMC9371766 DOI: 10.1016/j.diagmicrobio.2022.115788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/17/2022] [Accepted: 08/06/2022] [Indexed: 11/03/2022]
Abstract
Monoclonal antibody therapy has been approved for prophylaxis and treatment of severe COVID-19 infection. Greatest benefit appears limited to those yet to mount an effective immune response from natural infection or vaccination, but concern exists around ability to make timely assessment of immune status of community-based patients where laboratory-based serodiagnostics predominate. Participants were invited to undergo paired laboratory-based (Abbott Architect SARS-CoV-2 IgG Quant II chemiluminescent microparticle immunoassay) and lateral flow assays (LFA; a split SARS-CoV-2 IgM/IgG and total antibody test) able to detect SARS-CoV-2 anti-spike antibodies. LFA band strength was compared with CMIA titer by log-linear regression. Two hundred individuals (median age 43.5 years, IQR 30−59; 60.5% female) underwent testing, with a further 100 control sera tested. Both LFA band strengths correlated strongly with CMIA antibody titers (P < 0.001). LFAs have the potential to assist in early identification of seronegative patients who may demonstrate the greatest benefit from monoclonal antibody treatment.
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Yadav AK, Ghosh S, Faujdar DS, Rajmohan KS, Bhalla S, Shekhawat VS, Jindamwar P, Dubey S, Sahai A, Rakesh CR, Chand S, Rawat MS, Gupta S, Dhawan R, Kotwal A, Bobdey S, Teli P, Kaushik SK, Vaidya R. Findings of second multicentric follow-up serosurvey among Health Care Workers in government hospitals. Med J Armed Forces India 2022:S0377-1237(22)00082-X. [PMID: 35910399 PMCID: PMC9322976 DOI: 10.1016/j.mjafi.2022.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/27/2022] [Indexed: 11/24/2022] Open
Abstract
Background The change in serological status of community may be used as input for guiding the public health policy. Hence, the present study was conducted to determine change in seroprevalence of COVID-19 among healthcare workers (HCWs). Methods From the baseline multicentric study sample, a subsample was followed up, and a seroepidemiological study was conducted among them between 6 and 22 weeks after the second dose of the vaccination. Multistage population proportion to size sampling was performed for the selection of subsample of HCWs. The serosurvey was conducted using the enzyme-linked immunosorbent assay-based IgG antibody test (COVID KAVACH). Results Follow-up serological testing was done in subsample of 1122 participants of original 3253 participants. The mean age of the participants was 34.6 (8.13) years. A total of 300 (26.7%) participants were females. The seroprevalence was 78.52, (95%CI:76-80.1). Among those who were seronegative at initial test, 708 (77.04%) were seroconverted. Those who were not seroconverted (241 (21.5%)) have longer duration from the second dose of the vaccination (93 (31.4) vs. 56 (38.4); p value < 0.001). The COVID-19 infection was significantly associated with seropositive status and being a medical staff was associated with remaining seronegative on follow-up. The higher age (≥50 years) was found to be significantly associated with seroreversion. Conclusion Four in five HCWs had detectable antibodies. Seroepidemiological studies carry vital information to control the public health response in the course of the pandemic. The study can also further help as a platform to study the seroconversion and effect of vaccination among HCWs for newer variants of SARS-CoV-2.
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Affiliation(s)
- Arun Kumar Yadav
- Associate Professor, Department of Community Medicine, Armed Forces Medical College, Pune, India
| | - S Ghosh
- Col AFMS (Health), O/o DGAFMS, New Delhi, India
| | - D S Faujdar
- Associate Professor, Department of Community Medicine, Armed Forces Medical College, Pune, India
| | - K S Rajmohan
- Professor (Pathology) & Neuropathologist, ACMS, Delhi, India
| | - Sharad Bhalla
- Professor (Microbiology), Command Hospital (Eastern Command), Kolkatta, India
| | - V S Shekhawat
- Classified Specialist (Medicine & Endocrinologist), INHS Asvini, Colaba, Mumbai, India
| | - Prashant Jindamwar
- Classified Specialist (Microbiology), Army Institute of Cardio-Thoracic Sciences (AICTS), Pune, India
| | - Sudhir Dubey
- Classified Specialist (Microbiology), ACMS, Delhi, India
| | - Atul Sahai
- Classified Specialist (Pathology), Jammu, India
| | - C R Rakesh
- Classified Specialist (Surgery), Command Hospital (Air Force), Bengaluru, India
| | - Satish Chand
- Assistant Professor (Dermatology), Command Hospital (Air Force), Bengaluru, India
| | - M S Rawat
- Graded Specialist (Pathology), Military Hospital, Ahmedabad, India
| | - Shilpi Gupta
- Graded Specialist (Microbiology), Military Hospital, Jaipur, India
| | - Rakhi Dhawan
- Senior Registrar, Military Hospital, Jaipur, India
| | | | - Saurabh Bobdey
- Professor, Department of Community Medicine, Armed Forces Medical College, Pune, India
| | - Prabhakar Teli
- Associate Professor, Department of Community Medicine, Armed Forces Medical College, Pune, India
| | - S K Kaushik
- Professor & Head, Department of Community Medicine, Armed Forces Medical College, Pune, India
| | - Rajesh Vaidya
- Dean & Deputy Commandant, Armed Forces Medical College, Pune, India
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Abstract
The study aimed to establish the performance of the SARS-CoV-2 Rapid Antibody Test (IgG and IgM) and the Elecsys Anti-SARS-CoV-2 S assay in vaccinated individuals. A panel of serum samples from Boca Biolistics was utilized to assess antibodies following vaccination, consisting of samples drawn prior to vaccination, after the first dose, or at least 14 days after the second dose of Moderna mRNA-1273 or Pfizer-BioNTech BNT162b2 COVID-19 vaccines. Agreement between the two methods was measured and stratified by test evaluator and assay lot. Agreement between the SARS-CoV-2 Rapid Antibody Test (IgG) and Elecsys Anti-SARS-CoV-2 S assay qualitative measurements at the different assessment points for both mRNA-1273 and BNT162b2 ranged between 97.06% (95% confidence interval [CI] 84.67, 99.93) to 100% (95% CI 82.35, 100). Agreement of the SARS-CoV-2 Rapid Antibody Test (IgG) with the Elecsys Anti-SARS-CoV-2 S assay was not highly influenced by either lot or evaluator. There was a medium-to-strong correlation between the semiquantitative SARS-CoV-2 Rapid Antibody Test (IgG) result and quantitative Elecsys Anti-SARS-CoV-2 S assay in samples taken after both doses of the vaccines, with higher intensity bands being associated with higher total anti-S antibody titer (mRNA-1273, P = 0.0019; BNT162b2, P < 0.0001). Conclusion Semiquantitative SARS-CoV-2 Rapid Antibody Test (IgG) and quantitative Elecsys Anti-SARS-CoV-2 S assay correlated well, suggesting that the SARS-CoV-2 Rapid Antibody Test (IgG) is helpful in understanding the immune response postvaccination. The current data support the use of the SARS-CoV-2 Rapid Antibody Test (IgG) in the vaccinated population. IMPORTANCE Serologic assays are an essential tool for seroprevalence surveys, for quality control of vaccines, and to determine the response to vaccination. Although a correlate of immunity has not yet been established for COVID-19 vaccines, antibody titers after natural infection and vaccination have been associated with protection from symptomatic SARS-CoV-2 infection. Rapid point-of-care assays can be of use in this context with advantages over centralized testing, such as speed and ease of use. The point-of-care SARS-CoV-2 Rapid Antibody Test (IgG) compared favorably to the Elecsys Anti-SARS-CoV-2 S assay with agreement rates above 97.06%, after one or two doses of Moderna mRNA-1273 or Pfizer-BioNTech BNT162b2. Semiquantitative SARS-CoV-2 Rapid Antibody Test (IgG) and quantitative Elecsys Anti-SARS-CoV-2 S assay results correlated well, suggesting that SARS-CoV-2 Rapid Antibody Test (IgG) is helpful in understanding the immune response postvaccination. The current data support the use of the SARS-CoV-2 Rapid Antibody Test (IgG) in the vaccinated population.
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Almaeen AH, Alduraywish AA, Ghazy AA, El-Metwally TH, Alayyaf M, Alrayes FH, Alinad AKM, Albulayhid SBH, Aldakhil AR, Taha AE. The Pre-Vaccination Donated Blood Is Free from Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) but Is Rich with Anti-SARS-CoV-2 Antibodies: A Cross-Section Saudi Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127119. [PMID: 35742368 PMCID: PMC9223027 DOI: 10.3390/ijerph19127119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/30/2022] [Accepted: 06/08/2022] [Indexed: 02/06/2023]
Abstract
(1) Backgrounds and Objectives: Since its discovery, information about the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has spread rapidly. However, many issues remain unresolved. Coronaviruses are primarily transmitted through respiratory secretions. The possibility of transmission via donated blood transfusion deserves studying. This is the first study in Saudi Arabia to look at pre-vaccination donated blood anti-SARS-CoV-2 antibody content as a marker for virus transmission via viral RNA positive blood and/or the potential therapeutic value of convalescent plasma. (2) Methods: A total of 300 blood samples were sequentially collected from unvaccinated donors who donated blood to the blood bank of Prince Mutaib Bin Abdulaziz Hospital in Sakaka, Al-Jouf, Saudi Arabia. Specific ELISA was used to detect anti-SARS-CoV-2 IgG and IgM antibodies. SARS-CoV-2 was detected using specific real-time reverse-transcription PCR (rRT-PCR). (3) Results: The prevalence of anti-SARS-CoV-2 IgG was low (9%), whereas the prevalence of anti-SARS-CoV-2 IgM was high (65%). Relevant demographics, anthropometrics, and lifestyle factors revealed significant associations (p < 0.05) between IgM-positivity only vs. age (age group 21−30 years), postgraduate education, no history of international travel, IgG-negativity, and absence of experience with COVID-19-like symptoms. Furthermore, there are significant associations (p < 0.05) between IgG-positivity only vs. age (age group 21−30 years), postgraduate education, and being a non-healthcare worker. All donors in the anti-SARS-CoV-2 IgG-positive group (n = 27) had previously experienced symptoms similar to COVID-19 (p < 0.001) and most of them (n = 24) showed anti-SARS-CoV-2 IgM-positive test (p = 0.006). However, all the samples tested negative for SARS-CoV-2 RNA using rRT-PCR. (4) Conclusion: Our findings add to the growing body of evidence that donated blood is safe, with the added benefit of convalescent plasma rich in potentially neutralizing IgG and IgM against SARS-CoV-2.
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Affiliation(s)
- Abdulrahman H. Almaeen
- Department of Pathology, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia;
| | | | - Amany A. Ghazy
- Microbiology and Immunology Division, Department of Pathology, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (A.A.G.); (A.E.T.)
- Department of Microbiology & Medical Immunology, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh 33516, Egypt
| | - Tarek H. El-Metwally
- Department of Pathology, Biochemistry Division, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia;
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut 71517, Egypt
| | - Mohammad Alayyaf
- Prince Mutaib Bin Abdulaziz Hospital, Sakaka 72388, Saudi Arabia;
| | - Fahad Hammad Alrayes
- College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (F.H.A.); (A.K.M.A.); (S.B.H.A.); (A.R.A.)
| | - Ahmed Khalid M. Alinad
- College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (F.H.A.); (A.K.M.A.); (S.B.H.A.); (A.R.A.)
| | | | - Abdulrhman Rabea Aldakhil
- College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (F.H.A.); (A.K.M.A.); (S.B.H.A.); (A.R.A.)
| | - Ahmed E. Taha
- Microbiology and Immunology Division, Department of Pathology, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (A.A.G.); (A.E.T.)
- Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt or
- Correspondence: or or
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12
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Heskin J, Pallett SJC, Al-Hindawi A, Davies GW, Rayment M, Mughal N, Randell P, Jones R, Moore LSP. Evaluating the performance characteristics of five lateral flow assays for the detection of the SARS-CoV-2 nucleocapsid antigen. Sci Rep 2022; 12:8811. [PMID: 35614181 PMCID: PMC9130972 DOI: 10.1038/s41598-022-12805-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 05/11/2022] [Indexed: 11/24/2022] Open
Abstract
In response to the COVID-19 pandemic, lateral flow assays (LFAs) for the detection of SARS-CoV-2 antigen have been proposed as a complementary option to the more costly and time consuming reverse-transcriptase polymerase chain reaction (RT-PCR). We assessed five commercially available SARS-CoV-2 antigen detecting LFAs (ASSUT EUROPE (Rome, Italy), Besthree (Taizhou, China), Encode (Zhuhai, China), Fortress (Antrim UK), and Hughes Medical (Buckinghamshire, UK), using samples collected from hospitalised individuals with COVID-19 and compared these results against established RT-PCR assays with the aim of estimating test performance characteristics. We performed a diagnostic accuracy study of the five LFAs on 110 inpatients with confirmed COVID-19 and 75 COVID-19 negative control participants. Assay evaluation was performed using a modified version of each manufacturer's protocol allowing for parallel testing of a single sample on multiple assays. Additional variables were studied including infection acquisition, oxygenation requirements at time of swabbing, and patient outcomes. The 110 patients were 48% (53) female, with mean age 67 years (range 26-100 years), and 77% (85) cases were community onset SARS-CoV-2. Across the five assays, sensitivity ranged from 64 (95% CI 53-73) to 76% (95% CI 65-85); Fortress performed best with sensitivity of 76% (95% CI 65-85). Specificity was high across all assays with 4/5 LFAs achieving 100%. LFA sensitivity was not dependant on RT-PCR cycle thresholds. SARS-CoV-2 antigen detecting LFAs may complement RT-PCR testing to facilitate early diagnosis and provide community testing strategies for identification of patients with COVID-19, however we find suboptimal test performance characteristics across a range of commercially available manufacturers, below WHO and MHRA pre-set sensitivity performance thresholds. With such variation in sensitivity between LFAs and PCR testing and between assay brands, we advise caution in the deployment of LFAs outside of environments with clinical oversight.
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Affiliation(s)
- J Heskin
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK.
| | - S J C Pallett
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK
| | - A Al-Hindawi
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
| | - G W Davies
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
| | - M Rayment
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
| | - N Mughal
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
- North West London Pathology, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK
| | - P Randell
- North West London Pathology, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK
| | - R Jones
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
| | - L S P Moore
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
- North West London Pathology, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK
- NIHR Health Protection Research Unit in Healthcare Associated Infections & Antimicrobial Resistance, Imperial College London, Du Cane Road, London, UK
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13
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Peremiquel-Trillas P, Saura-Lázaro A, Benavente-Moreno Y, Casabonne D, Loureiro E, Cabrera S, Duran A, Garrote L, Brao I, Trelis J, Galán M, Soler F, Julià J, Cortasa D, Domínguez MÁ, Albasanz-Puig A, Gudiol C, Ramírez-Tarruella D, Muniesa J, Rivas JP, Muñoz-Montplet C, Sedano A, Plans À, Calvo-Cerrada B, Calle C, Clopés A, Carnicer-Pont D, Alemany L, Fernández E. COVID-19 among workers of a comprehensive cancer centre between first and second epidemic waves (2020): a seroprevalence study in Catalonia, Spain. BMJ Open 2022; 12:e056637. [PMID: 35450905 PMCID: PMC9023852 DOI: 10.1136/bmjopen-2021-056637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Patients with cancer are at higher risk for severe COVID-19 infection. COVID-19 surveillance of workers in oncological centres is crucial to assess infection burden and prevent transmission. We estimate the SARS-CoV-2 seroprevalence among healthcare workers (HCWs) of a comprehensive cancer centre in Catalonia, Spain, and analyse its association with sociodemographic characteristics, exposure factors and behaviours. DESIGN Cross-sectional study (21 May 2020-26 June 2020). SETTING A comprehensive cancer centre (Institut Català d'Oncologia) in Catalonia, Spain. PARTICIPANTS All HCWs (N=1969) were invited to complete an online self-administered epidemiological survey and provide a blood sample for SARS-CoV-2 antibodies detection. PRIMARY OUTCOME MEASURE Prevalence (%) and 95% CIs of seropositivity together with adjusted prevalence ratios (aPR) and 95% CI were estimated. RESULTS A total of 1266 HCWs filled the survey (participation rate: 64.0%) and 1238 underwent serological testing (97.8%). The median age was 43.7 years (p25-p75: 34.8-51.0 years), 76.0% were female, 52.0% were nursing or medical staff and 79.0% worked on-site during the pandemic period. SARS-CoV-2 seroprevalence was 8.9% (95% CI 7.44% to 10.63%), with no differences by age and sex. No significant differences in terms of seroprevalence were observed between onsite workers and teleworkers. Seropositivity was associated with living with a person with COVID-19 (aPR 3.86, 95% CI 2.49 to 5.98). Among on-site workers, seropositive participants were twofold more likely to be nursing or medical staff. Nursing and medical staff working in a COVID-19 area showed a higher seroprevalence than other staff (aPR 2.45, 95% CI 1.08 to 5.52). CONCLUSIONS At the end of the first wave of the pandemic in Spain, SARS-CoV-2 seroprevalence among Institut Català d'Oncologia HCW was lower than the reported in other Spanish hospitals. The main risk factors were sharing household with infected people and contact with COVID-19 patients and colleagues. Strengthening preventive measures and health education among HCW is fundamental.
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Affiliation(s)
- Paula Peremiquel-Trillas
- Cancer Epidemiology Research Programme, Cancer Epidemiology and Prevention Department, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Epidemiology and Public Health Programme, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- School of Medicine and Clinical Sciences, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain
| | - Anna Saura-Lázaro
- Cancer Epidemiology Research Programme, Cancer Epidemiology and Prevention Department, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Epidemiology and Public Health Programme, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
| | - Yolanda Benavente-Moreno
- Cancer Epidemiology Research Programme, Cancer Epidemiology and Prevention Department, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Epidemiology and Public Health Programme, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Delphine Casabonne
- Cancer Epidemiology Research Programme, Cancer Epidemiology and Prevention Department, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Epidemiology and Public Health Programme, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Eva Loureiro
- Computer Science Services, Technology & Physics, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Computational Science and Artificial Intelligence, Schoolof Computer Science of Coruña, University of Coruña (UDC), Coruña, Spain
| | - Sandra Cabrera
- Research Nursing Department, Institut Català d'Oncologia (ICO), Badalona, Spain
| | - Angela Duran
- Nursing Department, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
| | - Lidia Garrote
- Nursing Department, Institut Català d'Oncologia, Badalona, Spain
| | - Immaculada Brao
- Nursing Department, Institut Català d'Oncologia (ICO), Girona, Spain
| | - Jordi Trelis
- School of Medicine and Clinical Sciences, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain
- Palliative Care Department and Medical Director, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
| | - Maica Galán
- Esofagogastric Tumours Functional Unit and Medical Director, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
| | - Francesc Soler
- Pharmacy Service and Medical Director, Institut Català d'Oncologia (ICO), Girona, Spain
| | - Joaquim Julià
- Palliative Care Department and Medical Director, Institut Català d'Oncologia (ICO), Badalona, Spain
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Dolça Cortasa
- Medical Director, Institut català d'Oncologia, Tarragona, Spain
| | - Maria Ángeles Domínguez
- Microbiology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
- Infectious Diseases Programme, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
- Department of Pathology Experimental Therapeutics, Universitat de Barcelona, L'Hosìtalet de Llobregat, Spain
| | - Adaia Albasanz-Puig
- Infectious Disease Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
- Infectious Disease Unit, Institut català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- CIBER of Infectious Diseases (CIBERINFEC), Madrid, Spain
| | - Carlota Gudiol
- Infectious Disease Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
- Infectious Disease Unit, Institut català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- CIBER of Infectious Diseases (CIBERINFEC), Madrid, Spain
| | | | - Joan Muniesa
- Computer Science Services, Technology & Physics, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
| | - Juan Pedro Rivas
- Computer Science Services, Technology & Physics, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
| | - Carles Muñoz-Montplet
- Computer Science Services, Technology & Physics, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Medical Physics and Radiation Protection Department, Institut Català d'Oncologia (ICO), Girona, Spain
- Department of Medical Sciences, Universitat de Girona, Girona, Spain
| | - Ana Sedano
- Human Resources Department, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
| | - Àngel Plans
- Occupational Health Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
| | - Beatriz Calvo-Cerrada
- Occupational Health Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
| | - Candela Calle
- General Direction, Institut Català d'Oncologia (ICO), L'Hospìtalet de Llobregat, Spain
| | - Ana Clopés
- Scientific Direction, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
| | - Dolors Carnicer-Pont
- Epidemiology and Public Health Programme, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
- Cancer Prevention and Control Programme, Cancer Epidemiology and Prevention Department, Institut català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
- WHO Collaborating Center for Tobacco Control, Institut català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
| | - Laia Alemany
- Cancer Epidemiology Research Programme, Cancer Epidemiology and Prevention Department, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Epidemiology and Public Health Programme, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esteve Fernández
- Epidemiology and Public Health Programme, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
- School of Medicine and Clinical Sciences, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain
- Cancer Prevention and Control Programme, Cancer Epidemiology and Prevention Department, Institut català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
- WHO Collaborating Center for Tobacco Control, Institut català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
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14
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COVID-19 seroprevalence amongst healthcare workers: potential biases in estimating infection prevalence. Epidemiol Infect 2022; 150:e48. [PMID: 35184764 PMCID: PMC8914136 DOI: 10.1017/s0950268822000280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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15
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Chua PEY, Gwee SXW, Wang MX, Gui H, Pang J. Severe Acute Respiratory Syndrome Coronavirus 2 Diagnostic Tests for Border Screening During the Very Early Phase of Coronavirus Disease 2019 Pandemic: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2022; 9:748522. [PMID: 35237618 PMCID: PMC8882616 DOI: 10.3389/fmed.2022.748522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 01/06/2022] [Indexed: 12/23/2022] Open
Abstract
Diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during border screening among returning residents and prioritized travelers during the early phase of a pandemic can reduce the risk of importation and transmission in the community. This study aimed to compare the accuracy of various SARS-CoV-2 diagnostics and assess their potential utility as border screening for infection and immunity. Systematic literature searches were conducted in six electronic databases for studies reporting SARS-CoV-2 diagnostics (up to April 30, 2020). Meta-analysis and methodological assessment were conducted for all included studies. The performance of the diagnostic tests was evaluated with pooled sensitivity, specificity, and their respective 95% confidence intervals. A total of 5,416 unique studies were identified and 95 studies (at least 29,785 patients/samples) were included. Nucleic acid amplification tests (NAAT) consistently outperformed all other diagnostic methods regardless of the selected viral genes with a pooled sensitivity of 98% and a pooled specificity of 99%. Point-of-care (POC) serology tests had moderately high pooled sensitivity (69%), albeit lower than laboratory-based serology tests (89%), but both had high pooled specificity (96-98%). Serology tests were more sensitive for sampling collected at ≥ 7 days than ≤ 7 days from the disease symptoms onset. POC NAAT and POC serology tests are suitable for detecting infection and immunity against the virus, respectively as border screening. Independent validation in each country is highly encouraged with the preferred choice of diagnostic tool/s.
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Affiliation(s)
- Pearleen Ee Yong Chua
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
- Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore, Singapore
| | - Sylvia Xiao Wei Gwee
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
- Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore, Singapore
| | - Min Xian Wang
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
- Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore, Singapore
| | - Hao Gui
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
- Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore, Singapore
| | - Junxiong Pang
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
- Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore, Singapore
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16
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Pallett SJ, Jones R, Abdulaal A, Pallett MA, Rayment M, Patel A, Denny SJ, Mughal N, Khan M, Rosadas de Oliveira C, Pantelidis P, Randell P, Toumazou C, O'Shea MK, Tedder R, McClure MO, Davies GW, Moore LS. Variability in detection of SARS-CoV-2-specific antibody responses following mild infection: a prospective multicentre cross-sectional study, London, United Kingdom, 17 April to 17 July 2020. Euro Surveill 2022; 27:2002076. [PMID: 35086612 PMCID: PMC8796290 DOI: 10.2807/1560-7917.es.2022.27.4.2002076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 07/03/2021] [Indexed: 12/13/2022] Open
Abstract
IntroductionImmunoassays targeting different SARS-CoV-2-specific antibodies are employed for seroprevalence studies. The degree of variability between immunoassays targeting anti-nucleocapsid (anti-NP; the majority) vs the potentially neutralising anti-spike antibodies (including anti-receptor-binding domain; anti-RBD), particularly in mild or asymptomatic disease, remains unclear.AimsWe aimed to explore variability in anti-NP and anti-RBD antibody detectability following mild symptomatic or asymptomatic SARS-CoV-2 infection and analyse antibody response for correlation with symptomatology.MethodsA multicentre prospective cross-sectional study was undertaken (April-July 2020). Paired serum samples were tested for anti-NP and anti-RBD IgG antibodies and reactivity expressed as binding ratios (BR). Multivariate linear regression was performed analysing age, sex, time since onset, symptomatology, anti-NP and anti-RBD antibody BR.ResultsWe included 906 adults. Antibody results (793/906; 87.5%; 95% confidence interval: 85.2-89.6) and BR strongly correlated (ρ = 0.75). PCR-confirmed cases were more frequently identified by anti-RBD (129/130) than anti-NP (123/130). Anti-RBD testing identified 83 of 325 (25.5%) cases otherwise reported as negative for anti-NP. Anti-NP presence (+1.75/unit increase; p < 0.001), fever (≥ 38°C; +1.81; p < 0.001) or anosmia (+1.91; p < 0.001) were significantly associated with increased anti-RBD BR. Age (p = 0.85), sex (p = 0.28) and cough (p = 0.35) were not. When time since symptom onset was considered, we did not observe a significant change in anti-RBD BR (p = 0.95) but did note decreasing anti-NP BR (p < 0.001).ConclusionSARS-CoV-2 anti-RBD IgG showed significant correlation with anti-NP IgG for absolute seroconversion and BR. Higher BR were seen in symptomatic individuals, particularly those with fever. Inter-assay variability (12.5%) was evident and raises considerations for optimising seroprevalence testing strategies/studies.
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Affiliation(s)
- Scott Jc Pallett
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Rachael Jones
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Ahmed Abdulaal
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Mitchell A Pallett
- Department of Infectious Disease, MRC Centre for Molecular Bacteriology and Infection, Imperial College London, United Kingdom
| | - Michael Rayment
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Aatish Patel
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Sarah J Denny
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Nabeela Mughal
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
- North West London Pathology, London, United Kingdom
| | - Maryam Khan
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, London, United Kingdom
| | - Carolina Rosadas de Oliveira
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, London, United Kingdom
| | | | - Paul Randell
- North West London Pathology, London, United Kingdom
| | - Christofer Toumazou
- Faculty of Engineering, Department of Electrical and Electronic Engineering, Imperial College London, South Kensington Campus, London, United Kingdom
| | - Matthew K O'Shea
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
- Institute of Immunology and Immunotherapy, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Richard Tedder
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, London, United Kingdom
| | - Myra O McClure
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, London, United Kingdom
| | - Gary W Davies
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Luke Sp Moore
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
- North West London Pathology, London, United Kingdom
- Imperial College London, NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, London, United Kingdom
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Malaeb R, Yousef N, Al-Nagdah O, Ali QH, Saeed MAS, Haider A, Zelikova E, Malou N, Guiramand S, Mills C, Luquero F, Porten K. High seroprevalence of antibodies against SARS-CoV-2 among healthcare workers 8 months after the first wave in Aden, Yemen. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000767. [PMID: 36962647 PMCID: PMC10022234 DOI: 10.1371/journal.pgph.0000767] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 10/06/2022] [Indexed: 11/10/2022]
Abstract
The true burden of COVID-19 in Yemen is underestimated. The healthcare system is dysfunctional and there is a high shortage of health care workers in the country. Testing for SARS-CoV-2 remains limited and official surveillance data is restricted to those who are severe or highly suspected. In this study, Médecins Sans Frontières (MSF) aimed to conduct serological screening using rapid tests for asymptomatic staff at the MSF Aden Trauma Center to determine the SARS-CoV-2 antibody seropositivity. Four months after the peak of the first wave, we offered all the staff at the MSF Aden Trauma Center PCR if symptomatic, and a baseline SARS-CoV-2 serology screening followed by follow-up screenings. A final round was scheduled four months after the baseline. A rapid serology lateral flow test, NG-Test IgM-IgG was used in all rounds and in the final round, an electrochemiluminescence immunoassay (ECLIA) (Elecsys Anti-SARS-CoV-2 assay). Univariate and multivariate analyses were used to identify risk factors for seropositivity. The level of agreement between the different serology assays used was investigated. Overall 69 out of 356 participants (19.4%, 95% CI 17.9-20.8) tested positive by NG-Test between September and November 2020. A sub-sample of 161 staff members were retested in January 2021. Of these, the NG-Test detected only 13 positive cases, whereas the ECLIA detected 109 positive cases. The adjusted seroprevalence by ECLIA was 59% (95%CI 52.2-65.9). The non-medical staff had significantly lower odds of seropositivity compared to the medical staff (AOR 0.43, 95% CI 0.15-0.7, p<0.001). The positive percent agreement between the two tests was very low (11%). Our results suggest a very high SARS-CoV-2 seroprevalence in healthcare workers in Yemen, highlighting the need for regular testing and rapid vaccination of all healthcare workers in the country.
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Magicova M, Fialova M, Zahradka I, Rajnochova-Bloudickova S, Hackajlo D, Raska P, Striz I, Viklicky O. Humoral response to SARS-CoV-2 is well preserved and symptom dependent in kidney transplant recipients. Am J Transplant 2021; 21:3926-3935. [PMID: 34212497 PMCID: PMC9906442 DOI: 10.1111/ajt.16746] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 01/25/2023]
Abstract
Data on the immune response to SARS-CoV-2 in kidney transplant recipients are scarce. Thus, we conducted a single-center observational study to assess the anti-SARS-CoV-2 IgG seroprevalence in outpatient kidney transplant recipients (KTR; n = 1037) and healthcare workers (HCW; n = 512) during the second wave of the COVID-19 pandemic in fall 2020 and evaluated the clinical variables affecting antibody levels. Antibodies against S1 and S2 subunit of SARS-CoV-2 were evaluated using immunochemiluminescent assay (cut off 9.5 AU/ml, sensitivity of 91.2% and specificity of 90.2%). Anti-SARS-CoV-2 IgG seroprevalence was lower in KTR than in HCW (7% vs. 11.9%, p = .001). Kidney transplant recipients with SARS-CoV-2 infection were younger (p = .001) and received CNI-based immunosuppression more frequently (p = .029) than seronegative KTR. Anti-SARS-CoV-2 IgG positive symptomatic KTR had a higher BMI (p = .04) than asymptomatic KTR. Interestingly, anti-SARS-CoV-2 IgG levels were higher in KTR than in HCW (median 31 AU/ml, IQR 17-84 vs. median 15 AU/ml, IQR 11-39, p < .001). The presence of moderate to severe symptoms in KTR was found to be the only independent factor affecting IgG levels (Beta coefficient = 41.99, 95% CI 9.92-74.06, p = .011) in the multivariable model. In conclusion, KTR exhibit a well-preserved symptom-dependent humoral response to SARS-CoV-2 infection.
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Affiliation(s)
- Maria Magicova
- Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Martina Fialova
- Department of Immunology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Ivan Zahradka
- Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Silvie Rajnochova-Bloudickova
- Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - David Hackajlo
- Department of Informatics, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Petr Raska
- Department of Informatics, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Ilja Striz
- Department of Immunology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Ondrej Viklicky
- Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic,Correspondence Ondrej Viklicky, Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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19
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Martínez PT, García PD, Salas MR, Sánchez RR, Avendaño-Ortíz J, Guerrero-Monjo S, García F, Llamas MÁ, López-Collazo E, Saz-Leal P, Del Fresno C. SARS-CoV-2 IgG seropositivity in a cohort of 449 non-hospitalized individuals during Spanish COVID-19 lockdown. Sci Rep 2021; 11:21612. [PMID: 34732800 PMCID: PMC8566591 DOI: 10.1038/s41598-021-00990-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 10/21/2021] [Indexed: 12/13/2022] Open
Abstract
The Coronavirus Disease of 2019 (COVID-19) pandemic caused by SARS-CoV-2 led the Spanish government to impose a national lockdown in an attempt to control the spread of the infection. Mobility restrictions and the requirement of a medical prescription for serological testing for COVID-19 were included among the control measures. Under this scenario, between April 15th and June 15th, 2020, we performed an observational study including 449 individuals allowed to be tested according to the governmental restrictions, i.e. fulfilling the following prescription requirements: manifestation of COVID-19-compatible symptoms, contact with a confirmed COVID-19 patient, or employment as an essential worker, including health care workers, firefighters and public safety personnel such as police. Importantly, a relevant feature of the studied cohort was that none of the participants had been hospitalized. We analyzed SARS-CoV-2 IgG seropositivity in this specific cohort, uncovering intrinsic features of great demographic interest. The overall rate of IgG seropositivity was 33.69% (95% CI: 29.27-38.21). This frequency was comparable among the different participant occupations. A RT-PCR positive test, contact with a household member previously tested positive and the presence of COVID-19-compatible symptoms were positively associated with IgG + results. Among these symptoms, ageusia/anosmia was positively and independently associated with SARS-CoV-2 IgG seropositivity, while odynophagia was inversely associated. However, fever, ageusia/anosmia and asthenia were the most frequent symptoms described by IgG + subjects. Therefore, our data illustrate how specific cohorts display particular characteristics that should be taken into account when studying population-wide SARS-CoV-2 seroprevalence and key defining symptoms of COVID-19.
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Affiliation(s)
| | | | | | | | - José Avendaño-Ortíz
- The Innate Immune Response Group, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | | | | | - Miguel Ángel Llamas
- EMPIREO Diagnóstico Molecular, Madrid, Spain
- LABIANA Pharmaceuticals SLU, Barcelona, Spain
| | - Eduardo López-Collazo
- The Innate Immune Response Group, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | | | - Carlos Del Fresno
- The Innate Immune Response Group, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain.
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20
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Vaselli NM, Hungerford D, Shenton B, Khashkhusha A, Cunliffe NA, French N. The seroprevalence of SARS-CoV-2 during the first wave in Europe 2020: A systematic review. PLoS One 2021; 16:e0250541. [PMID: 34727115 PMCID: PMC8562786 DOI: 10.1371/journal.pone.0250541] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 09/23/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND A year following the onset of the COVID-19 pandemic, new infections and deaths continue to increase in Europe. Serological studies, through providing evidence of past infection, can aid understanding of the population dynamics of SARS-CoV-2 infection. OBJECTIVES This systematic review of SARS-CoV-2 seroprevalence studies in Europe was undertaken to inform public health strategies including vaccination, that aim to accelerate population immunity. METHODS We searched the databases Web of Science, MEDLINE, EMBASE, SCOPUS, Cochrane Database of Systematic Reviews and grey literature sources for studies reporting seroprevalence of SARS-CoV-2 antibodies in Europe published between 01/12/2019-30/09/20. We provide a narrative synthesis of included studies. Studies were categorized into subgroups including healthcare workers (HCWs), community, outbreaks, pregnancy and children/school. Due to heterogeneity in other subgroups, we only performed a random effects meta-analysis of the seroprevalence amongst HCWs stratified by their country. RESULTS 115 studies were included spanning 17 European countries, that estimated the seroprevalence of SARS-CoV-2 from samples obtained between November 2019 -August 2020. A total of 54/115 studies included HCWs with a reported seroprevalence among HCWs ranging from 0.7% to 45.3%, which did not differ significantly by country. In community studies significant heterogeneity was reported in the seroprevalence between different age groups and the majority of studies reported there was no significant difference by gender. CONCLUSION This review demonstrates a wide heterogeneity in reported seroprevalence of SARS-CoV-2 antibodies between populations. Continued evaluation of seroprevalence is required to understand the impact of public health measures and inform interventions including vaccination programmes.
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Affiliation(s)
- Natasha Marcella Vaselli
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Daniel Hungerford
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- NIHR HPRU in Gastrointestinal Infections at the University of Liverpool, Liverpool, United Kingdom
- NIHR HPRU in Emerging and Zoonotic Infections at the University of Liverpool, Liverpool, United Kingdom
| | - Ben Shenton
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Arwa Khashkhusha
- School of Medicine, Faculty of Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Nigel A. Cunliffe
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- NIHR HPRU in Gastrointestinal Infections at the University of Liverpool, Liverpool, United Kingdom
| | - Neil French
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- NIHR HPRU in Emerging and Zoonotic Infections at the University of Liverpool, Liverpool, United Kingdom
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21
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Heskin J, Pallett SJC, Mughal N, Jones R, Rayment M, Davies GW, Moore LSP. Healthcare worker perceptions of routine asymptomatic SARS-CoV-2 screening using lateral flow assays: A qualitative analysis across two London hospitals. J Infect 2021; 84:e26-e28. [PMID: 34736983 PMCID: PMC8559300 DOI: 10.1016/j.jinf.2021.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/23/2021] [Accepted: 10/26/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Joseph Heskin
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, United Kingdom.
| | - Scott J C Pallett
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, United Kingdom
| | - Nabeela Mughal
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, United Kingdom; Imperial College Healthcare NHS Trust, North West London Pathology, Fulham Palace Road, London W6 8RF, United Kingdom
| | - Rachael Jones
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, United Kingdom
| | - Michael Rayment
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, United Kingdom
| | - Gary W Davies
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, United Kingdom
| | - Luke S P Moore
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, United Kingdom; Imperial College Healthcare NHS Trust, North West London Pathology, Fulham Palace Road, London W6 8RF, United Kingdom; NIHR Health Protection Research Unit in Healthcare Associated Infections & Antimicrobial Resistance, Imperial College London, Du Cane Road, London, United Kingdom
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22
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Ajab S, Ádam B, Al Hammadi M, Al Bastaki N, Al Junaibi M, Al Zubaidi A, Hegazi M, Grivna M, Kady S, Koornneef E, Neves R, Uva AS, Sheek-Hussein M, Loney T, Serranheira F, Paulo MS. Occupational Health of Frontline Healthcare Workers in the United Arab Emirates during the COVID-19 Pandemic: A Snapshot of Summer 2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11410. [PMID: 34769927 PMCID: PMC8583571 DOI: 10.3390/ijerph182111410] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 02/05/2023]
Abstract
The study aim was to understand the availability of personal protective equipment (PPE) and the levels of anxiety, depression, and burnout of healthcare workers (HCWs) in the United Arab Emirates (UAE). This study was an online-based, cross-sectional survey during July and August 2020. Participants were eligible from the entire country, and 1290 agreed to participate. The majority of HCWs were females aged 30-39 years old, working as nurses, and 80% considered PPE to be available. Twelve percent of respondents tested positive for SARS-CoV-2. Half of HCWs considered themselves physically tired (52.2%), reported musculoskeletal pain or discomfort (54.2%), and perceived moderate-to-high levels of burnout on at least one of three burnout domains (52.8%). A quarter of HCWs reported anxiety (26.3%) or depression (28.1%). HCWs reporting not having musculoskeletal pain, having performed physical activity, and higher scores of available PPE reported lower scores of anxiety, depression, and burnout. UAE HCWs experienced more access to PPE and less anxiety, depression, and burnout compared with HCWs in other countries. Study findings can be used by healthcare organizations and policymakers to ensure adequate measures are implemented to maximize the health and wellbeing of HCWs during the current COVID-19 and future pandemics.
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Affiliation(s)
- Suad Ajab
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (S.A.); (B.Á.); (M.G.); (E.K.); (M.S.-H.)
| | - Balázs Ádam
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (S.A.); (B.Á.); (M.G.); (E.K.); (M.S.-H.)
| | - Muna Al Hammadi
- Tawam Hospital, Al Ain P.O. Box 17666, United Arab Emirates;
| | - Najwa Al Bastaki
- Department of Medical Education and Research, Dubai Health Authority, Dubai P.O. Box 4545, United Arab Emirates;
| | - Mohamed Al Junaibi
- Ministry of Presidential Affairs, Abu Dhabi P.O. Box 280, United Arab Emirates; (M.A.J.); (A.A.Z.); (S.K.)
| | - Abdulmajeed Al Zubaidi
- Ministry of Presidential Affairs, Abu Dhabi P.O. Box 280, United Arab Emirates; (M.A.J.); (A.A.Z.); (S.K.)
| | - Mona Hegazi
- Department of Family Medicine, Mediclinic City Hospital, Dubai P.O. Box 505004, United Arab Emirates;
| | - Michal Grivna
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (S.A.); (B.Á.); (M.G.); (E.K.); (M.S.-H.)
- Department of Public Health and Preventive Medicine, Second Faculty of Medicine, Charles University, 150 06 Prague, Czech Republic
| | - Suhail Kady
- Ministry of Presidential Affairs, Abu Dhabi P.O. Box 280, United Arab Emirates; (M.A.J.); (A.A.Z.); (S.K.)
| | - Erik Koornneef
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (S.A.); (B.Á.); (M.G.); (E.K.); (M.S.-H.)
- Ministry of Presidential Affairs, Abu Dhabi P.O. Box 280, United Arab Emirates; (M.A.J.); (A.A.Z.); (S.K.)
| | - Raquel Neves
- Health Science Faculty, Higher College of Technology Abu Dhabi, Abu Dhabi P.O. Box 25026, United Arab Emirates;
| | - António Sousa Uva
- CHRC, Comprehensive Health Research Center, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal; (A.S.U.); (F.S.)
| | - Mohamud Sheek-Hussein
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (S.A.); (B.Á.); (M.G.); (E.K.); (M.S.-H.)
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates;
| | - Florentino Serranheira
- CHRC, Comprehensive Health Research Center, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal; (A.S.U.); (F.S.)
| | - Marília Silva Paulo
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (S.A.); (B.Á.); (M.G.); (E.K.); (M.S.-H.)
- CHRC, Comprehensive Health Research Center, Nova Medical School, Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal
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23
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Kapuczinski A, de Terwangne C, De Keukeleire S, Goffard JC, Sorgente A, Place S, De Cubber M. Exposure to SARS-CoV-2 in Hospital Environment: Working in a COVID-19 Ward Is a Risk Factor for Infection. Pathogens 2021; 10:1175. [PMID: 34578207 PMCID: PMC8466053 DOI: 10.3390/pathogens10091175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/04/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022] Open
Abstract
Aims. Health care workers (HCWs) are at risk of acquiring the Severe Acute Respiratory Syndrome Coronavirus 2 Infection (SARS-CoV-2). The aim of the study is to determine the SARS-CoV-2 positivity rates during the first epidemiologic peak among HCWs of a south Belgian hospital and to identify risks factors for infection. Methods. All hospital staff who worked during the first epidemiological peak were asked to answer a questionnaire regarding demographical data, function, type of working unit, type of contact with patients, eventual symptomatology, and the positivity of reverse transcription-polymerase chain reaction (RT-PCR) testing or immunoassay. Results. A total of 235 questionnaires were collected; 90 (38%) HCWs tested positive for SARS-CoV-2 from either RT-PCR or immunoassay testing. The positivity rate of HCWs between wards was statistically different (p = 0.004) and was higher in COVID-19 wards than Intensive Care Unit (ICU) and Emergency Department (ED). A total of 114 (49%) HCWs presented SARS-CoV-2-compatible symptomatology; 79 (88%) were positive on either RT-PCR or immunoassay testing; 74 (37%) HCWs were unable to work during the studied period; 5 were hospitalized. No deaths were reported. Multivariate logistic regression modeling showed that having symptoms was highly associated with test positivity (OR 23.3, CI 11.1, 53.1, p-value < 0.001). Working in a COVID-19 ward against working in ICU or ED was also predictive of positivity among HCWs (OR 3.25, CI 1.50, 7.28, p-value = 0.003). Discussion and Conclusions. This study shows a higher positivity rate compared to already reported positivity rates among HCWs. Reported differences in positivity rates depend on many factors, such as local crisis intensity, screening strategy, training in use of self-protective equipment, and study selection bias. HCWs working in COVID-19 wards, in comparison to ED and ICU, seemed at greater risk of being infected in this study. This could be explained by the disparity of HCWs' experience in handling self-protective equipment and knowledge in infection prevention. Hence, care should be taken in proper training for less-experienced HCWs during hospital epidemics. The latter could increase HCWs' protection and consequently decrease work absenteeism, ensuring enhanced continuity of patient care during hospital crisis. Rapid quarantine of symptomatic HCWs could reduce contamination rates, as having symptoms was highly associated with test positivity in this study.
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Affiliation(s)
- Abeline Kapuczinski
- Department of Internal Medicine, Centre Hospitalier EpiCURA, 7301 Hornu, Belgium; (C.d.T.); (S.P.)
| | - Christophe de Terwangne
- Department of Internal Medicine, Centre Hospitalier EpiCURA, 7301 Hornu, Belgium; (C.d.T.); (S.P.)
| | - Steven De Keukeleire
- Department of Laboratory Medicine, Centre Hospitalier EpiCURA, 7301 Hornu, Belgium;
| | - Jean-Christophe Goffard
- Department of Internal Medicine, Erasmus Hospital, Université Libre de Bruxelles, 1070 Bruxelles, Belgium;
| | - Antonio Sorgente
- Department of Cardiology, Centre Hospitalier EpiCURA Hospital, 7301 Hornu, Belgium; (A.S.); (M.D.C.)
| | - Sammy Place
- Department of Internal Medicine, Centre Hospitalier EpiCURA, 7301 Hornu, Belgium; (C.d.T.); (S.P.)
| | - Michael De Cubber
- Department of Cardiology, Centre Hospitalier EpiCURA Hospital, 7301 Hornu, Belgium; (A.S.); (M.D.C.)
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24
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Murongazvombo AS, Jones RS, Rayment M, Mughal N, Azadian B, Donaldson H, Davies GW, Moore LSP, Aiken AM. Association between SARS-CoV-2 exposure and antibody status among healthcare workers in two London hospitals: a cross-sectional study. Infect Prev Pract 2021; 3:100157. [PMID: 34316587 PMCID: PMC8217738 DOI: 10.1016/j.infpip.2021.100157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/15/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Patient-facing (frontline) health-care workers (HCWs) are at high risk of repeated exposure to SARS-CoV-2. AIM We sought to determine the association between levels of frontline exposure and likelihood of SARS-CoV-2 seropositivity amongst HCW. METHODS A cross-sectional study was undertaken using purposefully collected data from HCWs at two hospitals in London, United Kingdom (UK) over eight weeks in May-June 2020. Information on sociodemographic, clinical and occupational characteristics was collected using an anonymised questionnaire. Serology was performed using split SARS-CoV-2 IgM/IgG lateral flow immunoassays. Exposure risk was categorised into five pre-defined ordered grades. Multivariable logistic regression was used to examine the association between being frontline and SARS-CoV-2 seropositivity after controlling for other risks of infection. FINDINGS 615 HCWs participated in the study. 250/615 (40.7%) were SARS-CoV-2 IgM and/or IgG positive. After controlling for other exposures, there was non-significant evidence of a modest association between being a frontline HCW (any level) and SARS-CoV-2 seropositivity compared to non-frontline status (OR 1.39, 95% CI 0.84-2.30, P=0.200). There was 15% increase in the odds of SARS-CoV-2 seropositivity for each step along the frontline exposure gradient (OR 1.15, 95% CI 1.00-1.32, P=0.043). CONCLUSION We found a high SARS-CoV-2 IgM/IgG seropositivity with modest evidence for a dose-response association between increasing levels of frontline exposure risk and seropositivity. Even in well-resourced hospital settings, appropriate use of personal protective equipment, in addition to other transmission-based precautions for inpatient care of SARS-CoV-2 patients could reduce the risk of hospital-acquired SARS-CoV-2 infection among frontline HCW.
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Affiliation(s)
| | - Rachael S. Jones
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
| | - Michael Rayment
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
| | - Nabeela Mughal
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
- North West London Pathology, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK
| | - Berge Azadian
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
| | - Hugo Donaldson
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
- North West London Pathology, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK
| | - Gary W. Davies
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
| | - Luke SP. Moore
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
- North West London Pathology, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK
- Imperial College London, NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Du Cane Road, London, W12 0NN, UK
| | - Alexander M. Aiken
- London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
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25
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Jamwal VL, Kumar N, Bhat R, Jamwal PS, Singh K, Dogra S, Kulkarni A, Bhadra B, Shukla MR, Saran S, Dasgupta S, Vishwakarma RA, Gandhi SG. Optimization and validation of RT-LAMP assay for diagnosis of SARS-CoV2 including the globally dominant Delta variant. Virol J 2021; 18:178. [PMID: 34461941 PMCID: PMC8404189 DOI: 10.1186/s12985-021-01642-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/12/2021] [Indexed: 01/12/2023] Open
Abstract
Background Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19 pandemic, has infected more than 179 million people worldwide. Testing of infected individuals is crucial for identification and isolation, thereby preventing further spread of the disease. Presently, Taqman™ Reverse Transcription Real Time PCR is considered gold standard, and is the most common technique used for molecular testing of COVID-19, though it requires sophisticated equipments, expertise and is also relatively expensive. Objective Development and optimization of an alternate molecular testing method for the diagnosis of COVID-19, through a two step Reverse Transcription Loop-mediated isothermal AMPlification (RT-LAMP). Results Primers for LAMP were carefully designed for discrimination from other closely related human pathogenic coronaviruses. Care was also taken that primer binding sites are present in conserved regions of SARS-CoV2. Our analysis shows that the primer binding sites are well conserved in all the variants of concern (VOC) and variants of interest (VOI), notified by World Health Organization (WHO). These lineages include B.1.1.7, B.1.351, P.1, B.1.617.2, B.1.427/B.1.429, P.2, B.1.525, P.3, B.1.526 and B.1.617.1. Various DNA polymerases with strand displacement activity were evaluated and conditions were optimized for LAMP amplification and visualization. Different LAMP primer sets were also evaluated using synthetic templates as well as patient samples. Conclusion In a double blind study, the RT-LAMP assay was validated on more than 150 patient samples at two different sites. The RT-LAMP assay appeared to be 89.2% accurate when compared to the Taqman™ rt-RT-PCR assay. Supplementary Information The online version contains supplementary material available at 10.1186/s12985-021-01642-9.
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Affiliation(s)
- Vijay Lakshmi Jamwal
- CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu, 180001, India.,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Natish Kumar
- CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu, 180001, India
| | - Rahul Bhat
- CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu, 180001, India.,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Piyush Singh Jamwal
- CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu, 180001, India
| | - Kaurab Singh
- Higher Education Department, Union Territory of Jammu and Kashmir, Jammu, India
| | - Sandeep Dogra
- Department of Microbiology, Government Medical College, Jammu, 180001, India
| | - Abhishek Kulkarni
- A2O - Biology, Reliance Technology Group, Reliance Industries Limited, RCP, Navi Mumbai, 400701, India
| | - Bhaskar Bhadra
- A2O - Biology, Reliance Technology Group, Reliance Industries Limited, RCP, Navi Mumbai, 400701, India
| | - Manish R Shukla
- A2O - Biology, Reliance Technology Group, Reliance Industries Limited, RCP, Navi Mumbai, 400701, India
| | - Saurabh Saran
- CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu, 180001, India.,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Santanu Dasgupta
- A2O - Biology, Reliance Technology Group, Reliance Industries Limited, RCP, Navi Mumbai, 400701, India
| | - Ram A Vishwakarma
- CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu, 180001, India
| | - Sumit G Gandhi
- CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu, 180001, India. .,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
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26
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Iqbal B, Khan M, Shah N, Dawood MM, Jehanzeb V, Shafi M. Comparison of SARS-CoV-2 antigen electrochemiluminescence immunoassay to RT-PCR assay for laboratory diagnosis of COVID-19 in Peshawar. Diagnosis (Berl) 2021; 9:364-368. [PMID: 34455727 DOI: 10.1515/dx-2021-0078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/04/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Antigen based rapid diagnostic tests possesses a potential to be utilized along with Gold standard methods to detect Covid-19 infection to cope with the demand of testing. The aim of this study was to determine diagnostic accuracy of electrochemiluminescence based automated antigen detection immunoassay comparing with molecular based test RT-PCR (Covid-19). METHODS It was a cross-sectional study conducted in RMI Peshawar, from 1st April 2021 till 30th April 2021. The study comprised 170 individuals who were suspected of having Covid-19. Nasopharyngeal samples taken from suspected individuals were analyzed by RT-PCR and automated antigen test (Elecsys SARS-CoV-2 Antigen) simultaneously. The correlation of SARS-CoV-2 antigen with PCR positive and negative cases was analyzed for specificity, sensitivity respectively. RESULTS The ECLIA based Elecsys antigen test (Roche) revealed overall sensitivity 72%, specificity 95% and accuracy of 94.9%. Sensitivity of antigen test progressively declined from 94.3% in Ct <25 to 70.8% in Ct 26-29 and then to 47.2% in Ct 30-35. CONCLUSIONS Based on the findings of our study we conclude that automated antigen testing (Elecsys SARS-CoV-2 Antigen) cannot replace molecular based testing like RT PCR. Elecsys SARS-CoV-2 Ag test should be used complementary to RT-PCR in testing algorithms. Frequent testing strategy should be adopted while using automated antigen testing to overcome its limitation in individuals with low viral loads.
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Affiliation(s)
- Bilal Iqbal
- Rehman Medical Institute Peshawar, Peshawar, Pakistan
| | - Maria Khan
- Rehman Medical Institute Peshawar, Peshawar, Pakistan
| | - Noman Shah
- Rehman Medical Institute Peshawar, Peshawar, Pakistan
| | | | | | - Mohsin Shafi
- Khyber Medical College Peshawar, Peshawar, Pakistan
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27
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Ghorbanizamani F, Tok K, Moulahoum H, Harmanci D, Hanoglu SB, Durmus C, Zihnioglu F, Evran S, Cicek C, Sertoz R, Arda B, Goksel T, Turhan K, Timur S. Dye-Loaded Polymersome-Based Lateral Flow Assay: Rational Design of a COVID-19 Testing Platform by Repurposing SARS-CoV-2 Antibody Cocktail and Antigens Obtained from Positive Human Samples. ACS Sens 2021; 6:2988-2997. [PMID: 34270230 PMCID: PMC8315240 DOI: 10.1021/acssensors.1c00854] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 07/07/2021] [Indexed: 02/06/2023]
Abstract
The global pandemic of COVID-19 continues to be an important threat, especially with the fast transmission rate observed after the discovery of novel mutations. In this perspective, prompt diagnosis requires massive economical and human resources to mitigate the disease. The current study proposes a rational design of a colorimetric lateral flow immunoassay (LFA) based on the repurposing of human samples to produce COVID-19-specific antigens and antibodies in combination with a novel dye-loaded polymersome for naked-eye detection. A group of 121 human samples (61 serums and 60 nasal swabs) were obtained and analyzed by RT-PCR and ELISA. Pooled samples were used to purify antibodies using affinity chromatography, while antigens were purified via magnetic nanoparticles-based affinity. The purified proteins were confirmed for their specificity to COVID-19 via commercial LFA, ELISA, and electrochemical tests in addition to sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis. Polymersomes were prepared using methoxy polyethylene glycol-b-polycaprolactone (mPEG-b-PCL) diblock copolymers and loaded with a Coomassie Blue dye. The polymersomes were then functionalized with the purified antibodies and applied for the preparation of two types of LFA (antigen test and antibody test). Overall, the proposed diagnostic tests demonstrated 93 and 92.2% sensitivity for antigen and antibody tests, respectively. The repeatability (92-94%) and reproducibility (96-98%) of the tests highlight the potential of the proposed LFA. The LFA test was also analyzed for stability, and after 4 weeks, 91-97% correct diagnosis was observed. The current LFA platform is a valuable assay that has great economical and analytical potential for widespread applications.
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Affiliation(s)
- Faezeh Ghorbanizamani
- Department of Biochemistry, Faculty of Science,
Ege University, Bornova, 35100 Izmir,
Turkey
| | - Kerem Tok
- Department of Biochemistry, Faculty of Science,
Ege University, Bornova, 35100 Izmir,
Turkey
| | - Hichem Moulahoum
- Department of Biochemistry, Faculty of Science,
Ege University, Bornova, 35100 Izmir,
Turkey
| | - Duygu Harmanci
- Department of Biochemistry, Faculty of Science,
Ege University, Bornova, 35100 Izmir,
Turkey
| | - Simge Balaban Hanoglu
- Department of Biochemistry, Faculty of Science,
Ege University, Bornova, 35100 Izmir,
Turkey
| | - Ceren Durmus
- Department of Biochemistry, Faculty of Science,
Ege University, Bornova, 35100 Izmir,
Turkey
| | - Figen Zihnioglu
- Department of Biochemistry, Faculty of Science,
Ege University, Bornova, 35100 Izmir,
Turkey
| | - Serap Evran
- Department of Biochemistry, Faculty of Science,
Ege University, Bornova, 35100 Izmir,
Turkey
| | - Candan Cicek
- Department of Medical Microbiology, Faculty of
Medicine, Ege University, Bornova, 35100 Izmir,
Turkey
| | - Ruchan Sertoz
- Department of Medical Microbiology, Faculty of
Medicine, Ege University, Bornova, 35100 Izmir,
Turkey
| | - Bilgin Arda
- Department of Infectious Diseases and Clinical
Microbiology, Faculty of Medicine, Ege University, Bornova,
35100 Izmir, Turkey
| | - Tuncay Goksel
- Department of Pulmonary Medicine, Faculty of Medicine,
Ege University, Bornova, 35100 Izmir,
Turkey
- EGESAM-Ege University Translational
Pulmonary Research Center, Bornova, 35100 Izmir,
Turkey
| | - Kutsal Turhan
- Department of Thoracic Surgery, Faculty of Medicine,
Ege University, Bornova, 35100 Izmir,
Turkey
| | - Suna Timur
- Department of Biochemistry, Faculty of Science,
Ege University, Bornova, 35100 Izmir,
Turkey
- Central Research Test and Analysis Laboratory
Application and Research Center, Ege University, Bornova, 35100
Izmir, Turkey
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28
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Meng Z, Guo S, Zhou Y, Li M, Wang M, Ying B. Applications of laboratory findings in the prevention, diagnosis, treatment, and monitoring of COVID-19. Signal Transduct Target Ther 2021; 6:316. [PMID: 34433805 PMCID: PMC8386162 DOI: 10.1038/s41392-021-00731-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/21/2021] [Accepted: 07/30/2021] [Indexed: 02/07/2023] Open
Abstract
The worldwide pandemic of coronavirus disease 2019 (COVID-19) presents us with a serious public health crisis. To combat the virus and slow its spread, wider testing is essential. There is a need for more sensitive, specific, and convenient detection methods of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Advanced detection can greatly improve the ability and accuracy of the clinical diagnosis of COVID-19, which is conducive to the early suitable treatment and supports precise prophylaxis. In this article, we combine and present the latest laboratory diagnostic technologies and methods for SARS-CoV-2 to identify the technical characteristics, considerations, biosafety requirements, common problems with testing and interpretation of results, and coping strategies of commonly used testing methods. We highlight the gaps in current diagnostic capacity and propose potential solutions to provide cutting-edge technical support to achieve a more precise diagnosis, treatment, and prevention of COVID-19 and to overcome the difficulties with the normalization of epidemic prevention and control.
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Affiliation(s)
- Zirui Meng
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Shuo Guo
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yanbing Zhou
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Mengjiao Li
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Minjin Wang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Binwu Ying
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
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29
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Lamb G, Heskin J, Randell P, Mughal N, Moore LS, Jones R, Davies GW, Rayment M. Real-world evaluation of COVID-19 lateral flow device (LFD) mass-testing in healthcare workers at a London hospital; a prospective cohort analysis. J Infect 2021; 83:452-457. [PMID: 34364950 PMCID: PMC8340567 DOI: 10.1016/j.jinf.2021.07.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/21/2021] [Accepted: 07/28/2021] [Indexed: 12/12/2022]
Abstract
Objectives Real-world evaluation of the performance of the Innova lateral flow immunoassay antigen device (LFD) for regular COVID-19 testing of hospital workers. Methods This prospective cohort analysis took place at a London NHS Trust. 5076 secondary care healthcare staff participated in LFD testing from 18 November 2020 to21 January 2021. Staff members submitted results and symptoms via an online portal twice weekly. Individuals with positive LFD results were invited for confirmatory SARS CoV-2 PCR testing. The positive predictive value (PPV) of the LFD was measured. Secondary outcome measures included time from LFD result to PCR test and staff symptom profiles. Results 284/5076 individuals reported a valid positive LFD result, and a paired PCR result was obtained in 259/284 (91.2%). 244 were PCR positive yielding a PPV of 94.21% (244/259, 95% CI 90.73% to 96.43%). 204/259 (78.8%) staff members had the PCR within 36 hours of the LFD test. Symptom profiles were confirmed for 132/244 staff members (54.1%) with positive PCR results (true positives) and 13/15 (86.6%) with negative PCR results (false positives). 91/132 true positives (68.9%) were symptomatic at the time of LFD testing: 65/91 (71.4%) had symptoms meeting the PHE case definition of COVID-19, whilst 26/91 (28.6%) had atypical symptoms. 18/41 (43.9%) staff members who were asymptomatic at the time of positive LFD developed symptoms in the subsequent four days. 9/13 (76.9%) false positives were asymptomatic, 1/13 (7.7%) had atypical symptoms and 3/13 (23.1%) had symptoms matching the PHE case definition. Conclusions The PPV of the Innova LFD is high when used amongst hospital staff during periods of high prevalence of COVID-19, yet we find frequent use by symptomatic staff rather than as a purely asymptomatic screening tool. LFD testing does allow earlier isolation of infected workers and facilitates detection of individuals whose symptoms do not qualify for PCR testing.
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Affiliation(s)
- Georgia Lamb
- Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, United Kingdom.
| | - Joseph Heskin
- Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, United Kingdom
| | - Paul Randell
- Imperial College Healthcare NHS Trust, North West London Pathology, Fulham Palace Road, London, W6 8RF, United Kingdom
| | - Nabeela Mughal
- Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, United Kingdom
| | - Luke Sp Moore
- Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, United Kingdom; Imperial College Healthcare NHS Trust, North West London Pathology, Fulham Palace Road, London, W6 8RF, United Kingdom; NIHR Health Protection Research Unit in Healthcare Associated Infections & Antimicrobial Resistance, Imperial College London, Du Cane Road, London, W12 0NN, United Kingdom
| | - Rachael Jones
- Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, United Kingdom
| | - Gary W Davies
- Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, United Kingdom
| | - Michael Rayment
- Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, United Kingdom
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30
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The front-line during the coronavirus disease 2019 pandemic: healthcare personnel. Curr Opin Infect Dis 2021; 34:372-383. [PMID: 34227581 DOI: 10.1097/qco.0000000000000734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW An estimated four to 11% of reported coronavirus disease 2019 (COVID-19) cases occurs in healthcare personnel (HCP). HCP are at high risk of acquiring and transmitting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) given their close contact with individuals with recognized and unrecognized COVID-19. We summarize the literature to date describing the epidemiology, identifying risk factors associated with COVID-19, and analyzing clinical characteristics and outcomes of SARS-CoV-2 infection in HCP. RECENT FINDINGS The prevalence of SARS-CoV-2 antibodies among HCP ranges from 0.7 to 45%. Although there is heterogeneity in the seroprevalence rate reported in the literature, HCP may be at increased risk of SARS-CoV-2 infection from exposure to patients with COVID-19. The literature supports that this can be minimized with adequate personal protective equipment (PPE) supply, proper hand hygiene, appropriate PPE use, and other infection prevention measures. In addition, infections in HCP are commonly acquired in the community as well as in nonclinical care settings including break rooms or work rooms. SUMMARY While much focus has been on minimizing patient-to-HCP transmission of SARS-CoV-2, additional efforts are needed to prevent exposures in nonclinical care settings and in the community.
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31
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Maltezou HC, Giannouchos TV, Pavli A, Tsonou P, Dedoukou X, Tseroni M, Papadima K, Hatzigeorgiou D, Sipsas NV, Souliotis K. Costs associated with COVID-19 in healthcare personnel in Greece: a cost-of-illness analysis. J Hosp Infect 2021; 114:126-133. [PMID: 33894306 PMCID: PMC8061082 DOI: 10.1016/j.jhin.2021.04.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/17/2021] [Accepted: 04/17/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Healthcare personnel (HCP) are at increased risk of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the aetiological agent of coronavirus disease 2019 (COVID-19). AIM To estimate the costs related to SARS-CoV-2 exposure and infection among HCP in Greece. METHODS Data were retrieved from the national database of SARS-CoV-2 infections and from the database of HCP exposed to patients with COVID-19. A cost-of-illness analysis was performed to estimate total, direct and indirect costs. RESULTS In total, 254 HCP with COVID-19 and 3332 HCP exposed to patients with COVID-19 during the first epidemic wave were studied. Of the 254 HCP with COVID-19, 49 (19.3%) were hospitalized (mean length of hospitalization 11.6 days) and four were admitted to intensive care units (mean duration 10.8 days). Overall, 1332 (40%) exposed HCP had a mean duration of absenteeism of 7.5 days, and 252 (99.2%) HCP with COVID-19 had a mean duration of absenteeism of 25.8 days. The total costs for the management of the two groups were estimated at €1,735,830 (€772,890 Euros for HCP with COVID-19 and €962,940 for exposed HCP). Absenteeism accounted for a large proportion of the total costs (80.4% of all expenditures), followed by costs for reverse transcriptase polymerase chain reaction and hospitalization (10.2% and 6.5% of all expenditures, respectively). CONCLUSION COVID-19 is associated with increased rates and duration of absenteeism among HCP. Indirect costs, particularly absenteeism, are the major driver of total costs among exposed HCP and HCP with COVID-19. The estimated total costs are conservative. Studies are needed to explore the impact of COVID-19 vaccination of HCP on absenteeism and COVID-19-associated costs.
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Affiliation(s)
- H C Maltezou
- Directorate for Research, Studies and Documentation, National Public Health Organization, Athens, Greece.
| | - T V Giannouchos
- Pharmacotherapy Outcomes Research Center, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | - A Pavli
- Department of Travel Medicine, National Public Health Organization, Athens, Greece
| | - P Tsonou
- Department of Travel Medicine, National Public Health Organization, Athens, Greece
| | - X Dedoukou
- National Public Health Organization, Athens, Greece
| | - M Tseroni
- Directorate for Epidemiologic Surveillance of Infectious Diseases, National Public Health Organization, Athens, Greece
| | - K Papadima
- Directorate for Epidemiologic Surveillance of Infectious Diseases, National Public Health Organization, Athens, Greece
| | - D Hatzigeorgiou
- Medical Directorate, Hellenic Air Force General Staff, Athens, Greece
| | - N V Sipsas
- Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - K Souliotis
- Faculty of Social and Political Sciences, University of Peloponnese, Corinth, Greece; Health Policy Institute, Athens, Greece
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32
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Evans S, Agnew E, Vynnycky E, Stimson J, Bhattacharya A, Rooney C, Warne B, Robotham J. The impact of testing and infection prevention and control strategies on within-hospital transmission dynamics of COVID-19 in English hospitals. Philos Trans R Soc Lond B Biol Sci 2021; 376:20200268. [PMID: 34053255 PMCID: PMC8165586 DOI: 10.1098/rstb.2020.0268] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 12/31/2022] Open
Abstract
Nosocomial transmission of SARS-CoV-2 is a key concern, and evaluating the effect of testing and infection prevention and control strategies is essential for guiding policy in this area. Using a within-hospital SEIR transition model of SARS-CoV-2 in a typical English hospital, we estimate that between 9 March 2020 and 17 July 2020 approximately 20% of infections in inpatients, and 73% of infections in healthcare workers (HCWs) were due to nosocomial transmission. Model results suggest that placing suspected COVID-19 patients in single rooms or bays has the potential to reduce hospital-acquired infections in patients by up to 35%. Periodic testing of HCWs has a smaller effect on the number of hospital-acquired COVID-19 cases in patients, but reduces infection in HCWs by as much as 37% and results in only a small proportion of staff absences (approx. 0.3% per day). This is considerably less than the 20-25% of staff that have been reported to be absent from work owing to suspected COVID-19 and self-isolation. Model-based evaluations of interventions, informed by data collected so far, can help to inform policy as the pandemic progresses and help prevent transmission in the vulnerable hospital population. This article is part of the theme issue 'Modelling that shaped the early COVID-19 pandemic response in the UK'.
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Affiliation(s)
- Stephanie Evans
- Modelling and Economics Unit, National Infection Service, Public Health England, London, UK
- Healthcare Associated Infection and Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK
| | - Emily Agnew
- Modelling and Economics Unit, National Infection Service, Public Health England, London, UK
- Healthcare Associated Infection and Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK
| | - Emilia Vynnycky
- Modelling and Economics Unit, National Infection Service, Public Health England, London, UK
- TB Modelling Group, TB Centre and Centre for Mathematical Modelling of Infectious Diseases, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - James Stimson
- Modelling and Economics Unit, National Infection Service, Public Health England, London, UK
- Healthcare Associated Infection and Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK
| | - Alex Bhattacharya
- Healthcare Associated Infection and Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK
| | | | - Ben Warne
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Julie Robotham
- Modelling and Economics Unit, National Infection Service, Public Health England, London, UK
- Healthcare Associated Infection and Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England, Oxford, UK
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Coltart CEM, Wells D, Sutherland E, Fowler A. National cross-sectional survey of 1.14 million NHS staff SARS-CoV-2 serology tests: a comparison of NHS staff with regional community seroconversion rates. BMJ Open 2021; 11:e049703. [PMID: 34257096 PMCID: PMC8282419 DOI: 10.1136/bmjopen-2021-049703] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES An initial report of findings from 1.14 million SARS CoV-2 serology tests in National Health Service (NHS) staff to compare NHS staff seroconversion with community seroconversion rates at a regional level. DESIGN A national cross-sectional survey. SETTING A SARS-CoV-2 antibody testing programme offered across all NHS Trusts. PARTICIPANTS 1.14 million NHS staff. INTERVENTION SARS-CoV-2 antibody testing. PRIMARY AND SECONDARY OUTCOME MEASURES SARS-CoV-2 antibody testing was used to estimate the seroprevalence of SARS-CoV-2 in NHS staff by region, compared with community seroprevalence as determined by the COVID-19 Infection Survey (Office for National Statistics). We also explored seroprevalence trends by regional COVID-19 activity, using regional death rates as a proxy for COVID-19 'activity'. RESULTS 1 146 310 tests were undertaken on NHS staff between 26 May and 31 August 2020. 186 897 NHS tests were positive giving a seroconversion rate of 16.3% (95% CI 16.2% to 16.4%), in contrast to the national community seroconversion rate of 5.9% (95% CI 5.3% to 6.6%). There was significant geographical regional variation, which mirrored the trends seen in community prevalence rates. NHS staff were infected at a higher rate than the general population (OR 3.1, 95% CI 2.8 to 3.5). NHS seroconversion by regional death rate suggested a trend towards higher seroconversion rates in the areas with higher COVID-19 'activity'. CONCLUSIONS This is the first cross-sectional survey assessing the risk of COVID-19 disease in healthcare workers at a national level. It is the largest study of its kind. It suggests that NHS staff have a significantly higher rate of COVID-19 seroconversion compared with the general population in England, with regional variation across the country which matches the background population prevalence trends. There was also a trend towards higher seroconversion rates in areas which had experienced high COVID-19 clinical activity. This work has global significance in terms of the value of such a testing programme and contributing to the understanding of healthcare worker seroconversion at a national level.
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Affiliation(s)
- Cordelia E M Coltart
- Institute for Global Health, University College London, London, UK
- Chief Medical Officer's Office, Department of Health and Social Care, London, UK
| | - David Wells
- COVID-19 Testing cell, NHS England and NHS Improvement, London, UK
| | - Esther Sutherland
- COVID-19 Infection Survey, Office for National Statistics, Newport, UK
| | - Aidan Fowler
- Chief Medical Officer's Office, Department of Health and Social Care, London, UK
- COVID-19 Testing cell, NHS England and NHS Improvement, London, UK
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Sil BK, Jamiruddin MR, Haq MA, Khondoker MU, Jahan N, Khandker SS, Ali T, Oishee MJ, Kaitsuka T, Mie M, Tomizawa K, Kobatake E, Haque M, Adnan N. AuNP Coupled Rapid Flow-Through Dot-Blot Immuno-Assay for Enhanced Detection of SARS-CoV-2 Specific Nucleocapsid and Receptor Binding Domain IgG. Int J Nanomedicine 2021; 16:4739-4753. [PMID: 34267520 PMCID: PMC8277418 DOI: 10.2147/ijn.s313140] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/24/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Serological tests detecting severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are widely used in seroprevalence studies and evaluating the efficacy of the vaccination program. Some of the widely used serological testing techniques are enzyme-linked immune-sorbent assay (ELISA), chemiluminescence immunoassay (CLIA), and lateral flow immunoassay (LFIA). However, these tests are plagued with low sensitivity or specificity, time-consuming, labor-intensive, and expensive. We developed a serological test implementing flow-through dot-blot assay (FT-DBA) for SARS-CoV-2 specific IgG detection, which provides enhanced sensitivity and specificity while being quick to perform and easy to use. METHODS SARS-CoV-2 antigens were immobilized on nitrocellulose membrane to capture human IgG, which was then detected with anti-human IgG conjugated gold nanoparticle (hIgG-AuNP). A total of 181 samples were analyzed in-house. Within which 35 were further evaluated in US FDA-approved CLIA Elecsys SARS-CoV-2 assay. The positive panel consisted of RT-qPCR positive samples from patients with both <14 days and >14 days from the onset of clinical symptoms. The negative panel contained samples collected from the pre-pandemic era dengue patients and healthy donors during the pandemic. Moreover, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FT-DBA were evaluated against RT-qPCR positive sera. However, the overall efficacies were assessed with sera that seroconverted against either nucleocapsid (NCP) or receptor-binding domain (RBD). RESULTS In-house ELISA selected a total of 81 true seropositive and 100 seronegative samples. The sensitivity of samples with <14 days using FT-DBA was 94.7%, increasing to 100% for samples >14 days. The overall detection sensitivity and specificity were 98.8% and 98%, respectively, whereas the overall PPV and NPV were 99.6% and 99%. Moreover, comparative analysis between in-house ELISA assays and FT-DBA revealed clinical agreement of Cohen's Kappa value of 0.944. The FT-DBA showed sensitivity and specificity of 100% when compared with commercial CLIA kits. CONCLUSION The assay can confirm past SARS-CoV-2 infection with high accuracy within 2 minutes compared to commercial CLIA or in-house ELISA. It can help track SARS-CoV-2 disease progression, population screening, and vaccination response. The ease of use of the assay without requiring any instruments while being semi-quantitative provides the avenue of its implementation in remote areas around the globe, where conventional serodiagnosis is not feasible.
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Affiliation(s)
- Bijon Kumar Sil
- Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhaka, 1205, Bangladesh
| | | | - Md Ahsanul Haq
- Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhaka, 1205, Bangladesh
| | | | - Nowshin Jahan
- Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhaka, 1205, Bangladesh
| | - Shahad Saif Khandker
- Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhaka, 1205, Bangladesh
| | - Tamanna Ali
- Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhaka, 1205, Bangladesh
| | | | - Taku Kaitsuka
- School of Pharmacy, International University of Health and Welfare, Okawa, Fukuoka, 831-8501, Japan
| | - Masayasu Mie
- School of Life Science and Technology, Tokyo Institute of Technology, Yokohama, Kanagawa, 226-8502, Japan
| | - Kazuhito Tomizawa
- Department of Molecular Physiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, 860-0811, Japan
| | - Eiry Kobatake
- School of Life Science and Technology, Tokyo Institute of Technology, Yokohama, Kanagawa, 226-8502, Japan
| | - Mainul Haque
- The Unit of Pharmacology, Faculty of Medicine and Defence Health Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, 57000, Malaysia
| | - Nihad Adnan
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
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35
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Meylan S, Dafni U, Lamoth F, Tsourti Z, Lobritz MA, Regina J, Bressin P, Senn L, Grandbastien B, Andre C, Fenwick C, D'Acremont V, Croxatto A, Guilleret I, Greub G, Manuel O, Calandra T, Pantaleo G, Lazor-Blanchet C. SARS-CoV-2 seroprevalence in healthcare workers of a Swiss tertiary care centre at the end of the first wave: a cross-sectional study. BMJ Open 2021; 11:e049232. [PMID: 34226231 PMCID: PMC8260307 DOI: 10.1136/bmjopen-2021-049232] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/18/2021] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To assess the SARS-CoV-2 transmission in healthcare workers (HCWs) using seroprevalence as a surrogate marker of infection in our tertiary care centre according to exposure. DESIGN Seroprevalence cross-sectional study. SETTING Single centre at the end of the first COVID-19 wave in Lausanne, Switzerland. PARTICIPANTS 1874 of 4074 responders randomly selected (46% response rate), stratified by work category among the 13 474 (13.9%) HCWs. MAIN OUTCOME MEASURES Evaluation of SARS-CoV-2 serostatus paired with a questionnaire of SARS-CoV-2 acquisition risk factors internal and external to the workplace. RESULTS The overall SARS-CoV-2 seroprevalence rate among HCWs was 10.0% (95% CI 8.7% to 11.5%). HCWs with daily patient contact did not experience increased rates of seropositivity relative to those without (10.3% vs 9.6%, respectively, p=0.64). HCWs with direct contact with patients with COVID-19 or working in COVID-19 units did not experience increased seropositivity rates relative to their counterparts (10.4% vs 9.8%, p=0.69 and 10.6% vs 9.9%, p=0.69, respectively). However, specific locations of contact with patients irrespective of COVID-19 status-in patient rooms or reception areas-did correlate with increased rates of seropositivity (11.9% vs 7.5%, p=0.019 and 14.3% vs 9.2%, p=0.025, respectively). In contrast, HCWs with a suspected or proven SARS-CoV-2-infected household contact had significantly higher seropositivity rates than those without such contacts (19.0% vs 8.7%, p<0.001 and 42.1% vs 9.4%, p<0.001, respectively). Finally, consistent use of a mask on public transportation correlated with decreased seroprevalence (5.3% for mask users vs 11.2% for intermittent or no mask use, p=0.030). CONCLUSIONS The overall seroprevalence was 10% without significant differences in seroprevalence between HCWs exposed to patients with COVID-19 and HCWs not exposed. This suggests that, once fully in place, protective measures limited SARS-CoV-2 occupational acquisition within the hospital environment. SARS-CoV-2 seroconversion among HCWs was associated primarily with community risk factors, particularly household transmission.
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Affiliation(s)
- Sylvain Meylan
- Infectious Diseases Service, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Urania Dafni
- Laboratory of Biostatistics, School of Health Sciences, Frontier Science Foundation-Hellas and University of Athens, Athens, Greece
| | - Frederic Lamoth
- Infectious Diseases Service, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Zoi Tsourti
- Laboratory of Biostatistics, School of Health Sciences, Frontier Science Foundation-Hellas and University of Athens, Athens, Greece
| | | | - Jean Regina
- Infectious Diseases Service, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Philippe Bressin
- Occupational Health Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Laurence Senn
- Service of Hospital Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Bruno Grandbastien
- Service of Hospital Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Cyril Andre
- Immunology Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Craig Fenwick
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Valerie D'Acremont
- Department of Ambulatory Care and Community Medicine, Centre for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Antony Croxatto
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Isabelle Guilleret
- Clinical Trial Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Gilbert Greub
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Oriol Manuel
- Infectious Diseases Service, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Thierry Calandra
- Infectious Diseases Service, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Giuseppe Pantaleo
- Immunology Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Abdul Bari AB, Samuel PJ. Road toward universal COVID-19 testing method - A review. J Immunoassay Immunochem 2021; 42:335-346. [PMID: 33689569 DOI: 10.1080/15321819.2021.1895214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Patients infected with novel coronavirus exhibit a wide range of symptoms from common cold to pneumonia. Furthermore, several cases have been reported as asymptomatic across the globe. Since there are no conclusive clinical manifestations, clinicians have to rely more on laboratory diagnostic methods for confirmation of coronavirus disease. Hematological and biochemical tests are found to be of more prognostic value. Genetic assays by means of rRT-PCR technique is time-consuming but seems to be a more sensitive and specific test among the available testing methods for diagnosis of the coronavirus disease. Radiological imaging of the CT chest of the confirmed positive patients taken during the initial few days doesn't show any significant changes. However, from the second week onward a ground glass lesion pattern is observed. The immunological tests which are being used as a rapid testing method are found to be more false test negative. Hence, based on the effectiveness of various testing methods, it can be concluded that either rRT-PCR or mass antibody testing has to be done, and it has to be compared with CT chest in order to avoid false negatives across the globe which may help in the prevention of community spread of the disease.
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Yuan H, Chiu PY, Chen CF. Paper-based analytical devices for point-of-care blood tests. BIOMICROFLUIDICS 2021; 15:041303. [PMID: 34326913 PMCID: PMC8310430 DOI: 10.1063/5.0055601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/11/2021] [Indexed: 05/28/2023]
Abstract
Blood can be a window to health, and as a result, is the most intensively studied human biofluid. Blood tests can diagnose diseases, monitor therapeutic drugs, and provide information about the health of an individual. Rapid response blood tests are becoming increasingly essential, especially when subsequent treatment is required. Toward this need, paper-based devices have been excellent tools for performing blood tests due to their ability to conduct rapid and low-cost diagnostics and analyses in a non-laboratory environment. In this Perspective, we review recent advances in paper-based blood tests, particularly focusing on the specific techniques and assays applied. Additionally, we discuss the future of these paper-based devices, such as how the signal intensity can be enhanced and how the in situ synthesis of nanomaterials can be used to improve the sensitivity, functionality, and operational simplicity. With these advances, paper-based devices are becoming increasingly valuable tools for point-of-care blood tests in various practical scenarios.
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Affiliation(s)
- Hao Yuan
- Institute of Applied Mechanics, National Taiwan University, Taipei 106, Taiwan
| | | | - Chien-Fu Chen
- Institute of Applied Mechanics, National Taiwan University, Taipei 106, Taiwan
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Dilshad MA, Sarwar S, Aslam F, Shabbir A, Rasool S, Tayyab GUN. Risk of Covid-19 infection during endoscopy: Efficacy of personal protective equipment (PPE) in protecting health professionals. Pak J Med Sci 2021; 37:1093-1098. [PMID: 34290789 PMCID: PMC8281186 DOI: 10.12669/pjms.37.4.4057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/01/2021] [Accepted: 03/15/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To correlate compliance to personal protective equipment (PPE) protocols and risk of exposure to SARS-COV-2 infection in endoscopy staff. METHODS We included 85 endoscopic procedures performed at Lahore General Hospital from May to July 2020. Standard operating procedures (SOPs) were implemented for patient selection, risk stratification and personal protective equipment (PPE) use for endoscopy staff. Patient and endoscopy staff were followed for Covid-19 infection. PPE scores for staff and Covid-19 positivity on follow-up were correlated using student's t test. RESULTS Following 85 procedures included, 2 (2.3%) patients became Covid-19 positive. PPE score was <9 in 5 (5.8%) procedures for endoscopist and Covid-19 developed in 2 (2.3%) of them, PPE score was <9 during 19 (22.3%) procedures in 1st assistant and 9 (10.5%) developed infection and for 2nd assistant PPE score was <9 in 19(22.3%) endoscopies and 5 (5.9%) tested positive for covid-19. Infectivity of endoscopy staff was 6.2%. Association between PPE score and risk of Covid-19 was not significant. (p value 0.51 for endoscopist, 0.10 for 1st assistant and 0.09 for 2nd assistant). CONCLUSION Compliance of SOPs for infection control reduces risk of acquiring Covid-19 infection during endoscopy. Proper use of PPE is effective for safety of endoscopy staff.
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Affiliation(s)
- Muhammad Akif Dilshad
- Dr. Akif Dilshad, MBBS, FCPS (Gastroenterology). Associate Professor Gastroenterology, Lahore General Hospital, Lahore, Pakistan
| | - Shahid Sarwar
- Dr. Shahid Sarwar, MBBS, FCPS (Medicine), FCPS (Gastroenterology), MCPS-HPE, FRCP (Edin) Professor of Medicine, Allama Iqbal Medical College, Lahore, Pakistan
| | - Farheen Aslam
- Farheen Aslam, PhD. Assistant Professor, Department of Biotechnology, Lahore College for Women University, Lahore, Pakistan
| | - Adnan Shabbir
- Adnan Shabbir, MBBS. Post Graduate Resident Gastroenterology Lahore General Hospital, Lahore, Pakistan
| | - Shafqat Rasool
- Shafqat Rasool, MBBS, FCPS (Gastroenterology). Assistant Professor Gastroenterology Lahore General Hospital, Lahore, Pakistan
| | - Ghias un-Nabi Tayyab
- Ghias Un Nabi Tayyab, MBBS, MRCP (UK) FCPS, FRCP (Edin) AGAF (USA). Professor of Medicine, Lahore General Hospital, Lahore, Pakistan
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Rasmi Y, Li X, Khan J, Ozer T, Choi JR. Emerging point-of-care biosensors for rapid diagnosis of COVID-19: current progress, challenges, and future prospects. Anal Bioanal Chem 2021; 413:4137-4159. [PMID: 34008124 PMCID: PMC8130795 DOI: 10.1007/s00216-021-03377-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 04/26/2021] [Indexed: 02/07/2023]
Abstract
Coronavirus disease 2019 (COVID-19) pandemic is currently a serious global health threat. While conventional laboratory tests such as quantitative real-time polymerase chain reaction (qPCR), serology tests, and chest computerized tomography (CT) scan allow diagnosis of COVID-19, these tests are time-consuming and laborious, and are limited in resource-limited settings or developing countries. Point-of-care (POC) biosensors such as chip-based and paper-based biosensors are typically rapid, portable, cost-effective, and user-friendly, which can be used for COVID-19 in remote settings. The escalating demand for rapid diagnosis of COVID-19 presents a strong need for a timely and comprehensive review on the POC biosensors for COVID-19 that meet ASSURED criteria: Affordable, Sensitive, Specific, User-friendly, Rapid and Robust, Equipment-free, and Deliverable to end users. In the present review, we discuss the importance of rapid and early diagnosis of COVID-19 and pathogenesis of COVID-19 along with the key diagnostic biomarkers. We critically review the most recent advances in POC biosensors which show great promise for the detection of COVID-19 based on three main categories: chip-based biosensors, paper-based biosensors, and other biosensors. We subsequently discuss the key benefits of these biosensors and their use for the detection of antigen, antibody, and viral nucleic acids. The commercial POC biosensors for COVID-19 are critically compared. Finally, we discuss the key challenges and future perspectives of developing emerging POC biosensors for COVID-19. This review would be very useful for guiding strategies for developing and commercializing rapid POC tests to manage the spread of infections.Graphical abstract.
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Affiliation(s)
- Yousef Rasmi
- Department of Biochemistry, Faculty of Medicine, Urmia University of Medical Sciences, 5714783734, Urmia, Iran
- Cellular and Molecular Research Center, Urmia University of Medical Sciences, 5714783734, Urmia, Iran
| | - Xiaokang Li
- Ludwig Institute for Cancer Research, University of Lausanne, Agora Center, 1005, Lausanne, Switzerland
- Department of Oncology, Centre hospitalier universitaire vaudois (CHUV), 1011, Lausanne, Switzerland
| | - Johra Khan
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Kingdom of Saudi Arabia
| | - Tugba Ozer
- Department of Bioengineering, Faculty of Chemical-Metallurgical Engineering, Yildiz Technical University, 34220, Istanbul, Turkey
| | - Jane Ru Choi
- Department of Mechanical Engineering, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada.
- Centre for Blood Research, Life Sciences Centre, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada.
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40
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Mortgat L, Verdonck K, Hutse V, Thomas I, Barbezange C, Heyndrickx L, Fischer N, Vuylsteke B, Kabouche I, Ariën KK, Desombere I, Duysburgh E. Prevalence and incidence of anti-SARS-CoV-2 antibodies among healthcare workers in Belgian hospitals before vaccination: a prospective cohort study. BMJ Open 2021; 11:e050824. [PMID: 34187832 PMCID: PMC8245288 DOI: 10.1136/bmjopen-2021-050824] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/25/2021] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To describe prevalence and incidence of anti-SARS-CoV-2 antibodies among Belgian hospital healthcare workers (HCW) in April-December 2020. DESIGN Prospective cohort study. Follow-up was originally planned until September and later extended. SETTING Multicentre study, 17 hospitals. PARTICIPANTS 50 HCW were randomly selected per hospital. HCW employed beyond the end of the study and whose profession involved contact with patients were eligible. 850 HCW entered the study in April-May 2020, 673 HCW (79%) attended the September visit and 308 (36%) the December visit. OUTCOME MEASURES A semiquantitative ELISA was used to detect IgG against SARS-CoV-2 in serum (Euroimmun) at 10 time points. In seropositive samples, neutralising antibodies were measured using a virus neutralisation test. Real-time reverse transcription PCR (RT-qPCR) was performed to detect SARS-CoV-2 on nasopharyngeal swabs. Participant characteristics and the presence of symptoms were collected via an online questionnaire. RESULTS Among all participants, 80% were women, 60% nurses and 21% physicians. Median age was 40 years. The seroprevalence remained relatively stable from April (7.7% (95% CI: 4.8% to 12.1%) to September (8.2% (95% CI: 5.7% to 11.6%)) and increased thereafter, reaching 19.7% (95% CI: 12.0% to 30.6%) in December 2020. 76 of 778 initially seronegative participants seroconverted during the follow-up (incidence: 205/1000 person-years). Among all seropositive individuals, 118/148 (80%) had a positive neutralisation test, 83/147 (56%) presented or reported a positive RT-qPCR, and 130/147 (88%) reported COVID-19-compatible symptoms at least once. However, only 46/73 (63%) of the seroconverters presented COVID-19-compatible symptoms in the month prior to seroconversion. CONCLUSIONS The seroprevalence among hospital HCW was slightly higher than that of the general Belgian population but followed a similar evolution, suggesting that infection prevention and control measures were effective and should be strictly maintained. After two SARS-CoV-2 waves, 80% of HCW remained seronegative, justifying their prioritisation in the vaccination strategy. TRIAL REGISTRATION NUMBER NCT04373889.
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Affiliation(s)
- Laure Mortgat
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- European Programme for Intervention Epidemiology Training (EPIET), ECDC, Solna, Sweden
| | - Kristien Verdonck
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Veronik Hutse
- Department of Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Isabelle Thomas
- Department of Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Cyril Barbezange
- Department of Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Leo Heyndrickx
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Natalie Fischer
- Department of Infectious Diseases in Humans, Sciensano, Brussels, Belgium
- European Public Health Microbiology Training (EUPHEM), ECDC, Solna, Sweden
| | - Bea Vuylsteke
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Ines Kabouche
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Kevin K Ariën
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Isabelle Desombere
- Department of Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Els Duysburgh
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
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Candel FJ, Barreiro P, San Román J, Carretero MM, Sanz JC, Perez-Abeledo M, Ramos B, Viñuela-Prieto JM, Canora J, Martínez-Peromingo FJ, Barba R, Zapatero A. The demography and characteristics of SARS-CoV-2 seropositive residents and staff of nursing homes for older adults in the Community of Madrid: the SeroSOS study. Age Ageing 2021; 50:1038-1047. [PMID: 33945607 PMCID: PMC8135991 DOI: 10.1093/ageing/afab096] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Nursing homes for older adults have concentrated large numbers of severe cases and deaths for COVID-19. Methods: Point seroprevalence study of nursing homes to describe the demography and characteristic of SARS-CoV-2 IgG-positive residents and staff. Results: Clinical information and blood samples were available for 9,332 residents (mean age 86.7 ± 8.1 years, 76.4% women) and 10,614 staff (mean age 45.6 ± 11.5, 86.2% women). Up to 84.4% of residents had frailty, 84.9% co-morbidity and 69.3% cognitive impairment; 65.2% of workers were health-aides. COVID-19 seroprevalence was 55.4% (95% CI, 54.4–56.4) for older adults and 31.5% (30.6–32.4) for staff. In multivariable analysis frailty of residents was related with seropositivity (OR: 1.19, p = 0.02). In the case of staff, age > 50 years (2.10, p < 0.001), obesity (1.19, p = 0.01), being a health-aide (1.94, p < 0.001), working in a center with high seroprevalence in residents (3.49, p < 0.001), and contact with external cases of COVID-19 (1.52, p < 0.001) were factors associated with seropositivity. Past symptoms of COVID-19 were good predictors of seropositivity for residents (5.41, p < 0.001) and staff (2.52, p < 0.001). Conclusions: Level of dependency influences risk of COVID-19 among residents. Individual and work factors, and contacts outside the nursing home are associated with COVID-19 exposure in staff members. It is key to strengthen control measures to prevent the introduction of COVID-19 into care facilities from the community.
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Affiliation(s)
- F J Candel
- Clinical Microbiology and Infectious Diseases, IdISSC and IML Health Institutes, Hospital Universitario San Carlos, Madrid
- Regional Public Health Laboratory, Community of Madrid
| | - P Barreiro
- Address correspondence to: Pablo Barreiro, MD PhD, Infectious Diseases. Internal Medicine. Hospital General Universitario La Paz. Madrid. Spain, E-mail:
| | - J San Román
- Department of Medical Specialties and Public Health, Rey Juan Carlos University, Madrid
- Regional Public Health Laboratory, Community of Madrid
| | - M M Carretero
- Regional Public Health Laboratory, Community of Madrid
| | - J C Sanz
- Regional Public Health Laboratory, Community of Madrid
| | | | - B Ramos
- Regional Public Health Laboratory, Community of Madrid
| | - J M Viñuela-Prieto
- Department of Neurosurgery, Hospital General Universitario La Paz, Madrid
| | - J Canora
- Assistant to the Vice-counselor of Public Health, Community of Madrid
| | | | - R Barba
- Medical Manager, Hospital Universitario Rey Juan Carlos, Madrid
| | - A Zapatero
- Vice-counselor of Public Health, Community of Madrid
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Vanroye F, den Bossche DV, Brosius I, Tack B, Esbroeck MV, Jacobs J. COVID-19 Antibody Detecting Rapid Diagnostic Tests Show High Cross-Reactivity When Challenged with Pre-Pandemic Malaria, Schistosomiasis and Dengue Samples. Diagnostics (Basel) 2021; 11:diagnostics11071163. [PMID: 34202195 PMCID: PMC8305106 DOI: 10.3390/diagnostics11071163] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/23/2021] [Accepted: 06/23/2021] [Indexed: 12/13/2022] Open
Abstract
COVID-19 Antibody Detecting Rapid Diagnostic Tests (COVID-19 Ab RDTs) are the preferred tool for SARS-CoV-2 seroprevalence studies, particularly in low- and middle-income countries. The present study challenged COVID-19 Ab RDTs with pre-pandemic samples of patients exposed to tropical pathogens. A retrospective study was performed on archived serum (n = 94) and EDTA whole blood (n = 126) samples obtained during 2010–2018 from 196 travelers with malaria (n = 170), schistosomiasis (n = 25) and dengue (n = 25). COVID-19 Ab RDTs were selected based on regulatory approval status, independent evaluation results and detecting antigens. Among 13 COVID-19 Ab RDT products, overall cross-reactivity was 18.5%; cross-reactivity for malaria, schistosomiasis and dengue was 20.3%, 18.1% and 7.5%, respectively. Cross-reactivity for current and recent malaria, malaria antibodies, Plasmodium species and parasite densities was similar. Cross-reactivity among the different RDT products ranged from 2.7% to 48.9% (median value 14.5%). IgM represented 67.9% of cross-reactive test lines. Cross-reactivity was not associated with detecting antigens, patient categories or disease (sub)groups, except for schistosomiasis (two products with ≥60% cross-reactivity). The high cross-reactivity for malaria, schistosomiasis and—to a lesser extent—dengue calls for risk mitigation when using COVID-19 Ab RDTs in co-endemic regions.
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Affiliation(s)
- Fien Vanroye
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
- Correspondence:
| | - Dorien Van den Bossche
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
| | - Isabel Brosius
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
| | - Bieke Tack
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
- Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
| | - Jan Jacobs
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
- Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
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Savio A, Calza S, Guerrini G, Romano V, Marchina E. Rapid Point-Of-Care Serology and Clinical History Assessment Increase Protection Provided by RT-PCR Screening: A Pilot Study Involving Three Nursing Homes in Brescia, a Hotspot of Lombardy. Front Public Health 2021; 9:649524. [PMID: 34249831 PMCID: PMC8264443 DOI: 10.3389/fpubh.2021.649524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 05/27/2021] [Indexed: 12/21/2022] Open
Abstract
Background: COVID-19 outbursts have been registered worldwide within care homes with asymptomatic transmission combined with shortage/inaccuracy of diagnostic tests undermining the efforts at containment of the disease. Nursing facilities in Lombardy (Italy) were left with no, or limited, access to testing for 8 weeks after the outbreak of COVID-19. Methods: This study includes 246 residents and 286 workers of three different nursing homes in Brescia-Lombardy. Clinical questionnaires and rapid serology tests were devised to integrate the data of the first available RT-PCR screening. Follow-up serology after 60-days was performed on 67 of 86 workers with positive serology or clinically suspicious. Findings: Thirty-seven residents and 18 workers had previous positive RT-PCR. Thorough screening disclosed two additional RT-PCR-positive workers. Serology screening revealed antibodies in 59 residents and 48 workers, including 32/37 residents and all workers previously positive at RT-PCR. Follow up serology disclosed antibodies in two additional workers with recent symptoms at the time of screening. The professionals in close contact with residents had more infections (47/226–20.79% vs. 1/60–1.66%; p = 0.00013 Fisher exact-test). A suspicious clinical score was present in 44/64 residents and in 41/50 workers who tested positive with either method with totally asymptomatic disease more frequent among residents 28.1 vs. 10.0% (p = 0.019 Fisher exact-test). Interpretation: Based on the available RT-PCR ± results at the time of symptoms/contacts, our integrated clinical and serological screening demonstrated sensitivity 89% and specificity 87%. This multimodal assessment proved extremely useful in understanding the viral spread in nursing homes, in defining its stage and in implementing protective measures. Rapid serology tests demonstrated efficient and particularly suited for older people less able to move/cooperate.
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Affiliation(s)
- Antonella Savio
- Histopathology Department, The Royal Marsden Hospital, London, United Kingdom
| | - Stefano Calza
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | | | | | - Eleonora Marchina
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
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44
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Muhsen K, Schwaber MJ, Bishara J, Kassem E, Atamna A, Na'amnih W, Goren S, Bialik A, Mohsen J, Zaide Y, Hazan N, Ariel-Cohen O, Cohen R, Shitrit P, Marchaim D, Benenson S, Ben-David D, Rubinovitch B, Gotessman T, Nutman A, Wiener-Well Y, Maor Y, Carmeli Y, Cohen D. Sero-Prevalence and Sero-Incidence of Antibodies to SARS-CoV-2 in Health Care Workers in Israel, Prior to Mass COVID-19 Vaccination. Front Med (Lausanne) 2021; 8:689994. [PMID: 34249979 PMCID: PMC8268152 DOI: 10.3389/fmed.2021.689994] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/13/2021] [Indexed: 01/13/2023] Open
Abstract
Objectives: This study aims to examine the prevalence and risk factors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sero-positivity in health care workers (HCWs), a main risk group, and assess the sero-incidence of SARS-CoV-2 infection between the first and second waves of coronavirus disease 2019 (COVID-19) in Israel. Methods: A longitudinal study was conducted among 874 HCWs from nine hospitals. Demographics, health information, and blood samples were obtained at baseline (first wave-April-May 2020) and at follow-up (n = 373) (second wave-September-November 2020). Sero-positivity was determined based on the detection of total antibodies to the nucleocapsid antigen of SARS-CoV-2, using electro-chemiluminescence immunoassay (Elecsys® Anti-SARS-CoV-2, Roche Diagnostics, Rotkreuz, Switzerland). Results: The sero-prevalence of SARS-CoV-2 antibodies was 1.1% [95% confidence intervals (CI) 0.6-2.1] at baseline and 8.3% (95% CI 5.9-11.6) at follow-up. The sero-conversion of SARS-CoV-2 serum antibody was 6.9% (95% CI 4.7-9.9) during the study period. The increase in SARS-CoV-2 sero-prevalence paralleled the rise in PCR-confirmed SARS-CoV-2 infections among the HCWs across the country. The likelihood of SARS-CoV-2 sero-prevalence was higher in males vs. females [odds ratio (OR) 2.52 (95% CI 1.05-6.06)] and in nurses vs. physicians [OR 4.26 (95% CI 1.08-16.77)] and was associated with being quarantined due to exposure to COVID-19 patients [OR 3.54 (95% CI 1.58-7.89)] and having a positive PCR result [OR 109.5 (95% CI 23.88-502.12)]. Conclusions: A significant increase in the risk of SARS-CoV-2 infection was found among HCWs between the first and second waves of COVID-19 in Israel. Nonetheless, the sero-prevalence of SARS-CoV-2 antibodies remains low, similar to the general population. Our findings reinforce the rigorous infection control policy, including quarantine, and utilization of personal protective equipment that should be continued together with COVID-19 immunization in HCWs and the general population.
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Affiliation(s)
- Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mitchell J Schwaber
- National Institute for Antibiotic Resistance and Infection Control, Israel Ministry of Health, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jihad Bishara
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Infectious Diseases Unit, Rabin Medical Centre, Beilinson Hospital, Petah-Tiqva, Israel
| | - Eias Kassem
- Department of Pediatrics, Hillel Yaffe Medical Centre, Hadera, Israel
| | - Alaa Atamna
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Infectious Diseases Unit, Rabin Medical Centre, Beilinson Hospital, Petah-Tiqva, Israel
| | - Wasef Na'amnih
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sophy Goren
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anya Bialik
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jameel Mohsen
- Department of Cardiology, Hillel Yaffe Medical Centre, Hadera, Israel
| | - Yona Zaide
- American Medical Laboratories, Herzlya, Israel
| | | | - Ortal Ariel-Cohen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Regev Cohen
- Infection Control Unit, Sanz Medical Centre, Netanya, Israel
| | - Pnina Shitrit
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Infection Control Unit, Meir Medical Centre, Kefar Saba, Israel
| | - Dror Marchaim
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Infection Control Unit, Shamir (Assaf Harofeh) Medical Centre, Be'er Ya'akov, Israel
| | - Shmuel Benenson
- Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Centre, Jerusalem, Israel
| | - Debby Ben-David
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Infection Control Unit, Wolfson Medical Centre, Wolfson, Israel
| | - Bina Rubinovitch
- Infection Control Unit, Beilinson Hospital, Rabin Medical Centre, Petah-Tiqva, Israel
| | - Tamar Gotessman
- Infectious Disease and Infection Control Service, Hasharon Hospital, Rabin Medical Centre, Petah-Tiqva, Israel
| | - Amir Nutman
- National Institute for Antibiotic Resistance and Infection Control, Israel Ministry of Health, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yonit Wiener-Well
- Infectious Disease Unit, Shaare Zedek Medical Centre, Jerusalem, Israel
| | - Yasmin Maor
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Infection Control Unit, Wolfson Medical Centre, Wolfson, Israel.,Infectious Disease Unit, Wolfson Medical Centre, Wolfson, Israel
| | - Yehuda Carmeli
- National Institute for Antibiotic Resistance and Infection Control, Israel Ministry of Health, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dani Cohen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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45
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Castillo-León J, Trebbien R, Castillo JJ, Svendsen WE. Commercially available rapid diagnostic tests for the detection of high priority pathogens: status and challenges. Analyst 2021; 146:3750-3776. [PMID: 34060546 DOI: 10.1039/d0an02286a] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The ongoing COVID-19 pandemic has shown the importance of having analytical devices that allow a simple, fast, and robust detection of pathogens which cause epidemics and pandemics. The information these devices can collect is crucial for health authorities to make effective decisions to contain the disease's advance. The World Health Organization published a list of primary pathogens that have raised concern as potential causes of future pandemics. Unfortunately, there are no rapid diagnostic tests commercially available and approved by the regulatory bodies to detect most of the pathogens listed by the WHO. This report describes these pathogens, the available detection methods, and highlights areas where more attention is needed to produce rapid diagnostic tests for future pandemic surveillance.
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Affiliation(s)
- Jaime Castillo-León
- Bioengineering Department, Technical University of Denmark, Ørsteds Plads, DK-2800 Kgs. Lyngby, Denmark.
| | - Ramona Trebbien
- Statens Serum Institut, 5 Artillerivej, DK-2300 Copenhagen, Denmark
| | - John J Castillo
- Escuela de Química, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Winnie E Svendsen
- Bioengineering Department, Technical University of Denmark, Ørsteds Plads, DK-2800 Kgs. Lyngby, Denmark.
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46
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Varona JF, Madurga R, Peñalver F, Abarca E, Almirall C, Cruz M, Ramos E, Castellano Vázquez JM. Seroprevalence of SARS-CoV-2 antibodies in over 6000 healthcare workers in Spain. Int J Epidemiol 2021; 50:400-409. [PMID: 33434269 PMCID: PMC7928898 DOI: 10.1093/ije/dyaa277] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 12/14/2020] [Indexed: 01/04/2023] Open
Abstract
Background: Spain has one of the highest incidences of coronavirus disease 2019 (COVID-19) worldwide, so Spanish health care workers (HCW) are at high risk of exposure. Our objective was to determine severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody seroprevalence amongst HCW and factors associated with seropositivity. Methods: A cross-sectional study evaluating 6190 workers (97.8% of the total workforce of a healthcare-system of 17 hospitals across four regions in Spain) was carried out between April and June 2020, by measuring immunoglobulin G (IgG)-SARS-CoV-2 antibody titres and related clinical data. Exposure risk was categorized as high (clinical environment; prolonged/direct contact with patients), moderate (clinical environment; non-intense/no patient contact) and low (non-clinical environment). Results: A total of 6038 employees (mean age 43.8 years; 71% female) were included in the final analysis. A total of 662 (11.0%) were seropositive for IgG against SARS-CoV-2 (39.4% asymptomatic). Adding available PCR-testing, 713 (11.8%) employees showed evidence of previous SARS-CoV-2 infection. However, before antibody testing, 482 of them (67%) had no previous diagnosis of SARS-CoV-2-infection. Seroprevalence was higher in high- and moderate-risk exposure (12.1 and 11.4%, respectively) compared with low-grade risk subjects (7.2%), and in Madrid (13.8%) compared with Barcelona (7.6%) and Coruña (2.0%). High-risk [odds ratio (OR): 2.06; 95% confidence interval (CI): 1.63–2.62] and moderate-risk (OR: 1.77; 95% CI: 1.32–2.37) exposures were associated with positive IgG-SARS-CoV-2 antibodies after adjusting for region, age and sex. Higher antibody titres were observed in moderate–severe disease (median antibody-titre: 13.7 AU/mL) compared with mild (6.4 AU/mL) and asymptomatic (5.1 AU/mL) infection, and also in older (>60 years: 11.8 AU/mL) compared with younger (<30 years: 4.2 AU/mL) people. Conclusions: Seroprevalence of IgG-SARS-CoV-2 antibodies in HCW is a little higher than in the general population and varies depending on regional COVID-19 incidence. The high rates of subclinical and previously undiagnosed infection observed in this study reinforce the utility of antibody screening. An occupational risk for SARS-CoV-2 infection related to working in a clinical environment was demonstrated in this HCW cohort.
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Affiliation(s)
- Jose F Varona
- Departamento de Medicina Interna, Hospital Universitario HM Montepríncipe, HM Hospitales, Madrid, Spain.,Facultad de Medicina, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain
| | - Rodrigo Madurga
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain.,Facultad de Ciencias Experimentales, Universidad Francisco de Vitoria, Madrid, Spain
| | - Francisco Peñalver
- Departamento de Seguridad, Salud y Bienestar, HM Hospitales, Madrid, Spain
| | - Elena Abarca
- Departamento de Laboratorio, HM Hospitales, Madrid, Spain
| | | | - Marta Cruz
- Departamento de Laboratorio, HM Hospitales, Madrid, Spain
| | - Enrique Ramos
- Departamento de Laboratorio, HM Hospitales, Madrid, Spain
| | - Jose María Castellano Vázquez
- Facultad de Medicina, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain.,Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain
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47
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Singh NK, Ray P, Carlin AF, Magallanes C, Morgan SC, Laurent LC, Aronoff-Spencer ES, Hall DA. Hitting the diagnostic sweet spot: Point-of-care SARS-CoV-2 salivary antigen testing with an off-the-shelf glucometer. Biosens Bioelectron 2021; 180:113111. [PMID: 33743492 PMCID: PMC7908832 DOI: 10.1016/j.bios.2021.113111] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/15/2021] [Accepted: 02/22/2021] [Indexed: 12/19/2022]
Abstract
Significant barriers to the diagnosis of latent and acute SARS-CoV-2 infection continue to hamper population-based screening efforts required to contain the COVID-19 pandemic in the absence of widely available antiviral therapeutics or vaccines. We report an aptamer-based SARS-CoV-2 salivary antigen assay employing only low-cost reagents ($3.20/test) and an off-the-shelf glucometer. The test was engineered around a glucometer as it is quantitative, easy to use, and the most prevalent piece of diagnostic equipment globally, making the test highly scalable with an infrastructure that is already in place. Furthermore, many glucometers connect to smartphones, providing an opportunity to integrate with contact tracing apps, medical providers, and electronic health records. In clinical testing, the developed assay detected SARS-CoV-2 infection in patient saliva across a range of viral loads - as benchmarked by RT-qPCR - within 1 h, with 100% sensitivity (positive percent agreement) and distinguished infected specimens from off-target antigens in uninfected controls with 100% specificity (negative percent agreement). We propose that this approach provides an inexpensive, rapid, and accurate diagnostic for distributed screening of SARS-CoV-2 infection at scale.
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Affiliation(s)
- Naveen K Singh
- Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA, 92093, USA
| | - Partha Ray
- Division of Surgical Oncology, Department of Surgery, Moores Cancer Center, University of California San Diego Health, La Jolla, CA, 92093, USA
| | - Aaron F Carlin
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Celestine Magallanes
- Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, 92093, USA
| | - Sydney C Morgan
- Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, 92093, USA
| | - Louise C Laurent
- Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, 92093, USA
| | - Eliah S Aronoff-Spencer
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA.
| | - Drew A Hall
- Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA, 92093, USA; Department of Bioengineering, University of California San Diego, La Jolla, CA, 92093, USA.
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48
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Gracienta TJ, Herardi R, Santosa F, Pasiak TF, Tjang YS. Diagnostic accuracy of antibody-based rapid diagnostic tests in detecting coronavirus disease 2019: systematic review. Arch Med Sci 2021; 18:949-957. [PMID: 35832707 PMCID: PMC9266800 DOI: 10.5114/aoms/135910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 04/19/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction The rapid transmission of coronavirus disease 2019 (COVID-19) requires a fast, accurate, and affordable detection method. Despite doubts of their diagnostic accuracy, rapid diagnostic tests (RDTs) are used worldwide due to their practicality. This systematic review aims to determine the diagnostic accuracy of antibody-based RDTs in detecting COVID-19. Material and methods A literature search was carried out on five journal databases using the PRISMA-P 2015 method. We included all studies published up to February 2021. The risk of bias was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Diagnostic Test Accuracy Studies. Data regarding peer-review status, study design, test kit information, immunoglobulin class, target antigen, and the number of samples were extracted and tabulated. We estimated the pooled sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with a 95% confidence interval. Results Thirty-three studies met the eligibility criteria. The pooled data results showed that the combined detection method of IgM or IgG had the highest sensitivity and NPV, which were 73.41% (95% CI: 72.22-74.57) and 75.34% (95% CI: 74.51-76.16), respectively. The single IgG detection method had the highest specificity and PPV of 96.68% (95% CI: 96.25-97.07) and 95.97% (95% CI: 95.47-96.42%), respectively. Conclusions Antibody-based RDTs are not satisfactory as primary diagnostic tests but have utility as a screening tool.
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Affiliation(s)
| | - Ryan Herardi
- Faculty of Medicine, Universitas Pembangunan Nasional Veteran Jakarta, Indonesia
| | - Frans Santosa
- Faculty of Medicine, Universitas Pembangunan Nasional Veteran Jakarta, Indonesia
| | | | - Yanto Sandy Tjang
- Faculty of Medicine, Universitas Pembangunan Nasional Veteran Jakarta, Indonesia
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49
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Kharlamova N, Dunn N, Bedri SK, Jerling S, Almgren M, Faustini F, Gunnarsson I, Rönnelid J, Pullerits R, Gjertsson I, Lundberg K, Månberg A, Pin E, Nilsson P, Hober S, Fink K, Fogdell-Hahn A. False Positive Results in SARS-CoV-2 Serological Tests for Samples From Patients With Chronic Inflammatory Diseases. Front Immunol 2021; 12:666114. [PMID: 34012450 PMCID: PMC8126683 DOI: 10.3389/fimmu.2021.666114] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/06/2021] [Indexed: 12/31/2022] Open
Abstract
Patients with chronic inflammatory diseases are often treated with immunosuppressants and therefore are of particular concern during the SARS-CoV-2 pandemic. Serological tests will improve our understanding of the infection and immunity in this population, unless they tests give false positive results. The aim of this study was to evaluate the specificity of SARS-Cov-2 serological assays using samples from patients with chronic inflammatory diseases collected prior to April 2019, thus defined as negative. Samples from patients with multiple sclerosis (MS, n=10), rheumatoid arthritis (RA, n=47) with or without rheumatoid factor (RF) and/or anti-cyclic citrullinated peptide antibodies (anti-CCP2) and systemic lupus erythematosus (SLE, n=10) with or without RF, were analyzed for SARS-CoV-2 antibodies using 17 commercially available lateral flow assays (LFA), two ELISA kits and one in-house developed IgG multiplex bead-based assay. Six LFA and the in-house validated IgG assay correctly produced negative results for all samples. However, the majority of assays (n=13), gave false positive signal for samples from patients with RA and SLE. This was most notable in samples from RF positive RA patients. No false positive samples were detected in any assay using samples from patients with MS. Poor specificity of commercial serological assays could possibly be, at least partly, due to interfering antibodies in samples from patients with chronic inflammatory diseases. For these patients, the risk of false positivity should be considered when interpreting results of the SARS-CoV-2 serological assays.
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Affiliation(s)
- Nastya Kharlamova
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nicky Dunn
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sahl K Bedri
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Svante Jerling
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Malin Almgren
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Francesca Faustini
- Department of Medicine Solna, Division of Rheumatology, Karolinska Institutet and Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | - Iva Gunnarsson
- Department of Medicine Solna, Division of Rheumatology, Karolinska Institutet and Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | - Johan Rönnelid
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Rille Pullerits
- Department of Rheumatology and Inflammation Research, Institution of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Immunology and Transfusion Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Inger Gjertsson
- Department of Rheumatology and Inflammation Research, Institution of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Karin Lundberg
- Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Medicine Solna, Division of Rheumatology, Karolinska Institutet and Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Månberg
- Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden
| | - Elisa Pin
- Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden
| | - Peter Nilsson
- Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden
| | - Sophia Hober
- Department of Protein Science, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Katharina Fink
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.,Centrum for Neurology, Academical Specialist Centrum, Stockholm, Sweden
| | - Anna Fogdell-Hahn
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
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50
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Pallett SJC, Jones R, Randell P, Davies GW, Moore LSP. Structured serological testing is an essential component to investigating SARS-CoV-2 reinfection. THE LANCET. INFECTIOUS DISEASES 2021; 21:598-599. [PMID: 33484647 PMCID: PMC7817473 DOI: 10.1016/s1473-3099(20)30990-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/17/2020] [Indexed: 01/25/2023]
Affiliation(s)
- Scott J C Pallett
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham B15 2WB, UK,Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Rachael Jones
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | | | - Gary W Davies
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Luke S P Moore
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK,North West London Pathology, London, UK,Imperial College London, NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, London, UK
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