451
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Petersen LR, Sami S, Vuong N, Pathela P, Weiss D, Morgenthau BM, Henseler RA, Daskalakis DC, Atas J, Patel A, Lukacs S, Mackey L, Grohskopf LA, Thornburg N, Akinbami LJ. Lack of antibodies to SARS-CoV-2 in a large cohort of previously infected persons. Clin Infect Dis 2020; 73:e3066-e3073. [PMID: 33147319 PMCID: PMC7665429 DOI: 10.1093/cid/ciaa1685] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/28/2020] [Indexed: 01/05/2023] Open
Abstract
Background Reports suggest that some persons previously infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lack detectable IgG antibodies. We aimed to determine the proportion IgG seronegative and predictors for seronegativity among persons previously infected with SARS-CoV-2. Methods We analyzed serologic data collected from health care workers and first responders in New York City and the Detroit metropolitan area with history of a positive SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) test result and who were tested for IgG antibodies to SARS-CoV-2 spike protein at least 2 weeks after symptom onset. Results Of 2,547 persons with previous confirmed SARS-CoV-2 infection, 160 (6.3%) were seronegative. Of 2,112 previously symptomatic persons, the proportion seronegative slightly increased from 14 to 90 days post symptom onset (p=0.06). The proportion seronegative ranged from 0% among 79 persons previously hospitalized to 11.0% among 308 persons with asymptomatic infections. In a multivariable model, persons taking immunosuppressive medications were more likely to be seronegative (31.9%, 95% confidence interval [CI] 10.7%-64.7%), while participants of non-Hispanic Black race/ethnicity (versus non-Hispanic White) (2.7%, 95% CI 1.5%-4.8%), with severe obesity (versus under/normal weight) (3.9%, 95% CI 1.7%-8.6%), or with more symptoms were less likely to be seronegative. Conclusions In our population with previous RT-PCR confirmed infection, approximately one in 16 persons lacked IgG antibodies. Absence of antibodies varied independently by illness severity, race/ethnicity, obesity, and immunosuppressive drug therapy. The proportion seronegative remained relatively stable among persons tested up to 90 days post symptom onset.
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Affiliation(s)
- Lyle R Petersen
- Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Samira Sami
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nga Vuong
- Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Preeti Pathela
- New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Don Weiss
- New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | | | - Rebecca A Henseler
- New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Demetre C Daskalakis
- New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Jenny Atas
- Region 2 South Healthcare Coalition, Romulus, Michigan, USA
| | - Anita Patel
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Susan Lukacs
- Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.,U.S. Public Health Service, Rockville, Maryland, USA
| | - Lisa Mackey
- Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Lisa A Grohskopf
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Lara J Akinbami
- Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.,U.S. Public Health Service, Rockville, Maryland, USA
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452
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Falahi S, Kenarkoohi A. COVID-19 reinfection: prolonged shedding or true reinfection? New Microbes New Infect 2020; 38:100812. [PMID: 33200033 PMCID: PMC7657875 DOI: 10.1016/j.nmni.2020.100812] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/06/2020] [Accepted: 11/06/2020] [Indexed: 12/20/2022] Open
Abstract
The SARS-CoV-2 pandemic is underway and millions of people have been infected. A large number of patients with COVID-19 have recovered and been discharged. While a number of recovered patients test positive again or even have a recurrence of clinical symptoms. Some researchers believe that a positive retest is related to the long-term persistence of the virus in the body, although there is some evidence in favor of reinfection. In this study, we focus more on the possible reasons for positive retesting, antibody responses, and review of possible reinfection case reports.
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Affiliation(s)
- S. Falahi
- Zoonotic Diseases Research Center, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - A. Kenarkoohi
- Department of Microbiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
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453
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Ogega CO, Skinner NE, Blair PW, Park HS, Littlefield K, Ganesan A, Ladiwala P, Antar AAR, Ray SC, Betenbaugh MJ, Pekosz A, Klein SL, Manabe YC, Cox AL, Bailey JR. Durable SARS-CoV-2 B cell immunity after mild or severe disease. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.10.28.20220996. [PMID: 33140070 PMCID: PMC7605583 DOI: 10.1101/2020.10.28.20220996] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Multiple studies have shown loss of SARS-CoV-2 specific antibodies over time after infection, raising concern that humoral immunity against the virus is not durable. If immunity wanes quickly, millions of people may be at risk for reinfection after recovery from COVID-19. However, memory B cells (MBC) could provide durable humoral immunity even if serum neutralizing antibody titers decline. We performed multi-dimensional flow cytometric analysis of S protein receptor binding domain (S-RBD)-specific MBC in cohorts of ambulatory COVID-19 patients with mild disease, and hospitalized patients with moderate to severe disease, at a median of 54 (39-104) days after onset of symptoms. We detected S-RBD-specific class-switched MBC in 13 out of 14 participants, including 4 of the 5 participants with lowest plasma levels of anti-S-RBD IgG and neutralizing antibodies. Resting MBC (rMBC) made up the largest proportion of S-RBD-specific class-switched MBC in both cohorts. FCRL5, a marker of functional memory when expressed on rMBC, was dramatically upregulated on S-RBD-specific rMBC. These data indicate that most SARS-CoV-2-infected individuals develop S-RBD-specific, class-switched MBC that phenotypically resemble germinal center-derived B cells induced by effective vaccination against other pathogens, providing evidence for durable B cell-mediated immunity against SARS-CoV-2 after recovery from mild or severe COVID-19 disease.
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Affiliation(s)
- Clinton O. Ogega
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nicole E. Skinner
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Paul W. Blair
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Han-Sol Park
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kirsten Littlefield
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Abhinaya Ganesan
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Pranay Ladiwala
- Advanced Mammalian Biomanufacturing Innovation Center, Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Annukka AR Antar
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Stuart C. Ray
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael J. Betenbaugh
- Advanced Mammalian Biomanufacturing Innovation Center, Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sabra L. Klein
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yukari C. Manabe
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Andrea L. Cox
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Justin R. Bailey
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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454
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Abstract
SARS-CoV-2, the virus that causes COVID-19, emerged in late 2019, and was declared a global pandemic on March 11th 2020. With over 50 million cases and 1.2 million deaths around the world, to date, this pandemic represents the gravest global health crisis of our times. Thus, the race to develop a COVID-19 vaccine is an urgent global imperative. At the time of writing, there are over 165 vaccine candidates being developed, with 33 in various stages of clinical testing. In this review, we discuss emerging insights about the human immune response to SARS-CoV-2, and their implications for vaccine design. We then review emerging knowledge of the immunogenicity of the numerous vaccine candidates that are currently being tested in the clinic and discuss the range of immune defense mechanisms that can be harnessed to develop novel vaccines that confer durable protection against SARS-CoV-2. Finally, we conclude with a discussion of the potential role of a systems vaccinology approach in accelerating the clinical testing of vaccines, to meet the urgent needs posed by the pandemic.
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Affiliation(s)
- Lilit Grigoryan
- Institute for Immunology, Transplantation and Infectious Diseases, Department of Pathology, Department of Microbiology & Immunology, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - Bali Pulendran
- Institute for Immunology, Transplantation and Infectious Diseases, Department of Pathology, Department of Microbiology & Immunology, Stanford University School of Medicine, Stanford, CA, 94305, United States.
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