51
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AL-Ibraheemi JSS, AL-Saeedi AS. The relationship between IgG and IgM levels and severity of symptoms in COVID-19 patients confirmed by rapid antigen test. J Med Life 2021; 14:790-796. [PMID: 35126749 PMCID: PMC8811674 DOI: 10.25122/jml-2021-0194] [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: 07/27/2021] [Accepted: 10/27/2021] [Indexed: 11/19/2022] Open
Abstract
This study aims to measure immunoglobulin G (IgG) and immunoglobulin M (IgM) response after detection of Severe Acute Respiratory Syndrome coronavirus (SARS CoV-2) antigens in coronavirus disease 2019 (COVID-19) patients concerning the severity of symptoms. SARS CoV-2 antigen was confirmed by rapid antigen test, and IgG and IgM were confirmed by VIDAS® SARS-COV-2 IgM and VIDAS® SARS-CoV-2 IgG automated qualitative assays used to rapidly detect antibodies 20–30 days after detection. The serological assay for detecting SARS-CoV-2 IgM and IgG antibodies shows a positive correlation for all patients detected with SARS-CoV-2 antigen with sensitivity 100% with differences in antibodies levels between patients regarding age and significantly related clinical symptoms with p-value 0.013 <0.05. The appearance of clinical symptoms was not significantly related to IgG levels at a p-value of 0.4 >0.05. However, the appearance of clinical symptoms was significantly related to IgM levels at a p-value of 0.002 <0.05. Antigen-dependent rapid tests can be used to detect SARS-CoV-2 in an early stage of infection with high sensitivity and specificity. Moreover, this study shows the age groups 21–30 and 31–40 have a better response to SARS-CoV-2 infection.
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Affiliation(s)
- Jasim Saeed Salman AL-Ibraheemi
- College of Medicine, University of Al-Ameed, Karbala, Iraq,Corresponding Author: Jasim Saeed Salman AL-Ibraheemi, College of Medicine, University of Al-Ameed, Karbala, Iraq. Phone: 009647801010887; E-mail: ;
| | - Abdul-Sattar AL-Saeedi
- Basic and Medical Sciences Branch, College of Nursing, University of Al-Ameed, Karbala, Iraq
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52
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Mariamenatu A, Abdu E. Convalescent plasma as a therapeutic agent for SARS-CoV, MERS-CoV and SARS-CoV-2: A scoping review. JOURNAL OF ACUTE DISEASE 2021. [DOI: 10.4103/2221-6189.312152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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53
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Post N, Eddy D, Huntley C, van Schalkwyk MCI, Shrotri M, Leeman D, Rigby S, Williams SV, Bermingham WH, Kellam P, Maher J, Shields AM, Amirthalingam G, Peacock SJ, Ismail SA. Antibody response to SARS-CoV-2 infection in humans: A systematic review. PLoS One 2020; 15:e0244126. [PMID: 33382764 PMCID: PMC7775097 DOI: 10.1371/journal.pone.0244126] [Citation(s) in RCA: 229] [Impact Index Per Article: 57.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/03/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Progress in characterising the humoral immune response to Severe Acute Respiratory Syndrome 2 (SARS-CoV-2) has been rapid but areas of uncertainty persist. Assessment of the full range of evidence generated to date to understand the characteristics of the antibody response, its dynamics over time, its determinants and the immunity it confers will have a range of clinical and policy implications for this novel pathogen. This review comprehensively evaluated evidence describing the antibody response to SARS-CoV-2 published from 01/01/2020-26/06/2020. METHODS Systematic review. Keyword-structured searches were carried out in MEDLINE, Embase and COVID-19 Primer. Articles were independently screened on title, abstract and full text by two researchers, with arbitration of disagreements. Data were double-extracted into a pre-designed template, and studies critically appraised using a modified version of the Public Health Ontario Meta-tool for Quality Appraisal of Public Health Evidence (MetaQAT) tool, with resolution of disagreements by consensus. Findings were narratively synthesised. RESULTS 150 papers were included. Most studies (113 or 75%) were observational in design, were based wholly or primarily on data from hospitalised patients (108, 72%) and had important methodological limitations. Few considered mild or asymptomatic infection. Antibody dynamics were well described in the acute phase, up to around three months from disease onset, but the picture regarding correlates of the antibody response was inconsistent. IgM was consistently detected before IgG in included studies, peaking at weeks two to five and declining over a further three to five weeks post-symptom onset depending on the patient group; IgG peaked around weeks three to seven post-symptom onset then plateaued, generally persisting for at least eight weeks. Neutralising antibodies were detectable within seven to 15 days following disease onset, with levels increasing until days 14-22 before levelling and then decreasing, but titres were lower in those with asymptomatic or clinically mild disease. Specific and potent neutralising antibodies have been isolated from convalescent plasma. Cross-reactivity but limited cross-neutralisation with other human coronaviridae was reported. Evidence for protective immunity in vivo was limited to small, short-term animal studies, showing promising initial results in the immediate recovery phase. CONCLUSIONS Literature on antibody responses to SARS-CoV-2 is of variable quality with considerable heterogeneity of methods, study participants, outcomes measured and assays used. Although acute phase antibody dynamics are well described, longer-term patterns are much less well evidenced. Comprehensive assessment of the role of demographic characteristics and disease severity on antibody responses is needed. Initial findings of low neutralising antibody titres and possible waning of titres over time may have implications for sero-surveillance and disease control policy, although further evidence is needed. The detection of potent neutralising antibodies in convalescent plasma is important in the context of development of therapeutics and vaccines. Due to limitations with the existing evidence base, large, cross-national cohort studies using appropriate statistical analysis and standardised serological assays and clinical classifications should be prioritised.
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Affiliation(s)
- Nathan Post
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Danielle Eddy
- National Infection Service, Public Health England, London, United Kingdom
| | - Catherine Huntley
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - May C. I. van Schalkwyk
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Madhumita Shrotri
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - David Leeman
- National Infection Service, Public Health England, London, United Kingdom
| | - Samuel Rigby
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sarah V. Williams
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - William H. Bermingham
- Department of Clinical Immunology, University Hospitals Birmingham, Birmingham, United Kingdom
| | - Paul Kellam
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - John Maher
- School of Cancer and Pharmaceutical Studies, King’s College London, London, United Kingdom
- Department of Immunology, Eastbourne Hospital, Eastbourne, United Kingdom
| | - Adrian M. Shields
- Clinical Immunology Service, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
| | | | - Sharon J. Peacock
- National Infection Service, Public Health England, London, United Kingdom
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Sharif A. Ismail
- National Infection Service, Public Health England, London, United Kingdom
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
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54
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Wouters E, Steenhuis M, Schrezenmeier H, Tiberghien P, Harvala H, Feys HB, van der Schoot E. Evaluation of SARS-CoV-2 antibody titers and potency for convalescent plasma donation: a brief commentary. Vox Sang 2020; 116:493-496. [PMID: 33368373 PMCID: PMC8246957 DOI: 10.1111/vox.13060] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/02/2020] [Accepted: 12/04/2020] [Indexed: 01/05/2023]
Affiliation(s)
- Elise Wouters
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium
| | - Maurice Steenhuis
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory Academic Medical Centre, Amsterdam, Netherlands
| | - Hubert Schrezenmeier
- Department of Transfusion Medicine, Ulm University, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg - Hessen and University Hospital Ulm, Ulm, Germany
| | - Pierre Tiberghien
- Etablissement Français du Sang, La Plaine St-Denis, France.,UMR1098 RIGHT, INSERM, Etablissement Français du Sang, Université de Franche-Comté, Besançon, France
| | - Heli Harvala
- Microbiology Services, NHS Blood and Transplant, London, UK
| | - Hendrik B Feys
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium
| | - Ellen van der Schoot
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory Academic Medical Centre, Amsterdam, Netherlands
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55
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Harvala H, Robb ML, Watkins N, Ijaz S, Dicks S, Patel M, Supasa P, Wanwisa D, Liu C, Mongkolsapaya J, Bown A, Bailey D, Vipond R, Grayson N, Temperton N, Gupta S, Ploeg RJ, Bolton J, Fyfe A, Gopal R, Simmonds P, Screaton G, Thompson C, Brooks T, Zambon M, Miflin G, Roberts DJ. Convalescent plasma therapy for the treatment of patients with COVID-19: Assessment of methods available for antibody detection and their correlation with neutralising antibody levels. Transfus Med 2020; 31:167-175. [PMID: 33333627 PMCID: PMC8246874 DOI: 10.1111/tme.12746] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION The lack of approved specific therapeutic agents to treat coronavirus disease (COVID-19) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has led to the rapid implementation of convalescent plasma therapy (CPT) trials in many countries, including the United Kingdom. Effective CPT is likely to require high titres of neutralising antibody (nAb) in convalescent donations. Understanding the relationship between functional neutralising antibodies and antibody levels to specific SARS-CoV-2 proteins in scalable assays will be crucial for the success of a large-scale collection. We assessed whether neutralising antibody titres correlated with reactivity in a range of enzyme-linked immunosorbent assays (ELISA) targeting the spike (S) protein, the main target for human immune response. METHODS Blood samples were collected from 52 individuals with a previous laboratory-confirmed SARS-CoV-2 infection. These were assayed for SARS-CoV-2 nAbs by microneutralisation and pseudo-type assays and for antibodies by four different ELISAs. Receiver operating characteristic (ROC) analysis was used to further identify sensitivity and specificity of selected assays to identify samples containing high nAb levels. RESULTS All samples contained SARS-CoV-2 antibodies, whereas neutralising antibody titres of greater than 1:20 were detected in 43 samples (83% of those tested) and >1:100 in 22 samples (42%). The best correlations were observed with EUROimmun immunoglobulin G (IgG) reactivity (Spearman Rho correlation coefficient 0.88; p < 0.001). Based on ROC analysis, EUROimmun would detect 60% of samples with titres of >1:100 with 100% specificity using a reactivity index of 9.1 (13/22). DISCUSSION Robust associations between nAb titres and reactivity in several ELISA-based antibody tests demonstrate their possible utility for scaled-up production of convalescent plasma containing potentially therapeutic levels of anti-SARS-CoV-2 nAbs.
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Affiliation(s)
- Heli Harvala
- National Microbiology Services, NHS Blood and Transplant, London, UK
| | - Matthew L Robb
- Statistics and Clinical Studies, NHS Blood and Transplant, Bristol, UK
| | - Nick Watkins
- Department of Research and Development, NHS Blood and Transplant Cambridge, Cambridge, UK
| | - Samreen Ijaz
- Virology Reference Department, National Infection Service, Public Health England, London, UK
| | - Steven Dicks
- Virology Reference Department, National Infection Service, Public Health England, London, UK
| | - Monika Patel
- High Containment Microbiology, National Infection Service, Public Health England, London, UK
| | - Piyada Supasa
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Dejnirattisai Wanwisa
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Chang Liu
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Juthathip Mongkolsapaya
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Dengue Hemorrhagic Fever Research Unit, Office for Research and Development, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Abbie Bown
- Rare and Imported Pathogens Laboratory, Public Health England, Porton Down, Wiltshire, UK
| | - Daniel Bailey
- Rare and Imported Pathogens Laboratory, Public Health England, Porton Down, Wiltshire, UK
| | - Richard Vipond
- Rare and Imported Pathogens Laboratory, Public Health England, Porton Down, Wiltshire, UK
| | - Nicholas Grayson
- Department of Paediatric Medicine, University of Oxford, University of Oxford, Oxford, UK
| | | | - Sunetra Gupta
- Department of Zoology, University of Oxford, Oxford, UK
| | - Rutger J Ploeg
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.,Department of Transplant Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Jai Bolton
- Department of Zoology, University of Oxford, Oxford, UK
| | - Alex Fyfe
- Department of Zoology, University of Oxford, Oxford, UK
| | - Robin Gopal
- Virology Reference Department, National Infection Service, Public Health England, London, UK
| | - Peter Simmonds
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Gavin Screaton
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Tim Brooks
- Rare and Imported Pathogens Laboratory, Public Health England, Porton Down, Wiltshire, UK
| | - Maria Zambon
- Virology Reference Department, National Infection Service, Public Health England, London, UK
| | - Gail Miflin
- Department of Chief Medical Officer, NHS Blood and Transplant, Bristol, UK
| | - David J Roberts
- NHS Blood and Transplant, Oxford, John Radcliffe Hospital, Oxford, UK.,Radcliffe Department of Medicine and BRC Haematology Theme, University of Oxford, John Radcliffe Hospital, Oxford, UK
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56
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Houlihan CF, Beale R. The complexities of SARS-CoV-2 serology. THE LANCET. INFECTIOUS DISEASES 2020; 20:1350-1351. [PMID: 32979317 PMCID: PMC7511169 DOI: 10.1016/s1473-3099(20)30699-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Catherine F Houlihan
- University College London Hospitals, NHS Foundation Trust, London, UK; University College London, London, UK.
| | - Rupert Beale
- University College London, London, UK; The Francis Crick Institute, London, UK
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57
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Focosi D, Anderson AO, Tang JW, Tuccori M. Convalescent Plasma Therapy for COVID-19: State of the Art. Clin Microbiol Rev 2020; 33:e00072-20. [PMID: 32792417 PMCID: PMC7430293 DOI: 10.1128/cmr.00072-20] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Convalescent plasma (CP) therapy has been used since the early 1900s to treat emerging infectious diseases; its efficacy was later associated with the evidence that polyclonal neutralizing antibodies can reduce the duration of viremia. Recent large outbreaks of viral diseases for which effective antivirals or vaccines are still lacking has renewed the interest in CP as a life-saving treatment. The ongoing COVID-19 pandemic has led to the scaling up of CP therapy to unprecedented levels. Compared with historical usage, pathogen reduction technologies have now added an extra layer of safety to the use of CP, and new manufacturing approaches are being explored. This review summarizes historical settings of application, with a focus on betacoronaviruses, and surveys current approaches for donor selection and CP collection, pooling technologies, pathogen inactivation systems, and banking of CP. We additionally list the ongoing registered clinical trials for CP throughout the world and discuss the trial results published thus far.
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Affiliation(s)
- Daniele Focosi
- North-Western Tuscany Blood Bank, Pisa University Hospital, Pisa, Italy
| | - Arthur O Anderson
- Department of Respiratory Mucosal Immunity, US Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
| | - Julian W Tang
- Respiratory Sciences, University of Leicester, Leicester, United Kingdom
| | - Marco Tuccori
- Division of Pharmacology and Pharmacovigilance, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Unit of Adverse Drug Reaction Monitoring, Pisa University Hospital, Pisa, Italy
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