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Melo-Vallès A, Ballesté-Delpierre C, Vila J. Review of the Microbiological Diagnostic Approaches of COVID-19. Front Public Health 2021; 9:592500. [PMID: 33987157 PMCID: PMC8110909 DOI: 10.3389/fpubh.2021.592500] [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: 08/10/2020] [Accepted: 03/24/2021] [Indexed: 11/13/2022] Open
Abstract
On March 12, the World Health Organization declared a pandemic following the exponential increase of SARS-CoV-2 cases. The rapid spread of the virus is due to both its high infectivity and the free circulation of unrecognized infectious cases. Thus, diagnostic testing is a key element to prevent further dissemination of the virus. Urged by WHO's call, laboratories worldwide have been working on nucleic acid tests protocols and immunoassays that became available, albeit poorly validated, within a comparatively short time. Since then, external studies evaluating these diagnostic tests have been published. The present study is a review of the COVID-19 diagnostic approaches, discussing both direct and indirect microbiological diagnoses. A compendium of the literature on commercial assays kits available to date is provided together with the conclusions drawn as well as RT-PCR protocols published by the WHO. Briefly, diagnostic accuracy varies according to time elapsed since symptom onset and evolves together with understanding of the COVID-19 disease. Taking into account all these variables will allow determining the most adequate diagnostic test to use and how to optimize diagnostic testing for COVID-19.
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Affiliation(s)
- Ada Melo-Vallès
- Bachelor of Human Biology, Fourth Grade Student, Life and Health Sciences Faculty, Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Jordi Vila
- ISGlobal Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Department of Clinical Microbiology, Centre for Biomedical Diagnosis, Hospital Clínic, Barcelona, Spain
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102
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Mouliou DS, Gourgoulianis KI. False-positive and false-negative COVID-19 cases: respiratory prevention and management strategies, vaccination, and further perspectives. Expert Rev Respir Med 2021; 15:993-1002. [PMID: 33896332 PMCID: PMC8074645 DOI: 10.1080/17476348.2021.1917389] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Introduction: A novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was reported via nucleic acid identification in December, 2019. Accuracy of SARS-CoV-2 diagnostic assays has emerged as a major barrier to COVID-19 diagnosis, particularly in cases requiring urgent or emergent treatment. Areas covered: In this review, we explore the major reasons for false-positive and false-negative SARS-CoV-2 test results. How clinical characteristics, specific respiratory comorbidities and SARS-CoV-2 vaccination impact on existing diagnostic assays are highlighted. Different COVID-19 management algorithms based on each test and limitations are thoroughly presented. Expert opinion: The diagnostic accuracy and the capacity of every available assay, which need to be interpreted in the light of the background incidence of SARS-CoV-2 infection in the communities in which they are used, are essential in order to minimize the number of falsely tested cases. Automated testing platforms may enhance diagnostic accuracy by minimizing the potential for human error in assays’ performance. Prior immunization against SARS-CoV-2 impairs the utility of serologic testing of suspected COVID-19 cases. Future avenues of research to evaluate lung tissue innate immune responses hold promise as a target for research to optimize SARS-CoV-2 and future infections’ testing accuracy.
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Affiliation(s)
- Dimitra S Mouliou
- Department of Respiratory Medicine, University of Thessaly, Larissa, Greece
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103
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Butt J, Murugan R, Hippchen T, Olberg S, van Straaten M, Wardemann H, Stebbins E, Kräusslich HG, Bartenschlager R, Brenner H, Laketa V, Schöttker B, Müller B, Merle U, Waterboer T. From Multiplex Serology to Serolomics-A Novel Approach to the Antibody Response against the SARS-CoV-2 Proteome. Viruses 2021; 13:749. [PMID: 33923338 PMCID: PMC8147094 DOI: 10.3390/v13050749] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/11/2021] [Accepted: 04/20/2021] [Indexed: 01/08/2023] Open
Abstract
The emerging SARS-CoV-2 pandemic entails an urgent need for specific and sensitive high-throughput serological assays to assess SARS-CoV-2 epidemiology. We, therefore, aimed at developing a fluorescent-bead based SARS-CoV-2 multiplex serology assay for detection of antibody responses to the SARS-CoV-2 proteome. Proteins of the SARS-CoV-2 proteome and protein N of SARS-CoV-1 and common cold Coronaviruses (ccCoVs) were recombinantly expressed in E. coli or HEK293 cells. Assay performance was assessed in a COVID-19 case cohort (n = 48 hospitalized patients from Heidelberg) as well as n = 85 age- and sex-matched pre-pandemic controls from the ESTHER study. Assay validation included comparison with home-made immunofluorescence and commercial enzyme-linked immunosorbent (ELISA) assays. A sensitivity of 100% (95% CI: 86-100%) was achieved in COVID-19 patients 14 days post symptom onset with dual sero-positivity to SARS-CoV-2 N and the receptor-binding domain of the spike protein. The specificity obtained with this algorithm was 100% (95% CI: 96-100%). Antibody responses to ccCoVs N were abundantly high and did not correlate with those to SARS-CoV-2 N. Inclusion of additional SARS-CoV-2 proteins as well as separate assessment of immunoglobulin (Ig) classes M, A, and G allowed for explorative analyses regarding disease progression and course of antibody response. This newly developed SARS-CoV-2 multiplex serology assay achieved high sensitivity and specificity to determine SARS-CoV-2 sero-positivity. Its high throughput ability allows epidemiologic SARS-CoV-2 research in large population-based studies. Inclusion of additional pathogens into the panel as well as separate assessment of Ig isotypes will furthermore allow addressing research questions beyond SARS-CoV-2 sero-prevalence.
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Affiliation(s)
- Julia Butt
- Infections and Cancer Epidemiology, German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ), 69120 Heidelberg, Germany;
| | - Rajagopal Murugan
- B Cell Immunology, German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ), 69120 Heidelberg, Germany; (R.M.); (H.W.)
| | - Theresa Hippchen
- Department of Internal Medicine IV, University Hospital Heidelberg, 69120 Heidelberg, Germany; (T.H.); (U.M.)
| | - Sylvia Olberg
- Department of Infectious Diseases, Virology, University Hospital Heidelberg, 69120 Heidelberg, Germany; (S.O.); (H.-G.K.); (V.L.); (B.M.)
- German Center for Infection Research (DZIF), Heidelberg Partner Site, 69120 Heidelberg, Germany;
| | - Monique van Straaten
- Division of Structural Biology of Infection and Immunity, German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ), 69120 Heidelberg, Germany; (M.v.S.); (E.S.)
| | - Hedda Wardemann
- B Cell Immunology, German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ), 69120 Heidelberg, Germany; (R.M.); (H.W.)
| | - Erec Stebbins
- Division of Structural Biology of Infection and Immunity, German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ), 69120 Heidelberg, Germany; (M.v.S.); (E.S.)
| | - Hans-Georg Kräusslich
- Department of Infectious Diseases, Virology, University Hospital Heidelberg, 69120 Heidelberg, Germany; (S.O.); (H.-G.K.); (V.L.); (B.M.)
- German Center for Infection Research (DZIF), Heidelberg Partner Site, 69120 Heidelberg, Germany;
| | - Ralf Bartenschlager
- German Center for Infection Research (DZIF), Heidelberg Partner Site, 69120 Heidelberg, Germany;
- Department of Infectious Diseases, Molecular Virology, Heidelberg University, 69120 Heidelberg, Germany
- Division Virus-Associated Carcinogenesis, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ), 69120 Heidelberg, Germany; (H.B.); (B.S.)
- Network Aging Research, University of Heidelberg, 69120 Heidelberg, Germany
| | - Vibor Laketa
- Department of Infectious Diseases, Virology, University Hospital Heidelberg, 69120 Heidelberg, Germany; (S.O.); (H.-G.K.); (V.L.); (B.M.)
- German Center for Infection Research (DZIF), Heidelberg Partner Site, 69120 Heidelberg, Germany;
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ), 69120 Heidelberg, Germany; (H.B.); (B.S.)
- Network Aging Research, University of Heidelberg, 69120 Heidelberg, Germany
| | - Barbara Müller
- Department of Infectious Diseases, Virology, University Hospital Heidelberg, 69120 Heidelberg, Germany; (S.O.); (H.-G.K.); (V.L.); (B.M.)
| | - Uta Merle
- Department of Internal Medicine IV, University Hospital Heidelberg, 69120 Heidelberg, Germany; (T.H.); (U.M.)
| | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ), 69120 Heidelberg, Germany;
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104
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Nguyen D, Skelly D, Goonawardane N. A Novel Immunofluorescence Assay for the Rapid Serological Detection of SARS-CoV-2 Infection. Viruses 2021; 13:v13050747. [PMID: 33923271 PMCID: PMC8146438 DOI: 10.3390/v13050747] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/22/2021] [Accepted: 04/22/2021] [Indexed: 12/14/2022] Open
Abstract
As of April 2021, the COVID-19 pandemic has swept through 213 countries and infected more than 132 million individuals globally, posing an unprecedented threat to human health. There are currently no specific antiviral treatments for COVID-19 and vaccination programmes, whilst promising, remain in their infancy. A key to restricting the pandemic is the ability to minimize human–human transmission and to predict the infection status of the population in the face of emerging SARS-CoV-2 variants. Success in this area is dependent on the rapid detection of COVID-19 positive individuals with current/previous SARS-CoV-2 infection status. In this regard, the ability to detect antibodies directed against the SARS-CoV-Spike protein in patient sera represents a powerful biomarker for confirmation of infection. Here, we report the design of a proof-of-concept cell–based fluorescent serology assay (termed C19-S-I-IFA) to detect SARS-CoV-2 infection. The assay is based on the capture of IgG antibodies in the serum of COVID-19-positive patients using cells exogenously expressing SARS-CoV-2-Spike and their subsequent fluorescent detection. We validate the assay in 30 blood samples collected in Oxford, UK, in 2020 during the height of the pandemic. Importantly, the assay can be modified to express emerging Spike-variants to permit assessments of the cross-reactivity of patient sera to emerging SARS-CoV-2 strains.
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Affiliation(s)
- Dung Nguyen
- Nuffield Department of Medicine, University of Oxford, Oxford OX1 3SY, UK; (D.N.); (D.S.)
| | - Donal Skelly
- Nuffield Department of Medicine, University of Oxford, Oxford OX1 3SY, UK; (D.N.); (D.S.)
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX1 2JD, UK
| | - Niluka Goonawardane
- Nuffield Department of Medicine, University of Oxford, Oxford OX1 3SY, UK; (D.N.); (D.S.)
- Correspondence:
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105
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Bortz RH, Florez C, Laudermilch E, Wirchnianski AS, Lasso G, Malonis RJ, Georgiev GI, Vergnolle O, Herrera NG, Morano NC, Campbell ST, Orner EP, Mengotto A, Dieterle ME, Fels JM, Haslwanter D, Jangra RK, Celikgil A, Kimmel D, Lee JH, Mariano MC, Nakouzi A, Quiroz J, Rivera J, Szymczak WA, Tong K, Barnhill J, Forsell MNE, Ahlm C, Stein DT, Pirofski LA, Goldstein DY, Garforth SJ, Almo SC, Daily JP, Prystowsky MB, Faix JD, Fox AS, Weiss LM, Lai JR, Chandran K. Single-Dilution COVID-19 Antibody Test with Qualitative and Quantitative Readouts. mSphere 2021; 6:e00224-21. [PMID: 33883259 PMCID: PMC8546701 DOI: 10.1128/msphere.00224-21] [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] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 03/24/2021] [Indexed: 12/24/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to place an immense burden on societies and health care systems. A key component of COVID-19 control efforts is serological testing to determine the community prevalence of SARS-CoV-2 exposure and quantify individual immune responses to prior SARS-CoV-2 infection or vaccination. Here, we describe a laboratory-developed antibody test that uses readily available research-grade reagents to detect SARS-CoV-2 exposure in patient blood samples with high sensitivity and specificity. We further show that this sensitive test affords the estimation of viral spike-specific IgG titers from a single sample measurement, thereby providing a simple and scalable method to measure the strength of an individual's immune response. The accuracy, adaptability, and cost-effectiveness of this test make it an excellent option for clinical deployment in the ongoing COVID-19 pandemic.IMPORTANCE Serological surveillance has become an important public health tool during the COVID-19 pandemic. Detection of protective antibodies and seroconversion after SARS-CoV-2 infection or vaccination can help guide patient care plans and public health policies. Serology tests can detect antibodies against past infections; consequently, they can help overcome the shortcomings of molecular tests, which can detect only active infections. This is important, especially when considering that many COVID-19 patients are asymptomatic. In this study, we describe an enzyme-linked immunosorbent assay (ELISA)-based qualitative and quantitative serology test developed to measure IgG and IgA antibodies against the SARS-CoV-2 spike glycoprotein. The test can be deployed using commonly available laboratory reagents and equipment and displays high specificity and sensitivity. Furthermore, we demonstrate that IgG titers in patient samples can be estimated from a single measurement, enabling the assay's use in high-throughput clinical environments.
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Affiliation(s)
- Robert H Bortz
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Catalina Florez
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA
- Department of Chemistry and Life Science, United States Military Academy at West Point, West Point, New York, USA
| | - Ethan Laudermilch
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Ariel S Wirchnianski
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Gorka Lasso
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Ryan J Malonis
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - George I Georgiev
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Olivia Vergnolle
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Natalia G Herrera
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Nicholas C Morano
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Sean T Campbell
- Department of Pathology, Albert Einstein College of Medicine, Bronx, New York, USA
- Montefiore Medical Center, Bronx, New York, USA
| | - Erika P Orner
- Department of Pathology, Albert Einstein College of Medicine, Bronx, New York, USA
- Montefiore Medical Center, Bronx, New York, USA
| | - Amanda Mengotto
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
- Montefiore Medical Center, Bronx, New York, USA
| | - M Eugenia Dieterle
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - J Maximilian Fels
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Denise Haslwanter
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Rohit K Jangra
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Alev Celikgil
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Duncan Kimmel
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
- Montefiore Medical Center, Bronx, New York, USA
| | - James H Lee
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Margarette C Mariano
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Antonio Nakouzi
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
- Montefiore Medical Center, Bronx, New York, USA
| | - Jose Quiroz
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
- Montefiore Medical Center, Bronx, New York, USA
| | - Johanna Rivera
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
- Montefiore Medical Center, Bronx, New York, USA
| | - Wendy A Szymczak
- Department of Pathology, Albert Einstein College of Medicine, Bronx, New York, USA
- Montefiore Medical Center, Bronx, New York, USA
| | - Karen Tong
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Jason Barnhill
- Department of Chemistry and Life Science, United States Military Academy at West Point, West Point, New York, USA
| | | | - Clas Ahlm
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | - Daniel T Stein
- Montefiore Medical Center, Bronx, New York, USA
- Division of Endocrinology and Diabetes, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Liise-Anne Pirofski
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
- Montefiore Medical Center, Bronx, New York, USA
| | - D Yitzchak Goldstein
- Department of Pathology, Albert Einstein College of Medicine, Bronx, New York, USA
- Montefiore Medical Center, Bronx, New York, USA
| | - Scott J Garforth
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Steven C Almo
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Johanna P Daily
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
- Montefiore Medical Center, Bronx, New York, USA
| | - Michael B Prystowsky
- Department of Pathology, Albert Einstein College of Medicine, Bronx, New York, USA
- Montefiore Medical Center, Bronx, New York, USA
| | - James D Faix
- Department of Pathology, Albert Einstein College of Medicine, Bronx, New York, USA
- Montefiore Medical Center, Bronx, New York, USA
| | - Amy S Fox
- Department of Pathology, Albert Einstein College of Medicine, Bronx, New York, USA
- Montefiore Medical Center, Bronx, New York, USA
| | - Louis M Weiss
- Department of Pathology, Albert Einstein College of Medicine, Bronx, New York, USA
- Montefiore Medical Center, Bronx, New York, USA
| | - Jonathan R Lai
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Kartik Chandran
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA
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106
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Abstract
Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread globally as a severe pandemic. SARS-CoV-2 infection stimulates antigen-specific antibody responses. Multiple serologic tests have been developed for SARS-CoV-2. However, which antigens are most suitable for serological testing remains poorly understood. Specifically, which antigens have the highest sensitivity and specificity for serological testing and which have the least cross-reactivity with other coronaviruses are currently unknown. Previous studies have shown that the S1 domain of the spike (S) protein has very low cross-reactivity between epidemic coronaviruses and common human coronaviruses, whereas the S2 domain of the S protein and the nucleocapsid protein (N protein) show low-level cross-reactivity. Therefore, S1 is considered more specific than the native homotrimer of the S protein, and the receptor-binding domain as an antigen to test patient antibodies is more sensitive than the native N protein. In addition, an increasing number of studies have used multiantigen protein arrays to screen serum from convalescent patients with COVID-19. Antigen combinations demonstrated improved performance compared to each individual antigen. For rapid antigen detection, the sensitivity of the test is higher in the first week of onset of the disease with high viral loads. Highly sensitive and specific immunological diagnostic methods for antibodies or those that directly detect viral antigens in clinical samples would be beneficial for the rapid and accurate diagnosis of SARS-CoV-2 infection.
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Affiliation(s)
- Dandan Li
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Jinming Li
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Beijing Engineering Research Center of Laboratory Medicine, Beijing, People's Republic of China
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107
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Levi-Schaffer F, de Marco A. Coronavirus disease 2019 and the revival of passive immunization: Antibody therapy for inhibiting severe acute respiratory syndrome coronavirus 2 and preventing host cell infection: IUPHAR review: 31. Br J Pharmacol 2021; 178:3359-3372. [PMID: 33401333 DOI: 10.1111/bph.15359] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/24/2020] [Accepted: 12/29/2020] [Indexed: 12/26/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic stimulated both the scientific community and healthcare companies to undertake an unprecedented effort with the aim of understanding the molecular mechanisms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and developing effective therapeutic solutions. The peculiar immune response triggered by this virus, which seems to last only few months, led to a search for alternatives such as passive immunization in addition to conventional vaccinations. Convalescent sera, monoclonal antibodies selected from the most potent neutralizing binders induced by the virus infection, recombinant human single-domain antibodies, and binders of variable scaffold and different origin have been tested alone or in combination exploiting monovalent, multivalent and multispecific formats. In this review, we analyse the state of the research in this field and present a summary of the ongoing projects finalized to identify suitable molecules for therapies based on passive immunization.
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Affiliation(s)
- Francesca Levi-Schaffer
- Pharmacology & Experimental Therapeutics Unit, School of Pharmacy, Faculty of Medicine, The Institute for Drug Research, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ario de Marco
- Laboratory for Environmental and Life Sciences, University of Nova Gorica, Nova Gorica, Slovenia
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108
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Andrey DO, Yerly S, Meyer B, Arm-Vernez I, Roux-Lombard P, Togni G, Guessous I, Spechbach H, Stringhini S, Agoritsas T, Stirnemann J, Reny JL, Siegrist CA, Eckerle I, Kaiser L, Vuilleumier N. Head-to-Head Evaluation of Five Automated SARS-CoV-2 Serology Immunoassays in Various Prevalence Settings. J Clin Med 2021; 10:jcm10081605. [PMID: 33920076 PMCID: PMC8069412 DOI: 10.3390/jcm10081605] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/30/2021] [Accepted: 04/04/2021] [Indexed: 01/28/2023] Open
Abstract
Purpose: To assess the diagnostic performances of five automated anti-SARS-CoV-2 immunoassays, Epitope (N), Diasorin (S1/S2), Euroimmun (S1), Roche N (N), and Roche S (S-RBD), and to provide a testing strategy based on pre-test probability. Methods: We assessed the receiver operating characteristic (ROC) areas under the curve (AUC) values, along with the sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs), of each assay using a validation sample set of 172 COVID-19 sera and 185 negative controls against a validated S1-immunofluorescence as a reference method. The three assays displaying the highest AUCs were selected for further serodetection of 2033 sera of a large population-based cohort. Results: In the validation analysis (pre-test probability: 48.1%), Roche N, Roche S and Euroimmun showed the highest discriminant accuracy (AUCs: 0.99, 0.98, and 0.98) with PPVs and NPVs above 96% and 94%, respectively. In the population-based cohort (pre-test probability: 6.2%) these three assays displayed AUCs above 0.97 and PPVs and NPVs above 90.5% and 99.4%, respectively. A sequential strategy using an anti-S assay as screening test and an anti-N as confirmatory assays resulted in a 96.7% PPV and 99.5% NPV, respectively. Conclusions: Euroimmun and both Roche assays performed equally well in high pre-test probability settings. At a lower prevalence, sequentially combining anti-S and anti-N assays resulted in the optimal trade-off between diagnostic performances and operational considerations.
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Affiliation(s)
- Diego O. Andrey
- Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals and Geneva University, 1211 Geneva, Switzerland; (S.Y.); (I.A.-V.); (P.R.-L.); (L.K.); (N.V.)
- Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, 1211 Geneva, Switzerland;
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, 1211 Geneva, Switzerland
- Correspondence: ; Tel.: +41-223729800; Fax: +41-223729830
| | - Sabine Yerly
- Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals and Geneva University, 1211 Geneva, Switzerland; (S.Y.); (I.A.-V.); (P.R.-L.); (L.K.); (N.V.)
- Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, 1211 Geneva, Switzerland;
| | - Benjamin Meyer
- Centre for Vaccinology, Department of Pathology and Immunology, University of Geneva, 1205 Geneva, Switzerland; (B.M.); (C.-A.S.)
| | - Isabelle Arm-Vernez
- Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals and Geneva University, 1211 Geneva, Switzerland; (S.Y.); (I.A.-V.); (P.R.-L.); (L.K.); (N.V.)
| | - Pascale Roux-Lombard
- Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals and Geneva University, 1211 Geneva, Switzerland; (S.Y.); (I.A.-V.); (P.R.-L.); (L.K.); (N.V.)
- Division of Immunology, Geneva University Hospitals, 1211 Geneva, Switzerland
| | - Giuseppe Togni
- Unilabs, Central Laboratory Collection Centers, 1296 Coppet, Switzerland;
| | - Idris Guessous
- Division and Department of Primary Care Medicine, Geneva University Hospitals, 1211 Geneva, Switzerland; (I.G.); (H.S.); (S.S.)
| | - Hervé Spechbach
- Division and Department of Primary Care Medicine, Geneva University Hospitals, 1211 Geneva, Switzerland; (I.G.); (H.S.); (S.S.)
| | - Silvia Stringhini
- Division and Department of Primary Care Medicine, Geneva University Hospitals, 1211 Geneva, Switzerland; (I.G.); (H.S.); (S.S.)
- Unit of Population Epidemiology, Division of Primary Care, Geneva University Hospitals, 1211 Geneva, Switzerland
| | - Thomas Agoritsas
- Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals, 1211 Geneva, Switzerland; (T.A.); (J.S.); (J.-L.R.)
| | - Jérôme Stirnemann
- Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals, 1211 Geneva, Switzerland; (T.A.); (J.S.); (J.-L.R.)
| | - Jean-Luc Reny
- Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals, 1211 Geneva, Switzerland; (T.A.); (J.S.); (J.-L.R.)
| | - Claire-Anne Siegrist
- Centre for Vaccinology, Department of Pathology and Immunology, University of Geneva, 1205 Geneva, Switzerland; (B.M.); (C.-A.S.)
- Department of Childhood and Adolescence, Geneva University Hospitals, 1211 Geneva, Switzerland
| | - Isabella Eckerle
- Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, 1211 Geneva, Switzerland;
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, 1211 Geneva, Switzerland
| | - Laurent Kaiser
- Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals and Geneva University, 1211 Geneva, Switzerland; (S.Y.); (I.A.-V.); (P.R.-L.); (L.K.); (N.V.)
- Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, 1211 Geneva, Switzerland;
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, 1211 Geneva, Switzerland
| | - Nicolas Vuilleumier
- Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals and Geneva University, 1211 Geneva, Switzerland; (S.Y.); (I.A.-V.); (P.R.-L.); (L.K.); (N.V.)
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109
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Zhuang S, Tang L, Dai Y, Feng X, Fang Y, Tang H, Jiang P, Wu X, Fang H, Chen H. Bioinformatic prediction of immunodominant regions in spike protein for early diagnosis of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). PeerJ 2021; 9:e11232. [PMID: 33889450 PMCID: PMC8038641 DOI: 10.7717/peerj.11232] [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: 12/09/2020] [Accepted: 03/16/2021] [Indexed: 01/06/2023] Open
Abstract
Background To contain the pandemics caused by SARS-CoV-2, early detection approaches with high accuracy and accessibility are critical. Generating an antigen-capture based detection system would be an ideal strategy complementing the current methods based on nucleic acids and antibody detection. The spike protein is found on the outside of virus particles and appropriate for antigen detection. Methods In this study, we utilized bioinformatics approaches to explore the immunodominant fragments on spike protein of SARS-CoV-2. Results The S1 subunit of spike protein was identified with higher sequence specificity. Three immunodominant fragments, Spike56-94, Spike199-264, and Spike577-612, located at the S1 subunit were finally selected via bioinformatics analysis. The glycosylation sites and high-frequency mutation sites on spike protein were circumvented in the antigen design. All the identified fragments present qualified antigenicity, hydrophilicity, and surface accessibility. A recombinant antigen with a length of 194 amino acids (aa) consisting of the selected immunodominant fragments as well as a universal Th epitope was finally constructed. Conclusion The recombinant peptide encoded by the construct contains multiple immunodominant epitopes, which is expected to stimulate a strong immune response in mice and generate qualified antibodies for SARS-CoV-2 detection.
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Affiliation(s)
- Siqi Zhuang
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lingli Tang
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yufeng Dai
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaojing Feng
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yiyuan Fang
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Haoneng Tang
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ping Jiang
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiang Wu
- Department of Parasitology, Xiangya School of Basic Medicine, Central South University, Changsha, Hunan, China
| | - Hezhi Fang
- Key Laboratory of Laboratory Medicine, Ministry of Education, Zhejiang Provincial Key Laboratory of Medical Genetics, College of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hongzhi Chen
- National Clinical Research Center for Metabolic Disease, Key Laboratory of Diabetes Immunology, Ministry of Education, Metabolic Syndrome Research Center, and Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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110
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Emmerich P, Murawski C, Ehmen C, von Possel R, Pekarek N, Oestereich L, Duraffour S, Pahlmann M, Struck N, Eibach D, Krumkamp R, Amuasi J, Maiga-Ascofaré O, Rakotozandrindrainy R, Asogun D, Ighodalo Y, Kann S, May J, Tannich E, Deschermeier C. Limited specificity of commercially available SARS-CoV-2 IgG ELISAs in serum samples of African origin. Trop Med Int Health 2021; 26:621-631. [PMID: 33666297 PMCID: PMC8014856 DOI: 10.1111/tmi.13569] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Specific serological tests are mandatory for reliable SARS-CoV-2 diagnostics and seroprevalence studies. Here, we assess the specificities of four commercially available SARS-CoV-2 IgG ELISAs in serum/plasma panels originating from Africa, South America, and Europe. METHODS 882 serum/plasma samples collected from symptom-free donors before the COVID-19 pandemic in three African countries (Ghana, Madagascar, Nigeria), Colombia, and Germany were analysed with three nucleocapsid-based ELISAs (Euroimmun Anti-SARS-CoV-2-NCP IgG, EDI™ Novel Coronavirus COVID-19 IgG, Mikrogen recomWell SARS-CoV-2 IgG), one spike/S1-based ELISA (Euroimmun Anti-SARS-CoV-2 IgG), and in-house common cold CoV ELISAs. RESULTS High specificity was confirmed for all SARS-CoV-2 IgG ELISAs for Madagascan (93.4-99.4%), Colombian (97.8-100.0%), and German (95.9-100.0%) samples. In contrast, specificity was much lower for the Ghanaian and Nigerian serum panels (Ghana: NCP-based assays 77.7-89.7%, spike/S1-based assay 94.3%; Nigeria: NCP-based assays 39.3-82.7%, spike/S1-based assay 90.7%). 15 of 600 African sera were concordantly classified as positive in both the NCP-based and the spike/S1-based Euroimmun ELISA, but did not inhibit spike/ACE2 binding in a surrogate virus neutralisation test. IgG antibodies elicited by previous infections with common cold CoVs were found in all sample panels, including those from Madagascar, Colombia, and Germany and thus do not inevitably hamper assay specificity. Nevertheless, high levels of IgG antibodies interacting with OC43 NCP were found in all 15 SARS-CoV-2 NCP/spike/S1 ELISA positive sera. CONCLUSIONS Depending on the chosen antigen and assay protocol, SARS-CoV-2 IgG ELISA specificity may be significantly reduced in certain populations probably due to interference of immune responses to endemic pathogens like other viruses or parasites.
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Affiliation(s)
- Petra Emmerich
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,Department of Tropical Medicine and Infectious Diseases, Center of Internal Medicine II, University of Rostock, Rostock, Germany
| | - Carolin Murawski
- Department for Infectious Disease Diagnostics, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Christa Ehmen
- Department for Infectious Disease Diagnostics, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Ronald von Possel
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Neele Pekarek
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Lisa Oestereich
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,German Center for Infection Research, Hamburg - Lübeck - Borstel - Riems, Germany
| | - Sophie Duraffour
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,German Center for Infection Research, Hamburg - Lübeck - Borstel - Riems, Germany
| | - Meike Pahlmann
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,German Center for Infection Research, Hamburg - Lübeck - Borstel - Riems, Germany
| | - Nicole Struck
- German Center for Infection Research, Hamburg - Lübeck - Borstel - Riems, Germany.,Department for Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Daniel Eibach
- German Center for Infection Research, Hamburg - Lübeck - Borstel - Riems, Germany.,Department for Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Ralf Krumkamp
- German Center for Infection Research, Hamburg - Lübeck - Borstel - Riems, Germany.,Department for Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - John Amuasi
- Global Health and Infectious Disease Research Group, Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | - Oumou Maiga-Ascofaré
- German Center for Infection Research, Hamburg - Lübeck - Borstel - Riems, Germany.,Infectious Disease Epidemiology Research Group, Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | | | - Danny Asogun
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | - Yemisi Ighodalo
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | - Simone Kann
- Medical Mission Institute, Würzburg, Germany
| | - Jürgen May
- Department for Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Egbert Tannich
- Department for Infectious Disease Diagnostics, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,National Reference Centre for Tropical Pathogens, Hamburg, Germany
| | - Christina Deschermeier
- Department for Infectious Disease Diagnostics, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
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Higgins V, Fabros A, Wang XY, Bhandari M, Daghfal DJ, Kulasingam V. Anti-SARS-CoV-2 IgM improves clinical sensitivity early in disease course. Clin Biochem 2021; 90:1-7. [PMID: 33476578 PMCID: PMC7816645 DOI: 10.1016/j.clinbiochem.2021.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is diagnosed by molecular-based detection of SARS-CoV-2 RNA. Serologic testing detects antibodies specific to SARS-CoV-2 and IgM specifically may serve as an adjunct test to PCR early in disease. We evaluated the Abbott anti-SARS-CoV-2 IgM and IgG assays along with DiaSorin anti-SARS-CoV-2 IgG and Roche anti-SARS-CoV-2 Total. METHODS Specimens from 175 PCR-positive patients and 107 control specimens were analyzed using Abbott IgM and IgG, DiaSorin IgG, and Roche Total (IgA, IgG, IgM) assays. Sensitivity, specificity, cross-reactivity, concordance between assays, trends over time, positive predictive value (PPV), and negative predictive value (NPV) were determined. RESULTS Abbott IgM sensitivity was 63.6% at 0 days post-PCR positivity, 76.5% at 1-5d, 76.3% at 6-14d, 85.2% at 15-30d, and 63.6% at > 30d. All assays exhibited highest sensitivity 15-30d post-PCR positivity (83.3-85.2%). Combining Abbott IgM and IgG improved sensitivity by 22.7% compared to IgG alone when tested 0d post-PCR positivity. All assays had a specificity of 100% and only Abbott IgG exhibited cross-reactivity (anti-dsDNA). Cohen's kappa varied between 0.86 and 0.93. Time to seroconversion from PCR positivity was lowest for Abbott IgM and highest for Abbott IgG. NPV was highest for Abbott IgM < 14 days post-PCR positivity and Abbott IgG ≥ 14 days. CONCLUSION The Abbott IgM assay exhibited the earliest response and greatest signal in most patients evaluated for serial sampling and had the highest NPV < 14 days post-PCR positivity, suggesting its potential utility as an adjunct test to PCR early in disease course.
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Affiliation(s)
- Victoria Higgins
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Anselmo Fabros
- Department of Clinical Biochemistry, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
| | - Xiao Yan Wang
- Department of Clinical Biochemistry, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
| | | | | | - Vathany Kulasingam
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada; Department of Clinical Biochemistry, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada.
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Kwok KO, Huang Y, Tsoi MTF, Tang A, Wong SYS, Wei WI, Hui DSC. Epidemiology, clinical spectrum, viral kinetics and impact of COVID-19 in the Asia-Pacific region. Respirology 2021; 26:322-333. [PMID: 33690946 PMCID: PMC8207122 DOI: 10.1111/resp.14026] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/08/2021] [Indexed: 01/08/2023]
Abstract
COVID-19 has hit the world by surprise, causing substantial mortality and morbidity since 2020. This narrative review aims to provide an overview of the epidemiology, induced impact, viral kinetics and clinical spectrum of COVID-19 in the Asia-Pacific Region, focusing on regions previously exposed to outbreaks of coronavirus. COVID-19 progressed differently by regions, with some (such as China and Taiwan) featured by one to two epidemic waves and some (such as Hong Kong and South Korea) featured by multiple waves. There has been no consensus on the estimates of important epidemiological time intervals or proportions, such that using them for making inferences should be done with caution. Viral loads of patients with COVID-19 peak in the first week of illness around days 2 to 4 and hence there is very high transmission potential causing community outbreaks. Various strategies such as government-guided and suppress-and-lift strategies, trigger-based/suppression approaches and alert systems have been employed to guide the adoption and easing of control measures. Asymptomatic and pre-symptomatic transmission is a hallmark of COVID-19. Identification and isolation of symptomatic patients alone is not effective in controlling the ongoing outbreaks. However, early, prompt and coordinated enactment predisposed regions to successful disease containment. Mass COVID-19 vaccinations are likely to be the light at the end of the tunnel. There is a need to review what we have learnt in this pandemic and examine how to transfer and improve existing knowledge for ongoing and future epidemics.
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Affiliation(s)
- Kin On Kwok
- JC School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
- Stanley Ho Centre for Emerging Infectious DiseasesThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
- Shenzhen Research Institute of the Chinese University of Hong KongShenzhenChina
| | - Ying Huang
- JC School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
| | - Margaret Ting Fong Tsoi
- JC School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
| | - Arthur Tang
- Department of SoftwareSungkyunkwan UniversitySeoulRepublic of Korea
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
| | - Wan In Wei
- JC School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
| | - David Shu Cheong Hui
- Stanley Ho Centre for Emerging Infectious DiseasesThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
- Department of Medicine and TherapeuticsThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
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113
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Zhang YV, Wiencek J, Meng QH, Theel ES, Babic N, Sepiashvili L, Pecora ND, Slev P, Cameron A, Konforte D. AACC Practical Recommendations for Implementing and Interpreting SARS-CoV-2 EUA and LDT Serologic Testing in Clinical Laboratories. Clin Chem 2021; 67:1188-1200. [PMID: 34470034 PMCID: PMC8083777 DOI: 10.1093/clinchem/hvab051] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/12/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND The clinical laboratory continues to play a critical role in managing the coronavirus pandemic. Numerous FDA emergency use authorization (EUA) and laboratory developed test (LDT) serologic assays have become available. The performance characteristics of these assays and their clinical utility continue to be defined in real-time during this pandemic. The American Association for Clinical Chemistry (AACC) convened a panel of experts from clinical chemistry, microbiology, and immunology laboratories, the in vitro diagnostics (IVD) industry, and regulatory agencies to provide practical recommendations for implementation and interpretation of these serologic tests in clinical laboratories. CONTENT The currently available EUA serologic tests and platforms, information on assay design, antibody classes including neutralizing antibodies, and the humoral immune responses to SARS-CoV-2 are discussed. Verification and validation of EUA and LDTs are described along with quality management approach. Four indications for serologic testing are outlined. Result interpretation, reporting comments, and the role of orthogonal testing are also recommended. SUMMARY This document aims to provide a comprehensive reference for laboratory professionals and healthcare workers to appropriately implement SARS-CoV-2 serologic assays in the clinical laboratory and interpret test results during this pandemic. Given the more frequent occurrence of outbreaks associated with either vector-borne or respiratory pathogens, this document will be a useful resource in planning for similar scenarios in the future.
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Affiliation(s)
- Y Victoria Zhang
- Department of Pathology and Lab Medicine, University of Rochester Medical Center
| | - Joesph Wiencek
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center
| | - Qing H Meng
- Department of Laboratory Medicine, Division of Pathology and Laboratory Medicine, The University of Texas/MD Anderson Cancer Center
| | - Elitza S Theel
- Department of Laboratory Medicine and Pathology, Mayo Clinic
| | - Nikolina Babic
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina
| | - Lusia Sepiashvili
- Departments of Biochemistry and Laboratory Medicine & Pathobiology The Hospital for Sick Children/University of Toronto
| | - Nicole D Pecora
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center
| | - Patricia Slev
- Department of Pathology, University of Utah, ARUP Laboratories
| | - Andrew Cameron
- Department of Clinical Microbiology, University of Rochester Medical Center
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Seroprevalence and Risk Factors for Exposure to Equine Coronavirus in Apparently Healthy Horses in Israel. Animals (Basel) 2021; 11:ani11030894. [PMID: 33800990 PMCID: PMC8004030 DOI: 10.3390/ani11030894] [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: 02/24/2021] [Revised: 03/11/2021] [Accepted: 03/18/2021] [Indexed: 01/14/2023] Open
Abstract
Simple Summary Equine coronavirus (ECoV) is a β-coronavirus that, together with other coronaviruses, are pathogenic to both human and animals, as seen in the recent COVID-19 pandemic. ECoV is considered as a diarrheic pathogen in foals and is included in the list of viral causes of enteritis. During the last decade, outbreaks of ECoV were reported in adult horses in the USA, EU and Japan. In Israel, other coronaviruses were reported in cattle, camels and in humans; however, coronaviruses have not been reported in horses. In this study, we aimed to determine the exposure of healthy horses to ECoV and determine the selected risk factors for infection. For this purpose, serum samples were collected from 333 healthy horses, 41 (12.3%) of which had anti-ECoV antibodies. Seropositive horses were found in more than half (58.6%) of the farms and horses located in central Israel were more likely to be positive. ECoV should be included in the differential diagnosis list of pathogens in cases of adult horses with acute onset of anorexia, lethargy, fever and gastrointestinal signs in Israel. Abstract Equine coronavirus (ECoV) infection is the cause of an emerging enteric disease of adult horses. Outbreaks have been reported in the USA, EU and Japan, as well as sporadic cases in the UK and Saudi Arabia. Infection of ECoV in horses in Israel has never been reported, and the risk of exposure is unknown. Importation and exportation of horses from and into Israel may have increased the exposure of horses in Israel to ECoV. While the disease is mostly self-limiting, with or without supportive treatment, severe complications may occur in some animals, and healthy carriers may pose a risk of infection to other horses. This study was set to evaluate the risk of exposure to ECoV of horses in Israel by using a previously validated, S1-based enzyme-linked immunosorbent assay (ELISA). A total of 41 out of 333 horses (12.3%) were seropositive. Exposure to ECoV was detected in 17 of 29 farms (58.6%) and the seroprevalence varied between 0 and 37.5% amongst farms. The only factor found to be significantly associated with ECoV exposure in the multivariable model was the geographical area (p < 0.001). ECoV should be included in the differential diagnosis list of pathogens in cases of adult horses with anorexia, lethargy, fever and gastrointestinal signs in Israel.
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Mahshid SS, Flynn SE, Mahshid S. The potential application of electrochemical biosensors in the COVID-19 pandemic: A perspective on the rapid diagnostics of SARS-CoV-2. Biosens Bioelectron 2021; 176:112905. [PMID: 33358285 PMCID: PMC7746140 DOI: 10.1016/j.bios.2020.112905] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/11/2020] [Accepted: 12/13/2020] [Indexed: 12/13/2022]
Abstract
Electrochemical biosensors combine the selectivity of electrochemical signal transducers with the specificity of biomolecular recognition strategies. Although they have been broadly studied in different areas of diagnostics, they are not yet fully commercialized. During the COVID-19 pandemic, electrochemical platforms have shown the potential to address significant limitations of conventional diagnostic platforms, including accuracy, affordability, and portability. The advantages of electrochemical platforms make them a strong candidate for rapid point-of-care detection of SARS-CoV-2 infection by targeting not only viral RNA but antigens and antibodies. Herein, we reviewed advancements in electrochemical biosensing platforms towards the detection of SARS-CoV-2 through studying similar viruses.
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Affiliation(s)
- Sahar Sadat Mahshid
- Biological Sciences Department, Sunnybrook Research Institute, Toronto, ON, M4N 3M5, Canada.
| | | | - Sara Mahshid
- Department of Bioengineering, McGill University, Montréal, QC, H3A 0C3, Canada.
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116
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Ansari A, Arya R, Sachan S, Jha SN, Kalia A, Lall A, Sette A, Grifoni A, Weiskopf D, Coshic P, Sharma A, Gupta N. Immune Memory in Mild COVID-19 Patients and Unexposed Donors Reveals Persistent T Cell Responses After SARS-CoV-2 Infection. Front Immunol 2021; 12:636768. [PMID: 33777028 PMCID: PMC7991090 DOI: 10.3389/fimmu.2021.636768] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/25/2021] [Indexed: 12/24/2022] Open
Abstract
Understanding the causes of the diverse outcome of COVID-19 pandemic in different geographical locations is important for the worldwide vaccine implementation and pandemic control responses. We analyzed 42 unexposed healthy donors and 28 mild COVID-19 subjects up to 5 months from the recovery for SARS-CoV-2 specific immunological memory. Using HLA class II predicted peptide megapools, we identified SARS-CoV-2 cross-reactive CD4+ T cells in around 66% of the unexposed individuals. Moreover, we found detectable immune memory in mild COVID-19 patients several months after recovery in the crucial arms of protective adaptive immunity; CD4+ T cells and B cells, with a minimal contribution from CD8+ T cells. Interestingly, the persistent immune memory in COVID-19 patients is predominantly targeted towards the Spike glycoprotein of the SARS-CoV-2. This study provides the evidence of both high magnitude pre-existing and persistent immune memory in Indian population. By providing the knowledge on cellular immune responses to SARS-CoV-2, our work has implication for the development and implementation of vaccines against COVID-19.
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Affiliation(s)
- Asgar Ansari
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, India
| | - Rakesh Arya
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Shilpa Sachan
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, India
| | - Someshwar Nath Jha
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, India
| | - Anurag Kalia
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, India
| | - Anupam Lall
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States.,Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA, United States
| | - Alba Grifoni
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Daniela Weiskopf
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Poonam Coshic
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ashok Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Nimesh Gupta
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, India
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Føns S, Krogfelt KA. How can we interpret SARS-CoV-2 antibody test results? Pathog Dis 2021; 79:6123719. [PMID: 33512464 PMCID: PMC7858042 DOI: 10.1093/femspd/ftaa069] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 11/09/2020] [Indexed: 12/16/2022] Open
Abstract
Since the outbreak of COVID-19, the world has raced to understand and accurately diagnose infection caused by SARS-CoV-2. Today, hundreds of commercial antibody tests are on the market despite often lacking proper validation and with unsatisfactory sensitivity and/or specificity. In addition, many questions related to the humoral response remain unresolved, although research is carried out at an unprecedented speed. Despite the shortcomings, serological assays have an important part to play in combating the pandemic by aiding in diagnosis and sero-epidemiological studies. However, careful attention must be paid to the application of serology and the interpretation of serological data—especially in low prevalence regions, both at an individual and at a population level. In this article, we argue that serological results are often misinterpreted, and in the eagerness to be first, methodological rigor is often taking a backseat.
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Affiliation(s)
- Sofie Føns
- Roskilde University, Department of Science and Environment, Universitetsvej 1, Roskilde, Denmark
| | - Karen A Krogfelt
- Roskilde University, Department of Science and Environment, Universitetsvej 1, Roskilde, Denmark
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Loock DJE, Rendón-Franco E, Williams ST, van Niekerk J, Swanepoel LH. Viral Prevalence in Wild Serval Population is Driven by Season and Sex. ECOHEALTH 2021; 18:113-122. [PMID: 34059963 PMCID: PMC8166362 DOI: 10.1007/s10393-021-01533-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 04/18/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
One of the key factors influencing the population dynamics of threatened species such as felids is disease, but long-term studies of the factors influencing seroprevalence of wild felids are extremely rare, hindering conservation efforts. We set out to determine seroprevalence of six viral diseases (feline panleukopenia virus, feline leukemia virus, feline coronavirus, feline calicivirus, feline herpes virus, and feline immunodeficiency virus) among a population of serval (Leptailurus serval) with an extremely high density in South Africa. We captured 55 individuals over four years and screened blood samples for antibodies to each virus. We found that seroprevalence were high (ranging from 30.0% positive for a single virus to 1.8% positive for up to five viruses) and that seroprevalence was influenced by season and sex, but not body condition. We suggest further monitoring of this population and recommend that long-term studies are conducted for serval and other felids to determine whether these trends are representative on a broader scale.
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Affiliation(s)
- Daan J E Loock
- Centre for Sustainable Agriculture, Faculty of Natural and Agricultural Sciences, University of the Free State, 205 Nelson Mandela Drive, Park West, Bloemfontein, 930, South Africa.
| | - Emilio Rendón-Franco
- Departamento de Producción Agrícola y Animal, UAM-Unidad Xochimilco, Calzada del Hueso, Coyoacán, Ciudad de México, 04960, México
| | - Samual T Williams
- Department of Zoology, School of Mathematical and Natural Sciences, University of Venda, Private Bag X5050, Thohoyandou, 0950, South Africa
- Department of Anthropology, Durham University, Durham, DH1 3LE, UK
- Institute for Globally Distributed Open Research and Education (IGDORE), Göteborg, Sweden
| | - Johan van Niekerk
- Centre for Sustainable Agriculture, Faculty of Natural and Agricultural Sciences, University of the Free State, 205 Nelson Mandela Drive, Park West, Bloemfontein, 930, South Africa
| | - Lourens H Swanepoel
- Department of Zoology, School of Mathematical and Natural Sciences, University of Venda, Private Bag X5050, Thohoyandou, 0950, South Africa
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Dowlatshahi S, Shabani E, Abdekhodaie MJ. Serological assays and host antibody detection in coronavirus-related disease diagnosis. Arch Virol 2021; 166:715-731. [PMID: 33492524 PMCID: PMC7830048 DOI: 10.1007/s00705-020-04874-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 09/27/2020] [Indexed: 02/08/2023]
Abstract
Coronaviruses (CoV) are a family of viral pathogens that infect both birds and mammals, including humans. Seven human coronaviruses (HCoV) have been recognized so far. HCoV-229E, -OC43, -NL63, and -HKU1 account for one-third of common colds with mild symptoms. The other three members are severe acute respiratory syndrome (SARS)-CoV, Middle East respiratory syndrome (MERS)-CoV, and SARS-CoV-2. These viruses are responsible for SARS, MERS, and CoV disease 2019 (COVID-19), respectively. A variety of diagnostic techniques, including chest X-rays, computer tomography (CT) scans, analysis of viral nucleic acids, proteins, or whole virions, and host antibody detection using serological assays have been developed for the detection of these viruses. In this review, we discuss conventional serological tests, such as enzyme-linked immunosorbent assay (ELISA), western blot (WB), immunofluorescence assay (IFA), lateral flow immunoassay (LFIA), and chemiluminescence immunoassay (CLIA), as well as biosensor-based assays that have been developed for diagnosing HCoV-associated diseases since 2003, with an in-depth focus on COVID-19.
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Affiliation(s)
- Sayeh Dowlatshahi
- Department of Chemical and Petroleum Engineering, Sharif University of Technology, Tehran, Iran
| | - Ehsan Shabani
- Department of Chemical and Petroleum Engineering, Sharif University of Technology, Tehran, Iran
| | - Mohammad J Abdekhodaie
- Department of Chemical and Petroleum Engineering, Sharif University of Technology, Tehran, Iran.
- Yeates School of Graduate Studies, Ryerson University, Toronto, ON, Canada.
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Ernst E, Wolfe P, Stahura C, Edwards KA. Technical considerations to development of serological tests for SARS-CoV-2. Talanta 2021; 224:121883. [PMID: 33379092 PMCID: PMC7654332 DOI: 10.1016/j.talanta.2020.121883] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/06/2020] [Accepted: 11/07/2020] [Indexed: 12/21/2022]
Abstract
The COVID-19 pandemic has had a devastating impact worldwide and has brought clinical assays both for acute diagnosis and prior exposure determination to the forefront. Serological testing intended for point-of-care or laboratory use can be used to determine more accurate individual and population assessments of prior exposure to SARS-CoV-2; improve our understanding of the degree to which immunity is conveyed to subsequent exposures; and quantify immune response to future vaccines. In response to this pandemic, initially more than 90 companies deployed serology assays to the U.S. market, many of which made overstated claims for their accuracy, regulatory approval status, and utility for intended purpose. The U.S. Food and Drug Administration subsequently instituted an Emergency Use Authorization (EUA) procedure requiring that manufacturers submit validation data, but allowing newly developed serological tests to be marketed without the usual approval process during this crisis. Although this rapid deployment was intended to benefit public health, the incomplete understanding of immune response to the virus and lack of assay vetting resulted in quality issues with some of these tests, and thus many were withdrawn after submission. Common assay platforms include lateral flow assays which can serve an important niche of low cost, rapid turnaround, and increased accessibility whereas established laboratory-based platforms based on ELISAs and chemiluminescence expand existing technologies to SARS-CoV-2 and can provide throughput and quantification capabilities. While most of the currently EUA assays rely on these well-established platforms, despite their apparent technical simplicity, there are numerous practical challenges both for manufacturers in developing and for end-users in running and interpreting such assays. Within are discussed technical challenges to serology development for SARS-CoV-2, with an emphasis on lateral flow assay technology.
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Affiliation(s)
- Emilie Ernst
- Department of Pharmaceutical Sciences School of Pharmacy and Pharmaceutical Sciences Binghamton University, Johnson City, NY, 13790, USA.
| | - Patricia Wolfe
- Department of Pharmaceutical Sciences School of Pharmacy and Pharmaceutical Sciences Binghamton University, Johnson City, NY, 13790, USA.
| | - Corrine Stahura
- Department of Pharmaceutical Sciences School of Pharmacy and Pharmaceutical Sciences Binghamton University, Johnson City, NY, 13790, USA.
| | - Katie A Edwards
- Department of Pharmaceutical Sciences School of Pharmacy and Pharmaceutical Sciences Binghamton University, Johnson City, NY, 13790, USA.
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Platten M, Cranen R, Peters C, Wisplinghoff H, Nienhaus A, Bach AD, Michels G. [Prevalence of SARS-CoV-2 in employees of a general hospital in Northrhine-Westphalia, Germany]. Dtsch Med Wochenschr 2021; 146:e30-e38. [PMID: 33513626 PMCID: PMC7920642 DOI: 10.1055/a-1322-5355] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND We assessed the prevalence of SARS-CoV-2 in the staff of a general hospital in North-Rhine-Westphalia in a cross-sectional study. METHOD Employees (n = 1363) were offered a nasopharyngeal swab and serology for SARS-CoV-2. Additionally, employees completed a questionnaire about preexisting conditions, contacts with SARS-CoV-2-positive individuals and COVID-19-specific symptoms. RESULTS 1212 employees participated. 19 of 1363 (1.4 %) employees tested positive by PCR (3 within and 16 before the study). 40 (3.3 %) and 105 (8.6 %) had IgG and IgA, respectively, 32 (2.6 %) both IgG and IgA. Overall, 47 employees tested positive. In this group, most frequently reported symptoms were headache (56 %), fatigue (49 %), sore throat (49 %), and cough (46 %); fever was reported by 33 %. SARS-CoV-2-positive employees reported more frequently contact with COVID-19 cases (60.5 % vs. 37.3 %, p = 0.006). Employees testing positive only for IgA reported less symptoms. CONCLUSION Between 27.04. and 20.05.2020, 3.9 % of the employees working in a general hospital were tested positive for SARS-CoV-2. This proportion was lower than expected; possible explanations are the low level of endemic infection and the extensive, uniform in-house preventative measures.
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Affiliation(s)
| | - Rita Cranen
- Arbeitsmedizin, St.-Antonius-Hospital Eschweiler, Eschweiler, Deutschland
| | - Claudia Peters
- Kompetenzzentrum Epidemiologie und Versorgungsforschung bei Pflegeberufen (CVcare), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland
| | - Hilmar Wisplinghoff
- Labor Dr. Wisplinghoff, Köln, Deutschland
- Institut für Virologie und klinische Mikrobiologie, Universität Witten/Herdecke, Witten, Deutschland; Institut für medizinische Mikrobiologie, Immunologie und Hygiene, Universität zu Köln, Köln, Deutschland
| | - Albert Nienhaus
- Kompetenzzentrum Epidemiologie und Versorgungsforschung bei Pflegeberufen (CVcare), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland
- Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege (BGW), Abteilung Arbeitsmedizin, Gefahrstoffe und Gesundheitswissenschaften (AGG), Hamburg, Deutschland
| | - Alexander Daniel Bach
- Klinik für Plastische und Ästhetische Chirurgie, Hand- und Wiederherstellungschirurgie, Ärztlicher Direktor (in Vertretung für die Betriebsleitung), St.-Antonius-Hospital Eschweiler, Eschweiler, Deutschland
| | - Guido Michels
- Klinik für Akut- und Notfallmedizin, St.-Antonius-Hospital Eschweiler, Eschweiler, Deutschland
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Cortese M, Laketa V. Advanced microscopy technologies enable rapid response to SARS-CoV-2 pandemic. Cell Microbiol 2021; 23:e13319. [PMID: 33595881 PMCID: PMC7995000 DOI: 10.1111/cmi.13319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/26/2021] [Accepted: 01/30/2021] [Indexed: 01/18/2023]
Abstract
The ongoing SARS‐CoV‐2 pandemic with over 80 million infections and more than a million deaths worldwide represents the worst global health crisis of the 21th century. Beyond the health crisis, the disruptions caused by the COVID‐19 pandemic have serious global socio‐economic consequences. It has also placed a significant pressure on the scientific community to understand the virus and its pathophysiology and rapidly provide anti‐viral treatments and procedures in order to help the society and stop the virus spread. Here, we outline how advanced microscopy technologies such as high‐throughput microscopy and electron microscopy played a major role in rapid response against SARS‐CoV‐2. General applicability of developed microscopy technologies makes them uniquely positioned to act as the first line of defence against any emerging infection in the future.
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Affiliation(s)
- Mirko Cortese
- Department of Infectious Diseases, Molecular Virology, University Hospital Heidelberg, Heidelberg, Germany
| | - Vibor Laketa
- Department of Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany.,German Center for Infection Research, Heidelberg, Germany
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Fraser DD, Cepinskas G, Slessarev M, Martin CM, Daley M, Patel MA, Miller MR, Patterson EK, O'Gorman DB, Gill SE, Oehler S, Miholits M, Webb B. Detection and Profiling of Human Coronavirus Immunoglobulins in Critically Ill Coronavirus Disease 2019 Patients. Crit Care Explor 2021; 3:e0369. [PMID: 33786445 PMCID: PMC7994038 DOI: 10.1097/cce.0000000000000369] [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] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Coronavirus disease 2019 continues to spread worldwide with high levels of morbidity and mortality. We performed anticoronavirus immunoglobulin G profiling of critically ill coronavirus disease 2019 patients to better define their underlying humoral response. DESIGN Blood was collected at predetermined ICU days to measure immunoglobulin G with a research multiplex assay against four severe acute respiratory syndrome coronavirus 2 proteins/subunits and against all six additionally known human coronaviruses. SETTING Tertiary care ICU and academic laboratory. SUBJECTS ICU patients suspected of being infected with severe acute respiratory syndrome coronavirus 2 had blood collected until either polymerase chain reaction testing was confirmed negative on ICU day 3 (coronavirus disease 2019 negative) or until death or discharge if the patient tested polymerase chain reaction positive (coronavirus disease 2019 positive). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Age- and sex-matched healthy controls and ICU patients who were either coronavirus disease 2019 positive or coronavirus disease 2019 negative were enrolled. Cohorts were well-balanced with the exception that coronavirus disease 2019 positive patients had greater body mass indexes, presented with bilateral pneumonias more frequently, and suffered lower Pao2:Fio2 ratios, when compared with coronavirus disease 2019 negative patients (p < 0.05). Mortality rate for coronavirus disease 2019 positive patients was 50%. On ICU days 1-3, anti-severe acute respiratory syndrome coronavirus 2 immunoglobulin G was significantly elevated in coronavirus disease 2019 positive patients, as compared to both healthy control subjects and coronavirus disease 2019 negative patients (p < 0.001). Weak severe acute respiratory syndrome coronavirus immunoglobulin G serologic responses were also detected, but not other coronavirus subtypes. The four anti-severe acute respiratory syndrome coronavirus 2 immunoglobulin G were maximal by ICU day 3, with all four anti-severe acute respiratory syndrome coronavirus 2 immunoglobulin G providing excellent diagnostic potential (severe acute respiratory syndrome coronavirus 2 Spike 1 protein immunoglobulin G, area under the curve 1.0, p < 0.0005; severe acute respiratory syndrome coronavirus receptor binding domain immunoglobulin G, area under the curve, 0.93-1.0; p ≤ 0.0001; severe acute respiratory syndrome coronavirus 2 Spike proteins immunoglobulin G, area under the curve, 1.0; p < 0.0001; severe acute respiratory syndrome coronavirus 2 Nucleocapsid protein immunoglobulin G area under the curve, 0.90-0.95; p ≤ 0.0003). Anti-severe acute respiratory syndrome coronavirus 2 immunoglobulin G increased and/or plateaued over 10 ICU days. CONCLUSIONS Critically ill coronavirus disease 2019 patients exhibited anti-severe acute respiratory syndrome coronavirus 2 immunoglobulin G, whereas serologic responses to non-severe acute respiratory syndrome coronavirus 2 antigens were weak or absent. Detection of human coronavirus immunoglobulin G against the different immunogenic structural proteins/subunits with multiplex assays may be useful for pathogen identification, patient cohorting, and guiding convalescent plasma therapy.
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Affiliation(s)
- Douglas D Fraser
- Lawson Health Research Institute, London, ON, Canada
- Pediatrics, Western University, London, ON, Canada
- Clinical Neurological Sciences, Western University, London, ON, Canada
- Physiology & Pharmacology, Western University, London, ON, Canada
| | - Gediminas Cepinskas
- Lawson Health Research Institute, London, ON, Canada
- Medical Biophysics, Western University, London, ON, Canada
| | - Marat Slessarev
- Lawson Health Research Institute, London, ON, Canada
- Medicine, Western University, London, ON, Canada
| | - Claudio M Martin
- Lawson Health Research Institute, London, ON, Canada
- Medicine, Western University, London, ON, Canada
| | - Mark Daley
- Lawson Health Research Institute, London, ON, Canada
- Computer Science, Western University, London, ON, Canada
- The Vector Institute for Artificial Intelligence, Toronto, ON, Canada
| | | | - Michael R Miller
- Lawson Health Research Institute, London, ON, Canada
- Pediatrics, Western University, London, ON, Canada
| | | | - David B O'Gorman
- Lawson Health Research Institute, London, ON, Canada
- Surgery, Western University, London, ON, Canada
- Biochemistry, Western University, London, ON, Canada
| | - Sean E Gill
- Lawson Health Research Institute, London, ON, Canada
- Physiology & Pharmacology, Western University, London, ON, Canada
- Medicine, Western University, London, ON, Canada
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Pape C, Remme R, Wolny A, Olberg S, Wolf S, Cerrone L, Cortese M, Klaus S, Lucic B, Ullrich S, Anders‐Össwein M, Wolf S, Cerikan B, Neufeldt CJ, Ganter M, Schnitzler P, Merle U, Lusic M, Boulant S, Stanifer M, Bartenschlager R, Hamprecht FA, Kreshuk A, Tischer C, Kräusslich H, Müller B, Laketa V. Microscopy-based assay for semi-quantitative detection of SARS-CoV-2 specific antibodies in human sera: A semi-quantitative, high throughput, microscopy-based assay expands existing approaches to measure SARS-CoV-2 specific antibody levels in human sera. Bioessays 2021; 43:e2000257. [PMID: 33377226 PMCID: PMC7883048 DOI: 10.1002/bies.202000257] [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: 09/21/2020] [Revised: 11/24/2020] [Accepted: 11/30/2020] [Indexed: 12/28/2022]
Abstract
Emergence of the novel pathogenic coronavirus SARS-CoV-2 and its rapid pandemic spread presents challenges that demand immediate attention. Here, we describe the development of a semi-quantitative high-content microscopy-based assay for detection of three major classes (IgG, IgA, and IgM) of SARS-CoV-2 specific antibodies in human samples. The possibility to detect antibodies against the entire viral proteome together with a robust semi-automated image analysis workflow resulted in specific, sensitive and unbiased assay that complements the portfolio of SARS-CoV-2 serological assays. Sensitive, specific and quantitative serological assays are urgently needed for a better understanding of humoral immune response against the virus as a basis for developing public health strategies to control viral spread. The procedure described here has been used for clinical studies and provides a general framework for the application of quantitative high-throughput microscopy to rapidly develop serological assays for emerging virus infections.
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Affiliation(s)
- Constantin Pape
- HCI/IWRHeidelberg UniversityHeidelbergGermany
- European Molecular Biology LaboratoryHeidelbergGermany
| | - Roman Remme
- HCI/IWRHeidelberg UniversityHeidelbergGermany
| | - Adrian Wolny
- HCI/IWRHeidelberg UniversityHeidelbergGermany
- European Molecular Biology LaboratoryHeidelbergGermany
| | - Sylvia Olberg
- Department of Infectious Diseases, VirologyUniversity Hospital HeidelbergHeidelbergGermany
| | | | | | - Mirko Cortese
- Department of Infectious Diseases, Molecular VirologyUniversity Hospital HeidelbergHeidelbergGermany
| | - Severina Klaus
- Department of Infectious Diseases, ParasitologyUniversity Hospital HeidelbergHeidelbergGermany
| | - Bojana Lucic
- Department of Infectious DiseasesIntegrative VirologyUniversity Hospital HeidelbergHeidelbergGermany
| | - Stephanie Ullrich
- Department of Infectious Diseases, VirologyUniversity Hospital HeidelbergHeidelbergGermany
| | - Maria Anders‐Össwein
- Department of Infectious Diseases, VirologyUniversity Hospital HeidelbergHeidelbergGermany
| | - Stefanie Wolf
- Department of Infectious Diseases, VirologyUniversity Hospital HeidelbergHeidelbergGermany
| | - Berati Cerikan
- Department of Infectious Diseases, Molecular VirologyUniversity Hospital HeidelbergHeidelbergGermany
| | - Christopher J. Neufeldt
- Department of Infectious Diseases, Molecular VirologyUniversity Hospital HeidelbergHeidelbergGermany
| | - Markus Ganter
- Department of Infectious Diseases, ParasitologyUniversity Hospital HeidelbergHeidelbergGermany
| | - Paul Schnitzler
- Department of Infectious Diseases, VirologyUniversity Hospital HeidelbergHeidelbergGermany
| | - Uta Merle
- Department of Gastroenterology and HepatologyUniversity Hospital of HeidelbergHeidelbergGermany
| | - Marina Lusic
- Department of Infectious DiseasesIntegrative VirologyUniversity Hospital HeidelbergHeidelbergGermany
- German Center for Infection ResearchHeidelbergGermany
| | - Steeve Boulant
- Department of Infectious Diseases, VirologyUniversity Hospital HeidelbergHeidelbergGermany
- Research Group “Cellular polarity and viral infection”German Cancer Research Center (DKFZ)HeidelbergGermany
| | - Megan Stanifer
- Department of Infectious Diseases, Molecular VirologyUniversity Hospital HeidelbergHeidelbergGermany
- Research Group “Cellular polarity and viral infection”German Cancer Research Center (DKFZ)HeidelbergGermany
| | - Ralf Bartenschlager
- Department of Infectious Diseases, Molecular VirologyUniversity Hospital HeidelbergHeidelbergGermany
- German Center for Infection ResearchHeidelbergGermany
| | | | - Anna Kreshuk
- European Molecular Biology LaboratoryHeidelbergGermany
| | | | - Hans‐Georg Kräusslich
- Department of Infectious Diseases, VirologyUniversity Hospital HeidelbergHeidelbergGermany
- German Center for Infection ResearchHeidelbergGermany
| | - Barbara Müller
- Department of Infectious Diseases, VirologyUniversity Hospital HeidelbergHeidelbergGermany
| | - Vibor Laketa
- Department of Infectious Diseases, VirologyUniversity Hospital HeidelbergHeidelbergGermany
- German Center for Infection ResearchHeidelbergGermany
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Latiano A, Tavano F, Panza A, Palmieri O, Niro GA, Andriulli N, Latiano T, Corritore G, Gioffreda D, Gentile A, Fontana R, Guerra M, Biscaglia G, Bossa F, Carella M, Miscio G, di Mauro L. False-positive results of SARS-CoV-2 IgM/IgG antibody tests in sera stored before the 2020 pandemic in Italy. Int J Infect Dis 2021; 104:159-163. [PMID: 33383223 PMCID: PMC7834192 DOI: 10.1016/j.ijid.2020.12.067] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES Aside from the outbreak of the coronavirus disease 2019 (COVID-19), serological tests are not well known for their diagnostic value. We assessed the performance of serological tests using stored sera from patients with a variety of pathologic conditions, collected before the 2020 pandemic in Italy. METHODS Rapid lateral flow tests and Enzyme-Linked Immunosorbent Assays (ELISA) that detect Immunoglobulin M (IgM) and Immunoglobulin G (IgG) antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were carried out using 1150 stored human serum samples that had been collected in 2018 and 2019. The tests were also run using samples from 15 control patients who had positive or negative oral swab test results, as assessed using real-time reverse transcription-polymerase chain reaction (rRT-PCR). The urea dissociation test was employed to rule out false-positive reactivity in the two antibody detection methods. RESULTS The lateral flow tests revealed 21 positive samples from the stored sera: 12 for IgM, four for IgG, and five for IgM/IgG. Among the nine rRT-PCR- positive controls, six individuals presented IgG and three IgM/IgG positivity. Using the urea (6 mol/L) dissociation test, two of the twelve stored samples that had shown IgM positivity were confirmed to be positive. The ELISA test detected four IgM-positive and three IgG-positive specimens. After treatment with 4 mol/L urea, the IgM-positive samples became negative, whereas the IgG positivity persisted. All of the rRT-PCR-positive controls were found to retain IgM or IgG positivity following the urea treatment. CONCLUSIONS Our findings highlight the limited utility of serological testing for the SARS-CoV-2 virus based on the results of specimens collected before the outbreak of the infection.
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Affiliation(s)
- Anna Latiano
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy.
| | - Francesca Tavano
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Anna Panza
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Orazio Palmieri
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Grazia A Niro
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | | | - Tiziana Latiano
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Giuseppe Corritore
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Domenica Gioffreda
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Annamaria Gentile
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Rosanna Fontana
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Maria Guerra
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Giuseppe Biscaglia
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Fabrizio Bossa
- Fondazione IRCCS Casa Sollievo della Sofferenza, Gastroenterology Unit, San Giovanni Rotondo, Foggia, Italy
| | - Massimo Carella
- Division of Medical Genetics, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Giuseppe Miscio
- Immunohematology and Transfusion Medicine Service, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Lazzaro di Mauro
- Immunohematology and Transfusion Medicine Service, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
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Ansari A, Arya R, Sachan S, Jha SN, Kalia A, Lall A, Sette A, Grifoni A, Weiskopf D, Coshic P, Sharma A, Gupta N. Immune memory in mild COVID-19 patients and unexposed donors from India reveals persistent T cell responses after SARS-CoV-2 infection. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2020.11.16.20232967. [PMID: 33655267 PMCID: PMC7924292 DOI: 10.1101/2020.11.16.20232967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Understanding the causes of the diverse outcome of COVID-19 pandemic in different geographical locations is important for the worldwide vaccine implementation and pandemic control responses. We analyzed 42 unexposed healthy donors and 28 mild COVID-19 subjects up to 5 months from the recovery for SARS-CoV-2 specific immunological memory. Using HLA class II predicted peptide megapools, we identified SARS-CoV-2 cross-reactive CD4+ T cells in around 66% of the unexposed individuals. Moreover, we found detectable immune memory in mild COVID-19 patients several months after recovery in the crucial arms of protective adaptive immunity; CD4+ T cells and B cells, with a minimal contribution from CD8+ T cells. Interestingly, the persistent immune memory in COVID-19 patients is predominantly targeted towards the Spike glycoprotein of the SARS-CoV-2. This study provides the evidence of both high magnitude pre-existing and persistent immune memory in Indian population. By providing the knowledge on cellular immune responses to SARS-CoV-2, our work has implication for the development and implementation of vaccines against COVID-19.
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Affiliation(s)
- Asgar Ansari
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, 110067, India
| | - Rakesh Arya
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Shilpa Sachan
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, 110067, India
| | - Someshwar Nath Jha
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, 110067, India
| | - Anurag Kalia
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, 110067, India
| | - Anupam Lall
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, 92037, USA
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA, 92037, USA
| | - Alba Grifoni
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, 92037, USA
| | - Daniela Weiskopf
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, 92037, USA
| | - Poonam Coshic
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Ashok Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Nimesh Gupta
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, 110067, India
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Exploring beyond clinical routine SARS-CoV-2 serology using MultiCoV-Ab to evaluate endemic coronavirus cross-reactivity. Nat Commun 2021; 12:1152. [PMID: 33608538 PMCID: PMC7896075 DOI: 10.1038/s41467-021-20973-3] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 01/06/2021] [Indexed: 12/11/2022] Open
Abstract
The humoral immune response to SARS-CoV-2 is a benchmark for immunity and detailed analysis is required to understand the manifestation and progression of COVID-19, monitor seroconversion within the general population, and support vaccine development. The majority of currently available commercial serological assays only quantify the SARS-CoV-2 antibody response against individual antigens, limiting our understanding of the immune response. To overcome this, we have developed a multiplex immunoassay (MultiCoV-Ab) including spike and nucleocapsid proteins of SARS-CoV-2 and the endemic human coronaviruses. Compared to three broadly used commercial in vitro diagnostic tests, our MultiCoV-Ab achieves a higher sensitivity and specificity when analyzing a well-characterized sample set of SARS-CoV-2 infected and uninfected individuals. We find a high response against endemic coronaviruses in our sample set, but no consistent cross-reactive IgG response patterns against SARS-CoV-2. Here we show a robust, high-content-enabled, antigen-saving multiplex assay suited to both monitoring vaccination studies and facilitating epidemiologic screenings for humoral immunity towards pandemic and endemic coronaviruses.
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González-Stegmaier R, Cereceda K, Briones JL, Beltran-Pávez C, Oyarzún-Arrau A, Riquelme-Barrios S, Selman C, Yarad F, Mahave M, Caglevic C, Morales R, Aguirre A, Valiente-Echeverría F, Soto-Rifo R, Marsiglia H, Gazitua R, Villarroel-Espindola F. Seroconversion and Abundance of IgG Antibodies against S1-RBD of SARS-CoV-2 and Neutralizing Activity in the Chilean Population. J Immunol Res 2021; 2021:6680337. [PMID: 33644235 PMCID: PMC7901042 DOI: 10.1155/2021/6680337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/03/2021] [Accepted: 01/24/2021] [Indexed: 01/08/2023] Open
Abstract
COVID-19 is a pandemic caused by SARS-CoV-2. In Chile, half a million people have been infected and more than 16,000 have died from COVID-19. As part of the clinical trial NCT04384588, we quantified IgG against S1-RBD of SARS-CoV-2 (anti-RBD) in recovered people in Santiago and evaluated their suitability as COVID-19 convalescent plasma donors. ELISA and a luminescent SARS-CoV-2 pseudotype were used for IgG and neutralizing antibody quantification. 72.9% of the convalescent population (468 of 639) showed seroconversion (5-55 μg/mL anti-RBD IgG) and were suitable candidates for plasma donation. Analysis by gender, age, and days after symptom offset did not show significant differences. Neutralizing activity correlated with an increased concentration of anti-RBD IgG (p < 0.0001) and showed a high variability between donors. We confirmed that the majority of the Chilean patients have developed anti-SARS-CoV-2 antibodies. The quantification of anti-RBD IgG in convalescent plasma donors is necessary to increase the detection of neutralizing antibodies.
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Affiliation(s)
- R. González-Stegmaier
- Translational Medicine Laboratory, Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | - K. Cereceda
- Translational Medicine Laboratory, Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | - J. L. Briones
- Haematology Department, Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | - C. Beltran-Pávez
- Laboratory of Molecular and Cellular Virology, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Chile
- HIV/AIDS Work Group, Faculty of Medicine, Universidad de Chile, Chile
| | - A. Oyarzún-Arrau
- Laboratory of Molecular and Cellular Virology, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Chile
- HIV/AIDS Work Group, Faculty of Medicine, Universidad de Chile, Chile
| | - S. Riquelme-Barrios
- Laboratory of Molecular and Cellular Virology, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Chile
- HIV/AIDS Work Group, Faculty of Medicine, Universidad de Chile, Chile
| | - C. Selman
- Diagnostic Units, Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
- Biobank, Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | - F. Yarad
- Diagnostic Units, Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | - M. Mahave
- Medical Oncology Department, Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | - C. Caglevic
- Cancer Research Department, Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | - R. Morales
- Internal Medicine Department, Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | - A. Aguirre
- Translational Medicine Laboratory, Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | - F. Valiente-Echeverría
- Laboratory of Molecular and Cellular Virology, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Chile
- HIV/AIDS Work Group, Faculty of Medicine, Universidad de Chile, Chile
| | - R. Soto-Rifo
- Laboratory of Molecular and Cellular Virology, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Chile
- HIV/AIDS Work Group, Faculty of Medicine, Universidad de Chile, Chile
| | - H. Marsiglia
- Radiotherapy Department, Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | - R. Gazitua
- Haematology Department, Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | - F. Villarroel-Espindola
- Translational Medicine Laboratory, Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
- Cancer Research Department, Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
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129
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Detection of Coronaviruses Using RNA Toehold Switch Sensors. Int J Mol Sci 2021; 22:ijms22041772. [PMID: 33578973 PMCID: PMC7916667 DOI: 10.3390/ijms22041772] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/05/2021] [Accepted: 02/07/2021] [Indexed: 12/13/2022] Open
Abstract
A rapid, sensitive and simple point-of-care (POC) nucleic acid diagnostic test is needed to prevent spread of infectious diseases. Paper-based toehold reaction, a recently emerged colorimetric POC nucleic acid diagnostic test, has been widely used for pathogen detection and microbiome profiling. Here, we introduce an amplification method called reverse transcription loop-mediated amplification (RT-LAMP) prior to the toehold reaction and modify it to enable more sensitive and faster colorimetric detection of RNA viruses. We show that incorporating the modified RT-LAMP to the toehold reaction detects as few as 120 copies of coronavirus RNA in 70 min. Cross-reactivity test against other coronaviruses indicates this toehold reaction with the modified RT-LAMP is highly specific to the target RNA. Overall, the paper-based toehold switch sensors with the modified RT-LAMP allow fast, sensitive, specific and colorimetric coronavirus detection.
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130
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Kwok KO, Li KK, Wei WI, Tang A, Wong SYS, Lee SS. Editor's Choice: Influenza vaccine uptake, COVID-19 vaccination intention and vaccine hesitancy among nurses: A survey. Int J Nurs Stud 2021; 114:103854. [PMID: 33326864 PMCID: PMC7831770 DOI: 10.1016/j.ijnurstu.2020.103854] [Citation(s) in RCA: 402] [Impact Index Per Article: 134.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/05/2020] [Accepted: 11/08/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND A healthy healthcare system requires healthy healthcare workers. Protecting healthcare workers including nurses against COVID-19 is crucial, and vaccination could be a viable future option. However, vaccine hesitancy remains a global challenge. Nurses, as a trustworthy and creditable source of vaccine-related information, may build public confidence in vaccination. Hence, research on vaccine hesitancy among nurses is warranted. OBJECTIVES This study estimated nurses' influenza vaccination behaviors and intention to receive COVID-19 vaccine when available, and examined their corresponding 5C psychological antecedents (confidence, complacency, constraints, calculation, and collective responsibility). To investigate the impact of COVID-19-related work demands, the mediation effects of work stress on the association between work demands and COVID-19 vaccination intention were also examined. DESIGN Cross-sectional online survey SETTINGS: Nurses were invited to participate via the promotion of a professional nursing organization and by personal referrals during the COVID-19 outbreak in Hong Kong between mid-March and late April 2020. PARTICIPANTS 1,205 eligible nurses (mean age = 40.79, SD = 10.47; 90% being female) were included in the analyses. METHODS Demographics, influenza vaccination, intention to have COVID-19 vaccine, the 5C vaccine hesitancy components, work stress and COVID-19-related work demands (insufficient supply of personal protective equipment, involvement in isolation rooms, and unfavorable attitudes towards workplace infection control policies) were reported in the survey. RESULTS The influenza vaccine uptake rate and the proportion intending to take COVID-19 vaccine were 49% and 63%, respectively. Influenza vaccination was associated with working in public hospitals and all 5C constructs (more confidence, more collective responsibility and less complacency, constraints, and calculation), whereas stronger COVID-19 vaccination intention was associated with younger age, more confidence, less complacency and more collective responsibility. COVID-19-related demands were associated with greater work stress, and hence stronger COVID-19 vaccination intention. CONCLUSION The potential uptake rate of COVID-19 vaccine among nurses was suboptimal to achieve herd immunity. The 5C constructs were useful in predicting influenza vaccination and, to a lesser extent, the intention to take COVID-19 vaccine. The uncertain attributes such as effectiveness, side effects, and effective duration of the COVID-19 vaccine may contribute to this discrepancy. With less work stress among nurses in the post-pandemic period, the intention to take COVID-19 vaccine will likely drop. The 5C constructs should be infused in vaccination campaigns. While a COVID-19 vaccine could be ready soon, the nursing profession may not be ready to accept it. More research work is needed to boost the uptake rate. TWEETABLE ABSTRACT Less than two-third of nurses intended to take COVID-19 vaccine when available. While a COVID-19 vaccine could be ready soon, nursing profession is not ready to accept it.
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Affiliation(s)
- Kin On Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China.
| | - Kin-Kit Li
- Department of Social and Behavioural Sciences, City University of Hong Kong, China
| | - Wan In Wei
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Arthur Tang
- Department of Software, Sungkyunkwan University, Seoul, South Korea
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Shui Shan Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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131
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Murrell I, Forde D, Zelek W, Tyson L, Chichester L, Palmer N, Jones R, Morgan BP, Moore C. Temporal development and neutralising potential of antibodies against SARS-CoV-2 in hospitalised COVID-19 patients: An observational cohort study. PLoS One 2021; 16:e0245382. [PMID: 33497420 PMCID: PMC7837461 DOI: 10.1371/journal.pone.0245382] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/29/2020] [Indexed: 12/17/2022] Open
Abstract
Antibody responses are important in the control of viral respiratory infection in the human host. What is not clear for SARS-CoV-2 is how rapidly this response occurs, or when antibodies with protective capability evolve. Hence, defining the events of SARS-CoV-2 seroconversion and the time frame for the development of antibodies with protective potential may help to explain the different clinical presentations of COVID-19. Furthermore, accurate descriptions of seroconversion are needed to inform the best use of serological assays for diagnostic testing and serosurveillance studies. Here, we describe the humoral responses in a cohort of hospitalised COVID-19 patients (n = 19) shortly following the onset of symptoms. Commercial and 'in-house' serological assays were used to measure IgG antibodies against different SARS-CoV-2 structural antigens-Spike (S) S1 sub-unit and Nucleocapsid protein (NP)-and to assess the potential for virus neutralisation mediated specifically by inhibition of binding between the viral attachment protein (S protein) and cognate receptor (ACE-2). Antibody response kinetics varied amongst the cohort, with patients seroconverting within 1 week, between 1-2 weeks, or after 2 weeks, following symptom onset. Anti-NP IgG responses were generally detected earlier, but reached maximum levels slower, than anti-S1 IgG responses. The earliest IgG antibodies produced by all patients included those that recognised the S protein receptor-binding domain (RBD) and were capable of inhibiting binding to ACE-2. These data revealed events and patterns of SARS-CoV-2 seroconversion that may be important predictors of the outcome of infection and guide the delivery of clinical services in the COVID-19 response.
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Affiliation(s)
- Isa Murrell
- Wales Specialist Virology Centre, Public Health Wales Microbiology, University Hospital of Wales, Cardiff, Wales, United Kingdom
| | - Donall Forde
- Wales Specialist Virology Centre, Public Health Wales Microbiology, University Hospital of Wales, Cardiff, Wales, United Kingdom
| | - Wioleta Zelek
- Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom
| | - Linda Tyson
- Wales Specialist Virology Centre, Public Health Wales Microbiology, University Hospital of Wales, Cardiff, Wales, United Kingdom
| | - Lisa Chichester
- Wales Specialist Virology Centre, Public Health Wales Microbiology, University Hospital of Wales, Cardiff, Wales, United Kingdom
| | - Nicki Palmer
- Wales Specialist Virology Centre, Public Health Wales Microbiology, University Hospital of Wales, Cardiff, Wales, United Kingdom
| | - Rachel Jones
- Wales Specialist Virology Centre, Public Health Wales Microbiology, University Hospital of Wales, Cardiff, Wales, United Kingdom
| | - B. Paul Morgan
- Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom
| | - Catherine Moore
- Wales Specialist Virology Centre, Public Health Wales Microbiology, University Hospital of Wales, Cardiff, Wales, United Kingdom
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132
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The Nucleocapsid protein triggers the main humoral immune response in COVID-19 patients. Biochem Biophys Res Commun 2021; 543:45-49. [PMID: 33515911 PMCID: PMC7825866 DOI: 10.1016/j.bbrc.2021.01.073] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 12/23/2022]
Abstract
In order to control the COVID-19 pandemic caused by SARS-CoV-2 infection, serious progress has been made to identify infected patients and to detect patients with a positive immune response against the virus. Currently, attempts to generate a vaccine against the coronavirus are ongoing. To understand SARS-CoV-2 immunoreactivity, we compared the IgG antibody response against SARS-CoV-2 in infected versus control patients by dot blot using recombinant viral particle proteins: N (Nucleocapsid), M (Membrane) and S (Spike). In addition, we used different protein fragments of the N and S protein to map immune epitopes. Most of the COVID-19 patients presented a specific immune response against the full length and fragments of the N protein and, to lesser extent, against a fragment containing amino acids 300-685 of the S protein. In contrast, immunoreactivity against other S protein fragments or the M protein was low. This response is specific for COVID-19 patients as very few of the control patients displayed immunoreactivity, likely reflecting an immune response against other coronaviruses. Altogether, our results may help develop method(s) for measuring COVID-19 antibody response, selectivity of methods detecting such SARS-CoV-2 antibodies and vaccine development.
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133
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Dobaño C, Vidal M, Santano R, Jiménez A, Chi J, Barrios D, Ruiz-Olalla G, Rodrigo Melero N, Carolis C, Parras D, Serra P, Martínez de Aguirre P, Carmona-Torre F, Reina G, Santamaria P, Mayor A, García-Basteiro AL, Izquierdo L, Aguilar R, Moncunill G. Highly Sensitive and Specific Multiplex Antibody Assays To Quantify Immunoglobulins M, A, and G against SARS-CoV-2 Antigens. J Clin Microbiol 2021; 59:e01731-20. [PMID: 33127841 PMCID: PMC8111153 DOI: 10.1128/jcm.01731-20] [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] [Received: 07/05/2020] [Accepted: 10/29/2020] [Indexed: 12/13/2022] Open
Abstract
Reliable serological tests are required to determine the prevalence of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and to characterize immunity to the disease in order to address key knowledge gaps in the coronavirus disease 2019 (COVID-19) pandemic. Quantitative suspension array technology (qSAT) assays based on the xMAP Luminex platform overcome the limitations of rapid diagnostic tests and enzyme-linked immunosorbent assays (ELISAs) with their higher precision, dynamic range, throughput, miniaturization, cost-efficiency, and multiplexing capacity. We developed three qSAT assays for IgM, IgA, and IgG against a panel of eight SARS-CoV-2 antigens, including spike protein (S), nucleocapsid protein (N), and membrane protein (M) constructs. The assays were optimized to minimize the processing time and maximize the signal-to-noise ratio. We evaluated their performances using 128 prepandemic plasma samples (negative controls) and 104 plasma samples from individuals with SARS-CoV-2 diagnosis (positive controls), of whom 5 were asymptomatic, 51 had mild symptoms, and 48 were hospitalized. Preexisting IgG antibodies recognizing N, M, and S proteins were detected in negative controls, which is suggestive of cross-reactivity to common-cold coronaviruses. The best-performing antibody/antigen signatures had specificities of 100% and sensitivities of 95.78% at ≥14 days and 95.65% at ≥21 days since the onset of symptoms, with areas under the curve (AUCs) of 0.977 and 0.999, respectively. Combining multiple markers as assessed by qSAT assays has the highest efficiency, breadth, and versatility to accurately detect low-level antibody responses for obtaining reliable data on the prevalence of exposure to novel pathogens in a population. Our assays will allow gaining insights into antibody correlates of immunity and their kinetics, required for vaccine development to combat the COVID-19 pandemic.
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Affiliation(s)
- Carlota Dobaño
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Rebeca Santano
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Alfons Jiménez
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Jordi Chi
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Diana Barrios
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Gemma Ruiz-Olalla
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Natalia Rodrigo Melero
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Carlo Carolis
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Daniel Parras
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Pau Serra
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | | | - Francisco Carmona-Torre
- Infectious Diseases Division, Clínica Universidad de Navarra, Pamplona, Spain
- Clinical Microbiology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Gabriel Reina
- Clínica Universidad de Navarra, Navarra Institute for Health Research, Pamplona, Spain
| | - Pere Santamaria
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Julia McFarlane Diabetes Research Centre, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Diseases, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Alfredo Mayor
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Alberto L García-Basteiro
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
- International Health Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Luis Izquierdo
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
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134
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A Multiplex Microsphere IgG Assay for SARS-CoV-2 Using ACE2-Mediated Inhibition as a Surrogate for Neutralization. J Clin Microbiol 2021; 59:JCM.02489-20. [PMID: 33139422 PMCID: PMC8111159 DOI: 10.1128/jcm.02489-20] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 10/29/2020] [Indexed: 01/10/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has highlighted the challenges inherent to the serological detection of a novel pathogen such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Serological tests can be used diagnostically and for surveillance, but their usefulness depends on their throughput, sensitivity, and specificity. Here, we describe a multiplex fluorescent microsphere-based assay, 3Flex, that can detect antibodies to three major SARS-CoV-2 antigens—spike (S) protein, the spike ACE2 receptor-binding domain (RBD), and nucleocapsid (NP). The coronavirus disease 2019 (COVID-19) pandemic has highlighted the challenges inherent to the serological detection of a novel pathogen such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Serological tests can be used diagnostically and for surveillance, but their usefulness depends on their throughput, sensitivity, and specificity. Here, we describe a multiplex fluorescent microsphere-based assay, 3Flex, that can detect antibodies to three major SARS-CoV-2 antigens—spike (S) protein, the spike ACE2 receptor-binding domain (RBD), and nucleocapsid (NP). Specificity was assessed using 213 prepandemic samples. Sensitivity was measured and compared to that of the Abbott Architect SARS-CoV-2 IgG assay using serum samples from 125 unique patients equally binned (n = 25) into 5 time intervals (≤5, 6 to 10, 11 to 15, 16 to 20, and ≥21 days from symptom onset). With samples obtained at ≤5 days from symptom onset, the 3Flex assay was more sensitive (48.0% versus 32.0%), but the two assays performed comparably using serum obtained ≥21 days from symptom onset. A larger collection (n = 534) of discarded sera was profiled from patients (n = 140) whose COVID-19 course was characterized through chart review. This revealed the relative rise, peak (S, 23.8; RBD, 23.6; NP, 16.7 [in days from symptom onset]), and decline of the antibody response. Considerable interperson variation was observed with a subset of extensively sampled intensive care unit (ICU) patients. Using soluble ACE2, inhibition of antibody binding was demonstrated for S and RBD, and not for NP. Taking the data together, this study described the performance of an assay built on a flexible and high-throughput serological platform that proved adaptable to the emergence of a novel infectious agent.
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135
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Dobaño C, Vidal M, Santano R, Jiménez A, Chi J, Barrios D, Ruiz-Olalla G, Rodrigo Melero N, Carolis C, Parras D, Serra P, Martínez de Aguirre P, Carmona-Torre F, Reina G, Santamaria P, Mayor A, García-Basteiro AL, Izquierdo L, Aguilar R, Moncunill G. Highly Sensitive and Specific Multiplex Antibody Assays To Quantify Immunoglobulins M, A, and G against SARS-CoV-2 Antigens. J Clin Microbiol 2021. [PMID: 33127841 DOI: 10.1101/2020.06.11.147363] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
Reliable serological tests are required to determine the prevalence of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and to characterize immunity to the disease in order to address key knowledge gaps in the coronavirus disease 2019 (COVID-19) pandemic. Quantitative suspension array technology (qSAT) assays based on the xMAP Luminex platform overcome the limitations of rapid diagnostic tests and enzyme-linked immunosorbent assays (ELISAs) with their higher precision, dynamic range, throughput, miniaturization, cost-efficiency, and multiplexing capacity. We developed three qSAT assays for IgM, IgA, and IgG against a panel of eight SARS-CoV-2 antigens, including spike protein (S), nucleocapsid protein (N), and membrane protein (M) constructs. The assays were optimized to minimize the processing time and maximize the signal-to-noise ratio. We evaluated their performances using 128 prepandemic plasma samples (negative controls) and 104 plasma samples from individuals with SARS-CoV-2 diagnosis (positive controls), of whom 5 were asymptomatic, 51 had mild symptoms, and 48 were hospitalized. Preexisting IgG antibodies recognizing N, M, and S proteins were detected in negative controls, which is suggestive of cross-reactivity to common-cold coronaviruses. The best-performing antibody/antigen signatures had specificities of 100% and sensitivities of 95.78% at ≥14 days and 95.65% at ≥21 days since the onset of symptoms, with areas under the curve (AUCs) of 0.977 and 0.999, respectively. Combining multiple markers as assessed by qSAT assays has the highest efficiency, breadth, and versatility to accurately detect low-level antibody responses for obtaining reliable data on the prevalence of exposure to novel pathogens in a population. Our assays will allow gaining insights into antibody correlates of immunity and their kinetics, required for vaccine development to combat the COVID-19 pandemic.
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Affiliation(s)
- Carlota Dobaño
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Rebeca Santano
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Alfons Jiménez
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Jordi Chi
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Diana Barrios
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Gemma Ruiz-Olalla
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Natalia Rodrigo Melero
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Carlo Carolis
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Daniel Parras
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Pau Serra
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | | | - Francisco Carmona-Torre
- Infectious Diseases Division, Clínica Universidad de Navarra, Pamplona, Spain
- Clinical Microbiology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Gabriel Reina
- Clínica Universidad de Navarra, Navarra Institute for Health Research, Pamplona, Spain
| | - Pere Santamaria
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Julia McFarlane Diabetes Research Centre, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Diseases, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Alfredo Mayor
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Alberto L García-Basteiro
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
- International Health Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Luis Izquierdo
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
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136
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Ezhilan M, Suresh I, Nesakumar N. SARS-CoV, MERS-CoV and SARS-CoV-2: A Diagnostic Challenge. MEASUREMENT : JOURNAL OF THE INTERNATIONAL MEASUREMENT CONFEDERATION 2021; 168:108335. [PMID: 33519010 PMCID: PMC7833337 DOI: 10.1016/j.measurement.2020.108335] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/20/2020] [Accepted: 08/01/2020] [Indexed: 05/15/2023]
Abstract
The highly pathogenic MERS-CoV, SARS-CoV and SARS-CoV-2 cause acute respiratory syndrome and are often fatal. These new viruses pose major problems to global health in general and primarily to infection control and public health services. Accurate and selective assessment of MERS-CoV, SARS-CoV and SARS-CoV-2 would assist in the effective diagnosis of infected individual, offer clinical guidance and aid in assessing clinical outcomes. In this mini-review, we review the literature on various aspects, including the history and diversity of SARS-CoV-2, SARS-CoV and MERS-CoV, their detection methods in effective clinical diagnosis, clinical assessment of COVID-19, safety guidelines recommended by World Health Organization and legal regulations. This review article also deals with existing challenges and difficulties in the clinical diagnosis of SARS-CoV-2. Developing alternative diagnostic platforms by spotting the shortcomings of the existing point-of-care diagnostic devices would be useful in preventing future outbreaks.
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Affiliation(s)
- Madeshwari Ezhilan
- School of Electrical and Electronics Engineering, Centre for Nanotechnology & Advanced Biomaterials (CeNTAB), SASTRA Deemed University, Thanjavur 613401, Tamil Nadu, India
| | - Indhu Suresh
- School of Electrical and Electronics Engineering, Centre for Nanotechnology & Advanced Biomaterials (CeNTAB), SASTRA Deemed University, Thanjavur 613401, Tamil Nadu, India
| | - Noel Nesakumar
- School of Chemical and Biotechnology, Centre for Nanotechnology & Advanced Biomaterials (CeNTAB), SASTRA Deemed University, Thanjavur 613401, Tamil Nadu, India
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137
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Fenwick C, Croxatto A, Coste AT, Pojer F, André C, Pellaton C, Farina A, Campos J, Hacker D, Lau K, Bosch BJ, Gonseth Nussle S, Bochud M, D'Acremont V, Trono D, Greub G, Pantaleo G. Changes in SARS-CoV-2 Spike versus Nucleoprotein Antibody Responses Impact the Estimates of Infections in Population-Based Seroprevalence Studies. J Virol 2021; 95:e01828-20. [PMID: 33144321 PMCID: PMC7925109 DOI: 10.1128/jvi.01828-20] [Citation(s) in RCA: 156] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/25/2020] [Indexed: 12/11/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific antibody responses to the spike (S) protein monomer, S protein native trimeric form, or the nucleocapsid (N) proteins were evaluated in cohorts of individuals with acute infection (n = 93) and in individuals enrolled in a postinfection seroprevalence population study (n = 578) in Switzerland. Commercial assays specific for the S1 monomer, for the N protein, or within a newly developed Luminex assay using the S protein trimer were found to be equally sensitive in antibody detection in the acute-infection-phase samples. Interestingly, compared to anti-S antibody responses, those against the N protein appear to wane in the postinfection cohort. Seroprevalence in a "positive patient contacts" group (n = 177) was underestimated by N protein assays by 10.9 to 32.2%, while the "randomly selected" general population group (n = 311) was reduced by up to 45% relative to the S protein assays. The overall reduction in seroprevalence targeting only anti-N antibodies for the total cohort ranged from 9.4 to 31%. Of note, the use of the S protein in its native trimer form was significantly more sensitive compared to monomeric S proteins. These results indicate that the assessment of anti-S IgG antibody responses against the native trimeric S protein should be implemented to estimate SARS-CoV-2 infections in population-based seroprevalence studies.IMPORTANCE In the present study, we have determined SARS-CoV-2-specific antibody responses in sera of acute and postinfection phase subjects. Our results indicate that antibody responses against viral S and N proteins were equally sensitive in the acute phase of infection, but that responses against N appear to wane in the postinfection phase where those against the S protein persist over time. The most sensitive serological assay in both acute and postinfection phases used the native S protein trimer as the binding antigen, which has significantly greater conformational epitopes for antibody binding compared to the S1 monomer protein used in other assays. We believe these results are extremely important in order to generate correct estimates of SARS-CoV-2 infections in the general population. Furthermore, the assessment of antibody responses against the trimeric S protein will be critical to evaluate the durability of the antibody response and for the characterization of a vaccine-induced antibody response.
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Affiliation(s)
- Craig Fenwick
- Service of Immunology and Allergy, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Antony Croxatto
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Alix T Coste
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Florence Pojer
- Protein Production and Structure Core Facility, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Cyril André
- Service of Immunology and Allergy, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Céline Pellaton
- Service of Immunology and Allergy, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Alex Farina
- Service of Immunology and Allergy, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jérémy Campos
- Service of Immunology and Allergy, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - David Hacker
- Protein Production and Structure Core Facility, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Kelvin Lau
- Protein Production and Structure Core Facility, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Berend-Jan Bosch
- Virology Section, Infectious Diseases and Immunology Division, Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Semira Gonseth Nussle
- Centre for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Murielle Bochud
- Centre for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Valerie D'Acremont
- Centre for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Didier Trono
- School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Gilbert Greub
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Service of Infectious Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - Giuseppe Pantaleo
- Service of Immunology and Allergy, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Swiss Vaccine Research Institute, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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138
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Huergo MAC, Thanh NTK. Current advances in the detection of COVID-19 and evaluation of the humoral response. Analyst 2021; 146:382-402. [PMID: 33410826 DOI: 10.1039/d0an01686a] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The new outbreak caused by coronavirus SARS-CoV-2 started at the end of 2019 and was declared a pandemic in March 2020. Since then, several diagnostic approaches have been re-adapted, and also improved from the previous detections of SARS and MERS coronavirus. The best strategy to handle this situation seems to rely on a triad of detection methods: (i) highly sensitive and specific techniques as the gold standard method, (ii) easier and faster point of care tests accessible for large population screening, and (iii) serology assays to complement the direct detection and to use for surveillance. In this study, we assessed the techniques and tests described in the literature, their advantages and disadvantages, and the interpretation of the results. Quantitative reverse transcription polymerase chain reaction (RT-qPCR) is undoubtedly the gold standard technique utilized not only for diagnostics, but also as a standard for comparison and validation of newer approaches. Other nucleic acid amplification methods have been shown to be adequate as point of care (POC) diagnostic tests with similar performance as RT-qPCR. The analysis of seroconversion with immunotests shows the complexity of the immune response to COVID-19. The detection of anti-SARS-CoV-2 antibodies can also help to detect previously infected asymptomatic individuals with negative RT-qPCR tests. Nevertheless, more controlled serology cohort studies should be performed as soon as possible to understand the immune response to SARS-CoV-2.
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Affiliation(s)
- Maria Ana Cristina Huergo
- Theoretical and Applied Physical Chemical Research Institute (INIFTA), National Univesity of La Plata (UNLP), CONICET. Sucursal 4 Casilla de Correo 16, 1900 La Plata, Argentina.
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139
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Characteristics of Three Different Chemiluminescence Assays for Testing for SARS-CoV-2 Antibodies. DISEASE MARKERS 2021; 2021:8810196. [PMID: 33532006 PMCID: PMC7834819 DOI: 10.1155/2021/8810196] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/03/2020] [Accepted: 12/24/2020] [Indexed: 01/08/2023]
Abstract
Several tests based on chemiluminescence immunoassay techniques have become available to test for SARS-CoV-2 antibodies. There is currently insufficient data on serology assay performance beyond 35 days after symptoms onset. We aimed to evaluate SARS-CoV-2 antibody tests on three widely used platforms. A chemiluminescent microparticle immunoassay (CMIA; Abbott Diagnostics, USA), a luminescence immunoassay (LIA; Diasorin, Italy), and an electrochemiluminescence immunoassay (ECLIA; Roche Diagnostics, Switzerland) were investigated. In a multigroup study, sensitivity was assessed in a group of participants with confirmed SARS-CoV-2 (n = 145), whereas specificity was determined in two groups of participants without evidence of COVID-19 (i.e., healthy blood donors, n = 191, and healthcare workers, n = 1002). Receiver operating characteristic (ROC) curves, multilevel likelihood ratios (LR), and positive (PPV) and negative (NPV) predictive values were characterized. Finally, analytical specificity was characterized in samples with evidence of the Epstein–Barr virus (EBV) (n = 9), cytomegalovirus (CMV) (n = 7), and endemic common-cold coronavirus infections (n = 12) taken prior to the current SARS-CoV-2 pandemic. The diagnostic accuracy was comparable in all three assays (AUC 0.98). Using the manufacturers' cut-offs, the sensitivities were 90%, 95% confidence interval [84,94] (LIA), 93% [88,96] (CMIA), and 96% [91,98] (ECLIA). The specificities were 99.5% [98.9,99.8] (CMIA), 99.7% [99.3,99.9] (LIA), and 99.9% [99.5,99.98] (ECLIA). The LR at half of the manufacturers' cut-offs were 60 (CMIA), 82 (LIA), and 575 (ECLIA) for positive and 0.043 (CMIA) and 0.035 (LIA, ECLIA) for negative results. ECLIA had higher PPV at low pretest probabilities than CMIA and LIA. No interference with EBV or CMV infection was observed, whereas endemic coronavirus in some cases provided signals in LIA and/or CMIA. Although the diagnostic accuracy of the three investigated assays is comparable, their performance in low-prevalence settings is different. Introducing gray zones at half of the manufacturers' cut-offs is suggested, especially for orthogonal testing approaches that use a second assay for confirmation.
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140
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Cohen SA, Kellogg C, Equils O. Neutralizing and cross-reacting antibodies: implications for immunotherapy and SARS-CoV-2 vaccine development. Hum Vaccin Immunother 2021; 17:84-87. [PMID: 32678695 PMCID: PMC7872068 DOI: 10.1080/21645515.2020.1787074] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 06/13/2020] [Indexed: 12/28/2022] Open
Abstract
The novel coronavirus SARS-CoV-2 emerged in China in 2019 and quickly spread globally, causing a pandemic. There is an urgent need to develop vaccines against the virus, and both convalescent plasma and immune globulin are currently in clinical trials for treatment of patients with COVID-19. It is unclear whether antibodies induced by SARS-CoV-2 have neutralizing capacity and whether they can protect from future infection. Seasonal human coronaviruses (HCoV) have been circulating for decades. It is currently unknown whether antibodies against seasonal HCoV may cross-neutralize SARS-CoV-2. Data from neonates suggest that trans-placental antibodies against HCoV may have neutralizing capacity. Here we briefly review the epidemiologic observations on HCoV and discuss the potential implications for neutralizing and cross-neutralizing antibodies against SARS-CoV-2.
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Affiliation(s)
- Samuel A. Cohen
- Department of Preventive Medicine, Keck School of Medicine of USC, Los Angeles, US
- MiOra, Public Health Nonprofit (www.miora.org)
| | - Caitlyn Kellogg
- MiOra, Public Health Nonprofit (www.miora.org)
- MiOra Covid-19 Response, University of California San Diego School of Medicine, Los Angeles, US
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141
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Laboratory diagnosis of COVID-19 in secondary care hospitals in India: will standalone serology suffice? World J Pediatr 2021; 17:8-9. [PMID: 33484439 PMCID: PMC7823185 DOI: 10.1007/s12519-020-00399-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/24/2020] [Indexed: 11/23/2022]
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142
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Yadouleton A, Sander AL, Moreira-Soto A, Tchibozo C, Hounkanrin G, Badou Y, Fischer C, Krause N, Akogbeto P, de Oliveira Filho EF, Dossou A, Brünink S, Aïssi MAJ, Djingarey MH, Hounkpatin B, Nagel M, Drexler JF. Limited Specificity of Serologic Tests for SARS-CoV-2 Antibody Detection, Benin. Emerg Infect Dis 2021; 27:233-237. [PMID: 33261717 PMCID: PMC7774555 DOI: 10.3201/eid2701.203281] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
We used commercially available ELISAs to test 68 samples from coronavirus disease cases and prepandemic controls from Benin. We noted <25% false-positive results among controls, likely due to unspecific immune responses elicited by acute malaria. Serologic tests must be carefully evaluated to assess coronavirus disease spread and immunity in tropical regions.
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Affiliation(s)
| | | | | | - Carine Tchibozo
- Université Nationale des Sciences, Technologies, Ingénierie et Mathématiques, Cotonou, Benin (A. Yadouleton)
- Laboratoire des Fièvres Hémorragiques Virales du Benin, Cotonou (A. Yadouleton, C. Tchibozo, G. Hounkanrin, Y. Badou)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany (A.-L. Sander, A. Moreira-Soto, C. Fischer, N. Krause, E.F. de Oliveira Filho, S. Brünink, J.F. Drexler)
- Ministry of Health, Cotonou (P. Akogbeto, A. Dossou, B. Hounkpatin)
- Conseil National de Lutte contre le VIH-Sida, la Tuberculose, le Paludisme, les IST et les Epidémies, Cotonou (M.A. Joël Aïssi)
- World Health Organization Regional Office for Africa, Health Emergencies Programme, Brazzaville, Congo (M.H. Djingarey)
- Deutsche Gesellschaft für Internationale Zusammenarbeit, Bonn, Germany (M. Nagel)
- German Centre for Infection Research, associated partner Charité-Universitätsmedizin, Berlin, Germany (J.F. Drexler)
| | - Gildas Hounkanrin
- Université Nationale des Sciences, Technologies, Ingénierie et Mathématiques, Cotonou, Benin (A. Yadouleton)
- Laboratoire des Fièvres Hémorragiques Virales du Benin, Cotonou (A. Yadouleton, C. Tchibozo, G. Hounkanrin, Y. Badou)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany (A.-L. Sander, A. Moreira-Soto, C. Fischer, N. Krause, E.F. de Oliveira Filho, S. Brünink, J.F. Drexler)
- Ministry of Health, Cotonou (P. Akogbeto, A. Dossou, B. Hounkpatin)
- Conseil National de Lutte contre le VIH-Sida, la Tuberculose, le Paludisme, les IST et les Epidémies, Cotonou (M.A. Joël Aïssi)
- World Health Organization Regional Office for Africa, Health Emergencies Programme, Brazzaville, Congo (M.H. Djingarey)
- Deutsche Gesellschaft für Internationale Zusammenarbeit, Bonn, Germany (M. Nagel)
- German Centre for Infection Research, associated partner Charité-Universitätsmedizin, Berlin, Germany (J.F. Drexler)
| | - Yvette Badou
- Université Nationale des Sciences, Technologies, Ingénierie et Mathématiques, Cotonou, Benin (A. Yadouleton)
- Laboratoire des Fièvres Hémorragiques Virales du Benin, Cotonou (A. Yadouleton, C. Tchibozo, G. Hounkanrin, Y. Badou)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany (A.-L. Sander, A. Moreira-Soto, C. Fischer, N. Krause, E.F. de Oliveira Filho, S. Brünink, J.F. Drexler)
- Ministry of Health, Cotonou (P. Akogbeto, A. Dossou, B. Hounkpatin)
- Conseil National de Lutte contre le VIH-Sida, la Tuberculose, le Paludisme, les IST et les Epidémies, Cotonou (M.A. Joël Aïssi)
- World Health Organization Regional Office for Africa, Health Emergencies Programme, Brazzaville, Congo (M.H. Djingarey)
- Deutsche Gesellschaft für Internationale Zusammenarbeit, Bonn, Germany (M. Nagel)
- German Centre for Infection Research, associated partner Charité-Universitätsmedizin, Berlin, Germany (J.F. Drexler)
| | - Carlo Fischer
- Université Nationale des Sciences, Technologies, Ingénierie et Mathématiques, Cotonou, Benin (A. Yadouleton)
- Laboratoire des Fièvres Hémorragiques Virales du Benin, Cotonou (A. Yadouleton, C. Tchibozo, G. Hounkanrin, Y. Badou)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany (A.-L. Sander, A. Moreira-Soto, C. Fischer, N. Krause, E.F. de Oliveira Filho, S. Brünink, J.F. Drexler)
- Ministry of Health, Cotonou (P. Akogbeto, A. Dossou, B. Hounkpatin)
- Conseil National de Lutte contre le VIH-Sida, la Tuberculose, le Paludisme, les IST et les Epidémies, Cotonou (M.A. Joël Aïssi)
- World Health Organization Regional Office for Africa, Health Emergencies Programme, Brazzaville, Congo (M.H. Djingarey)
- Deutsche Gesellschaft für Internationale Zusammenarbeit, Bonn, Germany (M. Nagel)
- German Centre for Infection Research, associated partner Charité-Universitätsmedizin, Berlin, Germany (J.F. Drexler)
| | - Nina Krause
- Université Nationale des Sciences, Technologies, Ingénierie et Mathématiques, Cotonou, Benin (A. Yadouleton)
- Laboratoire des Fièvres Hémorragiques Virales du Benin, Cotonou (A. Yadouleton, C. Tchibozo, G. Hounkanrin, Y. Badou)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany (A.-L. Sander, A. Moreira-Soto, C. Fischer, N. Krause, E.F. de Oliveira Filho, S. Brünink, J.F. Drexler)
- Ministry of Health, Cotonou (P. Akogbeto, A. Dossou, B. Hounkpatin)
- Conseil National de Lutte contre le VIH-Sida, la Tuberculose, le Paludisme, les IST et les Epidémies, Cotonou (M.A. Joël Aïssi)
- World Health Organization Regional Office for Africa, Health Emergencies Programme, Brazzaville, Congo (M.H. Djingarey)
- Deutsche Gesellschaft für Internationale Zusammenarbeit, Bonn, Germany (M. Nagel)
- German Centre for Infection Research, associated partner Charité-Universitätsmedizin, Berlin, Germany (J.F. Drexler)
| | - Petas Akogbeto
- Université Nationale des Sciences, Technologies, Ingénierie et Mathématiques, Cotonou, Benin (A. Yadouleton)
- Laboratoire des Fièvres Hémorragiques Virales du Benin, Cotonou (A. Yadouleton, C. Tchibozo, G. Hounkanrin, Y. Badou)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany (A.-L. Sander, A. Moreira-Soto, C. Fischer, N. Krause, E.F. de Oliveira Filho, S. Brünink, J.F. Drexler)
- Ministry of Health, Cotonou (P. Akogbeto, A. Dossou, B. Hounkpatin)
- Conseil National de Lutte contre le VIH-Sida, la Tuberculose, le Paludisme, les IST et les Epidémies, Cotonou (M.A. Joël Aïssi)
- World Health Organization Regional Office for Africa, Health Emergencies Programme, Brazzaville, Congo (M.H. Djingarey)
- Deutsche Gesellschaft für Internationale Zusammenarbeit, Bonn, Germany (M. Nagel)
- German Centre for Infection Research, associated partner Charité-Universitätsmedizin, Berlin, Germany (J.F. Drexler)
| | - Edmilson F. de Oliveira Filho
- Université Nationale des Sciences, Technologies, Ingénierie et Mathématiques, Cotonou, Benin (A. Yadouleton)
- Laboratoire des Fièvres Hémorragiques Virales du Benin, Cotonou (A. Yadouleton, C. Tchibozo, G. Hounkanrin, Y. Badou)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany (A.-L. Sander, A. Moreira-Soto, C. Fischer, N. Krause, E.F. de Oliveira Filho, S. Brünink, J.F. Drexler)
- Ministry of Health, Cotonou (P. Akogbeto, A. Dossou, B. Hounkpatin)
- Conseil National de Lutte contre le VIH-Sida, la Tuberculose, le Paludisme, les IST et les Epidémies, Cotonou (M.A. Joël Aïssi)
- World Health Organization Regional Office for Africa, Health Emergencies Programme, Brazzaville, Congo (M.H. Djingarey)
- Deutsche Gesellschaft für Internationale Zusammenarbeit, Bonn, Germany (M. Nagel)
- German Centre for Infection Research, associated partner Charité-Universitätsmedizin, Berlin, Germany (J.F. Drexler)
| | - Anges Dossou
- Université Nationale des Sciences, Technologies, Ingénierie et Mathématiques, Cotonou, Benin (A. Yadouleton)
- Laboratoire des Fièvres Hémorragiques Virales du Benin, Cotonou (A. Yadouleton, C. Tchibozo, G. Hounkanrin, Y. Badou)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany (A.-L. Sander, A. Moreira-Soto, C. Fischer, N. Krause, E.F. de Oliveira Filho, S. Brünink, J.F. Drexler)
- Ministry of Health, Cotonou (P. Akogbeto, A. Dossou, B. Hounkpatin)
- Conseil National de Lutte contre le VIH-Sida, la Tuberculose, le Paludisme, les IST et les Epidémies, Cotonou (M.A. Joël Aïssi)
- World Health Organization Regional Office for Africa, Health Emergencies Programme, Brazzaville, Congo (M.H. Djingarey)
- Deutsche Gesellschaft für Internationale Zusammenarbeit, Bonn, Germany (M. Nagel)
- German Centre for Infection Research, associated partner Charité-Universitätsmedizin, Berlin, Germany (J.F. Drexler)
| | - Sebastian Brünink
- Université Nationale des Sciences, Technologies, Ingénierie et Mathématiques, Cotonou, Benin (A. Yadouleton)
- Laboratoire des Fièvres Hémorragiques Virales du Benin, Cotonou (A. Yadouleton, C. Tchibozo, G. Hounkanrin, Y. Badou)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany (A.-L. Sander, A. Moreira-Soto, C. Fischer, N. Krause, E.F. de Oliveira Filho, S. Brünink, J.F. Drexler)
- Ministry of Health, Cotonou (P. Akogbeto, A. Dossou, B. Hounkpatin)
- Conseil National de Lutte contre le VIH-Sida, la Tuberculose, le Paludisme, les IST et les Epidémies, Cotonou (M.A. Joël Aïssi)
- World Health Organization Regional Office for Africa, Health Emergencies Programme, Brazzaville, Congo (M.H. Djingarey)
- Deutsche Gesellschaft für Internationale Zusammenarbeit, Bonn, Germany (M. Nagel)
- German Centre for Infection Research, associated partner Charité-Universitätsmedizin, Berlin, Germany (J.F. Drexler)
| | - Melchior A. Joël Aïssi
- Université Nationale des Sciences, Technologies, Ingénierie et Mathématiques, Cotonou, Benin (A. Yadouleton)
- Laboratoire des Fièvres Hémorragiques Virales du Benin, Cotonou (A. Yadouleton, C. Tchibozo, G. Hounkanrin, Y. Badou)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany (A.-L. Sander, A. Moreira-Soto, C. Fischer, N. Krause, E.F. de Oliveira Filho, S. Brünink, J.F. Drexler)
- Ministry of Health, Cotonou (P. Akogbeto, A. Dossou, B. Hounkpatin)
- Conseil National de Lutte contre le VIH-Sida, la Tuberculose, le Paludisme, les IST et les Epidémies, Cotonou (M.A. Joël Aïssi)
- World Health Organization Regional Office for Africa, Health Emergencies Programme, Brazzaville, Congo (M.H. Djingarey)
- Deutsche Gesellschaft für Internationale Zusammenarbeit, Bonn, Germany (M. Nagel)
- German Centre for Infection Research, associated partner Charité-Universitätsmedizin, Berlin, Germany (J.F. Drexler)
| | - Mamoudou Harouna Djingarey
- Université Nationale des Sciences, Technologies, Ingénierie et Mathématiques, Cotonou, Benin (A. Yadouleton)
- Laboratoire des Fièvres Hémorragiques Virales du Benin, Cotonou (A. Yadouleton, C. Tchibozo, G. Hounkanrin, Y. Badou)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany (A.-L. Sander, A. Moreira-Soto, C. Fischer, N. Krause, E.F. de Oliveira Filho, S. Brünink, J.F. Drexler)
- Ministry of Health, Cotonou (P. Akogbeto, A. Dossou, B. Hounkpatin)
- Conseil National de Lutte contre le VIH-Sida, la Tuberculose, le Paludisme, les IST et les Epidémies, Cotonou (M.A. Joël Aïssi)
- World Health Organization Regional Office for Africa, Health Emergencies Programme, Brazzaville, Congo (M.H. Djingarey)
- Deutsche Gesellschaft für Internationale Zusammenarbeit, Bonn, Germany (M. Nagel)
- German Centre for Infection Research, associated partner Charité-Universitätsmedizin, Berlin, Germany (J.F. Drexler)
| | - Benjamin Hounkpatin
- Université Nationale des Sciences, Technologies, Ingénierie et Mathématiques, Cotonou, Benin (A. Yadouleton)
- Laboratoire des Fièvres Hémorragiques Virales du Benin, Cotonou (A. Yadouleton, C. Tchibozo, G. Hounkanrin, Y. Badou)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany (A.-L. Sander, A. Moreira-Soto, C. Fischer, N. Krause, E.F. de Oliveira Filho, S. Brünink, J.F. Drexler)
- Ministry of Health, Cotonou (P. Akogbeto, A. Dossou, B. Hounkpatin)
- Conseil National de Lutte contre le VIH-Sida, la Tuberculose, le Paludisme, les IST et les Epidémies, Cotonou (M.A. Joël Aïssi)
- World Health Organization Regional Office for Africa, Health Emergencies Programme, Brazzaville, Congo (M.H. Djingarey)
- Deutsche Gesellschaft für Internationale Zusammenarbeit, Bonn, Germany (M. Nagel)
- German Centre for Infection Research, associated partner Charité-Universitätsmedizin, Berlin, Germany (J.F. Drexler)
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143
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Yaqinuddin A, Ambia AR, Elgazzar TA. Case fatalities due to COVID-19: Why there is a difference between the East and West? AIMS ALLERGY AND IMMUNOLOGY 2021. [DOI: 10.3934/allergy.2021005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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144
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Xiao C, Ling S, Qiu M, Deng Z, Chen L, Zhu A, Chen Y, Liu Y, Lin X, Lin F, Wu Q, Shen L, Ye F, Liu X, Li Y, Zhao J, Yang Z, Cowling BJ, Webby R, Zanin M, Wong S. Human post-infection serological response to the spike and nucleocapsid proteins of SARS-CoV-2. Influenza Other Respir Viruses 2021; 15:7-12. [PMID: 32844604 PMCID: PMC7461388 DOI: 10.1111/irv.12798] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/20/2020] [Accepted: 07/26/2020] [Indexed: 01/15/2023] Open
Abstract
To inform seroepidemiological studies, we characterized the IgG- responses in COVID-19 patients against the two major SARS-CoV-2 viral proteins, spike (S) and nucleocapsid (N). We tested 70 COVID-19 sera collected up to 85 days post-symptom onset and 230 non-COVID-19 sera, including 27 SARS sera from 2003. Although the average SARS-CoV-2 S and N-IgG titers were comparable, N-responses were more variable among individuals. S- and N-assay specificity tested with non-COVID-19 sera were comparable at 97.5% and 97.0%, respectively. Therefore, S will make a better target due to its lower cross-reactive potential and its' more consistent frequency of detection compared to N.
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Affiliation(s)
- Cheng Xiao
- Guangzhou Medical UniversityGuangzhouChina
- State Key Laboratory of Respiratory DiseaseNational Clinical Research Center for Respiratory DiseaseGuangzhouChina
| | - Shiman Ling
- Guangzhou Medical UniversityGuangzhouChina
- State Key Laboratory of Respiratory DiseaseNational Clinical Research Center for Respiratory DiseaseGuangzhouChina
| | - Minshan Qiu
- Department of Intensive CareDongguan People's HospitalDongguanChina
| | - Zhenxuan Deng
- Department of Intensive CareDongguan People's HospitalDongguanChina
| | - Liping Chen
- Guangzhou Medical UniversityGuangzhouChina
- State Key Laboratory of Respiratory DiseaseNational Clinical Research Center for Respiratory DiseaseGuangzhouChina
| | - Airu Zhu
- Guangzhou Medical UniversityGuangzhouChina
- State Key Laboratory of Respiratory DiseaseNational Clinical Research Center for Respiratory DiseaseGuangzhouChina
| | - Yi Chen
- Central LaboratoryGuangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangzhouChina
| | - Yong Liu
- Guangzhou Medical UniversityGuangzhouChina
- Kingmed Virology Diagnostics and Translational CenterGuangzhou Kingmed Center for Clinical LaboratoryGuangzhouChina
- Guangzhou Institute of Respiratory HealthThe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina
| | - Xia Lin
- Guangzhou Medical UniversityGuangzhouChina
- State Key Laboratory of Respiratory DiseaseNational Clinical Research Center for Respiratory DiseaseGuangzhouChina
| | - Fangmei Lin
- Guangzhou Medical UniversityGuangzhouChina
- State Key Laboratory of Respiratory DiseaseNational Clinical Research Center for Respiratory DiseaseGuangzhouChina
| | - Qiubao Wu
- Guangzhou Medical UniversityGuangzhouChina
- Nanshan Medicine InnovationGuangdongChina
| | - Lihan Shen
- Department of Intensive CareDongguan People's HospitalDongguanChina
| | - Feng Ye
- Department of Pulmonary and Critical Care MedicineThe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina
| | - Xiaoqing Liu
- Department of Intensive CareThe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina
| | - Yimin Li
- Department of Intensive CareThe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina
| | - Jincun Zhao
- State Key Laboratory of Respiratory DiseaseNational Clinical Research Center for Respiratory DiseaseGuangzhouChina
| | - Zifeng Yang
- State Key Laboratory of Respiratory DiseaseNational Clinical Research Center for Respiratory DiseaseGuangzhouChina
- Guangzhou Institute of Respiratory HealthThe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina
- Macau University of Science and TechnologyMacau SARChina
| | | | - Richard Webby
- Division of VirologySt. Jude’s Children’s Research HospitalMemphisTNUSA
| | - Mark Zanin
- Guangzhou Medical UniversityGuangzhouChina
- State Key Laboratory of Respiratory DiseaseNational Clinical Research Center for Respiratory DiseaseGuangzhouChina
- School of Public HealthThe University of Hong KongHong Kong SARChina
| | - Sook‐San Wong
- Guangzhou Medical UniversityGuangzhouChina
- State Key Laboratory of Respiratory DiseaseNational Clinical Research Center for Respiratory DiseaseGuangzhouChina
- School of Public HealthThe University of Hong KongHong Kong SARChina
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145
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Böger B, Fachi MM, Vilhena RO, Cobre AF, Tonin FS, Pontarolo R. Systematic review with meta-analysis of the accuracy of diagnostic tests for COVID-19. Am J Infect Control 2021; 49:21-29. [PMID: 32659413 PMCID: PMC7350782 DOI: 10.1016/j.ajic.2020.07.011] [Citation(s) in RCA: 278] [Impact Index Per Article: 92.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To collate the evidence on the accuracy parameters of all available diagnostic methods for detecting SARS-CoV-2. METHODS A systematic review with meta-analysis was performed. Searches were conducted in Pubmed and Scopus (April 2020). Studies reporting data on sensitivity or specificity of diagnostic tests for COVID-19 using any human biological sample were included. RESULTS Sixteen studies were evaluated. Meta-analysis showed that computed tomography has high sensitivity (91.9% [89.8%-93.7%]), but low specificity (25.1% [21.0%-29.5%]). The combination of IgM and IgG antibodies demonstrated promising results for both parameters (84.5% [82.2%-86.6%]; 91.6% [86.0%-95.4%], respectively). For RT-PCR tests, rectal stools/swab, urine, and plasma were less sensitive while sputum (97.2% [90.3%-99.7%]) presented higher sensitivity for detecting the virus. CONCLUSIONS RT-PCR remains the gold standard for the diagnosis of COVID-19 in sputum samples. However, the combination of different diagnostic tests is highly recommended to achieve adequate sensitivity and specificity.
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146
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Recent Developments in SARS-CoV-2 Neutralizing Antibody Detection Methods. Curr Med Sci 2021; 41:1052-1064. [PMID: 34935114 PMCID: PMC8692081 DOI: 10.1007/s11596-021-2470-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/20/2021] [Indexed: 12/14/2022]
Abstract
The ongoing Coronavirus disease 19 pandemic has likely changed the world in ways not seen in the past. Neutralizing antibody (NAb) assays play an important role in the management of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) outbreak. Using these tools, we can assess the presence and duration of antibody-mediated protection in naturally infected individuals, screen convalescent plasma preparations for donation, test the efficacy of immunotherapy, and analyze NAb titers and persistence after vaccination to predict vaccine-induced protective effects. This review briefly summarizes the various methods used for the detection of SARS-CoV-2 NAbs and compares their advantages and disadvantages to facilitate their development and clinical application.
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147
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Maple PAC, Sikora K. How Useful is COVID-19 Antibody Testing - A Current Assessment for Oncologists. Clin Oncol (R Coll Radiol) 2021; 33:e73-e81. [PMID: 33350940 PMCID: PMC7553121 DOI: 10.1016/j.clon.2020.10.008] [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: 06/19/2020] [Revised: 09/25/2020] [Accepted: 10/06/2020] [Indexed: 12/28/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic due to infection by a new human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has seriously disrupted the provision of oncology services and their uptake. Antibody testing, both at an individual level and of populations, has been widely viewed to be a key activity for guiding the options for treatment of high-risk individuals, as well as the implementation of safe control of infection measures. Ideally, the detection of a specific antibody should signify that all individuals tested have been infected by SARS-CoV-2 and that in the case of specific IgG that they are immune to further infection. This would enable SARS-CoV-2-infected individuals to be appropriately managed and healthcare workers shown to be immune to return to work where they would no longer pose a risk to their patients or be at risk themselves. Unfortunately, this is not the case for COVID-19, where it has been shown that immunity may not be protective, and seroconversion delayed or absent. The variability in antibody test performance, particularly that of lateral flow assays, has caused confusion for the public and healthcare professions alike. Many antibody test devices have been made available without independent evaluations and these may lack both adequate sensitivity and specificity. This review seeks to educate healthcare workers, particularly those working in oncology, of the current benefits and limitations of SARS-CoV-2 antibody testing.
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Affiliation(s)
- P A C Maple
- Clinical Neurology Research Group, Division of Clinical Neuroscience, University of Nottingham School of Medicine, Queen's Medical Centre, Nottingham, UK
| | - K Sikora
- Medical Division, Rutherford Cancer Centres, London, UK.
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148
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Abstract
The newly emerged severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) has recently caused pandemic Coronavirus Disease-2019 (COVID-19). Considering the serious medical, economic and social consequences of this pandemic and the lack of definite medication and vaccine it is necessary to describe natural immune responses to the SARS-CoV-2 in order to exploit them for treating the patients and monitoring the general population. Moreover, detecting the most immunogenic antigens of the virus is fundamental for designing effective vaccines. Antibodies being valuable for diagnostic therapeutic and protective purposes are suitable to be addressed in this context. Herein, we have summarized the findings of serological investigations and the outcomes of neutralizing antibodies administration in COVID-19 patients.
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Affiliation(s)
- Sara Assadiasl
- Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Fatahi
- Department of Pharmaceutical Nanotechnology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,Nanotechnology Research Centre, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Zavvar
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Nicknam
- Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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149
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Catry E, Jacqmin H, Dodemont M, Saad Albichr I, Lardinois B, de Fays B, Delaere B, Closset M, Laurent T, Denis O, Galanti L, Mullier F, Huang TD. Analytical and clinical evaluation of four commercial SARS-CoV-2 serological immunoassays in hospitalized patients and ambulatory individuals. J Virol Methods 2020; 289:114060. [PMID: 33359614 PMCID: PMC7834313 DOI: 10.1016/j.jviromet.2020.114060] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/21/2020] [Accepted: 12/21/2020] [Indexed: 12/30/2022]
Abstract
Hospitalized patients seroconverted at ≥ 3 weeks pso. Ambulatory symptomatic individuals seroconverted at 14 days pso. Illness’ severity degree and infection phase impacted the longitudinal Ab changes. Five “severe-to-critically” ill patients have positive Ab levels up to 16 weeks pso. Total Ab immunoassay, compared to IgG, present a better sensitivity and specificity.
Background This study aimed to compare four anti-SARS-CoV-2 immunoassays in populations presenting different clinical severity levels. Methods Three populations were included: “severe-to-critical” ICU-hospitalized patients (n = 18), “mild-to-moderate” hospitalized patients (n = 16) and non-hospitalized symptomatic patients (n = 24). Four commercial immunoassays were analyzed and validated: anti-IgG ARCHITECT® (Abbott), anti-Total antibodies (Ab) VITROS® (Ortho Clinical Diagnostics), anti-IgG NovaLisa® (NovaTec Immundiagnostica) and Healgen® IgM and IgG (Zhejiang Orient Gene Biotech). Sensitivities were evaluated according to days post-symptoms onset (pso). Specificities were evaluated on SARS-CoV-2-negative control sera collected before January 2020. Results A majority of severe-to-critically ill patients showed detectable Ab already at day 14 and sensitivities reached 100 % after 22 days pso. For patients with “mild-to-moderate” illness, sensitivities increased by at least 5-fold from day 0 to day 14 pso. Non-hospitalized symptomatic individuals already seroconverted at day 14 days pso with 100 % sensitivities for Total Ab VITROS®. Specificities were evaluated at 97 % for ARCHITECT® and NovaLisa®, 98 % for VITROS® and at 94 % for Healgen® combined IgM and IgG. Five “severe-to-critically” ill patients presented high positive Ab levels for at least 16 weeks pso. Conclusion The Ab levels and the evaluated sensitivities, representing the true positive rate, increased overtime and were related to the COVID-19 severity. Automated Total Ab immunoassay showed better sensitivities and specificity for immunological surveillance and vaccine evaluation.
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Affiliation(s)
- E Catry
- Université catholique de Louvain, CHU UCL Namur, Department of Laboratory Medicine, Yvoir, Belgium.
| | - H Jacqmin
- Université catholique de Louvain, CHU UCL Namur, Department of Laboratory Medicine, Yvoir, Belgium
| | - M Dodemont
- Université catholique de Louvain, CHU UCL Namur, Department of Laboratory Medicine, Yvoir, Belgium
| | - I Saad Albichr
- Université catholique de Louvain, CHU UCL Namur, Department of Laboratory Medicine, Yvoir, Belgium
| | - B Lardinois
- Université catholique de Louvain, CHU UCL Namur, Department of Laboratory Medicine, Yvoir, Belgium
| | - B de Fays
- Université catholique de Louvain, CHU UCL Namur, Department of Infectious Diseases, Yvoir, Belgium
| | - B Delaere
- Université catholique de Louvain, CHU UCL Namur, Department of Infectious Diseases, Yvoir, Belgium
| | - M Closset
- Université catholique de Louvain, CHU UCL Namur, Department of Laboratory Medicine, Yvoir, Belgium
| | - T Laurent
- Université catholique de Louvain, CHU UCL Namur, Department of Laboratory Medicine, Namur, Belgium
| | - O Denis
- Université catholique de Louvain, CHU UCL Namur, Department of Laboratory Medicine, Yvoir, Belgium; Université catholique de Louvain, CHU UCL Namur, Infection Control and Prevention Unit, Yvoir, Belgium
| | - L Galanti
- Université catholique de Louvain, CHU UCL Namur, Department of Laboratory Medicine, Yvoir, Belgium
| | - F Mullier
- Université catholique de Louvain, CHU UCL Namur, Department of Laboratory Medicine, Yvoir, Belgium
| | - T D Huang
- Université catholique de Louvain, CHU UCL Namur, Department of Laboratory Medicine, Yvoir, Belgium
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150
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Benner SE, Patel EU, Laeyendecker O, Pekosz A, Littlefield K, Eby Y, Fernandez RE, Miller J, Kirby CS, Keruly M, Klock E, Baker OR, Schmidt HA, Shrestha R, Burgess I, Bonny TS, Clarke W, Caturegli P, Sullivan D, Shoham S, Quinn TC, Bloch EM, Casadevall A, Tobian AAR, Redd AD. SARS-CoV-2 Antibody Avidity Responses in COVID-19 Patients and Convalescent Plasma Donors. J Infect Dis 2020; 222:1974-1984. [PMID: 32910175 PMCID: PMC7499592 DOI: 10.1093/infdis/jiaa581] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 09/08/2020] [Indexed: 12/12/2022] Open
Abstract
Background Convalescent plasma therapy is a leading treatment for conferring temporary immunity to COVID-19–susceptible individuals or for use as post-exposure prophylaxis. However, not all recovered patients develop adequate antibody titers for donation and the relationship between avidity and neutralizing titers is currently not well understood. Methods SARS-CoV-2 anti-spike and anti-nucleocapsid IgG titers and avidity were measured in a longitudinal cohort of COVID-19 hospitalized patients (n = 16 individuals) and a cross-sectional sample of convalescent plasma donors (n = 130). Epidemiologic correlates of avidity were examined in donors by linear regression. The association of avidity and a high neutralizing titer (NT) were also assessed in donors using modified Poisson regression. Results Antibody avidity increased over duration of infection and remained elevated. In convalescent plasma donors, higher levels of anti-spike avidity were associated with older age, male sex, and hospitalization. Higher NTs had a stronger positive correlation with anti-spike IgG avidity (Spearman ρ = 0.386; P < .001) than with anti-nucleocapsid IgG avidity (Spearman ρ = 0.211; P = .026). Increasing levels of anti-spike IgG avidity were associated with high NT (≥160) (adjusted prevalence ratio = 1.58 [95% confidence interval = 1.19–2.12]), independent of age, sex, and hospitalization. Conclusions SARS-CoV-2 antibody avidity correlated with duration of infection and higher neutralizing titers, suggesting a potential alternative screening parameter for identifying optimal convalescent plasma donors.
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Affiliation(s)
- Sarah E Benner
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Eshan U Patel
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Oliver Laeyendecker
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.,Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kirsten Littlefield
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yolanda Eby
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Reinaldo E Fernandez
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Jernelle Miller
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Charles S Kirby
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Morgan Keruly
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Ethan Klock
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Owen R Baker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Haley A Schmidt
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Ruchee Shrestha
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Imani Burgess
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Tania S Bonny
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - William Clarke
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Patrizio Caturegli
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - David Sullivan
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Shmuel Shoham
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Thomas C Quinn
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.,Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Arturo Casadevall
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Andrew D Redd
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.,Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
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