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Banjar A, Al-Tawfiq JA, Alruwaily A, Alserehi H, Al-Qunaibet A, Alaswad R, Almutlaq H, Almudaiheem A, Khojah AT, Alsaif F, Almolad SK, Alqahtani S, AlJurayyan A, Alotaibi A, Almalki S, Abuhaimed Y, Alkhashan A, Alfaifi A, Alabdulkareem K, Jokhdar H, Assiri A, Almudarra S. Seroprevalence of antibodies to SARS-CoV-2 among blood donors in the early months of the pandemic in Saudi Arabia. Int J Infect Dis 2021; 104:452-457. [PMID: 33465488 PMCID: PMC7816871 DOI: 10.1016/j.ijid.2021.01.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Serologic testing provides better understanding of SARS-CoV-2 prevalence and its transmission. This study was an investigation of the prevalence of antibodies to SARS-CoV-2 among blood donors in Saudi Arabia. OBJECTIVE To estimate the seroprevalence of anti-SARS-CoV-2 antibodies among blood donors in Saudi Arabia during the early phase of the COVID-19 pandemic. METHODS Serology results and epidemiological data were analyzed for 837 adult blood donors, with no confirmed SARS-CoV-2 infection, in Saudi Arabia from 20th to 25th May 2020. Seroprevalence was determined using electrochemical immunoassay to detect anti-SARS-CoV-2 antibodies. RESULTS The overall seroprevalence of anti-SARS-CoV-2 antibodies was 1.4% (12/837). Non-citizens had higher seroprevalence compared with citizens (OR 13.6, p = 0.001). Secondary education was significantly associated with higher seroprevalence compared with higher education (OR 6.8, p = 0.005). The data showed that the highest seroprevalence was in Makkah (8.1%). Uisng Makkah seroprevalence as the reference, the seroprevalence in other areas was: Madinah 4.1% (OR 0.48, 95% CI 0.12-1.94), Jeddah 2.3% (OR 0.27, 95% CI 0.31-2.25), and Qassim 2.9 % (OR 0.34, 95% CI 0.04-2.89) and these were not statistically different from seroprevalence in the Makkah region. CONCLUSIONS At the early months of the COVID-19 pandemic in Saudi Arabia, the seroprevalence of antibodies to SARS-CoV-2 among blood donors was low, but was higher among non-citizens. These findings may indicate that non-citizens and less educated individuals may be less attentive to preventive measures. Monitoring seroprevalence trends over time require repeated sampling.
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Affiliation(s)
- Ayman Banjar
- Deputy Ministry for Public Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Infectious Disease Division, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
| | - Amaal Alruwaily
- Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Haleema Alserehi
- Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Ada Al-Qunaibet
- Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Rehab Alaswad
- Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Hind Almutlaq
- Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia
| | | | - Abdullah T Khojah
- Faculty of Medicine, Al Imam Muhammad ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Faisal Alsaif
- Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Saeed Alqahtani
- Deputy Ministry for Laboratories and Blood Banks, Ministry of Health, Riyadh, Saudi Arabia
| | | | - Abdullah Alotaibi
- Dammam Regional Laboratory, Ministry of Health, Dammam, Saudi Arabia
| | - Safar Almalki
- Jeddah Regional Laboratory, Ministry of Health, Jeddah, Saudi Arabia
| | - Yousef Abuhaimed
- King Saud bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
| | - Abdullah Alkhashan
- Deputy Ministry for Laboratories and Blood Banks, Ministry of Health, Riyadh, Saudi Arabia
| | - Amal Alfaifi
- Deputy Ministry for Public Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Khaled Alabdulkareem
- Deputy Ministry for Public Health, Ministry of Health, Riyadh, Saudi Arabia; Faculty of Medicine, Al Imam Muhammad ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Hani Jokhdar
- Deputy Ministry for Public Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdullah Assiri
- Deputy Ministry for Public Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Sami Almudarra
- Deputy Ministry for Public Health, Ministry of Health, Riyadh, Saudi Arabia; Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia.
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102
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González F, Vielot NA, Sciaudone M, Toval-Ruíz C, Premkumar L, Gutierrez L, Cuadra EC, Blandón P, de Silva AM, Rubinstein R, Bowman N, Becker-Dreps S, Bucardo F. Seroepidemiology of SARS-CoV-2 infections in an urban Nicaraguan population. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021. [PMID: 33688687 DOI: 10.1101/2021.02.25.21252447] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
In a Nicaraguan population-based cohort, SARS-CoV-2 seroprevalence was 34%, with higher prevalence in children compared to adults. Having a seropositive household member was associated with a two-fold probability of individual seropositivity, suggesting a role for household transmission. Co-morbidities and preventive behaviors were not associated with SARS-CoV-2 seroprevalence.
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103
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Rostami A, Sepidarkish M, Leeflang MMG, Riahi SM, Nourollahpour Shiadeh M, Esfandyari S, Mokdad AH, Hotez PJ, Gasser RB. SARS-CoV-2 seroprevalence worldwide: a systematic review and meta-analysis. Clin Microbiol Infect 2021; 27:331-340. [PMID: 33228974 PMCID: PMC7584920 DOI: 10.1016/j.cmi.2020.10.020] [Citation(s) in RCA: 235] [Impact Index Per Article: 78.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/15/2020] [Accepted: 10/19/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES COVID-19 has been arguably the most important public health concern worldwide in 2020, and efforts are now escalating to suppress or eliminate its spread. In this study we undertook a meta-analysis to estimate the global and regional seroprevalence rates in humans of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and to assess whether seroprevalence is associated with geographical, climatic and/or sociodemographic factors. METHODS We systematically reviewed PubMed, Scopus, Embase, medRxiv and bioRxiv databases for preprints or peer-reviewed articles (up to 14 August 2020). Study eligibility criteria were population-based studies describing the prevalence of anti-SARS-CoV-2 (IgG and/or IgM) serum antibodies. Participants were people from different socioeconomic and ethnic backgrounds (from the general population), whose prior COVID-19 status was unknown and who were tested for the presence of anti-SARS-CoV-2 serum antibodies. We used a random-effects model to estimate pooled seroprevalence, and then extrapolated the findings to the global population (for 2020). Subgroup and meta-regression analyses explored potential sources of heterogeneity in the data, and relationships between seroprevalence and sociodemographic, geographical and/or climatic factors. RESULTS In total, 47 studies involving 399 265 people from 23 countries met the inclusion criteria. Heterogeneity (I2 = 99.4%, p < 0.001) was seen among studies; SARS-CoV-2 seroprevalence in the general population varied from 0.37% to 22.1%, with a pooled estimate of 3.38% (95%CI 3.05-3.72%; 15 879/399 265). On a regional level, seroprevalence varied from 1.45% (0.95-1.94%, South America) to 5.27% (3.97-6.57%, Northern Europe), although some variation appeared to relate to the serological assay used. The findings suggested an association of seroprevalence with income levels, human development indices, geographic latitudes and/or climate. Extrapolating to the 2020 world population, we estimated that 263.5 million individuals had been exposed or infected at the time of this study. CONCLUSIONS This study showed that SARS-CoV-2 seroprevalence varied markedly among geographic regions, as might be expected early in a pandemic. Longitudinal surveys to continually monitor seroprevalence around the globe will be critical to support prevention and control efforts, and might indicate levels of endemic stability or instability in particular countries and regions.
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Affiliation(s)
- Ali Rostami
- Infectious Diseases and Tropical Medicine Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Mariska M G Leeflang
- Department of Epidemiology and Data Science, Amsterdam Public Health, Amsterdam UMC/University of Amsterdam, Amsterdam, the Netherlands
| | - Seyed Mohammad Riahi
- Cardiovascular Diseases Research Center, Department of Epidemiology and Biostatistics, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Sahar Esfandyari
- Department of Physiology and Biophysics, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Peter J Hotez
- Texas Children's Hospital Center for Vaccine Development, Department of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Robin B Gasser
- Department of Veterinary Biosciences, Melbourne Veterinary School, The University of Melbourne, Parkville, Victoria, Australia.
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104
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Comelli A, Focà E, Sansone E, Tomasi C, Albini E, Quiros-Roldan E, Tomasoni LR, Sala E, Bonfanti C, Caccuri F, Caruso A, De Palma G, Castelli F. Serological Response to SARS-CoV-2 in Health Care Workers Employed in a Large Tertiary Hospital in Lombardy, Northern Italy. Microorganisms 2021; 9:488. [PMID: 33669151 PMCID: PMC7996483 DOI: 10.3390/microorganisms9030488] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND COVID-19 pandemic is requesting unprecedented efforts by health-care workers (HCWs) in all countries, and especially in Italy during the first semester of 2020. METHODS This is a retrospective, observational study conducted at the Spedali Civili General Hospital, in Brescia, Northern Italy during the SARS CoV-2 pandemic in the first semester of 2020. Serum samples from HCWs were tested for SARS-CoV-2 spike protein-specific antibodies. An online survey was used to collect demographic, clinical, and epidemiological data. RESULTS Of the 1893 HCWs included, 433 (22.9%) were found seropositive for SARS-CoV-2 IgG. The cumulative prevalence of SARS-CoV-2 infection (antibodies production or past positive RT-PCR on nasal/throat swab) was 25.1% (475/1893). Fifty-six out of 433 (13%) seropositive participants declared to have been asymptomatic during the study period. The development of COVID-19 signs or symptoms is the main determinant of seropositivity (OR: 11.3, p < 0.0001) along with their duration and severity. 40/290 (14.5%) HCWs with documented positive RT-PCR during the study period did not show any detectable antibody response. IgG levels positively correlate with age, COVID-19-compatible signs and symptoms experienced and their duration. CONCLUSIONS In this study, carried out in one of the most affected areas in Europe, we demonstrate that most HCWs with COVID-19 related symptoms develop a spike protein-specific antibodies with potential neutralizing effect.
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Affiliation(s)
- Agnese Comelli
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy; (E.F.); (E.Q.-R.); (L.R.T.); (F.C.)
| | - Emanuele Focà
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy; (E.F.); (E.Q.-R.); (L.R.T.); (F.C.)
| | - Emanuele Sansone
- Postgraduate School of Occupational Health, DSMC, University of Brescia, 25123 Brescia, Italy;
| | | | - Elisa Albini
- Unit of Occupational Health, Hygiene, Toxicology and Occupational Prevention, ASST Spedali Civili, 25123 Brescia, Italy; (E.A.); (E.S.)
| | - Eugenia Quiros-Roldan
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy; (E.F.); (E.Q.-R.); (L.R.T.); (F.C.)
| | - Lina Rachele Tomasoni
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy; (E.F.); (E.Q.-R.); (L.R.T.); (F.C.)
| | - Emma Sala
- Unit of Occupational Health, Hygiene, Toxicology and Occupational Prevention, ASST Spedali Civili, 25123 Brescia, Italy; (E.A.); (E.S.)
| | - Carlo Bonfanti
- Department of Microbiology and Virology, Spedali Civili, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (C.B.); (F.C.); (A.C.)
| | - Francesca Caccuri
- Department of Microbiology and Virology, Spedali Civili, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (C.B.); (F.C.); (A.C.)
| | - Arnaldo Caruso
- Department of Microbiology and Virology, Spedali Civili, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (C.B.); (F.C.); (A.C.)
| | - Giuseppe De Palma
- University Department of Occupational Health and Industrial Hygiene, DSMC, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy;
| | - Francesco Castelli
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy; (E.F.); (E.Q.-R.); (L.R.T.); (F.C.)
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105
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Pagani G, Giacomelli A, Conti F, Bernacchia D, Rondanin R, Prina A, Scolari V, Rizzo A, Beltrami M, Caimi C, Gandolfi CE, Castaldi S, Rivieccio BA, Buonanno G, Marano G, Ottomano C, Boracchi P, Biganzoli E, Galli M. Prevalence of SARS-CoV-2 in an area of unrestricted viral circulation: Mass seroepidemiological screening in Castiglione d'Adda, Italy. PLoS One 2021; 16:e0246513. [PMID: 33626045 PMCID: PMC7904134 DOI: 10.1371/journal.pone.0246513] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/20/2021] [Indexed: 12/24/2022] Open
Abstract
Castiglione D'Adda is one of the municipalities more precociously and severely affected by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) epidemic in Lombardy. With our study we aimed to understand the diffusion of the infection by mass serological screening. We searched for SARS-CoV-2 IgGs in the entire population on a voluntary basis using lateral flow immunochromatographic tests (RICT) on capillary blood (rapid tests). We then performed chemioluminescent serological assays (CLIA) and naso-pharyngeal swabs (NPS) in a randomized representative sample and in each subject with a positive rapid test. Factors associated with RICT IgG positivity were assessed by uni- and multivariate logistic regression models. Out of the 4143 participants, 918 (22·2%) showed RICT IgG positivity. In multivariable analysis, IgG positivity increases with age, with a significant non-linear effect (p = 0·0404). We found 22 positive NPSs out of the 1330 performed. Albeit relevant, the IgG prevalence is lower than expected and suggests that a large part of the population remains susceptible to the infection. The observed differences in prevalence might reflect a different infection susceptibility by age group. A limited persistence of active infections could be found after several weeks after the epidemic peak in the area.
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Affiliation(s)
- Gabriele Pagani
- Dipartimento di Scienze Biomediche e Cliniche “L. Sacco”, Università degli Studi di Milano, Milano, Italy
- Malattie Infettive III Divisione, ASST FBF-Sacco, Milano, Italy
| | - Andrea Giacomelli
- Dipartimento di Scienze Biomediche e Cliniche “L. Sacco”, Università degli Studi di Milano, Milano, Italy
- Malattie Infettive III Divisione, ASST FBF-Sacco, Milano, Italy
| | - Federico Conti
- Dipartimento di Scienze Biomediche e Cliniche “L. Sacco”, Università degli Studi di Milano, Milano, Italy
- Malattie Infettive III Divisione, ASST FBF-Sacco, Milano, Italy
| | - Dario Bernacchia
- Dipartimento di Scienze Biomediche e Cliniche “L. Sacco”, Università degli Studi di Milano, Milano, Italy
- Malattie Infettive III Divisione, ASST FBF-Sacco, Milano, Italy
| | | | | | - Vittore Scolari
- Institut Curie-PSL Research University, CNRS, Sorbonne Université, Paris, France
| | - Arianna Rizzo
- Dipartimento di Scienze Biomediche e Cliniche “L. Sacco”, Università degli Studi di Milano, Milano, Italy
| | - Martina Beltrami
- Dipartimento di Scienze Biomediche e Cliniche “L. Sacco”, Università degli Studi di Milano, Milano, Italy
| | - Camilla Caimi
- Dipartimento di Scienze Biomediche e Cliniche “L. Sacco”, Università degli Studi di Milano, Milano, Italy
| | - Cecilia Eugenia Gandolfi
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milano, Italy
| | - Silvana Castaldi
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milano, Italy
| | | | - Giacomo Buonanno
- Fondazione Istituto Insubrico di Ricerca per la Vita, LIUC Università Cattaneo, Castellanza, Italy
| | - Giuseppe Marano
- Dipartimento di Scienze Cliniche e di Comunità, Laboratorio di Statistica Medica Biometria ed Epidemiologia “G.A. Maccacaro”, Università degli Studi di Milano, Milano, Italy
| | | | - Patrizia Boracchi
- Dipartimento di Scienze Cliniche e di Comunità, Laboratorio di Statistica Medica Biometria ed Epidemiologia “G.A. Maccacaro”, Università degli Studi di Milano, Milano, Italy
| | - Elia Biganzoli
- Dipartimento di Scienze Cliniche e di Comunità, Laboratorio di Statistica Medica Biometria ed Epidemiologia “G.A. Maccacaro”, Università degli Studi di Milano, Milano, Italy
| | - Massimo Galli
- Dipartimento di Scienze Biomediche e Cliniche “L. Sacco”, Università degli Studi di Milano, Milano, Italy
- Malattie Infettive III Divisione, ASST FBF-Sacco, Milano, Italy
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106
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Persistence of SARS-CoV-2-specific B and T cell responses in convalescent COVID-19 patients 6-8 months after the infection. MED 2021; 2:281-295.e4. [PMID: 33589885 PMCID: PMC7874960 DOI: 10.1016/j.medj.2021.02.001] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/28/2020] [Accepted: 02/03/2021] [Indexed: 12/12/2022]
Abstract
Background Monitoring the adaptive immune responses during the natural course of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection provides useful information for the development of vaccination strategies against this virus and its emerging variants. We thus profiled the serum anti-SARS-CoV-2 antibody (Ab) levels and specific memory B and T cell responses in convalescent coronavirus disease 2019 (COVID-19) patients. Methods A total of 119 samples from 88 convalescent donors who experienced mild to critical disease were tested for the presence of elevated anti-spike and anti-receptor binding domain Ab levels over a period of 8 months. In addition, the levels of SARS-CoV-2 neutralizing Abs and specific memory B and T cell responses were tested in a subset of samples. Findings Anti-SARS-CoV-2 Abs were present in 85% of the samples collected within 4 weeks after the onset of symptoms in COVID-19 patients. Levels of specific immunoglobulin M (IgM)/IgA Abs declined after 1 month, while levels of specific IgG Abs and plasma neutralizing activities remained relatively stable up to 6 months after diagnosis. Anti-SARS-CoV-2 IgG Abs were still present, although at a significantly lower level, in 80% of the samples collected at 6-8 months after symptom onset. SARS-CoV-2-specific memory B and T cell responses developed with time and were persistent in all of the patients followed up for 6-8 months. Conclusions Our data suggest that protective adaptive immunity following natural infection of SARS-CoV-2 may persist for at least 6-8 months, regardless of disease severity. Development of medium- or long-term protective immunity through vaccination may thus be possible. Funding This project was supported by the European Union's Horizon 2020 research and innovation programme (ATAC, no. 101003650), the Italian Ministry of Health (Ricerca Finalizzata grant no. GR-2013-02358399), the Center for Innovative Medicine, and the Swedish Research Council. J.A. was supported by the SciLifeLab/KAW national COVID-19 research program project grant 2020.
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107
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La Rosa G, Mancini P, Bonanno Ferraro G, Veneri C, Iaconelli M, Bonadonna L, Lucentini L, Suffredini E. SARS-CoV-2 has been circulating in northern Italy since December 2019: Evidence from environmental monitoring. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 750:141711. [PMID: 32835962 PMCID: PMC7428442 DOI: 10.1016/j.scitotenv.2020.141711] [Citation(s) in RCA: 208] [Impact Index Per Article: 69.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 04/14/2023]
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease COVID-19, a public health emergency worldwide, and Italy is among the most severely affected countries. The first autochthonous Italian case of COVID-19 was documented on February 21, 2020. We investigated the possibility that SARS-CoV-2 emerged in Italy earlier than that date, by analysing 40 composite influent wastewater samples collected - in the framework of other wastewater-based epidemiology projects - between October 2019 and February 2020 from five wastewater treatment plants (WWTPs) in three cities and regions in northern Italy (Milan/Lombardy, Turin/Piedmont and Bologna/Emilia Romagna). Twenty-four additional samples collected in the same WWTPs between September 2018 and June 2019 (i.e. long before the onset of the epidemic) were included as 'blank' samples. Viral concentration was performed according to the standard World Health Organization procedure for poliovirus sewage surveillance, with modifications. Molecular analysis was undertaken with both nested RT-PCR and real-rime RT-PCR assays. A total of 15 positive samples were confirmed by both methods. The earliest dates back to 18 December 2019 in Milan and Turin and 29 January 2020 in Bologna. Virus concentration in the samples ranged from below the limit of detection (LOD) to 5.6 × 104 genome copies (g.c.)/L, and most of the samples (23 out of 26) were below the limit of quantification of PCR. Our results demonstrate that SARS-CoV-2 was already circulating in northern Italy at the end of 2019. Moreover, it was circulating in different geographic regions simultaneously, which changes our previous understanding of the geographical circulation of the virus in Italy. Our study highlights the importance of environmental surveillance as an early warning system, to monitor the levels of virus circulating in the population and identify outbreaks even before cases are notified to the healthcare system.
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Affiliation(s)
- Giuseppina La Rosa
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy.
| | - Pamela Mancini
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | | | - Carolina Veneri
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Marcello Iaconelli
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Lucia Bonadonna
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Luca Lucentini
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Elisabetta Suffredini
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
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108
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La Rosa G, Mancini P, Bonanno Ferraro G, Veneri C, Iaconelli M, Bonadonna L, Lucentini L, Suffredini E. SARS-CoV-2 has been circulating in northern Italy since December 2019: Evidence from environmental monitoring. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021. [PMID: 32835962 DOI: 10.1101/2020.06.25.20140061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease COVID-19, a public health emergency worldwide, and Italy is among the most severely affected countries. The first autochthonous Italian case of COVID-19 was documented on February 21, 2020. We investigated the possibility that SARS-CoV-2 emerged in Italy earlier than that date, by analysing 40 composite influent wastewater samples collected - in the framework of other wastewater-based epidemiology projects - between October 2019 and February 2020 from five wastewater treatment plants (WWTPs) in three cities and regions in northern Italy (Milan/Lombardy, Turin/Piedmont and Bologna/Emilia Romagna). Twenty-four additional samples collected in the same WWTPs between September 2018 and June 2019 (i.e. long before the onset of the epidemic) were included as 'blank' samples. Viral concentration was performed according to the standard World Health Organization procedure for poliovirus sewage surveillance, with modifications. Molecular analysis was undertaken with both nested RT-PCR and real-rime RT-PCR assays. A total of 15 positive samples were confirmed by both methods. The earliest dates back to 18 December 2019 in Milan and Turin and 29 January 2020 in Bologna. Virus concentration in the samples ranged from below the limit of detection (LOD) to 5.6 × 104 genome copies (g.c.)/L, and most of the samples (23 out of 26) were below the limit of quantification of PCR. Our results demonstrate that SARS-CoV-2 was already circulating in northern Italy at the end of 2019. Moreover, it was circulating in different geographic regions simultaneously, which changes our previous understanding of the geographical circulation of the virus in Italy. Our study highlights the importance of environmental surveillance as an early warning system, to monitor the levels of virus circulating in the population and identify outbreaks even before cases are notified to the healthcare system.
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Affiliation(s)
- Giuseppina La Rosa
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy.
| | - Pamela Mancini
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | | | - Carolina Veneri
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Marcello Iaconelli
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Lucia Bonadonna
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Luca Lucentini
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Elisabetta Suffredini
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
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109
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Seroepidemiology of SARS-CoV-2 infections in an urban population-based cohort in León, Nicaragua. Epidemiol Infect 2021; 149:e247. [PMID: 35172912 PMCID: PMC8674192 DOI: 10.1017/s0950268821002144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In a Nicaraguan population-based cohort, SARS-CoV-2 seroprevalence reached 28% in the first 6 months of the country's epidemic and reached 35% 6 months later. Immune waning was uncommon. Individuals with a seropositive household member were over three times as likely to be seropositive themselves, suggesting the importance of household transmission.
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Post N, Eddy D, Huntley C, van Schalkwyk MCI, Shrotri M, Leeman D, Rigby S, Williams SV, Bermingham WH, Kellam P, Maher J, Shields AM, Amirthalingam G, Peacock SJ, Ismail SA. Antibody response to SARS-CoV-2 infection in humans: A systematic review. PLoS One 2020; 15:e0244126. [PMID: 33382764 PMCID: PMC7775097 DOI: 10.1371/journal.pone.0244126] [Citation(s) in RCA: 229] [Impact Index Per Article: 57.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/03/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Progress in characterising the humoral immune response to Severe Acute Respiratory Syndrome 2 (SARS-CoV-2) has been rapid but areas of uncertainty persist. Assessment of the full range of evidence generated to date to understand the characteristics of the antibody response, its dynamics over time, its determinants and the immunity it confers will have a range of clinical and policy implications for this novel pathogen. This review comprehensively evaluated evidence describing the antibody response to SARS-CoV-2 published from 01/01/2020-26/06/2020. METHODS Systematic review. Keyword-structured searches were carried out in MEDLINE, Embase and COVID-19 Primer. Articles were independently screened on title, abstract and full text by two researchers, with arbitration of disagreements. Data were double-extracted into a pre-designed template, and studies critically appraised using a modified version of the Public Health Ontario Meta-tool for Quality Appraisal of Public Health Evidence (MetaQAT) tool, with resolution of disagreements by consensus. Findings were narratively synthesised. RESULTS 150 papers were included. Most studies (113 or 75%) were observational in design, were based wholly or primarily on data from hospitalised patients (108, 72%) and had important methodological limitations. Few considered mild or asymptomatic infection. Antibody dynamics were well described in the acute phase, up to around three months from disease onset, but the picture regarding correlates of the antibody response was inconsistent. IgM was consistently detected before IgG in included studies, peaking at weeks two to five and declining over a further three to five weeks post-symptom onset depending on the patient group; IgG peaked around weeks three to seven post-symptom onset then plateaued, generally persisting for at least eight weeks. Neutralising antibodies were detectable within seven to 15 days following disease onset, with levels increasing until days 14-22 before levelling and then decreasing, but titres were lower in those with asymptomatic or clinically mild disease. Specific and potent neutralising antibodies have been isolated from convalescent plasma. Cross-reactivity but limited cross-neutralisation with other human coronaviridae was reported. Evidence for protective immunity in vivo was limited to small, short-term animal studies, showing promising initial results in the immediate recovery phase. CONCLUSIONS Literature on antibody responses to SARS-CoV-2 is of variable quality with considerable heterogeneity of methods, study participants, outcomes measured and assays used. Although acute phase antibody dynamics are well described, longer-term patterns are much less well evidenced. Comprehensive assessment of the role of demographic characteristics and disease severity on antibody responses is needed. Initial findings of low neutralising antibody titres and possible waning of titres over time may have implications for sero-surveillance and disease control policy, although further evidence is needed. The detection of potent neutralising antibodies in convalescent plasma is important in the context of development of therapeutics and vaccines. Due to limitations with the existing evidence base, large, cross-national cohort studies using appropriate statistical analysis and standardised serological assays and clinical classifications should be prioritised.
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Affiliation(s)
- Nathan Post
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Danielle Eddy
- National Infection Service, Public Health England, London, United Kingdom
| | - Catherine Huntley
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - May C. I. van Schalkwyk
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Madhumita Shrotri
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - David Leeman
- National Infection Service, Public Health England, London, United Kingdom
| | - Samuel Rigby
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sarah V. Williams
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - William H. Bermingham
- Department of Clinical Immunology, University Hospitals Birmingham, Birmingham, United Kingdom
| | - Paul Kellam
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - John Maher
- School of Cancer and Pharmaceutical Studies, King’s College London, London, United Kingdom
- Department of Immunology, Eastbourne Hospital, Eastbourne, United Kingdom
| | - Adrian M. Shields
- Clinical Immunology Service, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
| | | | - Sharon J. Peacock
- National Infection Service, Public Health England, London, United Kingdom
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Sharif A. Ismail
- National Infection Service, Public Health England, London, United Kingdom
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Del Fante C, Franchini M, Baldanti F, Percivalle E, Glingani C, Marano G, Mengoli C, Mortellaro C, Viarengo G, Perotti C, Liumbruno GM. A retrospective study assessing the characteristics of COVID-19 convalescent plasma donors and donations. Transfusion 2020; 61:830-838. [PMID: 33231325 PMCID: PMC7753739 DOI: 10.1111/trf.16208] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/23/2020] [Accepted: 10/23/2020] [Indexed: 02/06/2023]
Abstract
Background Although many trials are currently investigating the safety and efficacy of convalescent plasma (CP) in critically ill COVID‐19 patients, there is a paucity of ongoing and published studies evaluating the CP donors' side. This retrospective study reports the first Italian experience on CP donors' selection and donations. Methods Patients aged 18‐68 years who had recovered from COVID‐19 at least 2 weeks previously were recruited between March 18 and June 30, 2020 in a study protocol at the Italian hospitals of Pavia and Mantova. Results During the study period, 494 of 512 donors recruited were judged eligible and underwent 504 plasmapheresis procedures. Eighty‐five percent (437/512) of the CP donors were males. The average time between symptom recovery and CP donation was 36.6 (±20.0) days. Four hundred and eighty‐eight plasmapheresis procedures (96.8%) were concluded and each unit was divided into two subunits (total 976) with an average volume of 316.2 (±22.7) mL. Ninety‐three percent (460/494) of CP donors at the time of plasma donation had a neutralizing IgG titer ≥1:80. Plasmapheresis‐related adverse reactions occurred in 2.6% (13/504) of cases; all the reactions were mild and none required therapeutic intervention. Donors' age and COVID‐19 severity were positively associated with greater antibody responses. Conclusion This study demonstrates the feasibility and safety of a pilot CP program conducted in Italy. The identification of factors (ie, age and severity of COVID‐19) positively associated with higher neutralizing antibody titers at the time of donation may help to optimize the selection of CP donors.
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Affiliation(s)
- Claudia Del Fante
- Immunohematology and Transfusion Service, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Massimo Franchini
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantova, Italy.,Italian National Blood Centre, Rome, Italy
| | - Fausto Baldanti
- Molecular Virology Unit, Microbiology and Virology Department, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elena Percivalle
- Molecular Virology Unit, Microbiology and Virology Department, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Claudia Glingani
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantova, Italy
| | | | | | - Cristina Mortellaro
- Immunohematology and Transfusion Service, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gianluca Viarengo
- Immunohematology and Transfusion Service, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Cesare Perotti
- Immunohematology and Transfusion Service, IRCCS Policlinico San Matteo, Pavia, Italy
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Amendola A, Bianchi S, Gori M, Colzani D, Canuti M, Borghi E, Raviglione MC, Zuccotti GV, Tanzi E. Evidence of SARS-CoV-2 RNA in an Oropharyngeal Swab Specimen, Milan, Italy, Early December 2019. Emerg Infect Dis 2020; 27:648-650. [PMID: 33292923 PMCID: PMC7853584 DOI: 10.3201/eid2702.204632] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
We identified severe acute respiratory syndrome coronavirus 2 RNA in an oropharyngeal swab specimen collected from a child with suspected measles in early December 2019, ≈3 months before the first identified coronavirus disease case in Italy. This finding expands our knowledge on timing and mapping of novel coronavirus transmission pathways.
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113
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Lombardi F, Belmonti S, Ricci R, Borghetti A, Fabbiani M, Ciccullo A, Cauda R, Di Giambenedetto S. No evidence of SARS-CoV-2 circulation in HIV-infected patients between December 2019 and February 2020 in Rome, Italy. Clin Microbiol Infect 2020; 27:S1198-743X(20)30722-9. [PMID: 33278571 PMCID: PMC7709603 DOI: 10.1016/j.cmi.2020.11.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/22/2020] [Accepted: 11/24/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Francesca Lombardi
- Università Cattolica del Sacro Cuore, Dipartimento di Sicurezza e Bioetica Sezione Malattie Infettive, Rome, Italy.
| | - Simone Belmonti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Area of Pathology, Department of Woman and Child Health and Public Health, Istituto di Anatomia Patologica, Rome, Italy
| | - Rosalba Ricci
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Institute of Microbiology and Virology, Rome, Italy
| | - Alberto Borghetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Malattie Infettive, Rome, Italy
| | - Massimiliano Fabbiani
- Infectious and Tropical Diseases Unit, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Arturo Ciccullo
- Università Cattolica del Sacro Cuore, Dipartimento di Sicurezza e Bioetica Sezione Malattie Infettive, Rome, Italy
| | - Roberto Cauda
- Università Cattolica del Sacro Cuore, Dipartimento di Sicurezza e Bioetica Sezione Malattie Infettive, Rome, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Malattie Infettive, Rome, Italy
| | - Simona Di Giambenedetto
- Università Cattolica del Sacro Cuore, Dipartimento di Sicurezza e Bioetica Sezione Malattie Infettive, Rome, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Malattie Infettive, Rome, Italy
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Perotti C, Baldanti F, Bruno R, Del Fante C, Seminari E, Casari S, Percivalle E, Glingani C, Musella V, Belliato M, Garuti M, Meloni F, Frigato M, Di Sabatino A, Klersy C, De Donno G, Franchini M. Mortality reduction in 46 severe Covid-19 patients treated with hyperimmune plasma. A proof of concept single arm multicenter trial. Haematologica 2020; 105:2834-2840. [PMID: 33256382 PMCID: PMC7716363 DOI: 10.3324/haematol.2020.261784] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/15/2020] [Indexed: 12/15/2022] Open
Abstract
Hyperimmune plasma from Covid-19 convalescent is a potential treatment for severe Covid-19. We conducted a multicenter one arm proof of concept interventional study. Patients with Covid-19 disease with moderate-to-severe Acute Respiratory Distress Syndrome, elevated C-reactive Protein and need for mechanical ventilation and/or CPAP were enrolled. One to three 250-300 ml unit of hyperimmune plasma (neutralizing antibodies titer ≥1:160) were administered. Primary outcome was 7-days hospital mortality. Secondary outcomes were PaO2/FiO2, laboratory and radiologic changes, as well as weaning from mechanical ventilation and safety. The study observed 46 patients from March, 25 to April, 21 2020. Patients were aged 63, 61% male, of them, 30 were on CPAP and 7 intubated. PaO2/FiO2 was 128 (SD 47). Bilateral infiltrates on chest X-ray was present in 36 patients (84%). Symptoms and ARDS duration were 14 (SD 7) and 6 days (SD 3). Three patients (6.5%) died within 7 days as compared to an expected 15% from the National Statistics and 30% from a small concurrent cohort of 23 patients. The upper one-sided 90%CI was 13.9%, allowing to reject the null hypothesis of a 15% mortality. PaO2/FiO2 increased by 112 units (95%CI 82 to142) in survivors, the chest radiogram severity decreased in 23% (95%CI 5% to 42%); CRP, Ferritin and LDH decreased by 60, 36 and 20% respectively. Weaning from CPAP was obtained in 26/30 patients and 3/7 were extubated. Five serious adverse events occurred in 4 patients (2 likely, 2 possible treatment related). In conclusion, Hyperimmune plasma in Covid-19 shows promising benefits, to be confirmed in a randomized controlled trial. This proof of concept study could open to future developments including hyperimmune plasma banking, development of standardized pharmaceutical products and monoclonal antibodies.
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Affiliation(s)
- Cesare Perotti
- Departments of Immunohematology and Transfusion, Infectious Diseases, Respiratory Diseases, Intensive Care, Virology and Clinical Epidemiology & Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Fausto Baldanti
- Departments of Immunohematology and Transfusion, Infectious Diseases, Respiratory Diseases, Intensive Care, Virology and Clinical Epidemiology & Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia
- University of Pavia, Pavia
| | - Raffaele Bruno
- Departments of Immunohematology and Transfusion, Infectious Diseases, Respiratory Diseases, Intensive Care, Virology and Clinical Epidemiology & Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia
- University of Pavia, Pavia
| | - Claudia Del Fante
- Departments of Immunohematology and Transfusion, Infectious Diseases, Respiratory Diseases, Intensive Care, Virology and Clinical Epidemiology & Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Elena Seminari
- Departments of Immunohematology and Transfusion, Infectious Diseases, Respiratory Diseases, Intensive Care, Virology and Clinical Epidemiology & Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Salvatore Casari
- Departments of Immunohematology and Transfusion, Infectious Diseases, Respiratory Diseases, Carlo Poma Hospital, ASST Mantova, Mantova, Italy
| | - Elena Percivalle
- Departments of Immunohematology and Transfusion, Infectious Diseases, Respiratory Diseases, Intensive Care, Virology and Clinical Epidemiology & Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Claudia Glingani
- Departments of Immunohematology and Transfusion, Infectious Diseases, Respiratory Diseases, Carlo Poma Hospital, ASST Mantova, Mantova, Italy
| | - Valeria Musella
- Departments of Immunohematology and Transfusion, Infectious Diseases, Respiratory Diseases, Intensive Care, Virology and Clinical Epidemiology & Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Mirko Belliato
- Departments of Immunohematology and Transfusion, Infectious Diseases, Respiratory Diseases, Intensive Care, Virology and Clinical Epidemiology & Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Martina Garuti
- Departments of Immunohematology and Transfusion, Infectious Diseases, Respiratory Diseases, Carlo Poma Hospital, ASST Mantova, Mantova, Italy
| | - Federica Meloni
- Departments of Immunohematology and Transfusion, Infectious Diseases, Respiratory Diseases, Intensive Care, Virology and Clinical Epidemiology & Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia
- University of Pavia, Pavia
| | - Marilena Frigato
- Departments of Immunohematology and Transfusion, Infectious Diseases, Respiratory Diseases, Carlo Poma Hospital, ASST Mantova, Mantova, Italy
| | - Antonio Di Sabatino
- Departments of Immunohematology and Transfusion, Infectious Diseases, Respiratory Diseases, Intensive Care, Virology and Clinical Epidemiology & Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia
- University of Pavia, Pavia
| | - Catherine Klersy
- Departments of Immunohematology and Transfusion, Infectious Diseases, Respiratory Diseases, Intensive Care, Virology and Clinical Epidemiology & Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Giuseppe De Donno
- Departments of Immunohematology and Transfusion, Infectious Diseases, Respiratory Diseases, Carlo Poma Hospital, ASST Mantova, Mantova, Italy
| | - Massimo Franchini
- Departments of Immunohematology and Transfusion, Infectious Diseases, Respiratory Diseases, Carlo Poma Hospital, ASST Mantova, Mantova, Italy
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Amendola A, Tanzi E, Folgori L, Barcellini L, Bianchi S, Gori M, Cammi G, Albani E, Zuccotti GV. Low seroprevalence of SARS-CoV-2 infection among healthcare workers of the largest children hospital in Milan during the pandemic wave. Infect Control Hosp Epidemiol 2020; 41:1468-1469. [PMID: 32758311 PMCID: PMC7438626 DOI: 10.1017/ice.2020.401] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Antonella Amendola
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Coordinated Research Centre “EpiSoMI,” University of Milan, Milan, Italy
| | - Elisabetta Tanzi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Coordinated Research Centre “EpiSoMI,” University of Milan, Milan, Italy
| | - Laura Folgori
- Department of Paediatrics, Children Hospital V. Buzzi, University of Milan, Milan, Italy
| | - Lucia Barcellini
- Department of Paediatrics, Children Hospital V. Buzzi, University of Milan, Milan, Italy
| | - Silvia Bianchi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Maria Gori
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Giulia Cammi
- Department of Paediatrics, Children Hospital V. Buzzi, University of Milan, Milan, Italy
| | - Elena Albani
- Department of Paediatrics, Children Hospital V. Buzzi, University of Milan, Milan, Italy
| | - Gian Vincenzo Zuccotti
- Department of Paediatrics, Children Hospital V. Buzzi, University of Milan, Milan, Italy
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Levin AT, Hanage WP, Owusu-Boaitey N, Cochran KB, Walsh SP, Meyerowitz-Katz G. Assessing the age specificity of infection fatality rates for COVID-19: systematic review, meta-analysis, and public policy implications. Eur J Epidemiol 2020; 35:1123-1138. [PMID: 33289900 PMCID: PMC7721859 DOI: 10.1007/s10654-020-00698-1] [Citation(s) in RCA: 460] [Impact Index Per Article: 115.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/10/2020] [Indexed: 12/17/2022]
Abstract
Determine age-specific infection fatality rates for COVID-19 to inform public health policies and communications that help protect vulnerable age groups. Studies of COVID-19 prevalence were collected by conducting an online search of published articles, preprints, and government reports that were publicly disseminated prior to 18 September 2020. The systematic review encompassed 113 studies, of which 27 studies (covering 34 geographical locations) satisfied the inclusion criteria and were included in the meta-analysis. Age-specific IFRs were computed using the prevalence data in conjunction with reported fatalities 4 weeks after the midpoint date of the study, reflecting typical lags in fatalities and reporting. Meta-regression procedures in Stata were used to analyze the infection fatality rate (IFR) by age. Our analysis finds a exponential relationship between age and IFR for COVID-19. The estimated age-specific IFR is very low for children and younger adults (e.g., 0.002% at age 10 and 0.01% at age 25) but increases progressively to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85. Moreover, our results indicate that about 90% of the variation in population IFR across geographical locations reflects differences in the age composition of the population and the extent to which relatively vulnerable age groups were exposed to the virus. These results indicate that COVID-19 is hazardous not only for the elderly but also for middle-aged adults, for whom the infection fatality rate is two orders of magnitude greater than the annualized risk of a fatal automobile accident and far more dangerous than seasonal influenza. Moreover, the overall IFR for COVID-19 should not be viewed as a fixed parameter but as intrinsically linked to the age-specific pattern of infections. Consequently, public health measures to mitigate infections in older adults could substantially decrease total deaths.
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Affiliation(s)
- Andrew T Levin
- Dartmouth College, Hanover, USA
- National Bureau for Economic Research, Cambridge, USA
- Centre for Economic Policy Research, London, United Kingdom
| | | | | | | | | | - Gideon Meyerowitz-Katz
- University of Wollongong, Wollongong, Australia.
- Western Sydney Local Health District, PO Box 792, Seven Hills, NSW, 2147, Australia.
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Lai CC, Wang JH, Hsueh PR. Population-based seroprevalence surveys of anti-SARS-CoV-2 antibody: An up-to-date review. Int J Infect Dis 2020; 101:314-322. [PMID: 33045429 PMCID: PMC7546669 DOI: 10.1016/j.ijid.2020.10.011] [Citation(s) in RCA: 141] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 09/23/2020] [Accepted: 10/04/2020] [Indexed: 01/12/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has led to a global pandemic. However, the majority of currently available data are restricted to laboratory-confirmed cases for symptomatic patients, and the SARS-CoV-2 infection can manifest as an asymptomatic or mild disease. Therefore, the true extent of the burden of COVID-19 may be underestimated. Improved serological detection of specific antibodies against SARS-CoV-2 could help estimate the true numbers of infections. This article comprehensively reviews the associated literature and provides updated information regarding the seroprevalence of the anti-SARS-CoV-2 antibody. The seroprevalence can vary across different sites and the seroprevalence can increase with time during longitudinal follow-up. Although healthcare workers (HCWs), especially those caring for COVID-19 patients, are considered as a high-risk group, the seroprevalence in HCWs wearing adequate personal protective equipment is thought to be no higher than that in other groups. With regard to sex, no statistically significant difference has been found between male and female subjects. Some, but not all, studies have shown that children have a lower risk than other age groups. Finally, seroprevalence can vary according to different populations, such as pregnant women and hemodialysis patients; however, limited studies have examined these associations. Furthermore, the continued surveillance of seroprevalence is warranted to estimate and monitor the growing burden of COVID-19.
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Affiliation(s)
- Chih-Cheng Lai
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan
| | - Jui-Hsiang Wang
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan
| | - Po-Ren Hsueh
- Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
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Lu L, Zhang H, Zhan M, Jiang J, Yin H, Dauphars DJ, Li SY, Li Y, He YW. Antibody response and therapy in COVID-19 patients: what can be learned for vaccine development? SCIENCE CHINA-LIFE SCIENCES 2020; 63:1833-1849. [PMID: 33355886 PMCID: PMC7756132 DOI: 10.1007/s11427-020-1859-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 11/27/2020] [Indexed: 01/08/2023]
Abstract
The newly emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected millions of people and caused tremendous morbidity and mortality worldwide. Effective treatment for coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 infection is lacking, and different therapeutic strategies are under testing. Host humoral and cellular immunity to SARS-CoV-2 infection is a critical determinant for patients’ outcomes. SARS-CoV-2 infection results in seroconversion and production of anti-SARS-CoV-2 antibodies. The antibodies may suppress viral replication through neutralization but might also participate in COVID-19 pathogenesis through a process termed antibody-dependent enhancement. Rapid progress has been made in the research of antibody response and therapy in COVID-19 patients, including characterization of the clinical features of antibody responses in different populations infected by SARS-CoV-2, treatment of COVID-19 patients with convalescent plasma and intravenous immunoglobin products, isolation and characterization of a large panel of monoclonal neutralizing antibodies and early clinical testing, as well as clinical results from several COVID-19 vaccine candidates. In this review, we summarize the recent progress and discuss the implications of these findings in vaccine development.
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Affiliation(s)
- Ligong Lu
- Zhuhai Interventional Medical Center, Zhuhai Precision Medical Center, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Zhuhai, 519000, China.
| | - Hui Zhang
- First Affiliated Hospital, China Medical University, Shenyang, 110001, China
| | - Meixiao Zhan
- Zhuhai Interventional Medical Center, Zhuhai Precision Medical Center, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Zhuhai, 519000, China
| | - Jun Jiang
- tricision Biotherapeutic Inc., Zhuhai, 519041, China
| | - Hua Yin
- Zhuhai Interventional Medical Center, Zhuhai Precision Medical Center, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Zhuhai, 519000, China
| | - Danielle J Dauphars
- Department of Immunology, Duke University Medical University Medical Center, Durham, NC, 27710, USA
| | - Shi-You Li
- tricision Biotherapeutic Inc., Zhuhai, 519041, China
| | - Yong Li
- Zhuhai Interventional Medical Center, Zhuhai Precision Medical Center, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Zhuhai, 519000, China
| | - You-Wen He
- Department of Immunology, Duke University Medical University Medical Center, Durham, NC, 27710, USA.
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Cento V, Alteri C, Merli M, Di Ruscio F, Tartaglione L, Rossotti R, Travi G, Vecchi M, Raimondi A, Nava A, Colagrossi L, Fumagalli R, Ughi N, Epis OM, Fanti D, Beretta A, Galbiati F, Scaglione F, Vismara C, Puoti M, Campisi D, Perno CF. Effectiveness of infection-containment measures on SARS-CoV-2 seroprevalence and circulation from May to July 2020, in Milan, Italy. PLoS One 2020; 15:e0242765. [PMID: 33216817 PMCID: PMC7679019 DOI: 10.1371/journal.pone.0242765] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 11/09/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Through a hospital-based SARS-CoV-2 molecular and serological screening, we evaluated the effectiveness of two months of lockdown and two of surveillance, in Milan, Lombardy, the first to be overwhelmed by COVID-19 pandemics during March-April 2020. METHODS All subjects presenting at the major hospital of Milan from May-11 to July-5, 2020, underwent a serological screening by chemiluminescent assays. Those admitted were further tested by RT-PCR. RESULTS The cumulative anti-N IgG seroprevalence in the 2753 subjects analyzed was of 5.1% (95%CI = 4.3%-6.0%), with a peak of 8.4% (6.1%-11.4%) 60-63 days since the peak of diagnoses (March-20). 31/106 (29.2%) anti-N reactive subjects had anti-S1/S2 titers >80 AU/mL. Being tested from May-18 to June-5, or residing in the provinces with higher SARS-CoV-2 circulation, were positively and independently associated with anti-N IgG reactivity (OR [95%CI]: 2.179[1.455-3.264] and 3.127[1.18-8.29], respectively). In the 18 RT-PCR positive, symptomatic subjects, anti-N seroprevalence was 33.3% (95% CI: 14.8%-56.3%). CONCLUSION SARS-CoV-2 seroprevalence in Milan is low, and in a downward trend after only 60-63 days since the peak of diagnoses. Italian confinement measures were effective, but the risk of contagion remains concrete. In hospital-settings, the performance of molecular and serological screenings upon admission remains highly advisable.
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Affiliation(s)
- Valeria Cento
- Chemical-Clinical and Microbiological Analyses, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Claudia Alteri
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Marco Merli
- Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Federica Di Ruscio
- Chemical-Clinical and Microbiological Analyses, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Residency in Microbiology and Virology, Università degli Studi di Milano, Milan, Italy
| | - Livia Tartaglione
- Chemical-Clinical and Microbiological Analyses, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Residency in Microbiology and Virology, Università degli Studi di Milano, Milan, Italy
| | - Roberto Rossotti
- Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Giovanna Travi
- Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Marta Vecchi
- Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Alessandro Raimondi
- Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Alice Nava
- Chemical-Clinical and Microbiological Analyses, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Luna Colagrossi
- Residency in Microbiology and Virology, Università degli Studi di Milano, Milan, Italy
| | - Roberto Fumagalli
- Department of Anesthesiology, Critical Care and Pain Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Nicola Ughi
- Rheumatology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Diana Fanti
- Chemical-Clinical and Microbiological Analyses, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Andrea Beretta
- Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Filippo Galbiati
- Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Francesco Scaglione
- Chemical-Clinical and Microbiological Analyses, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Chiara Vismara
- Chemical-Clinical and Microbiological Analyses, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Massimo Puoti
- Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Daniela Campisi
- Chemical-Clinical and Microbiological Analyses, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Carlo Federico Perno
- Chemical-Clinical and Microbiological Analyses, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
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120
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Santos-Hövener C, Neuhauser HK, Rosario AS, Busch M, Schlaud M, Hoffmann R, Gößwald A, Koschollek C, Hoebel J, Allen J, Haack-Erdmann A, Brockmann S, Ziese T, Nitsche A, Michel J, Haller S, Wilking H, Hamouda O, Corman VM, Drosten C, Schaade L, Wieler LH, Lampert T. Serology- and PCR-based cumulative incidence of SARS-CoV-2 infection in adults in a successfully contained early hotspot (CoMoLo study), Germany, May to June 2020. Euro Surveill 2020; 25:2001752. [PMID: 33243353 PMCID: PMC7693167 DOI: 10.2807/1560-7917.es.2020.25.47.2001752] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 11/25/2020] [Indexed: 11/20/2022] Open
Abstract
Three months after a coronavirus disease (COVID-19) outbreak in Kupferzell, Germany, a population-based study (n = 2,203) found no RT-PCR-positives. IgG-ELISA seropositivity with positive virus neutralisation tests was 7.7% (95% confidence interval (CI): 6.5-9.1) and 4.3% with negative neutralisation tests. We estimate 12.0% (95% CI: 10.4-14.0%) infected adults (24.5% asymptomatic), six times more than notified. Full hotspot containment confirms the effectiveness of prompt protection measures. However, 88% naïve adults are still at high COVID-19 risk.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Stefan Brockmann
- Department of Health Protection and Epidemiology, Baden-Wuerttemberg State Health Office, Stuttgart, Germany
| | | | | | | | | | | | | | - Victor M Corman
- National Consultant Laboratory for Coronaviruses, Berlin Institute of Virology, Charité - Universitätsmedizin, Berlin, Germany
- German Centre for Infection Research (DZIF), Berlin, Germany
| | - Christian Drosten
- National Consultant Laboratory for Coronaviruses, Berlin Institute of Virology, Charité - Universitätsmedizin, Berlin, Germany
- German Centre for Infection Research (DZIF), Berlin, Germany
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121
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Calcagno A, Ghisetti V, Emanuele T, Trunfio M, Faraoni S, Boglione L, Burdino E, Audagnotto S, Lipani F, Nigra M, D'Avolio A, Bonora S, Di Perri G. Risk for SARS-CoV-2 Infection in Healthcare Workers, Turin, Italy. Emerg Infect Dis 2020; 27. [PMID: 33021927 PMCID: PMC7774556 DOI: 10.3201/eid2701.203027] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
We measured severe acute respiratory syndrome coronavirus 2 spike protein subunits S1/S2 antibodies by using capillary electrophoresis and a chemiluminescence immunoassay for 5,444 active healthcare workers in Italy. Seroprevalence was 6.9% and higher among participants having contact with patients. Seroconversion was not observed in 37/213 previously infected participants.
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122
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Lumley SF, Eyre DW, McNaughton AL, Howarth A, Hoosdally S, Hatch SB, Kavanagh J, Chau KK, Downs LO, Cox S, Dunn L, Justice A, Wareing S, Dingle K, Rudkin J, Auckland K, Fyfe A, Bolton J, Paton R, Mentzer AJ, Jeffery K, Andersson MI, James T, Peto TEA, Marsden BD, Screaton G, Cornall RJ, Klenerman P, Ebner D, Stuart DI, Crook DW, Stoesser N, Kennedy SH, Thompson C, Gupta S, Matthews PC. SARS-CoV-2 antibody prevalence, titres and neutralising activity in an antenatal cohort, United Kingdom, 14 April to 15 June 2020. Euro Surveill 2020; 25:2001721. [PMID: 33094717 PMCID: PMC7651878 DOI: 10.2807/1560-7917.es.2020.25.41.2001721] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 10/22/2020] [Indexed: 12/29/2022] Open
Abstract
SARS-CoV-2 IgG screening of 1,000 antenatal serum samples in the Oxford area, United Kingdom, between 14 April and 15 June 2020, yielded a 5.3% seroprevalence, mirroring contemporaneous regional data. Among the 53 positive samples, 39 showed in vitro neutralisation activity, correlating with IgG titre (Pearson's correlation p<0.0001). While SARS-CoV-2 seroprevalence in pregnancy cohorts could potentially inform population surveillance, clinical correlates of infection and immunity in pregnancy, and antenatal epidemiology evolution over time need further study.
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Affiliation(s)
- Sheila F Lumley
- Nuffield Department of Medicine, University of Oxford, Medawar Building, South Parks Road, Oxford, United Kingdom
- Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- These authors contributed equally to this work
| | - David W Eyre
- Nuffield Department of Medicine, University of Oxford, Medawar Building, South Parks Road, Oxford, United Kingdom
- Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- These authors contributed equally to this work
- Nuffield Department of Population Health, University of Oxford, Big Data Institute, Old Road Campus, Oxford, United Kingdom
| | - Anna L McNaughton
- Nuffield Department of Medicine, University of Oxford, Medawar Building, South Parks Road, Oxford, United Kingdom
- These authors contributed equally to this work
| | - Alison Howarth
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, United Kingdom
| | - Sarah Hoosdally
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, United Kingdom
| | - Stephanie B Hatch
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Big Data Institute, Old Road Campus, Oxford, United Kingdom
| | - James Kavanagh
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, United Kingdom
| | - Kevin K Chau
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, United Kingdom
| | - Louise O Downs
- Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
| | - Stuart Cox
- Department of Clinical Biochemistry, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
| | - Laura Dunn
- Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
| | - Anita Justice
- Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
| | - Susan Wareing
- Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
| | - Kate Dingle
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, United Kingdom
| | - Justine Rudkin
- Nuffield Department of Population Health, University of Oxford, Big Data Institute, Old Road Campus, Oxford, United Kingdom
| | - Kathryn Auckland
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, United Kingdom
| | - Alexander Fyfe
- Department of Zoology, University of Oxford, Medawar Building, South Parks Road, Oxford, United Kingdom
| | - Jai Bolton
- Department of Zoology, University of Oxford, Medawar Building, South Parks Road, Oxford, United Kingdom
| | - Robert Paton
- Department of Zoology, University of Oxford, Medawar Building, South Parks Road, Oxford, United Kingdom
| | - Alexander J Mentzer
- Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, United Kingdom
| | - Katie Jeffery
- Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
| | - Monique I Andersson
- Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
| | - Tim James
- Department of Clinical Biochemistry, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
| | - Tim E A Peto
- Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, United Kingdom
| | - Brian D Marsden
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford, United Kingdom
- The Division of Structural Biology, Nuffield Department of Medicine, University of Oxford, The Henry Wellcome Building, Roosevelt Dr, Headington, Oxford, United Kingdom
- Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Old Road Campus, Roosevelt Drive, Headington, Oxford, United Kingdom
| | - Gavin Screaton
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, Roosevelt Drive, Headington, Oxford, United Kingdom
| | - Richard J Cornall
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, Roosevelt Drive, Headington, Oxford, United Kingdom
| | - Paul Klenerman
- Nuffield Department of Medicine, University of Oxford, Medawar Building, South Parks Road, Oxford, United Kingdom
- Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, United Kingdom
| | - Daniel Ebner
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Big Data Institute, Old Road Campus, Oxford, United Kingdom
| | - David I Stuart
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford, United Kingdom
- The Division of Structural Biology, Nuffield Department of Medicine, University of Oxford, The Henry Wellcome Building, Roosevelt Dr, Headington, Oxford, United Kingdom
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Big Data Institute, Old Road Campus, Oxford, United Kingdom
| | - Derrick W Crook
- Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, United Kingdom
| | - Nicole Stoesser
- Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, United Kingdom
| | - Stephen H Kennedy
- Nuffield Department of Women's & Reproductive Health, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Craig Thompson
- Department of Zoology, University of Oxford, Medawar Building, South Parks Road, Oxford, United Kingdom
| | - Sunetra Gupta
- Department of Zoology, University of Oxford, Medawar Building, South Parks Road, Oxford, United Kingdom
| | - Philippa C Matthews
- Nuffield Department of Medicine, University of Oxford, Medawar Building, South Parks Road, Oxford, United Kingdom
- Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- These authors contributed equally to this work
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, United Kingdom
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123
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Tsitsilonis OE, Paraskevis D, Lianidou E, Pierros V, Akalestos A, Kastritis E, Moutsatsou P, Scorilas A, Sphicopoulos T, Terpos E, Thomaidis N, Tsakris A, Voulgaris N, Daskalaki CC, Evangelakou Z, Fouki C, Gianniou DD, Gumeni S, Kostaki EG, Kostopoulos IV, Manola MS, Orologas-Stavrou N, Panteli C, Papanagnou ED, Rousakis P, Sklirou AD, Smilkou S, Stergiopoulou D, Trougakos IP, Tsiodras S, Sfikakis PP, Dimopoulos MA. Seroprevalence of Antibodies against SARS-CoV-2 among the Personnel and Students of the National and Kapodistrian University of Athens, Greece: A Preliminary Report. Life (Basel) 2020; 10:E214. [PMID: 32967110 PMCID: PMC7555935 DOI: 10.3390/life10090214] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 01/19/2023] Open
Abstract
Due to early implementation of public health measures, Greece had low number of SARS-CoV-2 infections and COVID-19 severe incidents in hospitalized patients. The National and Kapodistrian University of Athens (ΝΚUA), especially its health-care/medical personnel, has been actively involved in the first line of state responses to COVID-19. To estimate the prevalence of antibodies (Igs) against SARS-CoV-2 among NKUA members, we designed a five consecutive monthly serosurvey among randomly selected NKUA consenting volunteers. Here, we present the results from the first 2500 plasma samples collected during June-July 2020. Twenty-five donors were tested positive for anti-SARS-CoV-2 Igs; thus, the overall seroprevalence was 1.00%. The weighted overall seroprevalence was 0.93% (95% CI: 0.27, 2.09) and varied between males [1.05% (95% CI: 0.18, 2.92)] and females [0.84% (95% CI: 0.13, 2.49)], age-groups and different categories (higher in participants from the School of Health Sciences and in scientific affiliates/faculty members/laboratory assistants), but no statistical differences were detected. Although focused on the specific population of NKUA members, our study shows that the prevalence of anti-SARS-CoV-2 Igs for the period June-July 2020 remained low and provides knowledge of public health importance for the NKUA members. Given that approximately one in three infections was asymptomatic, continuous monitoring of the progression of the pandemic by assessing Ig seroprevalence is needed.
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Affiliation(s)
- Ourania E Tsitsilonis
- Department of Biology, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece
| | - Dimitrios Paraskevis
- Department of Hygiene Epidemiology and Medical Statistics, School of Medicine, NKUA, 15772 Athens, Greece
| | - Evi Lianidou
- Department of Chemistry, NKUA, Athens 15771, Greece
| | - Vassilios Pierros
- Department of Informatics and Telecommunications, NKUA, 15784 Athens, Greece
| | | | - Efstathios Kastritis
- Department of Clinical Therapeutics, School of Medicine, Alexandra General Hospital, NKUA, 11528 Athens, Greece
| | - Paraskevi Moutsatsou
- Department of Clinical Biochemistry, School of Medicine, University General Hospital Attikon, NKUA, 12462 Haidari, Greece
| | - Andreas Scorilas
- Department of Biology, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece
| | - Thomas Sphicopoulos
- Department of Informatics and Telecommunications, NKUA, 15784 Athens, Greece
| | - Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, Alexandra General Hospital, NKUA, 11528 Athens, Greece
| | | | | | | | - Christina C Daskalaki
- Department of Biology, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece
| | - Zoi Evangelakou
- Department of Biology, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece
| | - Christina Fouki
- Department of Hygiene Epidemiology and Medical Statistics, School of Medicine, NKUA, 15772 Athens, Greece
| | - Despoina D Gianniou
- Department of Biology, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece
| | - Sentiljana Gumeni
- Department of Biology, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece
| | - Evangelia-Georgia Kostaki
- Department of Hygiene Epidemiology and Medical Statistics, School of Medicine, NKUA, 15772 Athens, Greece
| | - Ioannis V Kostopoulos
- Department of Biology, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece
| | - Maria S Manola
- Department of Biology, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece
| | | | - Chrysanthi Panteli
- Department of Biology, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece
| | - Eleni-Dimitra Papanagnou
- Department of Biology, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece
| | - Pantelis Rousakis
- Department of Biology, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece
| | - Aimilia D Sklirou
- Department of Biology, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece
| | | | | | - Ioannis P Trougakos
- Department of Biology, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece
| | - Soritios Tsiodras
- Fourth Department of Propedeutic Internal Medicine, School of Medicine, University General Hospital Attikon, NKUA, 12462 Haidari, Greece
| | - Petros P Sfikakis
- First Department of Propaedeutic Internal Medicine, School of Medicine, Laiko General Hospital, NKUA, 15772 Athens, Greece
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124
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Petti S, Cowling BJ. Ecologic association between influenza and COVID-19 mortality rates in European countries. Epidemiol Infect 2020; 148:e209. [PMID: 32912363 PMCID: PMC7506171 DOI: 10.1017/s0950268820002125] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/12/2020] [Accepted: 09/08/2020] [Indexed: 12/12/2022] Open
Abstract
Ecologic studies investigating COVID-19 mortality determinants, used to make predictions and design public health control measures, generally focused on population-based variable counterparts of individual-based risk factors. Influenza is not causally associated with COVID-19, but shares population-based determinants, such as similar incidence/mortality trends, transmission patterns, efficacy of non-pharmaceutical interventions, comorbidities and underdiagnosis. We investigated the ecologic association between influenza mortality rates and COVID-19 mortality rates in the European context. We considered the 3-year average influenza (2014-2016) and COVID-19 (31 May 2020) crude mortality rates in 34 countries using EUROSTAT and ECDC databases and performed correlation and regression analyses. The two variables - log transformed, showed significant Spearman's correlation ρ = 0.439 (P = 0.01), and regression coefficients, b = 0.743 (95% confidence interval, 0.272-1.214; R2 = 0.244; P = 0.003), b = 0.472 (95% confidence interval, 0.067-0.878; R2 = 0.549; P = 0.02), unadjusted and adjusted for confounders (population size and cardiovascular disease mortality), respectively. Common significant determinants of both COVID-19 and influenza mortality rates were life expectancy, influenza vaccination in the elderly (direct associations), number of hospital beds per population unit and crude cardiovascular disease mortality rate (inverse associations). This analysis suggests that influenza mortality rates were independently associated with COVID-19 mortality rates in Europe, with implications for public health preparedness, and implies preliminary undetected SARS-CoV-2 spread in Europe.
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Affiliation(s)
- S. Petti
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - B. J. Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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125
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da Silva SJR, Silva CTAD, Guarines KM, Mendes RPG, Pardee K, Kohl A, Pena L. Clinical and Laboratory Diagnosis of SARS-CoV-2, the Virus Causing COVID-19. ACS Infect Dis 2020; 6:2319-2336. [PMID: 32786280 PMCID: PMC7441751 DOI: 10.1021/acsinfecdis.0c00274] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Indexed: 01/08/2023]
Abstract
In December 2019, a novel beta (β) coronavirus eventually named SARS-CoV-2 emerged in Wuhan, Hubei province, China, causing an outbreak of severe and even fatal pneumonia in humans. The virus has spread very rapidly to many countries across the world, resulting in the World Health Organization (WHO) to declare a pandemic on March 11, 2020. Clinically, the diagnosis of this unprecedented illness, called coronavirus disease-2019 (COVID-19), becomes difficult because it shares many symptoms with other respiratory pathogens, including influenza and parainfluenza viruses. Therefore, laboratory diagnosis is crucial for the clinical management of patients and the implementation of disease control strategies to contain SARS-CoV-2 at clinical and population level. Here, we summarize the main clinical and imaging findings of COVID-19 patients and discuss the advances, features, advantages, and limitations of different laboratory methods used for SARS-CoV-2 diagnosis.
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Affiliation(s)
| | - Caroline Targino Alves da Silva
- Department of Virology, Aggeu
Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz),
50670-420, Recife, Pernambuco, Brazil
| | - Klarissa Miranda Guarines
- Department of Virology, Aggeu
Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz),
50670-420, Recife, Pernambuco, Brazil
| | - Renata Pessôa Germano Mendes
- Department of Virology, Aggeu
Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz),
50670-420, Recife, Pernambuco, Brazil
| | - Keith Pardee
- Leslie Dan Faculty of Pharmacy,
University of Toronto, Toronto, ON M5S 3M2,
Canada
| | - Alain Kohl
- MRC-University of Glasgow Centre for Virus
Research, Glasgow, Scotland G61 1QH, U.K.
| | - Lindomar Pena
- Department of Virology, Aggeu
Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz),
50670-420, Recife, Pernambuco, Brazil
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126
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Nardone M, Cordone A, Petti S. Occupational COVID-19 risk to dental staff working in a public dental unit in the outbreak epicenter. Oral Dis 2020; 28 Suppl 1:878-890. [PMID: 32881190 DOI: 10.1111/odi.13632] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 08/14/2020] [Accepted: 08/27/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The management of the COVID-19 outbreak occurred in Lombardy (Italy) implied that non-COVID-19 health care was remodeled, limiting adequate resources in non-hospital public dental healthcare settings. This situation offered the opportunity to investigate the occupational COVID-19 risk to dental staff in public non-hospital dental units. METHODS An infection control protocol was designed for dental health care in the Territorial Health and Social Services Authority (ASST) "Melegnano and Martesana" (Milan). Since specific guidance from central authorities was lacking, information was gathered from international public health organizations. The probability to visit asymptomatic COVID-19-infected patients was estimated, and the occupational risk to dental staff was calculated. RESULTS The probability to visit asymptomatic patients passed from 1.2% (95% confidence interval -95 CI, 0.6%-2.5%) in the first period (20 February-15 March 2020) to 11.1% (95 CI, 5.8%-23.6%) in the second period (16 March-30 April). Dentists and dental assistants did not develop COVID-19, while one nurse did, the nature of her occupational risk was unclear, as nurses provided prevalently non-dental health care. The probabilities of developing COVID-19 per worked hour per person excluding and including this uncertain situation were 0.0% (95 CI, 0.0%-3.2%) and 0.9% (95 CI, 0.1%-4.7%). CONCLUSION Relatively simple infection control procedures were enough to control occupational COVID-19 risk during the outbreak.
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Affiliation(s)
- Michele Nardone
- Territorial Health and Social Services Authority (ASST) "Melegnano and Martesana", Milan, Italy
| | - Angelo Cordone
- Territorial Health and Social Services Authority (ASST) "Melegnano and Martesana", Milan, Italy
| | - Stefano Petti
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
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Vena A, Berruti M, Adessi A, Blumetti P, Brignole M, Colognato R, Gaggioli G, Giacobbe DR, Bracci-Laudiero L, Magnasco L, Signori A, Taramasso L, Varelli M, Vendola N, Ball L, Robba C, Battaglini D, Brunetti I, Pelosi P, Bassetti M. Prevalence of Antibodies to SARS-CoV-2 in Italian Adults and Associated Risk Factors. J Clin Med 2020; 9:jcm9092780. [PMID: 32867328 PMCID: PMC7563864 DOI: 10.3390/jcm9092780] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/08/2020] [Accepted: 08/18/2020] [Indexed: 01/25/2023] Open
Abstract
We aimed to assess the prevalence of and factors associated with anti- severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) positivity in a large population of adult volunteers from five administrative departments of the Liguria and Lombardia regions. A total of 3609 individuals were included in this analysis. Participants were tested for anti-SARS-CoV-2 antibodies [Immunoglobulin G (IgG) and M (IgM) class antibodies] at three private laboratories (Istituto Diganostico Varelli, Medical Center, and Casa della Salute di Genova). Demographic data, occupational or private exposure to SARS-CoV-2-infected patients, and prior medical history consistent with SARS-CoV-2 infection were collected according to a preplanned analysis. The overall seroprevalence of anti-SARS-CoV-2 antibodies (IgG and/or IgM) was 11.0% [398/3609; confidence interval (CI) 10.0%–12.1%]. Seroprevalence was higher in female inmates than in male inmates (12.5% vs. 9.2%, respectively, p = 0.002), with the highest rate observed among adults aged >55 years (13.2%). A generalized estimating equations model showed that the main risk factors associated with SARS-CoV-2 seroprevalence were the following: an occupational exposure to the virus [Odd ratio (OR) = 2.36; 95% CI 1.59–3.50, p = 0.001], being a long-term care facility resident (OR = 4.53; 95% CI 3.19–6.45, p = 0.001), and reporting previous symptoms of influenza-like illness (OR = 4.86; 95% CI 3.75–6.30, p = 0.001) or loss of sense of smell or taste (OR = 41.00; 95% CI 18.94–88.71, p = 0.001). In conclusion, we found a high prevalence (11.0%) of SARS-CoV-2 infection that is significantly associated with residing in long-term care facilities or occupational exposure to the virus. These findings warrant further investigation into SARS-CoV-2 antibody prevalence among the Italian population.
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Affiliation(s)
- Antonio Vena
- Infectious Diseases Unit, San Martino Policlinico Hospital—IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.V.); (M.B.); (D.R.G.); (L.M.); (L.T.)
| | - Marco Berruti
- Infectious Diseases Unit, San Martino Policlinico Hospital—IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.V.); (M.B.); (D.R.G.); (L.M.); (L.T.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy
| | | | - Pietro Blumetti
- Medical Center srl, Sesto Calende, 21018 Varese, Italy; (P.B.); (R.C.)
| | - Michele Brignole
- Department of Cardiology, Arrhytmology Centre and Syncope Unit, Ospedale del Tigullio, 16033 Lavagna, Italy;
- IRCCS Istituto Auxologico Italiano, Faint and Fall Programme, Ospedale San Luca, 20149 Milano, Italy
| | - Renato Colognato
- Medical Center srl, Sesto Calende, 21018 Varese, Italy; (P.B.); (R.C.)
| | - Germano Gaggioli
- Division of Cardiology, Ospedale Villa Scassi, 16149 Genova, Italy;
| | - Daniele Roberto Giacobbe
- Infectious Diseases Unit, San Martino Policlinico Hospital—IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.V.); (M.B.); (D.R.G.); (L.M.); (L.T.)
| | - Luisa Bracci-Laudiero
- Institute of Translational Pharmacology, Consiglio Nazionale Delle Ricerche (CNR), 00185 Rome, Italy;
- Division of Rheumatology and Immuno-Rheumatology Research Laboratories, Bambino Gesù Children’s Hospital, 00165 Rome, Italy
| | - Laura Magnasco
- Infectious Diseases Unit, San Martino Policlinico Hospital—IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.V.); (M.B.); (D.R.G.); (L.M.); (L.T.)
| | - Alessio Signori
- Section of Biostatistics, Department of Health Sciences, University of Genova, 16132 Genova, Italy;
| | - Lucia Taramasso
- Infectious Diseases Unit, San Martino Policlinico Hospital—IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.V.); (M.B.); (D.R.G.); (L.M.); (L.T.)
| | - Marco Varelli
- Diagnostic Institute Varelli, Clinical Analysis, 80126 Napoli, Italy;
| | - Nicoletta Vendola
- Division of Obstetrics and Gynecology, Sant’Andrea Hospital, 13100 Vercelli, Italy;
| | - Lorenzo Ball
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (L.B.); (P.P.)
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (C.R.); (D.B.); (I.B.)
| | - Chiara Robba
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (C.R.); (D.B.); (I.B.)
| | - Denise Battaglini
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (C.R.); (D.B.); (I.B.)
| | - Iole Brunetti
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (C.R.); (D.B.); (I.B.)
| | - Paolo Pelosi
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (L.B.); (P.P.)
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (C.R.); (D.B.); (I.B.)
| | - Matteo Bassetti
- Infectious Diseases Unit, San Martino Policlinico Hospital—IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.V.); (M.B.); (D.R.G.); (L.M.); (L.T.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy
- Correspondence: ; Tel.: +39-010-555-4658; Fax: +39-010-555-6712
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128
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Clinical and Analytical Performance of an Automated Serological Test That Identifies S1/S2-Neutralizing IgG in COVID-19 Patients Semiquantitatively. J Clin Microbiol 2020; 58:JCM.01224-20. [PMID: 32580948 PMCID: PMC7448652 DOI: 10.1128/jcm.01224-20] [Citation(s) in RCA: 123] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 06/22/2020] [Indexed: 12/21/2022] Open
Abstract
In the coronavirus (CoV) disease 2019 (COVID-19) pandemic, highly selective serological testing is essential to define exposure to severe acute respiratory syndrome CoV 2 (SARS-CoV-2). Many tests have been developed, yet with variable speeds to first results, and are of unknown quality, particularly when considering the prediction of neutralizing capacity. The LIAISON SARS-CoV-2 S1/S2 IgG assay was designed to measure antibodies against the SARS-CoV-2 native S1/S2 proteins in a standardized automated chemiluminescence assay. In the coronavirus (CoV) disease 2019 (COVID-19) pandemic, highly selective serological testing is essential to define exposure to severe acute respiratory syndrome CoV 2 (SARS-CoV-2). Many tests have been developed, yet with variable speeds to first results, and are of unknown quality, particularly when considering the prediction of neutralizing capacity. The LIAISON SARS-CoV-2 S1/S2 IgG assay was designed to measure antibodies against the SARS-CoV-2 native S1/S2 proteins in a standardized automated chemiluminescence assay. The clinical and analytical performances of the test were validated in an observational study using residual samples (>1,500) with a positive or negative COVID-19 diagnosis. The LIAISON SARS-CoV-2 S1/S2 IgG assay proved to be highly selective and specific and offered semiquantitative measures of serum or plasma levels of anti-S1/S2 IgG with neutralizing activity. The assay’s diagnostic sensitivities were 91.3% and 95.7% at >5 or ≥15 days from diagnosis, respectively, and 100% when assessed against a neutralizing assay. The assay’s specificity ranged between 97% and 98.5%. The average imprecision of the assay was a <5% coefficient of variation. Assay performance at 2 different cutoffs was evaluated to optimize predictive values. The automated LIAISON SARS-CoV-2 S1/S2 IgG assay brings efficient, sensitive, specific, and precise serological testing to the laboratory, with the capacity to test large amounts of samples per day; first results are available within 35 min, with a throughput of 170 tests/hour. The semiquantitative results provided by the test also associate with the presence of neutralizing antibodies and may provide a useful tool for the large-scale screening of convalescent-phase plasma for safe therapeutic use.
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129
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Noh JY, Seo YB, Yoon JG, Seong H, Hyun H, Lee J, Lee N, Jung S, Park MJ, Song W, Yoon J, Lim CS, Ryou J, Lee JY, Kim SS, Cheong HJ, Kim WJ, Yoon SY, Song JY. Seroprevalence of Anti-SARS-CoV-2 Antibodies among Outpatients in Southwestern Seoul, Korea. J Korean Med Sci 2020; 35:e311. [PMID: 32830472 PMCID: PMC7445312 DOI: 10.3346/jkms.2020.35.e311] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 08/11/2020] [Indexed: 11/29/2022] Open
Abstract
Serosurveillance studies reveal the actual disease burden and herd immunity level in the population. In Seoul, Korea, a cross-sectional investigation showed 0.07% anti-severe acute respiratory syndrome coronavirus-2 antibody seropositivity among 1,500 outpatients of the university hospitals. Low seroprevalence reflects well-implemented social distancing. Serosurveillance should be repeated as the pandemic progresses.
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Affiliation(s)
- Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yu Bin Seo
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Jin Gu Yoon
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hye Seong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hakjun Hyun
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jacob Lee
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Nuri Lee
- Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Seri Jung
- Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Min Jeong Park
- Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Wonkeun Song
- Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Jung Yoon
- Department of Laboratory Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chae Seung Lim
- Department of Laboratory Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jungsang Ryou
- Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Joo Yeon Lee
- Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Sung Soon Kim
- Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Soo Young Yoon
- Department of Laboratory Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
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130
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Neutralizing Antibody Production in Asymptomatic and Mild COVID-19 Patients, in Comparison with Pneumonic COVID-19 Patients. J Clin Med 2020; 9:jcm9072268. [PMID: 32708872 PMCID: PMC7408950 DOI: 10.3390/jcm9072268] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/13/2020] [Accepted: 07/15/2020] [Indexed: 12/28/2022] Open
Abstract
Objectives: To investigate antibody production in asymptomatic and mild COVID-19 patients. Methods: Sera from asymptomatic to severe COVID-19 patients were collected. Microneutralization (MN), fluorescence immunoassay (FIA), and enzyme-linked immunosorbent assay (ELISA) were performed. Results: A total of 70 laboratory-confirmed COVID-19 patients were evaluated, including 15 asymptomatic/anosmia, 49 mild symptomatic, and 6 pneumonia patients. The production of the neutralizing antibody was observed in 100% of pneumonia, 93.9% of mild symptomatic, and 80.0% of asymptomatic/anosmia groups. All the patients in the pneumonia group showed high MN titer (≥1:80), while 36.7% of mild symptomatic and 20.0% of asymptomatic/anosmia groups showed high titer (p < 0.001). Anti-SARS-CoV-2 antibodies could be more sensitively detected by FIA IgG (98.8%) and ELISA (97.6%) in overall. For the FIA IgG test, all patients in the pneumonia group exhibited a high COI value (≥15.0), while 89.8% of mild symptomatic and 73.3% of asymptomatic/anosmia groups showed a high value (p = 0.049). For the ELISA test, all patients in the pneumonia group showed a high optical density (OD) ratio (≥3.0), while 65.3% of mild symptomatic and 53.3% of asymptomatic/anosmia groups showed a high ratio (p = 0.006). Conclusions: Most asymptomatic and mild COVID-19 patients produced the neutralizing antibody, although the titers were lower than pneumonia patients. ELISA and FIA sensitively detected anti-SARS-CoV-2 antibodies.
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131
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Benazzo M, Cassaniti I, Maiorano E, Calastri A, Novazzi F, Bonetti A, Sarasini A, Bruno R, Baldanti F. SARS-CoV-2 Virologic and Immunologic Correlates in Patients with Olfactory and Taste Disorders. Microorganisms 2020; 8:E1052. [PMID: 32679910 PMCID: PMC7409064 DOI: 10.3390/microorganisms8071052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/09/2020] [Accepted: 07/14/2020] [Indexed: 12/21/2022] Open
Abstract
The main object of the study was to investigate the SARS-CoV-2 molecular and serological pattern in patients with mild symptoms including anosmia and ageusia. A cohort of 69 patients with olfactory and taste disorders (OTDs) were enrolled and prospectively monitored. Serological and molecular assays for the characterization of SARS-CoV-2 IgG and SARS-CoV-2 RNA, respectively, were performed at the time of enrolment and after 7 and 14 days. Patients were stratified according to the symptoms' onset. A total of 52 patients (75.4%) were diagnosed as COVID-19 positive being SARS-CoV-2 RNA and/or SARS-CoV-2 IgG positive. The remaining 17 (24.6%) were negative for COVID-19 and excluded from the analysis. We reported that only 34 out of 52 patients (65.4%) were positive for SARS-CoV-2 RNA. Moreover, the median time from onset of symptoms and enrolment was significantly higher in those patients with negative SARS-CoV-2 RNA in nasal swabs, suggesting that symptoms might last longer than SARS-CoV-2 replication. The great majority of patients (80%) developed SARS-CoV-2 IgG at three weeks after symptoms' onset while the detectability of SARS-CoV-2 RNA dramatically decreased over time, suggesting the crucial role of combination of molecular and serological assays for the diagnosis of COVID-19 in those patients reporting mild symptoms.
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Affiliation(s)
- Marco Benazzo
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (M.B.); (E.M.); (A.C.)
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Irene Cassaniti
- Molecular Virology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (I.C.); (F.N.); (A.B.); (A.S.)
| | - Eugenia Maiorano
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (M.B.); (E.M.); (A.C.)
| | - Anna Calastri
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (M.B.); (E.M.); (A.C.)
| | - Federica Novazzi
- Molecular Virology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (I.C.); (F.N.); (A.B.); (A.S.)
| | - Alice Bonetti
- Molecular Virology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (I.C.); (F.N.); (A.B.); (A.S.)
| | - Antonella Sarasini
- Molecular Virology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (I.C.); (F.N.); (A.B.); (A.S.)
| | - Raffaele Bruno
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
- Infectious Diseases Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Fausto Baldanti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
- Molecular Virology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (I.C.); (F.N.); (A.B.); (A.S.)
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Cassaniti I, Percivalle E, Sarasini A, Cambiè G, Batisti Biffignandi G, Cereda D, Baldanti F. Authors' response: COVID-19: how accurate are seroprevalence studies? Euro Surveill 2020; 25:2001437. [PMID: 32734854 PMCID: PMC7393854 DOI: 10.2807/1560-7917.es.2020.25.30.2001437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 07/29/2020] [Indexed: 11/20/2022] Open
Affiliation(s)
- Irene Cassaniti
- Molecular Virology Unit, Microbiology and Virology Department, IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Elena Percivalle
- Molecular Virology Unit, Microbiology and Virology Department, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Antonella Sarasini
- Molecular Virology Unit, Microbiology and Virology Department, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giuseppe Cambiè
- Immunohematology and Transfusion Medicine Unit, Ospedale Maggiore di Lodi, Lodi, Italy
| | | | - Danilo Cereda
- Lombardy Region, Directorate General for Health, UO Prevenzione, Milan, Italy
| | - Fausto Baldanti
- Molecular Virology Unit, Microbiology and Virology Department, IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
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133
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Kadkhoda K. Letter to the editor: COVID-19: how accurate are seroprevalence studies? Euro Surveill 2020; 25:2001374. [PMID: 32734860 PMCID: PMC7393853 DOI: 10.2807/1560-7917.es.2020.25.30.2001374] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 07/28/2020] [Indexed: 11/20/2022] Open
Affiliation(s)
- Kamran Kadkhoda
- Immunopathology Laboratory, Robert J. Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, United States
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134
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Fischer B, Knabbe C, Vollmer T. SARS-CoV-2 IgG seroprevalence in blood donors located in three different federal states, Germany, March to June 2020. Euro Surveill 2020; 25:2001285. [PMID: 32700672 PMCID: PMC7376847 DOI: 10.2807/1560-7917.es.2020.25.28.2001285] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 07/14/2020] [Indexed: 01/05/2023] Open
Abstract
Most cases of coronavirus disease 2019 are mild or asymptomatic. Therefore, many cases remain unrecorded. We determined seroprevalence of IgG antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 3,186 regular blood donors in three German federal states between 9 March and 3 June 2020. The IgG seroprevalence was 0.91% (95% confidence interval (CI): 0.58-1.24) overall, ranging from 0.66% (95% CI: 0.13-1.19) in Hesse to 1.22% (95% CI: 0.33-2.10) in Lower-Saxony.
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Affiliation(s)
- Bastian Fischer
- Herz- und Diabeteszentrum NRW, Institut für Laboratoriums- und Transfusionsmedizin, Bad Oeynhausen, Germany
| | - Cornelius Knabbe
- Herz- und Diabeteszentrum NRW, Institut für Laboratoriums- und Transfusionsmedizin, Bad Oeynhausen, Germany
| | - Tanja Vollmer
- Herz- und Diabeteszentrum NRW, Institut für Laboratoriums- und Transfusionsmedizin, Bad Oeynhausen, Germany
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