151
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Vilallonga R, Pellino G, Almirante B, Domínguez González JM, Blanco-Colino R, Petrola C, Armengol M. A Risk-Based Screening Approach to Patients Needing Surgery During the De-Escalation Phase of COVID-19 Pandemic. Surg Innov 2020; 28:239-244. [PMID: 33345708 PMCID: PMC8722680 DOI: 10.1177/1553350620975886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Since the outbreak of COVID-19 pandemic, many national and international surgical
societies have produced guidelines regarding the management of surgical
patients. During the mitigation phase of the pandemic, most documents suggested
to consider postponing elective procedures, unless this might have impacted the
life expectancy of patients. As awareness and knowledge about COVID-19 are
gradually increasing, and as we enter a phase when surgical services are
resuming their activities, surgical strategies have to adapt to this rapidly
evolving scenario. This is particularly relevant when considering screening
policies and the associated findings. We herein describe a risk-based approach
to the management of patients with surgical diseases, which might be useful in
order to limit the risks for healthcare workers and patients, while allowing for
resuming elective surgical practice safely.
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Affiliation(s)
- Ramon Vilallonga
- Endocrine, Bariatric and Metabolic Unit, Universitary Hospital Vall d'Hebron, Spain
| | | | - Benito Almirante
- Infectious diseases Department, Universitary Hospital Vall d'Hebron, Spain
| | | | | | - Carlos Petrola
- General Surgery Department, Universitary Hospital Vall d'Hebron, Spain
| | - Manel Armengol
- General Surgery Department, Universitary Hospital Vall d'Hebron, Spain
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152
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Galipeau Y, Greig M, Liu G, Driedger M, Langlois MA. Humoral Responses and Serological Assays in SARS-CoV-2 Infections. Front Immunol 2020; 11:610688. [PMID: 33391281 PMCID: PMC7775512 DOI: 10.3389/fimmu.2020.610688] [Citation(s) in RCA: 168] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 11/23/2020] [Indexed: 12/14/2022] Open
Abstract
In December 2019, the novel betacoronavirus Severe Acute Respiratory Disease Coronavirus 2 (SARS-CoV-2) was first detected in Wuhan, China. SARS-CoV-2 has since become a pandemic virus resulting in hundreds of thousands of deaths and deep socioeconomic implications worldwide. In recent months, efforts have been directed towards detecting, tracking, and better understanding human humoral responses to SARS-CoV-2 infection. It has become critical to develop robust and reliable serological assays to characterize the abundance, neutralization efficiency, and duration of antibodies in virus-exposed individuals. Here we review the latest knowledge on humoral immune responses to SARS-CoV-2 infection, along with the benefits and limitations of currently available commercial and laboratory-based serological assays. We also highlight important serological considerations, such as antibody expression levels, stability and neutralization dynamics, as well as cross-reactivity and possible immunological back-boosting by seasonal coronaviruses. The ability to accurately detect, measure and characterize the various antibodies specific to SARS-CoV-2 is necessary for vaccine development, manage risk and exposure for healthcare and at-risk workers, and for monitoring reinfections with genetic variants and new strains of the virus. Having a thorough understanding of the benefits and cautions of standardized serological testing at a community level remains critically important in the design and implementation of future vaccination campaigns, epidemiological models of immunity, and public health measures that rely heavily on up-to-date knowledge of transmission dynamics.
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Affiliation(s)
- Yannick Galipeau
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Matthew Greig
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - George Liu
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | | | - Marc-André Langlois
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
- uOttawa Center for Infection, Immunity and Inflammation (CI3), Ottawa, ON, Canada
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153
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Akinshina YA, Mardanly SS, Kiseleva VA. Immunochromatographic test for differentiation detection of IgM and IgG to SARS-CoV-2. Klin Lab Diagn 2020; 65:688-692. [PMID: 33301658 DOI: 10.18821/0869-2084-2020-65-11-688-692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The study presents the results of the creation and evaluation of the diagnostic characteristics of the rapid immunochromatographic test for the qualitative detection and differentiation of IgM/IgG antibodies to SARS-CoV-2 in human serum, plasma, and whole blood "ИХА-COVID-19-IgM / IgG". Have been tested some samples without antibodies to SARS-CoV-2 and a samples with two and one type of specific antibodies. The coincidence of the results of immunochromatographic analysis with the results of the immunochemiluminescent method was 87.2%. Test kit can be use as the rapid diagnostic test in the context of the COVID-19 pandemic and to assess the immune status of convalescents.
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154
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Tan AS, Nerurkar SN, Tan WCC, Goh D, Lai CPT, Poh Sheng Yeong J. The Virological, Immunological, and Imaging Approaches for COVID-19 Diagnosis and Research. SLAS Technol 2020; 25:522-544. [PMID: 32808850 PMCID: PMC7435207 DOI: 10.1177/2472630320950248] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/03/2020] [Accepted: 07/25/2020] [Indexed: 12/12/2022]
Abstract
In 2019, a novel coronavirus (SARS-CoV-2) was found to cause a highly contagious disease characterized by pneumonia. The disease (COVID-19) quickly spread around the globe, escalating to a global pandemic. In this review, we discuss the virological, immunological, and imaging approaches harnessed for COVID-19 diagnosis and research. COVID-19 shares many clinical characteristics with other respiratory illnesses.Accurate and early detection of the infection is pivotal to controlling the outbreak, as this enables case identification, isolation, and contact tracing. We summarize the available literature on current laboratory and point-of-care diagnostics, highlight their strengths and limitations, and describe the emerging diagnostic approaches on the horizon.We also discuss the various research techniques that are being used to evaluate host immunity in laboratory-confirmed patients. Additionally, pathological imaging of tissue samples from affected patients has a critical role in guiding investigations on this disease. Conventional techniques, such as immunohistochemistry and immunofluorescence, have been frequently used to characterize the immune microenvironment in COVID-19. We also outline the emerging imaging techniques, such as the RNAscope, which might also aid in our understanding of the significance of COVID-19-specific biomarkers, such as the angiotensin-converting enzyme 2 (ACE2) cellular receptor.Overall, great progress has been made in COVID-19 research in a short period. Extensive, global collation of our current knowledge of SARS-CoV-2 will provide insights into novel treatment modalities, such as monoclonal antibodies, and support the development of a SARS-CoV-2 vaccine.
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Affiliation(s)
- An Sen Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | | | - Wei Chang Colin Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Denise Goh
- Institute of Molecular Cell Biology (IMCB), Agency of Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Chi Peng Timothy Lai
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Joe Poh Sheng Yeong
- Institute of Molecular Cell Biology (IMCB), Agency of Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore
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155
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SARS-CoV-2 in children: spectrum of disease, transmission and immunopathological underpinnings. Pathology 2020; 52:801-808. [PMID: 32888706 PMCID: PMC7437539 DOI: 10.1016/j.pathol.2020.08.001] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/05/2020] [Accepted: 08/10/2020] [Indexed: 02/08/2023]
Abstract
As the SARS-CoV-2 pandemic unfolds across the globe, consistent themes are emerging with regard to aspects of SARS-CoV-2 infection and its associated disease entities in children. Overall, children appear to be less frequently infected by, and affected by, SARS-CoV-2 virus and the clinical disease COVID-19. Large epidemiological studies have revealed children represent less than 2% of the total confirmed COVID-19 cases, of whom the majority experience minimal or mild disease that do not require hospitalisation. Children do not appear to be major drivers of SARS-CoV-2 transmission, with minimal secondary virus transmission demonstrated within families, schools and community settings. There are several postulated theories regarding the relatively low SARS-CoV-2 morbidity and mortality seen in children, which largely relate to differences in immune responses compared to adults, as well as differences in angiotensin converting enzyme 2 distribution that potentially limits viral entry and subsequent inflammation, hypoxia and tissue injury. The recent emergence of a multisystem inflammatory syndrome bearing temporal and serological plausibility for an immune-mediated SARS-CoV-2-related disease entity is currently under investigation. This article summarises the current available data regarding SARS-CoV-2 and the paediatric population, including the spectrum of disease in children, the role of children in virus transmission, and host-virus factors that underpin the unique aspects of SARS-CoV-2 pathogenicity in children.
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156
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Dubey AK, Singh A, Prakash S, Kumar M, Singh AK. Race to arsenal COVID-19 therapeutics: Current alarming status and future directions. Chem Biol Interact 2020; 332:109298. [PMID: 33121920 PMCID: PMC7588316 DOI: 10.1016/j.cbi.2020.109298] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/16/2020] [Accepted: 10/21/2020] [Indexed: 01/08/2023]
Abstract
The on-going pandemic of COVID-19 wreaked by a viral infection of SARS-CoV-2, has generated a catastrophic plight across the globe. Interestingly, one of the hallmarks of COVID-19 is the so-called 'cytokine storm' due to attack of SARS-Cov-2 in the lungs. Considering, mesenchymal stem cells (MSCs) therapy could contribute against SARS-CoV-2 viruses attack because of their immune modulatory and anti-inflammatory ability linked to their stemness, to the arsenal of treatments for COVID-19. Another novel therapeutic strategies include the blockade of rampant generation of pro-inflammatory mediators like acute respiratory distress syndrome (ARDS), degradation of viral protein capsids by PROTACs, composed of Ubiquitin-proteasome framework, and ubiquitination-independent pathway directing the SARS-CoV-2 nucleocapsid protein (nCoV N) and proteasome activator (PA28γ), etc. This review is consequently an endeavour to highlight the several aspects of COVID-19 with incorporation of important treatment strategies discovered to date and putting the real effort on the future directions to put them into the perspective.
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Affiliation(s)
- Ankit Kumar Dubey
- Department of Biotechnology, Indian Institute of Technology Madras, Tamil Nadu, 600036, India
| | - Aakansha Singh
- CSIR-Central Drug Research Institute, Lucknow, 226014, India
| | - Shardendu Prakash
- Department of Pharmacy, Sardar Patel College of Pharmacy, Gorakhpur, 273013, India
| | - Manoj Kumar
- Department of Microbiology, SGPGIMS, Lucknow, 226014, India
| | - Ashok K Singh
- Pennsylvania State University, Penn State College of Medicine, Hershey, PA, 17033, USA.
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157
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Aran D, Beachler DC, Lanes S, Overhage JM. Prior presumed coronavirus infection reduces COVID-19 risk: A cohort study. J Infect 2020; 81:923-930. [PMID: 33127456 PMCID: PMC7590640 DOI: 10.1016/j.jinf.2020.10.023] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 10/25/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Immunological cross-reactivity between common cold coronaviruses (CCC) and SARS-CoV-2 might account for the reduced incidence of COVID-19 in children. Evidence to support speculation includes in vitro evidence for humoral and cellular cross-reactivity with SARS-CoV-2 in specimens obtained before the pandemic started. METHOD We used retrospective health insurance enrollment records, claims, and laboratory results to assemble a cohort of 869,236 insured individuals who had a PCR test for SARS-CoV-2. We estimated the effects of having clinical encounters for various diagnostic categories in the year preceding the study period on the risk of a positive test result. FINDINGS After adjusting for age, gender and care seeking behavior, we identified that individuals with diagnoses for common cold symptoms, including acute sinusitis, bronchitis, or pharyngitis in the preceding year had a lower risk of testing positive for SARS-CoV-2 (OR=0.76, 95%CI=0.75, 0.77). No reduction in the odds of a positive test for SARS-CoV-2 was seen in individuals under 18 years. The reduction in odds in adults remained stable for four years but was strongest in those with recent common cold symptoms. INTERPRETATION While this study cannot attribute this association to cross-immunity resulting from a prior CCC infection, it is one potential explanation. Regardless of the cause, the reduction in the odds of being infected by SARS-CoV-2 among those with a recent diagnosis of common cold symptoms may have a role in shifting future COVD-19 infection patterns from endemic to episodic.
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Affiliation(s)
- Dvir Aran
- Faculty of Biology, Technion-Israel Institute of Technology, Haifa, Israel; Department of Computer Science, Technion-Israel Institute of Technology, Haifa, Israel; Lorry I. Lokey Interdisciplinary Center for Life Sciences & Engineering, Technion-Israel Institute of Technology, Haifa, Israel; Anthem AI, Anthem Inc. Palo Alto, USA.
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158
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Zhu N, Wong PK. Advances in Viral Diagnostic Technologies for Combating COVID-19 and Future Pandemics. SLAS Technol 2020; 25:513-521. [PMID: 32833548 PMCID: PMC8960186 DOI: 10.1177/2472630320953798] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/17/2020] [Accepted: 08/08/2020] [Indexed: 12/26/2022]
Abstract
The emergence of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) threatens the health of the global population and challenges our preparedness for pandemic threats. Previous outbreaks of coronaviruses and other viruses have suggested the importance of diagnostic technologies in fighting viral outbreaks. Nucleic acid detection techniques are the gold standard for detecting SARS-CoV-2. Viral antigen tests and serological tests that detect host antibodies have also been developed for studying the epidemiology of COVID-19 and estimating the population that may have immunity to SARS-CoV-2. Nevertheless, the availability, cost, and performance of existing viral diagnostic technologies limit their practicality, and novel approaches are required for improving our readiness for global pandemics. Here, we review the principles and limitations of major viral diagnostic technologies and highlight recent advances of molecular assays for COVID-19. In addition, we discuss emerging technologies, such as clustered regularly interspaced short palindromic repeats (CRISPR) systems, high-throughput sequencing, and single-cell and single-molecule analysis, for improving our ability to understand, trace, and contain viral outbreaks. The prospects of viral diagnostic technologies for combating future pandemic threats are presented.
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Affiliation(s)
- Ninghao Zhu
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, USA
| | - Pak Kin Wong
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, USA
- Department of Mechanical Engineering and Department of Surgery, The Pennsylvania State University, University Park, PA, USA
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159
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Lim RRX, Bonanni A. The potential of electrochemistry for the detection of coronavirus-induced infections. Trends Analyt Chem 2020; 133:116081. [PMID: 33518851 PMCID: PMC7836945 DOI: 10.1016/j.trac.2020.116081] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Human coronaviruses (HCoV) are no stranger to the global environment. The etiology of previous outbreaks with reported symptoms of respiratory tract infections was attributed to different coronavirus strains, with the latest global pandemic in 2019 also belonging to the coronavirus family. Timely detection, effective therapeutics and future prevention are stake key holders in the management of coronavirus-induced infections. Apart from the gold standard clinical diagnostics, electrochemical techniques have also demonstrated their great potentials in the detection of different viruses and their correlated antibodies and antigens, showing high sensitivities and selectivities, and faster times for the analysis. This article aims to critically review the multifaceted electrochemical approaches, not only in the development of point-of-care portable devices but also as alternative detection strategies that can be coupled with traditional methods for the detection of various strains of coronaviruses.
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Affiliation(s)
- Rachel Rui Xia Lim
- Division of Chemistry & Biological Chemistry, School of Physical and Mathematical Sciences, Nanyang Technological University, Singapore, 637371, Singapore
| | - Alessandra Bonanni
- Division of Chemistry & Biological Chemistry, School of Physical and Mathematical Sciences, Nanyang Technological University, Singapore, 637371, Singapore
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160
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Alpdagtas S, Ilhan E, Uysal E, Sengor M, Ustundag CB, Gunduz O. Evaluation of current diagnostic methods for COVID-19. APL Bioeng 2020; 4:041506. [PMID: 33305162 PMCID: PMC7710383 DOI: 10.1063/5.0021554] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/23/2020] [Indexed: 12/15/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the agent responsible for the coronavirus disease of 2019 (COVID-19), which triggers lung failure, pneumonia, and multi-organ dysfunction. This enveloped, positive sense and single-stranded RNA virus can be transmitted through aerosol droplets, direct and indirect contacts. Thus, SARS-CoV-2 is highly contagious and has reached a pandemic level in a few months. Since COVID-19 has caused numerous human casualties and severe economic loss posing a global threat, the development of readily available, accurate, fast, and cost-effective diagnostic techniques in hospitals and in any places where humans spread the virus is urgently required. COVID-19 can be diagnosed by clinical findings and several laboratory tests. These tests may include virus isolation, nucleic acid-based molecular assays like real-time polymerase chain reactions, antigen or antibody-based immunological assays such as rapid immunochromatographic tests, enzyme-linked immunosorbent assays, immunofluorescence techniques, and indirect fluorescent antibody techniques, electrochemical sensors, etc. However, current methods should be developed by novel approaches for sensitive, specific, and accurate diagnosis of COVID-19 cases to control and prevent this outbreak. Thus, this review will cover an overview and comparison of multiple reports and commercially available kits that include molecular tests, immunoassays, and sensor-based diagnostic methods for diagnosis of COVID-19. The pros and cons of these methods and future perspectives will be thoroughly evaluated and discussed.
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161
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Wendel S, Kutner JM, Machado R, Fontão‐Wendel R, Bub C, Fachini R, Yokoyama A, Candelaria G, Sakashita A, Achkar R, Hamerschlak N, Scuracchio P, Amaral M, Dal Ben M, Araujo D, Soares C, Camargo A, Kallás E, Durigon E, Reis LF, Rizzo LV. Screening for SARS-CoV-2 antibodies in convalescent plasma in Brazil: Preliminary lessons from a voluntary convalescent donor program. Transfusion 2020; 60:2938-2951. [PMID: 32935877 PMCID: PMC7756544 DOI: 10.1111/trf.16065] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/02/2020] [Accepted: 08/02/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) collection began in two Brazilian hospitals for treatment of severe/critical patients. METHODS AND MATERIALS Mild/moderate COVID-19 convalescents were selected as CCP donors after reverse transcription polymerase chain reaction (RT-PCR) confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and absence of symptoms for ≥14 days plus (a) age (18-60 years), body weight greater than 55 kg; (b) immunohematological studies; (c) no infectious markers of hepatitis B virus, hepatitis C virus, human immunodeficiency virus, human T-lymphotropic virus-1/2, Chagas and syphilis infection; (d) no HLA antibodies (multiparous); (e) second RT-PCR (nasopharyngeal swab and/or blood) negativity; (f) virus neutralization test (cytopathic effect-based virus neutralization test neutralizing antibody) and anti-nucleocapsid protein SARS-CoV-2 IgM, IgG, and IgA enzyme-linked immunosorbent assays. RESULTS Among 271 donors (41 females, 230 males), 250 presented with neutralizing antibodies. Final RT-PCR was negative on swab (77.0%) or blood (88.4%; P = .46). Final definition of RT-PCR was only defined at more than 28 days after full recovery in 59 of 174 (33.9%) RT-PCR -ve, and 25/69 RT-PCR +ve (36.2%; 13 between 35 and 48 days). Neutralizing antibody titers of 160 or greater were found in 63.6%. Correlation between IgG signal/cutoff of 5.0 or greater and neutralizing antibody of 160 or greater was 82.4%. Combination of final RT-PCR -ve with neutralizing antibody ≥160 was 41.3% (112/271). Serial plasma collection showed decline in neutralizing antibody titers and IgA levels (P < .05), probably denoting a "golden period" for CCP collection (≤28 days after joining the program); IgA might have an important role as neutralizing antibody. Donor's weight, days between disease onset and serial plasma collection, and IgG and IgM levels are important predictors for neutralizing antibody titer. CONCLUSIONS RT-PCR +ve cases are still detected in 36.2% within 28 to 48 days after recovery. High anti-nucleocapsid protein IgG levels may be used as a surrogate marker to neutralizing antibody.
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Affiliation(s)
| | | | - Rafael Machado
- Department of MicrobiologyInstitute of Biomedical Sciences, University of Sao PauloSão PauloBrazil
| | | | - Carolina Bub
- Hospital Israelita Albert Einstein Blood BankSão PauloBrazil
| | | | - Ana Yokoyama
- Hospital Israelita Albert Einstein Blood BankSão PauloBrazil
| | | | - Araci Sakashita
- Hospital Israelita Albert Einstein Blood BankSão PauloBrazil
| | - Ruth Achkar
- Hospital Sírio‐Libanês Blood BankSão PauloBrazil
| | | | | | | | | | - Danielle Araujo
- Department of MicrobiologyInstitute of Biomedical Sciences, University of Sao PauloSão PauloBrazil
| | - Camila Soares
- Department of MicrobiologyInstitute of Biomedical Sciences, University of Sao PauloSão PauloBrazil
| | | | - Esper Kallás
- Infectious Disease DepartmentUniversity of São Paulo Medical SchoolSão PauloBrazil
| | - Edison Durigon
- Department of MicrobiologyInstitute of Biomedical Sciences, University of Sao PauloSão PauloBrazil
| | | | - Luiz Vicente Rizzo
- Albert Einstein Jewish Institute for Education and ResearchSão PauloBrazil
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162
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Pecora ND, Zand MS. Measuring the Serologic Response to Severe Acute Respiratory Syndrome Coronavirus 2: Methods and Meaning. Clin Lab Med 2020; 40:603-614. [PMID: 33121625 PMCID: PMC7414299 DOI: 10.1016/j.cll.2020.08.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The entire spectrum of diagnostic testing, from reagent supply to test performance, has been a major focus during the coronavirus disease 2019 (COVID-19) pandemic. The hope for serologic testing is that it will provide both epidemiologic information about seroprevalence as well as individual information about previous infection. This information is particularly helpful for high-risk individuals who may be outside of the viral shedding window, such as children with suspected multisystem inflammatory syndrome. It is not yet understood whether serologic testing can be interpreted in terms of protective immunity. These concerns must be addressed using highly sensitive and specific tests.
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Affiliation(s)
| | - Martin S Zand
- Department of Medicine, Nephrology (SMD), Clinical & Translational Science Institute, Clinical Research University of Rochester Medical Center, School of Medicine and Dentistry, 601 Elmwood Avenue, Box 675, Rochester, NY 14642, USA
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163
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Torres Viñas VR, Fernández Sarmiento J, Mulett Hoyos H, Acevedo Sedano L, Vásquez Hoyos P, Sarmiento MP, Pardo R, Fernández Laverde M, Piñeres Olave B, López Alarcón Y, Tamayo C, Jaramillo Bustamante JC, Lasso R, Agudelo MT, Orozco Marún R, Mazzilli Vega L, Zemanate Zúñiga E, Nieto Estrada VH. Declaración consenso de la Asociación Colombiana de Medicina Crítica y Cuidados Intensivos (AMCI) para atención y manejo del paciente pediátrico con sospecha o confirmación de infección severa por SARS-CoV-2. ACTA COLOMBIANA DE CUIDADO INTENSIVO 2020. [PMCID: PMC7538131 DOI: 10.1016/j.acci.2020.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Una nueva pandemia fue declarada por la Organización Mundial de la Salud por el virus SARS-CoV-2 recientemente. Este virus se caracteriza por ser altamente transmisible, letal y afectar a todos los grupos etarios. Esta declaración permitió la activación en todos los países de mecanismos de urgencia para atender esta crisis de salud pública que ha expuesto las debilidades de los sistemas de salud y el déficit de camas de cuidado intensivo adulto (UCIA) y pediátrico (UCIP). Colombia tiene un número reducido de camas de UCIP con respecto a otros países de medianos y bajos ingresos. Por esta razón, debemos optimizar los recursos, anticiparse a los casos graves y conocer el comportamiento de la enfermedad por el virus del SARS-CoV-2 (llamada COVID-19) en pediatría, especialmente en las formas severas de presentación en niños. La severidad y grado de afectación por el virus en todos los países ha sido muy similar con una mayor gravedad y frecuencia de infección en la población adulta, particularmente en personas mayores de 60 años y con comorbilidades (obesidad, hipertensión, diabetes, entre otros). No obstante, también se ha registrado en la población pediátrica casos graves que requieren intervenciones avanzadas en terapia intensiva, incluyendo una forma de presentación con gran respuesta inflamatoria en niños denominada síndrome inflamatorio multisistémico (MIS-C por sus siglas en inglés). La Asociación Colombiana de Medicina crítica y Cuidados Intensivos (AMCI) convocó un equipo multidisciplinario de expertos en medicina crítica pediátrica para establecer una declaratoria de consenso de buena práctica clínica para la atención de niños con COVID-19 grave que requieran atención en cuidado intermedio o cuidado intensivo pediátrico. El objetivo de esta declaración de consenso es facilitar y estandarizar la toma de decisiones en los aspectos más relevantes en la atención y realizar un abordaje integral del paciente pediátrico basado en la mejor evidencia disponible y opinión de expertos en cuidado intensivo pediátrico de al menos 10 años de experiencia de trabajo en el área. Adicionalmente, se buscó involucrar a aquellos intensivistas pediatras que deben hacer atención directa de los niños con COVID-19, pertenecen a hospitales de referencia o universitarios y tienen demostrada trayectoria en investigación y docencia en cuidado crítico pediátrico. Esta declaración de consenso se buscará actualizar con la frecuencia que sea necesaria de acuerdo con el cambio de la mejor evidencia disponible, que les permita a los médicos que atienden niños críticos con COVID-19 realizar una atención integral y adecuada acorde con la mejor literatura disponible.
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Stevanovic V, Vilibic-Cavlek T, Tabain I, Benvin I, Kovac S, Hruskar Z, Mauric M, Milasincic L, Antolasic L, Skrinjaric A, Staresina V, Barbic L. Seroprevalence of SARS-CoV-2 infection among pet animals in Croatia and potential public health impact. Transbound Emerg Dis 2020; 68:1767-1773. [PMID: 33191649 PMCID: PMC7753394 DOI: 10.1111/tbed.13924] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 10/23/2020] [Accepted: 11/09/2020] [Indexed: 12/24/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in late 2019 and has since caused a global pandemic. Experimental studies and sporadic reports have confirmed susceptibility of dogs and cats to SARS-CoV-2 infection. However, the importance of pet animals in the epidemiology of this infection is unclear. This study reports on a first large-scale serosurvey of SARS-CoV-2 infections in dogs and cats in Europe. From 26 February 2020, just one day after the first confirmed human case of SARS-CoV-2 infection in Croatia, to 15 June 2020, dog and cat serum samples were collected from animals admitted to three veterinary facilities in Croatia. Additionally, on 25 May 2020, a total of 122 serum samples from employees of the Faculty of Veterinary Medicine University of Zagreb were collected. Total of 656 dogs and 131 cat serum samples were tested using an in-house microneutralisation test (MNT). Human serum samples, as well as 172 randomly selected, dog sera were tested using enzyme-linked immunosorbent assay (ELISA). ELISA-positive human sera were subsequently tested using MNT. Neutralising antibodies were confirmed in 0.76% cats and 0.31% dogs. ELISA reactivity was recorded in 7.56% tested dog sera. On the other hand, 5.19% of administrative, basic and pre-clinical sciences department personnel and 5.13% of animal health service providers and laboratory personnel tested ELISA positive. Neutralising antibodies were not confirmed in any of the human samples. In conclusion, seropositivity among pet animals in Croatia is low, especially when compared to results from China. A small number of seropositive animals with a low titre of neutralising antibodies suggest infections are rare and are following infections in the human population. Additionally, contact with animals does not seem to be an occupational risk for veterinary practitioners.
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Affiliation(s)
- Vladimir Stevanovic
- Virology Unit, Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Tatjana Vilibic-Cavlek
- Department of Virology, Croatian Institute of Public Health, Zagreb, Croatia.,School for Medicine, University of Zagreb, Zagreb, Croatia
| | - Irena Tabain
- Department of Virology, Croatian Institute of Public Health, Zagreb, Croatia
| | - Iva Benvin
- Virology Unit, Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Snjezana Kovac
- Virology Unit, Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Zeljka Hruskar
- Department of Virology, Croatian Institute of Public Health, Zagreb, Croatia
| | - Maja Mauric
- Department for Animal Breeding and Livestock Production, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Ljiljana Milasincic
- Department of Virology, Croatian Institute of Public Health, Zagreb, Croatia
| | - Ljiljana Antolasic
- Department of Virology, Croatian Institute of Public Health, Zagreb, Croatia
| | - Alenka Skrinjaric
- Virology Unit, Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Vilim Staresina
- Virology Unit, Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Ljubo Barbic
- Virology Unit, Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
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165
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Drouot L, Hantz S, Jouen F, Velay A, Lamia B, Veber B, Sibilia J, Lotellier M, Candon S, Alain S, Fafi-Kremer S, Boyer O. Evaluation of Humoral Immunity to SARS-CoV-2: Diagnostic Value of a New Multiplex Addressable Laser Bead Immunoassay. Front Microbiol 2020; 11:603931. [PMID: 33324387 PMCID: PMC7726470 DOI: 10.3389/fmicb.2020.603931] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/26/2020] [Indexed: 12/17/2022] Open
Abstract
Despite efforts to develop anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody (Ab) immunoassays, reliable serological methods are still needed. We developed a multiplex addressable laser bead immunoassay (ALBIA) to detect and quantify anti-Spike S1 and nucleocapsid N Abs. Recombinant S1 and N proteins were bound to fluorescent beads (ALBIA-IgG-S1/N). Abs were revealed using class-specific anti-human Ig Abs. The performances of the test were analyzed on 575 serum samples including 192 from SARS-CoV-2 polymerase chain reaction-confirmed patients, 13 from seasonal coronaviruses, 70 from different inflammatory/autoimmune diseases, and 300 from healthy donors. Anti-S1 IgM were detected by monoplex ALBIA-IgM-S1. Comparison with chemiluminescent assays or enzyme-linked immunosorbent assays was performed using commercial tests. Multiplex ALBIA-IgG-S1/N was effective in detecting and quantifying anti-SARS-CoV-2 IgG Abs. Two weeks after first symptoms, sensitivity and specificity were 97.7 and 98.0% (anti-S1), and 100 and 98.7% (anti-N), respectively. Agreement with commercial tests was good to excellent, with a higher sensitivity of ALBIA. ALBIA-IgG-S1/N was positive in 53% of patients up to day 7, and in 75% between days 7 and 13. For ALBIA-IgM-S1, sensitivity and specificity were 74.4 and 98.7%, respectively. Patients in intensive care units had higher IgG Ab levels (Mann-Whitney test, p < 0.05). ALBIA provides a robust method for exploring humoral immunity to SARS-CoV-2. Serology should be performed after 2 weeks following first symptoms, when all COVID-19 (coronavirus disease 2019) patients had at least one anti-S1 or anti-N IgG Ab, illustrating the interest of a multiplex test.
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Affiliation(s)
- Laurent Drouot
- Normandie University, UNIROUEN, INSERM, U1234, Rouen, France
| | - Sébastien Hantz
- Limoges University Hospital, National Reference Center for Herpesviruses, Limoges, France
| | - Fabienne Jouen
- Normandie University, UNIROUEN, INSERM, U1234, Rouen, France.,Rouen University Hospital, Department of Immunology, Rouen, France
| | - Aurélie Velay
- Strasbourg University Hospital, Institute of Virology, Strasbourg, France
| | - Bouchra Lamia
- Pulmonology Department, Le Havre Hospital, Montivilliers, France
| | - Benoit Veber
- Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France
| | - Jean Sibilia
- Department of Rheumatology, Strasbourg University Hospital, Strasbourg, France
| | | | - Sophie Candon
- Normandie University, UNIROUEN, INSERM, U1234, Rouen, France.,Rouen University Hospital, Department of Immunology, Rouen, France
| | - Sophie Alain
- Limoges University Hospital, National Reference Center for Herpesviruses, Limoges, France
| | - Samira Fafi-Kremer
- Strasbourg University Hospital, Institute of Virology, Strasbourg, France
| | - Olivier Boyer
- Normandie University, UNIROUEN, INSERM, U1234, Rouen, France.,Rouen University Hospital, Department of Immunology, Rouen, France
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166
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Stowell SR, Guarner J. Role of Serology in the Coronavirus Disease 2019 Pandemic. Clin Infect Dis 2020; 71:1935-1936. [PMID: 32357206 PMCID: PMC7197618 DOI: 10.1093/cid/ciaa510] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/29/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Sean R Stowell
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jeannette Guarner
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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167
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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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168
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Huyghe E, Jansens H, Matheeussen V, Hoffbauer I, Goossens H, Peeters B. Performance of three automated SARS-CoV-2 antibody assays and relevance of orthogonal testing algorithms. Clin Chem Lab Med 2020; 59:411-419. [PMID: 33554506 DOI: 10.1515/cclm-2020-1378] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/03/2020] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Development and implementation of SARS-CoV-2 serologic assays gained momentum. Laboratories keep on investigating the performance of these assays. In this study, we compared three fully automated SARS-CoV-2 antibody assays. METHODS A total of 186 samples from 84 PCR-positive COVID-19 patients and 120 control samples taken before the SARS-CoV-2 pandemic were analyzed using commercial serologic assays from Roche, Siemens and DiaSorin. Time after the positive COVID-19 PCR result and onset of symptoms was retrieved from the medical record. An extended golden standard, using the result of all three assays was defined, judging if antibodies are present or absent in a sample. Diagnostic and screening sensitivity/specificity and positive/negative predictive value were calculated. RESULTS Diagnostic sensitivity (ability to detect a COVID-19 positive patient) ≥14 days after positive PCR testing was 96.7% (95% CI 88.5-99.6%) for DiaSorin, 93.3% (95% CI 83.8-98.2%) for Roche and 100% (95% CI 94.0-100%) for Siemens. Lower diagnostic sensitivities were observed <14 days after onset of symptoms for all three assay. Diagnostic specificity (ability to detect a COVID-19 negative patient) was 95.0% (95% CI 89.4-98.1%) for DiaSorin, 99.2% (95% CI 95.4-99.9%) for Roche and 100% (95% CI 97.0-100%) for Siemens. The sensitivity/specificity for detecting antibodies (ability of detecting absence (specificity) or presence (sensitivity) of COVID-19 antibodies) was 92.4% (95% CI 86.4-96.3%)/94.9% (95% CI 90.5-97.6%) for DiaSorin, 97.7% (95% CI 93.5-99.5%)/97.1% (95% CI 93.5-99.1%) for Roche and 98.5% (95% CI 94.6-99.8)/97.1 (95% CI 93.5-99.1%) for Siemens. CONCLUSIONS This study revealed acceptable performance for all three assays. An orthogonal testing algorithm using the Siemens and Roche assay achieved the highest positive predictive values for antibody detection in low seroprevalence settings.
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Affiliation(s)
- Evelyne Huyghe
- Department of Laboratory Medicine, University Hospital Antwerpen, Antwerpen, Belgium
| | - Hilde Jansens
- Department of Laboratory Medicine, University Hospital Antwerpen, Antwerpen, Belgium
| | - Veerle Matheeussen
- Department of Laboratory Medicine, University Hospital Antwerpen, Antwerpen, Belgium
| | - Ilse Hoffbauer
- Department of Laboratory Medicine, University Hospital Antwerpen, Antwerpen, Belgium
| | - Herman Goossens
- Department of Laboratory Medicine, University Hospital Antwerpen, Antwerpen, Belgium
| | - Bart Peeters
- Department of Laboratory Medicine, University Hospital Antwerpen, Antwerpen, Belgium
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169
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Infection fatality rate of SARS-CoV2 in a super-spreading event in Germany. Nat Commun 2020; 11:5829. [PMID: 33203887 PMCID: PMC7672059 DOI: 10.1038/s41467-020-19509-y] [Citation(s) in RCA: 145] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 10/14/2020] [Indexed: 12/18/2022] Open
Abstract
A SARS-CoV2 super-spreading event occurred during carnival in a small town in Germany. Due to the rapidly imposed lockdown and its relatively closed community, this town was seen as an ideal model to investigate the infection fatality rate (IFR). Here, a 7-day seroepidemiological observational study was performed to collect information and biomaterials from a random, household-based study population. The number of infections was determined by IgG analyses and PCR testing. We found that of the 919 individuals with evaluable infection status, 15.5% (95% CI:[12.3%; 19.0%]) were infected. This is a fivefold higher rate than the reported cases for this community (3.1%). 22.2% of all infected individuals were asymptomatic. The estimated IFR was 0.36% (95% CI:[0.29%; 0.45%]) for the community and 0.35% [0.28%; 0.45%] when age-standardized to the population of the community. Participation in carnival increased both infection rate (21.3% versus 9.5%, p < 0.001) and number of symptoms (estimated relative mean increase 1.6, p = 0.007). While the infection rate here is not representative for Germany, the IFR is useful to estimate the consequences of the pandemic in places with similar healthcare systems and population characteristics. Whether the super-spreading event not only increases the infection rate but also affects the IFR requires further investigation.
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170
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Coste AT, Jaton K, Papadimitriou-Olivgeris M, Greub G, Croxatto A. Comparison of SARS-CoV-2 serological tests with different antigen targets. J Clin Virol 2020; 134:104690. [PMID: 33253926 PMCID: PMC7670982 DOI: 10.1016/j.jcv.2020.104690] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 11/10/2020] [Indexed: 12/17/2022]
Abstract
Background These last months, dozens of SARS-CoV-2 serological tests have become available with varying performances. A major effort was completed to compare 17 serological tests available in April 2020 in Switzerland. Methods In a preliminary phase, we compared 17 IgG, IgM, IgA and pan Ig serological tests including ELISA, LFA, CLIA and ECLIA on a panel of 182 sera, comprising 113 sera from hospitalized patients with a positive RT-PCR, and 69 sampled before 1st November 2019, expected to give a positive and negative results, respectively. In a second phase, the five best performing and most available tests were further evaluated on a total of 582 sera (178 and 404 expected positive and negative, respectively), allowing the assessment of 20 possible cross-reactions with other viruses. Results In the preliminary phase, among eight IgG/pan-Ig ELISA or CLIA/ECLIA tests, five had a sensitivity and specificity above 90 % and 98 % respectively, and on six IgM/IgA tests, only one was acceptable. Only one LFA test on three showed good performances for both IgG and IgM. For all the tests IgM and IgG aroused concomitantly. In the second phase, no test showed particular cross-reaction. We observed an important heterogeneity in the development of the antibody response. Conclusions The majority of the evaluated tests exhibited high performances of IgG/pan-Ig sensitivity and specificity to detect the serological response of moderately to critically ill hospitalized patients. The IgM and IgA tests showed mostly insufficient performances with no added value for the early diagnostic on the cohort tested in this study.
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Affiliation(s)
- Alix T Coste
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - Katia Jaton
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Matthaios Papadimitriou-Olivgeris
- Service of Hospital Preventive Medicine, Lausanne University Hospital, Switzerland; Service of Infectious Diseases, Lausanne University Hospital, Switzerland
| | - Gilbert Greub
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Antony Croxatto
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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171
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Streeck H, Schulte B, Kümmerer BM, Richter E, Höller T, Fuhrmann C, Bartok E, Dolscheid-Pommerich R, Berger M, Wessendorf L, Eschbach-Bludau M, Kellings A, Schwaiger A, Coenen M, Hoffmann P, Stoffel-Wagner B, Nöthen MM, Eis-Hübinger AM, Exner M, Schmithausen RM, Schmid M, Hartmann G. Infection fatality rate of SARS-CoV2 in a super-spreading event in Germany. Nat Commun 2020; 11:5829. [PMID: 33203887 DOI: 10.1101/2020.05.04.20090076] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 10/14/2020] [Indexed: 05/20/2023] Open
Abstract
A SARS-CoV2 super-spreading event occurred during carnival in a small town in Germany. Due to the rapidly imposed lockdown and its relatively closed community, this town was seen as an ideal model to investigate the infection fatality rate (IFR). Here, a 7-day seroepidemiological observational study was performed to collect information and biomaterials from a random, household-based study population. The number of infections was determined by IgG analyses and PCR testing. We found that of the 919 individuals with evaluable infection status, 15.5% (95% CI:[12.3%; 19.0%]) were infected. This is a fivefold higher rate than the reported cases for this community (3.1%). 22.2% of all infected individuals were asymptomatic. The estimated IFR was 0.36% (95% CI:[0.29%; 0.45%]) for the community and 0.35% [0.28%; 0.45%] when age-standardized to the population of the community. Participation in carnival increased both infection rate (21.3% versus 9.5%, p < 0.001) and number of symptoms (estimated relative mean increase 1.6, p = 0.007). While the infection rate here is not representative for Germany, the IFR is useful to estimate the consequences of the pandemic in places with similar healthcare systems and population characteristics. Whether the super-spreading event not only increases the infection rate but also affects the IFR requires further investigation.
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Affiliation(s)
- Hendrik Streeck
- Institute of Virology, University Hospital, University of Bonn, Bonn, Germany.
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Braunschweig, Germany.
| | - Bianca Schulte
- Institute of Virology, University Hospital, University of Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Braunschweig, Germany
| | - Beate M Kümmerer
- Institute of Virology, University Hospital, University of Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Braunschweig, Germany
| | - Enrico Richter
- Institute of Virology, University Hospital, University of Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Braunschweig, Germany
| | - Tobias Höller
- Clinical Study Core Unit, Study Center Bonn (SZB), University Hospital, University of Bonn, Bonn, Germany
| | - Christine Fuhrmann
- Clinical Study Core Unit, Study Center Bonn (SZB), University Hospital, University of Bonn, Bonn, Germany
| | - Eva Bartok
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Braunschweig, Germany
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital, University of Bonn, Bonn, Germany
| | - Ramona Dolscheid-Pommerich
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Braunschweig, Germany
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital, University of Bonn, Bonn, Germany
| | - Moritz Berger
- Institute for Medical Biometry, Informatics and Epidemiology, University Hospital, University of Bonn, Bonn, Germany
| | - Lukas Wessendorf
- Institute of Virology, University Hospital, University of Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Braunschweig, Germany
| | - Monika Eschbach-Bludau
- Institute of Virology, University Hospital, University of Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Braunschweig, Germany
| | - Angelika Kellings
- Clinical Study Core Unit, Study Center Bonn (SZB), University Hospital, University of Bonn, Bonn, Germany
| | - Astrid Schwaiger
- Biobank Core Unit, University Hospital, University of Bonn, Bonn, Germany
| | - Martin Coenen
- Clinical Study Core Unit, Study Center Bonn (SZB), University Hospital, University of Bonn, Bonn, Germany
| | - Per Hoffmann
- Institute of Human Genetics, University Hospital, University of Bonn, Bonn, Germany
| | - Birgit Stoffel-Wagner
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Braunschweig, Germany
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital, University of Bonn, Bonn, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University Hospital, University of Bonn, Bonn, Germany
| | - Anna M Eis-Hübinger
- Institute of Virology, University Hospital, University of Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Braunschweig, Germany
| | - Martin Exner
- Institute for Hygiene and Public Health, University Hospital, University of Bonn, Bonn, Germany
| | | | - Matthias Schmid
- Institute for Medical Biometry, Informatics and Epidemiology, University Hospital, University of Bonn, Bonn, Germany
| | - Gunther Hartmann
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Braunschweig, Germany.
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital, University of Bonn, Bonn, Germany.
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172
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Slot E, Hogema BM, Reusken CBEM, Reimerink JH, Molier M, Karregat JHM, IJlst J, Novotný VMJ, van Lier RAW, Zaaijer HL. Low SARS-CoV-2 seroprevalence in blood donors in the early COVID-19 epidemic in the Netherlands. Nat Commun 2020; 11:5744. [PMID: 33184284 PMCID: PMC7665189 DOI: 10.1038/s41467-020-19481-7] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/14/2020] [Indexed: 12/19/2022] Open
Abstract
The world is combating an ongoing COVID-19 pandemic with health-care systems, society and economies impacted in an unprecedented way. It is unclear how many people have contracted the causative coronavirus (SARS-CoV-2) unknowingly and are asymptomatic. Therefore, reported COVID-19 cases do not reflect the true scale of outbreak. Here we present the prevalence and distribution of antibodies to SARS-CoV-2 in a healthy adult population of the Netherlands, which is a highly affected country, using a high-performance immunoassay. Our results indicate that one month into the outbreak (i) the seroprevalence in the Netherlands was 2.7% with substantial regional variation, (ii) the hardest-hit areas showed a seroprevalence of up to 9.5%, (iii) the seroprevalence was sex-independent throughout age groups (18-72 years), and (iv) antibodies were significantly more often present in younger people (18-30 years). Our study provides vital information on the extent of exposure to SARS-CoV-2 in a country where social distancing is in place.
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Affiliation(s)
- Ed Slot
- Department of Blood-borne Infections, Sanquin Research, Amsterdam, The Netherlands.
- Department of Medical Affairs, Sanquin Corporate Staff, Amsterdam, The Netherlands.
| | - Boris M Hogema
- Department of Blood-borne Infections, Sanquin Research, Amsterdam, The Netherlands
- Department of Virology, Sanquin Diagnostic Services, Amsterdam, The Netherlands
| | - Chantal B E M Reusken
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Johan H Reimerink
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Michel Molier
- Department of Blood-borne Infections, Sanquin Research, Amsterdam, The Netherlands
| | - Jan H M Karregat
- Department of Donor Studies, Sanquin Research, Amsterdam, The Netherlands
| | - Johan IJlst
- National Screening Laboratory, Sanquin Laboratory Services, Amsterdam, The Netherlands
| | - Věra M J Novotný
- Department of Medical Affairs, Sanquin Blood Bank, Amsterdam, The Netherlands
| | - René A W van Lier
- Landsteiner Laboratory, Sanquin Research, Amsterdam, The Netherlands
- Department of Experimental Immunology, University of Amsterdam, Amsterdam, The Netherlands
| | - Hans L Zaaijer
- Department of Blood-borne Infections, Sanquin Research, Amsterdam, The Netherlands.
- Department of Virology, Sanquin Diagnostic Services, Amsterdam, The Netherlands.
- Department of Medical Microbiology, Amsterdam UMC, Amsterdam, The Netherlands.
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173
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Almaghaslah D, Kandasamy G, Almanasef M, Vasudevan R, Chandramohan S. Review on the coronavirus disease (COVID-19) pandemic: Its outbreak and current status. Int J Clin Pract 2020; 74:e13637. [PMID: 32750190 PMCID: PMC7435532 DOI: 10.1111/ijcp.13637] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/28/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND In late December 2019 and on 1st January 2020, the coronavirus (COVID-19) infecting humans was first identified in Wuhan, Hubei Province, China. Later cases have also been confirmed worldwide. Coronaviruses are RNA viruses that are phenotypically and genotypically diverse. Globally, as of 6th April 2020, laboratory confirmed cases of COVID-19 reported to the World Health Organisation (WHO) amounted to 1 211 214, including 67 666 deaths. AIM In the current study, we performed a literature review on coronavirus outbreak to summarise details about the pathogenesis, epidemiology, diagnosis and the management strategies for the disease control. PATHOGENESIS Coronaviruses are tremendously precise and mature only in differentiated respiratory epithelial cells, as seen in both organ cultures as well as human volunteers. This virus will cause the antiviral T-cell response to be erratic, owing to the T-cell apoptosis activation, triggering the immune system to collapse. TRANSMISSION The understanding of the transmission of COVID-19 risk is incomplete. The transmission mainly occurs through the respiratory droplets once an infected person sneezes, like the spread of flu and other respiratory infectious agents. CLINICAL PRESENTATION Presentations of COVID-19 includes fever, cough, shortness of breath, malaise and respiratory distress. TREATMENT There have been no approved vaccines available for COVID-19 until today. The Ministry of Science and Technology in the People's Republic of China declared three potential antiviral medicines suitable for treating COVID-19. Those three medicines are, namely, favilavir, chloroquine phosphate and remdesivir. Hydroxychloroquine combined with azithromycin enhances the reduction of the viral load in COVID-19 patients. CONCLUSION The corona virus transmits quicker than its two predecessors the MERS-CoV and SARS-CoV, but has reduced casualty. The global effects of this latest pandemic are still unclear. Nevertheless, considering that so far no vaccine has been available; preventive approaches are the best way to fight against the virus.
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Affiliation(s)
- Dalia Almaghaslah
- Department of Clinical PharmacyCollege of PharmacyKing Khalid UniversityAbhaSaudi Arabia
| | - Geetha Kandasamy
- Department of Clinical PharmacyCollege of PharmacyKing Khalid UniversityAbhaSaudi Arabia
| | - Mona Almanasef
- Department of Clinical PharmacyCollege of PharmacyKing Khalid UniversityAbhaSaudi Arabia
| | - Rajalakshimi Vasudevan
- Department of Clinical PharmacyCollege of PharmacyKing Khalid UniversityAbhaSaudi Arabia
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174
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Li C, Zhao C, Bao J, Tang B, Wang Y, Gu B. Laboratory diagnosis of coronavirus disease-2019 (COVID-19). Clin Chim Acta 2020; 510:35-46. [PMID: 32621814 PMCID: PMC7329657 DOI: 10.1016/j.cca.2020.06.045] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/28/2020] [Accepted: 06/29/2020] [Indexed: 02/06/2023]
Abstract
The outbreak of Coronavirus Disease-2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has threatened health worldwide. As of the end of 2020, there were nearly 10 million confirmed cases and nearly 5 million deaths associated with COVID-19. Rapid and early laboratory diagnosis of COVID-19 is the main focus of treatment and control. Molecular tests are the basis for confirmation of COVID-19, but serological tests for SARS-CoV-2 are widely available and play an increasingly important role in understanding the epidemiology of the virus and in identifying populations at higher risk for infection. Point-of-care tests have the advantage of rapid, accurate, portable, low cost and non-specific device requirements, which provide great help for disease diagnosis and detection. This review will discuss the performance of different laboratory diagnostic tests and platforms, as well as suitable clinical samples for testing, and related biosafety protection. This review shall guide for the diagnosis of COVID-19 caused by SARS-CoV-2.
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Affiliation(s)
- Chenxi Li
- Medical Technology School of Xuzhou Medical University, Xuzhou Key Laboratory of Laboratory Diagnostics, Xuzhou 221004, China
| | - Chengxue Zhao
- Medical Technology School of Xuzhou Medical University, Xuzhou Key Laboratory of Laboratory Diagnostics, Xuzhou 221004, China
| | - Jingfeng Bao
- Medical Technology School of Xuzhou Medical University, Xuzhou Key Laboratory of Laboratory Diagnostics, Xuzhou 221004, China
| | - Bo Tang
- Nanjing Vazyme Medical Technology Co. Ltd., Nanjing 210046, China
| | - Yunfeng Wang
- Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, USA.
| | - Bing Gu
- Medical Technology School of Xuzhou Medical University, Xuzhou Key Laboratory of Laboratory Diagnostics, Xuzhou 221004, China; Department of Laboratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, China.
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175
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Zheng Z, Yao Z, Wu K, Zheng J. The diagnosis of SARS-CoV2 pneumonia: A review of laboratory and radiological testing results. J Med Virol 2020; 92:2420-2428. [PMID: 32462770 PMCID: PMC7283844 DOI: 10.1002/jmv.26081] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/22/2020] [Accepted: 05/25/2020] [Indexed: 12/20/2022]
Abstract
The rapid emergence of coronavirus disease 2019 (COVID-19) has necessitated the implementation of diverse pandemic control strategies throughout the world. To effectively control the spread of this disease, it is essential that it be diagnosed at an early stage so that patients can be reliably quarantined such that disease spread will be slowed. At present, the diagnosis of this infectious form of coronavirus pneumonia is largely dependent upon a combination of laboratory testing and imaging analyses of variable diagnostic efficacy. In the present report, we reviewed prior literature pertaining to the diagnosis of different forms of pneumonia caused by coronaviruses (severe acute respiratory syndrome [SARS], Middle East respiratory syndrome, and SARS-CoV-2) and assessed two different potential diagnostic approaches. We ultimately found that computed tomography was associated with a higher rate of diagnostic accuracy than was a real-time quantitative polymerase chain reaction-based approach (P = .0041), and chest radiography (P = .0100). Even so, it is important that clinicians utilize a combination of laboratory and radiological testing where possible to ensure that this virus is reliably and quickly detected such that it may be treated and patients may be isolated in a timely fashion, thereby effectively curbing the further progression of this pandemic.
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Affiliation(s)
- Zhong Zheng
- Department of Evidence‐based Medicine, Shanghai General Hospital, Shanghai Jiao Tong UniversitySchool of MedicineShanghaiChina
- Shanghai Medical Aid Team in Wuhan, Shanghai General Hospital, Shanghai Jiao Tong UniversitySchool of MedicineShanghaiChina
| | - Zhixian Yao
- Department of Evidence‐based Medicine, Shanghai General Hospital, Shanghai Jiao Tong UniversitySchool of MedicineShanghaiChina
- Shanghai Medical Aid Team in Wuhan, Shanghai General Hospital, Shanghai Jiao Tong UniversitySchool of MedicineShanghaiChina
| | - Ke Wu
- Department of Evidence‐based Medicine, Shanghai General Hospital, Shanghai Jiao Tong UniversitySchool of MedicineShanghaiChina
- Shanghai Medical Aid Team in Wuhan, Shanghai General Hospital, Shanghai Jiao Tong UniversitySchool of MedicineShanghaiChina
| | - Junhua Zheng
- Department of Evidence‐based Medicine, Shanghai General Hospital, Shanghai Jiao Tong UniversitySchool of MedicineShanghaiChina
- Shanghai Medical Aid Team in Wuhan, Shanghai General Hospital, Shanghai Jiao Tong UniversitySchool of MedicineShanghaiChina
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176
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Krishna E, Pathak VK, Prasad R, Jose H, Kumar MM. COVID-19 reinfection: Linked Possibilities and future outlook. J Family Med Prim Care 2020; 9:5445-5449. [PMID: 33532377 PMCID: PMC7842419 DOI: 10.4103/jfmpc.jfmpc_1672_20] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/29/2020] [Accepted: 10/07/2020] [Indexed: 12/28/2022] Open
Abstract
SARS-CoV-2 is the third major coronavirus epidemic to affect humans. There had been multiple instances of patients turning positive after recovering from SARS-2-CoV infection. Though many different theories emerge, false positive RT-PCR is logically the foremost cause and there is a general consensus that during quarantine re-infection from outside seems unlikely when strictly adhered to. As many new strains emerge worldwide during the course of on-going pandemic, the chances of re-infection cannot be ignored as it may contribute to false negative RT-PCR test results. SARS-2-CoV though a novel virus, is phylogenetically similar to SARS-like CoV with around 79% similarity. Studies on immunological response to these infections suggest that antibodies formed after infection confers immunity only for a short period of time before it starts to wane. Also studies on SARS-CoV-2 suggest that antibody formation and longevity of immunity in an individual is dependent on the strain of coronavirus, its severity and age of the person infected. All these considerations demand reviewing the treatment duration, discharge criteria, appropriate use of imaging techniques and importance of risk communication and health education to those recovered.
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Affiliation(s)
- Ekta Krishna
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Vineet Kumar Pathak
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Reshma Prasad
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Hannah Jose
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - M Mohan Kumar
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
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177
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Haselmann V, Kittel M, Gerhards C, Thiaucourt M, Eichner R, Costina V, Neumaier M. Comparison of test performance of commercial anti-SARS-CoV-2 immunoassays in serum and plasma samples. Clin Chim Acta 2020; 510:73-78. [PMID: 32652161 PMCID: PMC7343640 DOI: 10.1016/j.cca.2020.07.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/29/2020] [Accepted: 07/03/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND For epidemiologic, social and economic reasons, assessment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection prevalence and immunity are important to adapt decisions to current demands. Hence, immunoassays for detection of anti-SARS-CoV-2 antibodies are introduced rapidly without requiring FDA emergency use authorization approval. Thus, evaluation of test performance predominantly relies on laboratories. This study aimed to evaluate the test performance of recently launched commercial immunoassays in serum and plasma samples. METHODS 51 serum samples from 26 patients with confirmed SARS-CoV-2 infection after end of quarantine and 25 control patients were analyzed using anti-SARS-CoV-2 IgG immunoassays from Roche, Euroimmun and Epitope to assess diagnostic sensitivity and specificity. 20 matching pairs of serum and plasma samples were included to analyze comparability between different specimens. RESULTS Overall, a diagnostic sensitivity of 92.3%, 96.2-100% and 100% with a respective diagnostic specificity of 100%, 100% and 84-86% for the immunoassays from Roche, Euroimmun and Epitope were determined. In total, 84-96% of samples were correctly classified as negative and 92.3-95.2% as positive. The level of concordance between plasma- and serum-based testing diverged between the assays (Epitope r2 = 0.97; Euroimmun r2 = 0.91; Roche r2 = 0.76). CONCLUSIONS The immunoassays from Euroimmun and Roche revealed a higher specificity than the Epitope assay without a substantial drop of diagnostic sensitivity. Significant differences between plasma- and serum-based testing highlights the need for determination of appropriate cut-offs per specimen type. Hence, there is an urgent need for test harmonization and establishment of quality standards for an appropriate use of COVID-19 serological tests.
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Affiliation(s)
- Verena Haselmann
- Department of Clinical Chemistry, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany.
| | - Maximilian Kittel
- Department of Clinical Chemistry, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Catharina Gerhards
- Department of Clinical Chemistry, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Margot Thiaucourt
- Department of Clinical Chemistry, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Romy Eichner
- Department of Clinical Chemistry, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Victor Costina
- Department of Clinical Chemistry, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Michael Neumaier
- Department of Clinical Chemistry, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
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178
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Seroconversion in patients with cancer and oncology health care workers infected by SARS-CoV-2. Ann Oncol 2020; 32:113-119. [PMID: 33098994 PMCID: PMC7577226 DOI: 10.1016/j.annonc.2020.10.473] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/29/2020] [Accepted: 10/04/2020] [Indexed: 01/08/2023] Open
Abstract
Background Patients with cancer have high risk for severe complications and poor outcome to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related disease [coronavirus disease 2019 (COVID-19)]. Almost all subjects with COVID-19 develop anti-SARS-CoV-2 immunoglobulin G (IgG) within 3 weeks after infection. No data are available on the seroconversion rates of cancer patients and COVID-19. Patients and methods We conducted a multicenter, observational, prospective study that enrolled (i) patients and oncology health professionals with SARS-CoV-2 infection confirmed by real-time RT-PCR assays on nasal/pharyngeal swab specimens; (ii) patients and oncology health professionals with clinical or radiological suspicious of infection by SARS-CoV-2; and (iii) patients with cancer who are considered at high risk for infection and eligible for active therapy and/or major surgery. All enrolled subjects were tested with the 2019-nCoV IgG/IgM Rapid Test Cassette, which is a qualitative membrane-based immunoassay for the detection of IgG and IgM antibodies to SARS-CoV-2. The aim of the study was to evaluate anti-SARS-CoV-2 seroconversion rate in patients with cancer and oncology health care professionals with confirmed or clinically suspected COVID-19. Results From 30 March 2020 to 11 May 2020, 166 subjects were enrolled in the study. Among them, cancer patients and health workers were 61 (36.7%) and 105 (63.3%), respectively. Overall, 86 subjects (51.8%) had confirmed SARS-CoV-2 diagnosis by RT-PCR testing on nasopharyngeal swab specimen, and 60 (36.2%) had a clinical suspicious of COVID-19. Median time from symptom onset (for cases not confirmed by RT-PCR) or RT-PCR confirmation to serum antibody test was 17 days (interquartile range 26). In the population with confirmed RT-PCR, 83.8% of cases were IgG positive. No difference in IgG positivity was observed between cancer patients and health workers (87.9% versus 80.5%; P = 0.39). Conclusions Our data indicate that SARS-CoV-2-specific IgG antibody detection do not differ between cancer patients and healthy subjects.
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179
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Lapuente D, Maier C, Irrgang P, Hübner J, Peter AS, Hoffmann M, Ensser A, Ziegler K, Winkler TH, Birkholz T, Kremer AE, Steininger P, Korn K, Neipel F, Überla K, Tenbusch M. Rapid response flow cytometric assay for the detection of antibody responses to SARS-CoV-2. Eur J Clin Microbiol Infect Dis 2020; 40:751-759. [PMID: 33078221 PMCID: PMC7572153 DOI: 10.1007/s10096-020-04072-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 10/09/2020] [Indexed: 01/12/2023]
Abstract
SARS-CoV-2 has emerged as a previously unknown zoonotic coronavirus that spread worldwide causing a serious pandemic. While reliable nucleic acid–based diagnostic assays were rapidly available, only a limited number of validated serological assays were available in the early phase of the pandemic. Here, we evaluated a novel flow cytometric approach to assess spike-specific antibody responses.HEK 293T cells expressing SARS-CoV-2 spike protein in its natural confirmation on the surface were used to detect specific IgG and IgM antibody responses in patient sera by flow cytometry. A soluble angiotensin-converting-enzyme 2 (ACE-2) variant was developed as external standard to quantify spike-specific antibody responses on different assay platforms. Analyses of 201 pre-COVID-19 sera proved a high assay specificity in comparison to commercially available CLIA and ELISA systems, while also revealing the highest sensitivity in specimens from PCR-confirmed SARS-CoV-2-infected patients. The external standard allowed robust quantification of antibody responses among different assay platforms. In conclusion, our newly established flow cytometric assay allows sensitive and quantitative detection of SARS-CoV-2-specific antibodies, which can be easily adopted in different laboratories and does not rely on external supply of assay kits. The flow cytometric assay also provides a blueprint for rapid development of serological tests to other emerging viral infections
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Affiliation(s)
- Dennis Lapuente
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Clara Maier
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Pascal Irrgang
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Julian Hübner
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Antonia Sophia Peter
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Markus Hoffmann
- Infection Biology Unit, German Primate Center-Leibniz Institute for Primate Research, Göttingen, Germany
| | - Armin Ensser
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Katharina Ziegler
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Nürnberg, Germany
| | - Thomas H Winkler
- Department of Biology, Division of Genetics, Nikolaus-Fiebiger-Center for Molecular Medicine, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Torsten Birkholz
- Department of Anaesthesiology, University Hospital Erlangen, Erlangen, Germany
| | - Andreas E Kremer
- Department of Medicine 1, Gastroenterology, Pneumology and Endocrinology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Philipp Steininger
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Klaus Korn
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Frank Neipel
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Klaus Überla
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Tenbusch
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
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180
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Brochot E, Demey B, Touzé A, Belouzard S, Dubuisson J, Schmit JL, Duverlie G, Francois C, Castelain S, Helle F. Anti-spike, Anti-nucleocapsid and Neutralizing Antibodies in SARS-CoV-2 Inpatients and Asymptomatic Individuals. Front Microbiol 2020; 11:584251. [PMID: 33193227 PMCID: PMC7604306 DOI: 10.3389/fmicb.2020.584251] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/15/2020] [Indexed: 11/13/2022] Open
Abstract
A better understanding of the anti-SARS-CoV-2 immune response is necessary to finely evaluate commercial serological assays but also to predict protection against reinfection and to help the development of vaccines. For this reason, we monitored the anti-SARS-CoV-2 antibody response in infected patients. In order to assess the time of seroconversion, we used 151 samples from 30 COVID-19 inpatients and monitored the detection kinetics of anti-S1, anti-S2, anti-RBD and anti-N antibodies with in-house ELISAs. We observed that specific antibodies were detectable in all inpatients 2 weeks post-symptom onset and that the detection of the SARS-CoV-2 Nucleocapsid and RBD was more sensitive than the detection of the S1 or S2 subunits. Using retroviral particles pseudotyped with the spike of the SARS-CoV-2, we also monitored the presence of neutralizing antibodies in these samples as well as 25 samples from asymptomatic individuals that were shown SARS-CoV-2 seropositive using commercial serological tests. Neutralizing antibodies reached a plateau 2 weeks post-symptom onset and then declined in the majority of inpatients but they were undetectable in 56% of asymptomatic patients. Our results indicate that the SARS-CoV-2 does not induce a prolonged neutralizing antibody response. They also suggest that induction of neutralizing antibodies is not the only strategy to adopt for the development of a vaccine. Finally, they imply that anti-SARS-CoV-2 neutralizing antibodies should be titrated to optimize convalescent plasma therapy.
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Affiliation(s)
- Etienne Brochot
- Department of Virology, Amiens University Medical Center, Amiens, France
- AGIR Research Unit, UR UPJV 4294, Jules Verne University of Picardie, Amiens, France
| | - Baptiste Demey
- Department of Virology, Amiens University Medical Center, Amiens, France
- AGIR Research Unit, UR UPJV 4294, Jules Verne University of Picardie, Amiens, France
| | | | - Sandrine Belouzard
- Université Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, U1019-UMR 8204-CIIL-Center for Infection and Immunity of Lille, Lille, France
| | - Jean Dubuisson
- Université Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, U1019-UMR 8204-CIIL-Center for Infection and Immunity of Lille, Lille, France
| | - Jean-Luc Schmit
- Department of Virology, Amiens University Medical Center, Amiens, France
- AGIR Research Unit, UR UPJV 4294, Jules Verne University of Picardie, Amiens, France
| | - Gilles Duverlie
- Department of Virology, Amiens University Medical Center, Amiens, France
- AGIR Research Unit, UR UPJV 4294, Jules Verne University of Picardie, Amiens, France
| | - Catherine Francois
- Department of Virology, Amiens University Medical Center, Amiens, France
- AGIR Research Unit, UR UPJV 4294, Jules Verne University of Picardie, Amiens, France
| | - Sandrine Castelain
- Department of Virology, Amiens University Medical Center, Amiens, France
- AGIR Research Unit, UR UPJV 4294, Jules Verne University of Picardie, Amiens, France
| | - Francois Helle
- AGIR Research Unit, UR UPJV 4294, Jules Verne University of Picardie, Amiens, France
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Abstract
OBJECTIVES Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serology tests are clinically useful to document prior SARS-CoV-2 infections. Data are urgently needed to select assays with optimal sensitivity at acceptable specificity for antibody detection. METHODS A comparative evaluation was performed of 7 commercial SARS-CoV-2 serology assays on 171 sera from 135 subjects with polymerase chain reaction-confirmed SARS-CoV-2 infection (71 hospitalized patients and 64 paucisymptomatic individuals). Kinetics of IgA/IgM/IgG seroconversion to viral N and S protein epitopes were studied from 0 to 54 days after onset of symptoms. Cross-reactivity was verified on 57 prepandemic samples. RESULTS Wantai SARS-COV-2 Ab ELISA and Orient Gene COVID-19 IgG/IgM Rapid Test showed superior overall sensitivity for detection of SARS-CoV-2 antibodies. Elecsys Anti-SARS-CoV-2 assay and EUROIMMUN Anti-SARS-CoV-2 combined IgG/IgA showed acceptable sensitivity (>95%) vs the consensus result of all assays from 10 days post onset of symptoms. Wantai SARS-COV-2 Ab ELISA, Elecsys Anti-SARS-CoV-2 assay, and Innovita 2019-nCoV Ab rapid test showed least cross-reactivity, resulting in an optimal analytical specificity greater than 98%. CONCLUSIONS Wantai SARS-COV-2 Ab ELISA and Elecsys Anti-SARS-CoV-2 assays are suitable for sensitive and specific detection of SARS-CoV-2 antibodies from 10 days after onset of symptoms.
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Affiliation(s)
- Pauline H Herroelen
- AZ Delta Medical Laboratories, AZ Delta General Hospital, Roeselare, Belgium
| | - Geert A Martens
- AZ Delta Medical Laboratories, AZ Delta General Hospital, Roeselare, Belgium
- VUB Metabolomics Platform, Brussels Free University, Brussels, Belgium
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
| | - Dieter De Smet
- AZ Delta Medical Laboratories, AZ Delta General Hospital, Roeselare, Belgium
| | - Koen Swaerts
- AZ Delta Medical Laboratories, AZ Delta General Hospital, Roeselare, Belgium
| | - An-Sofie Decavele
- AZ Delta Medical Laboratories, AZ Delta General Hospital, Roeselare, Belgium
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182
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Graham NR, Whitaker AN, Strother CA, Miles AK, Grier D, McElvany BD, Bruce EA, Poynter ME, Pierce KK, Kirkpatrick BD, Stapleton RD, An G, van den Broek‐Altenburg E, Botten JW, Crothers JW, Diehl SA. Kinetics and isotype assessment of antibodies targeting the spike protein receptor-binding domain of severe acute respiratory syndrome-coronavirus-2 in COVID-19 patients as a function of age, biological sex and disease severity. Clin Transl Immunology 2020; 9:e1189. [PMID: 33072323 PMCID: PMC7541824 DOI: 10.1002/cti2.1189] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/11/2020] [Accepted: 09/11/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES There is an incomplete understanding of the host humoral immune response to severe acute respiratory syndrome (SARS)-coronavirus (CoV)-2, which underlies COVID-19, during acute infection. Host factors such as age and sex as well as the kinetics and functionality of antibody responses are important factors to consider as vaccine development proceeds. The receptor-binding domain of the CoV spike (RBD-S) protein mediates host cell binding and infection and is a major target for vaccine design to elicit neutralising antibodies. METHODS We assessed serum anti-SARS-CoV-2 RBD-S IgG, IgM and IgA antibodies by a two-step ELISA and neutralising antibodies in a cross-sectional study of hospitalised COVID-19 patients of varying disease severities. Anti-RBD-S IgG levels were also determined in asymptomatic seropositives. RESULTS We found equivalent levels of anti-RBD-S antibodies in male and female patients and no age-related deficiencies even out to 93 years of age. The anti-RBD-S response was evident as little as 6 days after onset of symptoms and for at least 5 weeks after symptom onset. Anti-RBD-S IgG, IgM and IgA responses were simultaneously induced within 10 days after onset, with anti-RBD-S IgG sustained over a 5-week period. Anti-RBD-S antibodies strongly correlated with neutralising activity. Lastly, anti-RBD-S IgG responses were higher in symptomatic COVID-19 patients during acute infection compared with asymptomatic seropositive donors. CONCLUSION Our results suggest that anti-RBD-S IgG reflect functional immune responses to SARS-CoV-2, but do not completely explain age- and sex-related disparities in COVID-19 fatalities.
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Affiliation(s)
- Nancy R Graham
- Department of Microbiology and Molecular GeneticsLarner College of Medicine, University of VermontBurlingtonVTUSA
- Vaccine Testing CenterLarner College of Medicine, University of VermontBurlingtonVTUSA
| | - Annalis N Whitaker
- Department of Medicine‐ImmunobiologyLarner College of Medicine, University of VermontBurlingtonVTUSA
- Cellular, Molecular, and Biomedical Sciences Graduate ProgramUniversity of VermontBurlingtonVTUSA
- Vermont Center for Immunology and Infectious DiseaseLarner College of Medicine, University of VermontBurlingtonVTUSA
| | - Camilla A Strother
- Department of Microbiology and Molecular GeneticsLarner College of Medicine, University of VermontBurlingtonVTUSA
- Cellular, Molecular, and Biomedical Sciences Graduate ProgramUniversity of VermontBurlingtonVTUSA
| | - Ashley K Miles
- Department of Microbiology and Molecular GeneticsLarner College of Medicine, University of VermontBurlingtonVTUSA
- Vaccine Testing CenterLarner College of Medicine, University of VermontBurlingtonVTUSA
| | - Dore Grier
- Department of Pathology and Laboratory MedicineLarner College of Medicine, University of VermontBurlingtonVTUSA
| | - Benjamin D McElvany
- Department of Microbiology and Molecular GeneticsLarner College of Medicine, University of VermontBurlingtonVTUSA
- Vaccine Testing CenterLarner College of Medicine, University of VermontBurlingtonVTUSA
| | - Emily A Bruce
- Department of Medicine‐ImmunobiologyLarner College of Medicine, University of VermontBurlingtonVTUSA
- Vermont Center for Immunology and Infectious DiseaseLarner College of Medicine, University of VermontBurlingtonVTUSA
- Translational Global Infectious Disease Research CenterUniversity of VermontBurlingtonVTUSA
| | - Matthew E Poynter
- Cellular, Molecular, and Biomedical Sciences Graduate ProgramUniversity of VermontBurlingtonVTUSA
- Vermont Center for Immunology and Infectious DiseaseLarner College of Medicine, University of VermontBurlingtonVTUSA
- Translational Global Infectious Disease Research CenterUniversity of VermontBurlingtonVTUSA
- Vermont Lung CenterLarner College of Medicine, University of VermontBurlingtonVTUSA
- Department of Medicine‐Pulmonary and Critical CareLarner College of Medicine, University of VermontBurlingtonVTUSA
| | - Kristen K Pierce
- Department of Microbiology and Molecular GeneticsLarner College of Medicine, University of VermontBurlingtonVTUSA
- Vaccine Testing CenterLarner College of Medicine, University of VermontBurlingtonVTUSA
- Translational Global Infectious Disease Research CenterUniversity of VermontBurlingtonVTUSA
- Department of Medicine‐Infectious DiseaseLarner College of Medicine University of VermontBurlingtonVTUSA
| | - Beth D Kirkpatrick
- Department of Microbiology and Molecular GeneticsLarner College of Medicine, University of VermontBurlingtonVTUSA
- Vaccine Testing CenterLarner College of Medicine, University of VermontBurlingtonVTUSA
- Vermont Center for Immunology and Infectious DiseaseLarner College of Medicine, University of VermontBurlingtonVTUSA
- Translational Global Infectious Disease Research CenterUniversity of VermontBurlingtonVTUSA
- Department of Medicine‐Infectious DiseaseLarner College of Medicine University of VermontBurlingtonVTUSA
| | - Renee D Stapleton
- Vermont Lung CenterLarner College of Medicine, University of VermontBurlingtonVTUSA
- Department of Medicine‐Pulmonary and Critical CareLarner College of Medicine, University of VermontBurlingtonVTUSA
| | - Gary An
- Translational Global Infectious Disease Research CenterUniversity of VermontBurlingtonVTUSA
- Department of SurgeryLarner College of Medicine, University of VermontBurlingtonVTUSA
| | | | - Jason W Botten
- Department of Microbiology and Molecular GeneticsLarner College of Medicine, University of VermontBurlingtonVTUSA
- Vaccine Testing CenterLarner College of Medicine, University of VermontBurlingtonVTUSA
- Department of Medicine‐ImmunobiologyLarner College of Medicine, University of VermontBurlingtonVTUSA
- Cellular, Molecular, and Biomedical Sciences Graduate ProgramUniversity of VermontBurlingtonVTUSA
- Vermont Center for Immunology and Infectious DiseaseLarner College of Medicine, University of VermontBurlingtonVTUSA
- Translational Global Infectious Disease Research CenterUniversity of VermontBurlingtonVTUSA
| | - Jessica W Crothers
- Vermont Center for Immunology and Infectious DiseaseLarner College of Medicine, University of VermontBurlingtonVTUSA
- Translational Global Infectious Disease Research CenterUniversity of VermontBurlingtonVTUSA
- Department of Medicine‐Infectious DiseaseLarner College of Medicine University of VermontBurlingtonVTUSA
| | - Sean A Diehl
- Department of Microbiology and Molecular GeneticsLarner College of Medicine, University of VermontBurlingtonVTUSA
- Vaccine Testing CenterLarner College of Medicine, University of VermontBurlingtonVTUSA
- Cellular, Molecular, and Biomedical Sciences Graduate ProgramUniversity of VermontBurlingtonVTUSA
- Vermont Center for Immunology and Infectious DiseaseLarner College of Medicine, University of VermontBurlingtonVTUSA
- Translational Global Infectious Disease Research CenterUniversity of VermontBurlingtonVTUSA
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183
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Algaissi A, Alfaleh MA, Hala S, Abujamel TS, Alamri SS, Almahboub SA, Alluhaybi KA, Hobani HI, Alsulaiman RM, AlHarbi RH, ElAssouli MZA, Alhabbab RY, AlSaieedi AA, Abdulaal WH, Al-Somali AA, Alofi FS, Khogeer AA, Alkayyal AA, Mahmoud AB, Almontashiri NAM, Pain A, Hashem AM. SARS-CoV-2 S1 and N-based serological assays reveal rapid seroconversion and induction of specific antibody response in COVID-19 patients. Sci Rep 2020; 10:16561. [PMID: 33024213 PMCID: PMC7538990 DOI: 10.1038/s41598-020-73491-5] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/27/2020] [Indexed: 12/23/2022] Open
Abstract
As the Coronavirus Disease 2019 (COVID-19), which is caused by the novel SARS-CoV-2, continues to spread rapidly around the world, there is a need for well validated serological assays that allow the detection of viral specific antibody responses in COVID-19 patients or recovered individuals. In this study, we established and used multiple indirect Enzyme Linked Immunosorbent Assay (ELISA)-based serological assays to study the antibody response in COVID-19 patients. In order to validate the assays we determined the cut off values, sensitivity and specificity of the assays using sera collected from pre-pandemic healthy controls, COVID-19 patients at different time points after disease-onset, and seropositive sera to other human coronaviruses (CoVs). The developed SARS-CoV-2 S1 subunit of the spike glycoprotein and nucleocapsid (N)-based ELISAs not only showed high specificity and sensitivity but also did not show any cross-reactivity with other CoVs. We also show that all RT-PCR confirmed COVID-19 patients tested in our study developed both virus specific IgM and IgG antibodies as early as week one after disease onset. Our data also suggest that the inclusion of both S1 and N in serological testing would capture as many potential SARS-CoV-2 positive cases as possible than using any of them alone. This is specifically important for tracing contacts and cases and conducting large-scale epidemiological studies to understand the true extent of virus spread in populations.
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Affiliation(s)
- Abdullah Algaissi
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratories Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
- Medical Research Center, Jazan University, Jazan, Saudi Arabia
| | - Mohamed A Alfaleh
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sharif Hala
- Pathogen Genomics Laboratory, Division of Biological and Environmental Sciences and Engineering (BESE), King Abdullah University of Science and Technology, Thuwa, Saudi Arabia
- King Abdullah International Medical Research Centre, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Turki S Abujamel
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sawsan S Alamri
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sarah A Almahboub
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khalid A Alluhaybi
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Haya I Hobani
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Reem M Alsulaiman
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rahaf H AlHarbi
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Biology, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - M-Z Aki ElAssouli
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rowa Y Alhabbab
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahdab A AlSaieedi
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Wesam H Abdulaal
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Afrah A Al-Somali
- Infectious Diseases Department, King Abdullah Medical Complex, Jeddah, Saudi Arabia
| | - Fadwa S Alofi
- Infectious Diseases Department, King Fahad Hospital, Almadinah Almunwarah, Saudi Arabia
| | - Asim A Khogeer
- Plan and Research Department, General Directorate of Health Affairs Makkah Region, Ministry of Health, Makkah, Saudi Arabia
| | - Almohanad A Alkayyal
- Department of Medical Laboratory Technology, University of Tabuk, Tabuk, Saudi Arabia
| | - Ahmad Bakur Mahmoud
- College of Applied Medical Sciences, Taibah University, Almadinah Almunwarah, Saudi Arabia
| | - Naif A M Almontashiri
- Center for Genetics and Inherited Diseases, Taibah University, Almadinah Almunwarah, Saudi Arabia
| | - Arnab Pain
- Pathogen Genomics Laboratory, Division of Biological and Environmental Sciences and Engineering (BESE), King Abdullah University of Science and Technology, Thuwa, Saudi Arabia
- Research Center for Zoonosis Control, Hokkaido University, Kita-ku, Sapporo, Japan
- Nuffield Division of Clinical Laboratory Sciences (NDCLS), University of Oxford, Oxford, UK
| | - Anwar M Hashem
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
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184
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Cameron A, Porterfield CA, Byron L, Wang J, Pearson Z, Bohrhunter JL, Cardillo AB, Ryan-Muntz L, Sorensen RA, Caserta M, Angeloni S, Hardy DJ, Zand M, Pecora ND. A multiplex microsphere IgG assay for SARS-CoV-2 using ACE2-mediated inhibition as a surrogate for neutralization. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.10.05.20203976. [PMID: 33052354 PMCID: PMC7553168 DOI: 10.1101/2020.10.05.20203976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The COVID-19 pandemic has highlighted challenges inherent to serological detection of a novel pathogen like SARS-CoV-2. Serological tests can be used diagnostically and for surveillance, but their usefulness depends on throughput, sensitivity and specificity. Here, we describe a multiplex fluorescent microsphere-based assay, 3Flex, that can detect antibodies to three SARS-CoV-2 antigens-spike (S) protein, the spike ACE2 receptor-binding domain (RBD), and nucleocapsid (NP). Specificity was assessed using 213 pre-pandemic samples. Sensitivity was measured and compared to the Abbott™ ARCHITECT™ SARS-CoV-2 IgG assay using serum from 125 unique patients equally binned ( n = 25) into 5 time intervals (≤5, 6 to 10, 11 to 15, 16 to 20, and ≥21 days from symptom onset). With samples obtained at ≤5 days from symptom onset, the 3Flex assay was more sensitive (48.0% vs. 32.0%), but the two assays performed comparably using serum obtained ≥21 days from symptom onset. A larger collection ( n = 534) of discarded sera was profiled from patients ( n = 140) whose COVID-19 course was characterized through chart review. This revealed the relative rise, peak (S, 23.8; RBD, 23.6; NP, 16.7; in days from symptom onset), and decline of the antibody response. Considerable interperson variation was observed with a subset of extensively sampled ICU patients. Using soluble ACE2, inhibition of antibody binding was demonstrated for S and RBD, and not for NP. Taken together, this study described the performance of an assay built on a flexible and high-throughput serological platform that proved adaptable to the emergence of a novel infectious agent.
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185
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Cobre ADF, Böger B, Fachi MM, Vilhena RDO, Domingos EL, Tonin FS, Pontarolo R. Risk factors associated with delay in diagnosis and mortality in patients with COVID-19 in the city of Rio de Janeiro, Brazil. CIENCIA & SAUDE COLETIVA 2020; 25:4131-4140. [DOI: 10.1590/1413-812320202510.2.26882020] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 07/27/2020] [Indexed: 12/15/2022] Open
Abstract
Abstract We investigated the predictors of delay in the diagnosis and mortality of patients with COVID-19 in Rio de Janeiro, Brazil. A cohort of 3,656 patients were evaluated (Feb-Apr 2020) and patients’ sociodemographic characteristics, and social development index (SDI) were used as determinant factors of diagnosis delays and mortality. Kaplan-Meier survival analyses, time-dependent Cox regression models, and multivariate logistic regression analyses were conducted. The median time from symptoms onset to diagnosis was eight days (interquartile range [IQR] 7.23-8.99 days). Half of the patients recovered during the evaluated period, and 8.3% died. Mortality rates were higher in men. Delays in diagnosis were associated with male gender (p = 0.015) and patients living in low SDI areas (p < 0.001). The age groups statistically associated with death were: 70-79 years, 80-89 years, and 90-99 years. Delays to diagnosis greater than eight days were also risk factors for death. Delays in diagnosis and risk factors for death from COVID-19 were associated with male gender, age under 60 years, and patients living in regions with lower SDI. Delays superior to eight days to diagnosis increased mortality rates.
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186
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Meyer B, Torriani G, Yerly S, Mazza L, Calame A, Arm-Vernez I, Zimmer G, Agoritsas T, Stirnemann J, Spechbach H, Guessous I, Stringhini S, Pugin J, Roux-Lombard P, Fontao L, Siegrist CA, Eckerle I, Vuilleumier N, Kaiser L. Validation of a commercially available SARS-CoV-2 serological immunoassay. Clin Microbiol Infect 2020; 26:1386-1394. [PMID: 32603801 PMCID: PMC7320699 DOI: 10.1016/j.cmi.2020.06.024] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/19/2020] [Accepted: 06/20/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To validate the diagnostic accuracy of a Euroimmun SARS-CoV-2 IgG and IgA immunoassay for COVID-19. METHODS In this unmatched (1:2) case-control validation study, we used sera of 181 laboratory-confirmed SARS-CoV-2 cases and 326 controls collected before SARS-CoV-2 emergence. Diagnostic accuracy of the immunoassay was assessed against a whole spike protein-based recombinant immunofluorescence assay (rIFA) by receiver operating characteristic (ROC) analyses. Discrepant cases between ELISA and rIFA were further tested by pseudo-neutralization assay. RESULTS COVID-19 patients were more likely to be male and older than controls, and 50.3% were hospitalized. ROC curve analyses indicated that IgG and IgA had high diagnostic accuracies with AUCs of 0.990 (95% Confidence Interval [95%CI]: 0.983-0.996) and 0.978 (95%CI: 0.967-0.989), respectively. IgG assays outperformed IgA assays (p=0.01). Taking an assessed 15% inter-assay imprecision into account, an optimized IgG ratio cut-off > 2.5 displayed a 100% specificity (95%CI: 99-100) and a 100% positive predictive value (95%CI: 96-100). A 0.8 cut-off displayed a 94% sensitivity (95%CI: 88-97) and a 97% negative predictive value (95%CI: 95-99). Substituting the upper threshold for the manufacturer's, improved assay performance, leaving 8.9% of IgG ratios indeterminate between 0.8-2.5. CONCLUSIONS The Euroimmun assay displays a nearly optimal diagnostic accuracy using IgG against SARS-CoV-2 in patient samples, with no obvious gains from IgA serology. The optimized cut-offs are fit for rule-in and rule-out purposes, allowing determination of whether individuals in our study population have been exposed to SARS-CoV-2 or not. IgG serology should however not be considered as a surrogate of protection at this stage.
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Affiliation(s)
- B Meyer
- Centre for Vaccinology, Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - G Torriani
- Department of Microbiology and Molecular Medicine, University of Geneva, Geneva, Switzerland
| | - S Yerly
- Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland
| | - L Mazza
- Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland
| | - A Calame
- Division of Infectious Disease, Geneva University Hospitals, Geneva, Switzerland
| | - I Arm-Vernez
- Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland
| | - G Zimmer
- Institute of Virology and Immunology (IVI), Mittelhäusern, Switzerland; Department of Infectious Diseases and Pathobiology (DIP), Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - T Agoritsas
- Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland; Department of Health Research Methods, Evidence, and Impact, Hamilton, Ontario, Canada
| | - J Stirnemann
- Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - H Spechbach
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - I Guessous
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - S Stringhini
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland; Unit of Population Epidemiology, Division of Primary Care, Geneva University Hospitals, Geneva, Switzerland
| | - J Pugin
- Division of Intensive Care, Geneva University Hospitals, Geneva, Switzerland
| | - P Roux-Lombard
- Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals and Geneva University, Geneva, Switzerland
| | - L Fontao
- Division of Dermatology and of Laboratory Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - C-A Siegrist
- Centre for Vaccinology, Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - I Eckerle
- Department of Microbiology and Molecular Medicine, University of Geneva, Geneva, Switzerland; Division of Infectious Disease, Geneva University Hospitals, Geneva, Switzerland; Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - N Vuilleumier
- Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals and Geneva University, Geneva, Switzerland; Division of Laboratory Medicine, Department of Medicine, Faculty of Medicine, Geneva, Switzerland
| | - L Kaiser
- Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland; Division of Infectious Disease, Geneva University Hospitals, Geneva, Switzerland; Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland.
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187
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Davidson N, Evans J, Giammichele D, Powell H, Hobson P, Teis B, Glover H, Guppy-Coles KB, Robson J. Comparative analysis of three laboratory based serological assays for SARS-CoV-2 in an Australian cohort. Pathology 2020; 52:764-769. [PMID: 33070955 PMCID: PMC7524654 DOI: 10.1016/j.pathol.2020.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/21/2020] [Accepted: 09/28/2020] [Indexed: 10/29/2022]
Abstract
Many unanswered questions remain regarding the role of SARS-CoV-2 serological assays in this unfolding COVID-19 pandemic. These include their utility for the diagnosis of acute SARS-CoV-2 infection, past infection or exposure, correlation with immunity and the effective duration of immunity. This study examined the performance of three laboratory based serological assays, EUROIMMUN Anti-SARS-CoV-2 IgA/IgG, MAGLUMI 2000 Plus 2019-nCov IgM/IgG and EDI Novel Coronavirus (COVID-19) IgM/IgG immunoassays. We evaluated 138 samples from a reference non-infected population and 71 samples from a cohort of 37 patients with SARS-CoV-2 confirmed positive by RT-PCR. The samples were collected at various intervals of 0-45 days post symptoms onset (PSO). Specificity and sensitivity of these assays was 60.9%/71.4% (IgA) and 94.2%/63.3% (IgG) for EUROIMMUN; 98.5%/18.4% (IgM) and 97.8%/53.1% (IgG) for MAGLUMI; and 94.9%/22.5% (IgM) and 93.5%/57.1% (IgG) for EDI, respectively. When samples collected ≥14 days PSO were considered, the sensitivities were 100.0 and 100.0%; 31.0 and 82.8%; 34.5 and 57.1%, respectively. Using estimated population prevalence of 0.1, 1, and 10%, the positive predictive value of all assays remained low. The EUROIMMUN Anti-SARS-CoV-2 IgA lacked specificity for acute diagnosis and all IgM assays offered poor diagnostic utility. Seroconversion can be delayed although all patients had seroconverted at 28 days in our cohort with the EUROIMMUN Anti-SARS-CoV-2 IgG. Despite this, with specificity of only 94% this assay would not be satisfactory for seroprevalence studies in the general Australian population given this is likely to be currently <1%.
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Affiliation(s)
- N Davidson
- Sullivan Nicolaides Pathology, Brisbane, Qld, Australia.
| | - J Evans
- Sullivan Nicolaides Pathology, Brisbane, Qld, Australia
| | - D Giammichele
- Sullivan Nicolaides Pathology, Brisbane, Qld, Australia
| | - H Powell
- Sullivan Nicolaides Pathology, Brisbane, Qld, Australia
| | - P Hobson
- Sullivan Nicolaides Pathology, Brisbane, Qld, Australia
| | - B Teis
- Sullivan Nicolaides Pathology, Brisbane, Qld, Australia
| | - H Glover
- Sullivan Nicolaides Pathology, Brisbane, Qld, Australia
| | | | - J Robson
- Sullivan Nicolaides Pathology, Brisbane, Qld, Australia
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188
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Nimer SD, Chapman J, Reidy L, Alencar A, Wu Y, Williams S, Pagan L, Gjolaj L, MacIntyre J, Triana M, Vance B, Andrews D, Fan YS, Zhou Y, Martinez O, Garcia-Buitrago M, Cray C, Tekin M, McCauley JL, Ruiz P, Pagan P, Lamar W, Alencar M, Bilbao D, Prieto S, Polania M, Suarez M, Lujardo M, Campos G, Morris M, Shukla B, Caban-Martinez A, Kobetz E, Parekh DJ, Jorda M. A How-to Guide to Building a Robust SARS-CoV-2 Testing Program at a University-Based Health System. Acad Pathol 2020; 7:2374289520958200. [PMID: 33088910 PMCID: PMC7545514 DOI: 10.1177/2374289520958200] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/31/2020] [Accepted: 08/15/2020] [Indexed: 12/28/2022] Open
Abstract
When South Florida became a hot spot for COVID-19 disease in March 2020, we faced an urgent need to develop test capability to detect SARS-CoV-2 infection. We assembled a transdisciplinary team of knowledgeable and dedicated physicians, scientists, technologists, and administrators who rapidly built a multiplatform, polymerase chain reaction- and serology-based detection program, established drive-through facilities, and drafted and implemented guidelines that enabled efficient testing of our patients and employees. This process was extremely complex, due to the limited availability of needed reagents, but outreach to our research scientists and multiple diagnostic laboratory companies, and government officials enabled us to implement both Food and Drug Administration authorized and laboratory-developed testing–based testing protocols. We analyzed our workforce needs and created teams of appropriately skilled and certified workers to safely process patient samples and conduct SARS-CoV-2 testing and contact tracing. We initiated smart test ordering, interfaced all testing platforms with our electronic medical record, and went from zero testing capacity to testing hundreds of health care workers and patients daily, within 3 weeks. We believe our experience can inform the efforts of others when faced with a crisis situation.
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Affiliation(s)
- Stephen D Nimer
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.,Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jennifer Chapman
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Pathology & Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Lisa Reidy
- Department of Pathology & Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alvaro Alencar
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.,Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - YanYun Wu
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Pathology & Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sion Williams
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Lazara Pagan
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Lauren Gjolaj
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jessica MacIntyre
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Melissa Triana
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Barbara Vance
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - David Andrews
- Department of Pathology & Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Yao-Shan Fan
- Department of Pathology & Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Yi Zhou
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Pathology & Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Octavio Martinez
- Department of Pathology & Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Monica Garcia-Buitrago
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Pathology & Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Carolyn Cray
- Department of Pathology & Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mustafa Tekin
- John P. Hussman Institute for Human Genomics and the Dr. John T. MacDonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jacob L McCauley
- John P. Hussman Institute for Human Genomics and the Dr. John T. MacDonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Philip Ruiz
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Paola Pagan
- Department of Pathology & Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Walter Lamar
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Maritza Alencar
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Daniel Bilbao
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Silvia Prieto
- Department of Pathology & Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Maritza Polania
- Department of Pathology & Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Maritza Suarez
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Melissa Lujardo
- Department of Pathology & Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Gloria Campos
- Department of Pathology & Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Michele Morris
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Bhavarth Shukla
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alberto Caban-Martinez
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Erin Kobetz
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.,Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Dipen J Parekh
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Merce Jorda
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Pathology & Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
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189
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Zamecnik CR, Rajan JV, Yamauchi KA, Mann SA, Loudermilk RP, Sowa GM, Zorn KC, Alvarenga BD, Gaebler C, Caskey M, Stone M, Norris PJ, Gu W, Chiu CY, Ng D, Byrnes JR, Zhou XX, Wells JA, Robbiani DF, Nussenzweig MC, DeRisi JL, Wilson MR. ReScan, a Multiplex Diagnostic Pipeline, Pans Human Sera for SARS-CoV-2 Antigens. CELL REPORTS MEDICINE 2020; 1:100123. [PMID: 32995758 PMCID: PMC7513813 DOI: 10.1016/j.xcrm.2020.100123] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/17/2020] [Accepted: 09/21/2020] [Indexed: 12/25/2022]
Abstract
Comprehensive understanding of the serological response to SARS-CoV-2 infection is important for both pathophysiologic insight and diagnostic development. Here, we generate a pan-human coronavirus programmable phage display assay to perform proteome-wide profiling of coronavirus antigens enriched by 98 COVID-19 patient sera. Next, we use ReScan, a method to efficiently sequester phage expressing the most immunogenic peptides and print them onto paper-based microarrays using acoustic liquid handling, which isolates and identifies nine candidate antigens, eight of which are derived from the two proteins used for SARS-CoV-2 serologic assays: spike and nucleocapsid proteins. After deployment in a high-throughput assay amenable to clinical lab settings, these antigens show improved specificity over a whole protein panel. This proof-of-concept study demonstrates that ReScan will have broad applicability for other emerging infectious diseases or autoimmune diseases that lack a valid biomarker, enabling a seamless pipeline from antigen discovery to diagnostic using one recombinant protein source. ReScan is a whole proteome screen to isolate and identify serologic assay targets Antibodies to linear peptides in COVID-19 sera bind spike and nucleocapsid proteins Rapid workflow that seamlessly translates biomarkers into a functional diagnostic Multiplexing linear S and N SARS-CoV-2 peptides can increase diagnostic specificity
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Affiliation(s)
- Colin R Zamecnik
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Jayant V Rajan
- Division of Experimental Medicine, Department of Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, USA
| | | | - Sabrina A Mann
- Chan Zuckerberg Biohub, San Francisco, CA, USA.,Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA, USA
| | - Rita P Loudermilk
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Gavin M Sowa
- University of California, San Francisco School of Medicine, San Francisco, CA, USA
| | - Kelsey C Zorn
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA, USA
| | - Bonny D Alvarenga
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Christian Gaebler
- Laboratory of Molecular Immunology, The Rockefeller University, New York, NY 10065, USA
| | - Marina Caskey
- Laboratory of Molecular Immunology, The Rockefeller University, New York, NY 10065, USA
| | - Mars Stone
- Vitalant Research Institute, San Francisco, CA, USA.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Philip J Norris
- Vitalant Research Institute, San Francisco, CA, USA.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA.,Department of Medicine, University of California, San Francisco, San Francisco, USA
| | - Wei Gu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Charles Y Chiu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA.,Department of Medicine, University of California, San Francisco, San Francisco, USA
| | - Dianna Ng
- Department of Medicine, University of California, San Francisco, San Francisco, USA
| | - James R Byrnes
- Department of Pharmaceutical Chemistry, University of California San Francisco, San Francisco, USA
| | - Xin X Zhou
- Department of Pharmaceutical Chemistry, University of California San Francisco, San Francisco, USA
| | - James A Wells
- Department of Pharmaceutical Chemistry, University of California San Francisco, San Francisco, USA.,Department of Cellular and Molecular Pharmacology, University of California, San Francisco, San Francisco, CA, USA
| | - Davide F Robbiani
- Laboratory of Molecular Immunology, The Rockefeller University, New York, NY 10065, USA
| | - Michel C Nussenzweig
- Laboratory of Molecular Immunology, The Rockefeller University, New York, NY 10065, USA.,Howard Hughes Medical Institute
| | - Joseph L DeRisi
- Chan Zuckerberg Biohub, San Francisco, CA, USA.,Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA, USA
| | - Michael R Wilson
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
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190
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Krüttgen A, Cornelissen CG, Dreher M, Hornef MW, Imöhl M, Kleines M. Determination of SARS-CoV-2 antibodies with assays from Diasorin, Roche and IDvet. J Virol Methods 2020; 287:113978. [PMID: 32979407 PMCID: PMC7510775 DOI: 10.1016/j.jviromet.2020.113978] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/18/2020] [Accepted: 09/19/2020] [Indexed: 02/01/2023]
Abstract
The sensitivity and specificity of seven serological assays for SARS-CoV-2 were compared. No single assay offered a combination of very high sensitivity and very high specificity. To maximize sensitivity and specificity two assays should be combined.
There is an ongoing need for highly reliable serological assays to detect individuals with past SARS-CoV-2 infection. Using 75 sera from patients tested positive or negative by SARS-CoV-2 PCR, we investigated the sensitivity and specificity of the Liaison SARS-CoV-2 S1/S2 IgG assay (DiaSorin), the Elecsys Anti-SARS-CoV-2 assay (Roche), and the ID Screen SARS-CoV-2-N IgG indirect kit (IDVet). We determined a sensitivity of 95.5 %, 95.5 %, and 100 % and a specificity of 90.5 %, 96.2 %, and 92.5 % for the DiaSorin assay, the Roche assay, and the IDVet assay, respectively. We conclude that serologic assays combining very high sensitivity and specificity are still not commercially available for SARS-CoV-2. For maximizing sensitivity and specificity of SARS-CoV-2 serological diagnostics, the combination of two assays may be helpful.
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Affiliation(s)
| | - Christian G Cornelissen
- Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, Germany
| | - Michael Dreher
- Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, Germany
| | - Mathias W Hornef
- Institute of Medical Microbiology, University Hospital RWTH Aachen, Germany
| | - Matthias Imöhl
- Laboratory Diagnostic Center, University Hospital RWTH Aachen, Germany
| | - Michael Kleines
- Laboratory Diagnostic Center, University Hospital RWTH Aachen, Germany.
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191
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Behera BC, Mishra RR, Thatoi H. Recent biotechnological tools for diagnosis of corona virus disease: A review. Biotechnol Prog 2020; 37:e3078. [PMID: 32902193 DOI: 10.1002/btpr.3078] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 08/22/2020] [Accepted: 09/06/2020] [Indexed: 12/14/2022]
Abstract
Recently, a corona virus disease (COVID-19) caused by a novel corona virus (sevier acute respiratory syndrome corona virus 2; SARS-CoV-2), rapidly spread throughout the world. It has been resulted an unprecedented public health crisis and has become a global threat. WHO declared it as a pandemic due to rapid transmission and severity of the disease. According to WHO, as of 22nd of August 2020, the disease spread over 213 countries of the world having 22,812,491 confirmed cases and 795,132 deaths recorded worldwide. In the absence of suitable antiviral drugs and vaccines, the current pandemic has created an urgent need for accurate diagnostic tools that would be helpful for early detection of the patients. Many tests including classical and high-throughput techniques have developed and obtained U.S. Food and drug administration (FDA) approval. However, efforts are being made to develop new diagnostic tools for detection of the disease. Several molecular diagnostic tests such as real-time-polymerase chain reaction, real-time isothermal loop-mediated amplification (RT-LAMP), full genome analysis by next-generation sequencing, clustered regularly interspaced short palindromic repeats technique and microarray-based assays along with other techniques such as computed tomography scan, biomarkers, biosensor, nanotechnology, serological test, enzyme-linked immunosorbent assay (ELISA), isolation of viral strain in cell culture are currently available for diagnosis of COVID-19 infection. This review provides a brief overview of promising high-throughput techniques currently used for detection of SARS-CoV-2, along with their scope and limitations that may be used for effective control of the disease.
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Affiliation(s)
- Bikash C Behera
- School of Biological Sciences, National Institute of Science Education and Research, Bhubaneswar, India
| | - Rashmi R Mishra
- Department of Biotechnology, MITS School of Biotechnology, Bhubaneswar, India
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192
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Huang AT, Garcia-Carreras B, Hitchings MDT, Yang B, Katzelnick LC, Rattigan SM, Borgert BA, Moreno CA, Solomon BD, Trimmer-Smith L, Etienne V, Rodriguez-Barraquer I, Lessler J, Salje H, Burke DS, Wesolowski A, Cummings DAT. A systematic review of antibody mediated immunity to coronaviruses: kinetics, correlates of protection, and association with severity. Nat Commun 2020; 11:4704. [PMID: 32943637 PMCID: PMC7499300 DOI: 10.1038/s41467-020-18450-4] [Citation(s) in RCA: 615] [Impact Index Per Article: 153.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/18/2020] [Indexed: 01/05/2023] Open
Abstract
Many public health responses and modeled scenarios for COVID-19 outbreaks caused by SARS-CoV-2 assume that infection results in an immune response that protects individuals from future infections or illness for some amount of time. The presence or absence of protective immunity due to infection or vaccination (when available) will affect future transmission and illness severity. Here, we review the scientific literature on antibody immunity to coronaviruses, including SARS-CoV-2 as well as the related SARS-CoV, MERS-CoV and endemic human coronaviruses (HCoVs). We reviewed 2,452 abstracts and identified 491 manuscripts relevant to 5 areas of focus: 1) antibody kinetics, 2) correlates of protection, 3) immunopathogenesis, 4) antigenic diversity and cross-reactivity, and 5) population seroprevalence. While further studies of SARS-CoV-2 are necessary to determine immune responses, evidence from other coronaviruses can provide clues and guide future research.
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Affiliation(s)
- Angkana T Huang
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Bernardo Garcia-Carreras
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Matt D T Hitchings
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Bingyi Yang
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Leah C Katzelnick
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Susan M Rattigan
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Brooke A Borgert
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Carlos A Moreno
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Benjamin D Solomon
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Luke Trimmer-Smith
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Veronique Etienne
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
- Department of Comparative, Diagnostic & Population Medicine, University of Florida, Gainesville, FL, USA
| | | | - Justin Lessler
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Henrik Salje
- Department of Biology, University of Florida, Gainesville, FL, USA
- Department of Genetics, University of Cambridge, Cambridge, UK
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Paris, France
| | - Donald S Burke
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Amy Wesolowski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Derek A T Cummings
- Department of Biology, University of Florida, Gainesville, FL, USA.
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.
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193
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Wu SY, Yau HS, Yu MY, Tsang HF, Chan LWC, Cho WCS, Shing Yu AC, Yuen Yim AK, Li MJW, Wong YKE, Pei XM, Cesar Wong SC. The diagnostic methods in the COVID-19 pandemic, today and in the future. Expert Rev Mol Diagn 2020; 20:985-993. [PMID: 32845192 DOI: 10.1080/14737159.2020.1816171] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The emergence of anovel coronavirus identified in patients with unknown cause of acute respiratory disease in Wuhan, China at the end of 2019 has caused aglobal outbreak. The causative coronavirus was later named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease caused by SARS-CoV-2 was named as Coronavirus Disease-2019 (COVID-19). As of 10 August 2020, more than 19,718,030 confirmed cases and 728,013 deaths have been reported. COVID-19 is spread via respiratory droplets which are inhaled into the lungs. AREAS COVERED In this article, we summarized the knowledge about the causative pathogen of COVID-19 and various diagnostic methods in this pandemic for better understanding of the limitations and the nuances of virus testing for COVID-19. EXPERT OPINION In this pandemic, rapid and accurate identification of COVID-19 patients are critical to break the chain of infection in the community. RT-PCR provides a rapid and reliable identification of SARS-CoV-2 infection. In the future, molecular diagnostics will still be the gold standard and next-generation sequencing can help us to understand more on the pathogenesis and detect novel mutations. It is believed that more sophisticated detection methods will be introduced to detect SARS-CoV-2 as earliest as possible.
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Affiliation(s)
- So Yat Wu
- Department of Health Technology and Informatics, Hong Kong Polytechnic University , Hong Kong Special Administrative Region, China
| | - Hoi Shan Yau
- Department of Health Technology and Informatics, Hong Kong Polytechnic University , Hong Kong Special Administrative Region, China
| | - Man Yee Yu
- Department of Health Technology and Informatics, Hong Kong Polytechnic University , Hong Kong Special Administrative Region, China
| | - Hin Fung Tsang
- Department of Health Technology and Informatics, Hong Kong Polytechnic University , Hong Kong Special Administrative Region, China
| | - Lawrence Wing Chi Chan
- Department of Health Technology and Informatics, Hong Kong Polytechnic University , Hong Kong Special Administrative Region, China
| | - William Chi Shing Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital , Hong Kong Special Administrative Region, China
| | | | | | - Marco J W Li
- Codex Genetics Limited , Hong Kong Special Administrative Region, China
| | - Yin Kwan Evelyn Wong
- Department of Health Technology and Informatics, Hong Kong Polytechnic University , Hong Kong Special Administrative Region, China
| | - Xiao Meng Pei
- Department of Health Technology and Informatics, Hong Kong Polytechnic University , Hong Kong Special Administrative Region, China
| | - Sze Chuen Cesar Wong
- Department of Health Technology and Informatics, Hong Kong Polytechnic University , Hong Kong Special Administrative Region, China
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194
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Cheng MP, Yansouni CP, Basta NE, Desjardins M, Kanjilal S, Paquette K, Caya C, Semret M, Quach C, Libman M, Mazzola L, Sacks JA, Dittrich S, Papenburg J. Serodiagnostics for Severe Acute Respiratory Syndrome-Related Coronavirus 2 : A Narrative Review. Ann Intern Med 2020; 173:450-460. [PMID: 32496919 PMCID: PMC7281623 DOI: 10.7326/m20-2854] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Accurate serologic tests to detect host antibodies to severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) will be critical for the public health response to the coronavirus disease 2019 pandemic. Many use cases are envisaged, including complementing molecular methods for diagnosis of active disease and estimating immunity for individuals. At the population level, carefully designed seroepidemiologic studies will aid in the characterization of transmission dynamics and refinement of disease burden estimates and will provide insight into the kinetics of humoral immunity. Yet, despite an explosion in the number and availability of serologic assays to test for antibodies against SARS-CoV-2, most have undergone minimal external validation to date. This hinders assay selection and implementation, as well as interpretation of study results. In addition, critical knowledge gaps remain regarding serologic correlates of protection from infection or disease, and the degree to which these assays cross-react with antibodies against related coronaviruses. This article discusses key use cases for SARS-CoV-2 antibody detection tests and their application to serologic studies, reviews currently available assays, highlights key areas of ongoing research, and proposes potential strategies for test implementation.
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Affiliation(s)
- Matthew P Cheng
- McGill University Health Centre and McGill Interdisciplinary Initiative in Infection and Immunity, Montreal, Quebec, Canada (M.P.C.)
| | - Cedric P Yansouni
- McGill University Health Centre, McGill Interdisciplinary Initiative in Infection and Immunity, and J.D. MacLean Centre for Tropical Diseases, McGill University, Montreal, Quebec, Canada (C.P.Y., M.S., M.L.)
| | - Nicole E Basta
- School of Population and Global Health, McGill University, Montreal, Quebec, Canada (N.E.B.)
| | - Michaël Desjardins
- Brigham and Women's Hospital, Boston, Massachusetts, and Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (M.D.)
| | - Sanjat Kanjilal
- Brigham and Women's Hospital and Harvard Medical School & Harvard Pilgrim Healthcare Institute, Boston, Massachusetts (S.K.)
| | - Katryn Paquette
- Montreal Children's Hospital, Montreal, Quebec, Canada (K.P.)
| | - Chelsea Caya
- McGill Interdisciplinary Initiative in Infection and Immunity, Montreal, Quebec, Canada (C.C.)
| | - Makeda Semret
- McGill University Health Centre, McGill Interdisciplinary Initiative in Infection and Immunity, and J.D. MacLean Centre for Tropical Diseases, McGill University, Montreal, Quebec, Canada (C.P.Y., M.S., M.L.)
| | - Caroline Quach
- CHU Sainte-Justine, Université de Montréal, Montreal, Canada (C.Q.)
| | - Michael Libman
- McGill University Health Centre, McGill Interdisciplinary Initiative in Infection and Immunity, and J.D. MacLean Centre for Tropical Diseases, McGill University, Montreal, Quebec, Canada (C.P.Y., M.S., M.L.)
| | - Laura Mazzola
- Foundation of Innovative New Diagnostics (FIND), Geneva, Switzerland (L.M., J.A.S.)
| | - Jilian A Sacks
- Foundation of Innovative New Diagnostics (FIND), Geneva, Switzerland (L.M., J.A.S.)
| | - Sabine Dittrich
- Foundation of Innovative New Diagnostics (FIND), Geneva, Switzerland, and Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (S.D.)
| | - Jesse Papenburg
- McGill Interdisciplinary Initiative in Infection and Immunity, School of Population and Global Health, McGill University, and Montreal Children's Hospital, Montreal, Quebec, Canada (J.P.)
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195
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Bortz RH, Florez C, Laudermilch E, Wirchnianski AS, Lasso G, Malonis RJ, Georgiev GI, Vergnolle O, Herrera NG, Morano NC, Campbell ST, Orner EP, Mengotto A, Dieterle ME, Fels JM, Haslwanter D, Jangra RK, Celikgil A, Kimmel D, Lee JH, Mariano M, Antonio N, Jose Q, Rivera J, Szymczak WA, Tong K, Barnhill J, Forsell MNE, Ahlm C, Stein DT, Pirofski LA, Goldstein DY, Garforth SJ, Almo SC, Daily JP, Prystowsky MB, Faix JD, Fox AS, Weiss LM, Lai JR, Chandran K. Development, clinical translation, and utility of a COVID-19 antibody test with qualitative and quantitative readouts. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.09.10.20192187. [PMID: 32935116 PMCID: PMC7491531 DOI: 10.1101/2020.09.10.20192187] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The COVID-19 global pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) continues to place an immense burden on societies and healthcare systems. A key component of COVID-19 control efforts is serologic testing to determine the community prevalence of SARS-CoV-2 exposure and quantify individual immune responses to prior infection or vaccination. Here, we describe a laboratory-developed antibody test that uses readily available research-grade reagents to detect SARS-CoV-2 exposure in patient blood samples with high sensitivity and specificity. We further show that this test affords the estimation of viral spike-specific IgG titers from a single sample measurement, thereby providing a simple and scalable method to measure the strength of an individual's immune response. The accuracy, adaptability, and cost-effectiveness of this test makes it an excellent option for clinical deployment in the ongoing COVID-19 pandemic.
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Affiliation(s)
- Robert H. Bortz
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Catalina Florez
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Department of Chemistry and Life Science, United States Military Academy at West Point, West Point, NY 10996, USA
| | - Ethan Laudermilch
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Ariel S. Wirchnianski
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Gorka Lasso
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Ryan J. Malonis
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - George I. Georgiev
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Olivia Vergnolle
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Natalia G. Herrera
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Nicholas C. Morano
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Sean T. Campbell
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Erika P. Orner
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Amanda Mengotto
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - M. Eugenia Dieterle
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - J. Maximilian Fels
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Denise Haslwanter
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Rohit K. Jangra
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Alev Celikgil
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Duncan Kimmel
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - James H. Lee
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Margarette Mariano
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Nakouzi Antonio
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - Quiroz Jose
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - Johanna Rivera
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - Wendy A. Szymczak
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Karen Tong
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Jason Barnhill
- Department of Chemistry and Life Science, United States Military Academy at West Point, West Point, NY 10996, USA
| | | | - Clas Ahlm
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | - Daniel T. Stein
- Division of Endocrinology & Diabetes, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - Liise-anne Pirofski
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | | | - Scott J. Garforth
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Steven C. Almo
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Johanna P. Daily
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | | | - James D. Faix
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Amy S. Fox
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Louis M. Weiss
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Jonathan R. Lai
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Kartik Chandran
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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Witkowska D. Mass Spectrometry and Structural Biology Techniques in the Studies on the Coronavirus-Receptor Interaction. Molecules 2020; 25:E4133. [PMID: 32927621 PMCID: PMC7571139 DOI: 10.3390/molecules25184133] [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: 08/01/2020] [Revised: 09/01/2020] [Accepted: 09/09/2020] [Indexed: 12/15/2022] Open
Abstract
Mass spectrometry and some other biophysical methods, have made substantial contributions to the studies on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and human proteins interactions. The most interesting feature of SARS-CoV-2 seems to be the structure of its spike (S) protein and its interaction with the human cell receptor. Mass spectrometry of spike S protein revealed how the glycoforms are distributed across the S protein surface. X-ray crystallography and cryo-electron microscopy made huge impact on the studies on the S protein and ACE2 receptor protein interaction, by elucidating the three-dimensional structures of these proteins and their conformational changes. The findings of the most recent studies in the scope of SARS-CoV-2-Human protein-protein interactions are described here.
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MESH Headings
- Amino Acid Sequence
- Angiotensin-Converting Enzyme 2
- Betacoronavirus/chemistry
- Betacoronavirus/pathogenicity
- Binding Sites
- COVID-19
- Coronavirus Infections/epidemiology
- Coronavirus Infections/virology
- Gene Expression
- Host-Pathogen Interactions
- Humans
- Models, Molecular
- Pandemics
- Peptidyl-Dipeptidase A/chemistry
- Peptidyl-Dipeptidase A/genetics
- Peptidyl-Dipeptidase A/metabolism
- Pneumonia, Viral/epidemiology
- Pneumonia, Viral/virology
- Protein Binding
- Protein Conformation, alpha-Helical
- Protein Conformation, beta-Strand
- Protein Interaction Domains and Motifs
- Receptors, Virus/chemistry
- Receptors, Virus/genetics
- Receptors, Virus/metabolism
- Severe acute respiratory syndrome-related coronavirus/chemistry
- Severe acute respiratory syndrome-related coronavirus/pathogenicity
- SARS-CoV-2
- Sequence Alignment
- Severe Acute Respiratory Syndrome/epidemiology
- Severe Acute Respiratory Syndrome/virology
- Spike Glycoprotein, Coronavirus/chemistry
- Spike Glycoprotein, Coronavirus/genetics
- Spike Glycoprotein, Coronavirus/metabolism
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Affiliation(s)
- Danuta Witkowska
- Institute of Health Sciences, Opole University, Katowicka 68, 45-060 Opole, Poland
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Abstract
Since Coronavirus Disease 2019 (COVID-19) first emerged in December 2019, the disease has rapidly evolved into a pandemic that threatens societies around the world. As soon as the causative pathogen, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified and its genome sequence determined, a laboratory diagnosis based on nucleic acid amplification technologies was quickly established and has played essential roles in the confirmation of a clinical diagnosis. Serological testing for antibodies against SARS-CoV-2 is becoming available for complementary diagnosis, identification of convalescent plasma, and epidemiologic studies. Additional laboratory biochemical tests, including monitoring the change in blood cells, blood gas, coagulation, liver function, cardiac markers, and inflammatory responses such as cytokine levels in plasma, are also critical in combating COVID-19. Nevertheless, with overwhelming numbers of patients and potentially large numbers of asymptomatic cases, clinical laboratories encounter enormous challenges in diagnostic approaches that can rapidly and accurately identify infected persons. Strategies that can effectively detect disease progression in order to stratify patients for appropriate care, and that can thereby prevent exacerbation of the disease, are urgently needed. This review discusses the laboratory's role and challenges in combating COVID-19.
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Affiliation(s)
- Bingliang Fang
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Qing H Meng
- Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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198
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Kilic T, Weissleder R, Lee H. Molecular and Immunological Diagnostic Tests of COVID-19: Current Status and Challenges. iScience 2020; 23:101406. [PMID: 32771976 PMCID: PMC7381402 DOI: 10.1016/j.isci.2020.101406] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/10/2020] [Accepted: 07/20/2020] [Indexed: 12/16/2022] Open
Abstract
Rapid spread of coronavirus disease 2019 (COVID-19) is ravaging the globe. Since its first report in December 2019, COVID-19 cases have exploded to over 14 million as of July 2020, claiming more than 600,000 lives. Implementing fast and widespread diagnostic tests is paramount to contain COVID-19, given the current lack of an effective therapeutic or vaccine. This review focuses on a broad description of currently available diagnostic tests to detect either the virus (SARS-CoV-2) or virus-induced immune responses. We specifically explain the working mechanisms of these tests and compare their analytical performance. These analyses will assist in selecting most effective tests for a given application, for example, epidemiology or global pandemic research, population screening, hospital-based testing, home-based and point-of-care testing, and therapeutic trials. Finally, we lay out the shortcomings of certain tests and future needs.
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Affiliation(s)
- Tugba Kilic
- Center for Systems Biology and Department of Radiology, Massachusetts General Hospital Research Institute, Harvard Medical School, Boston, MA 02114 USA
| | - Ralph Weissleder
- Center for Systems Biology and Department of Radiology, Massachusetts General Hospital Research Institute, Harvard Medical School, Boston, MA 02114 USA; Department of Systems Biology, Harvard Medical School, Boston, MA 02115, USA
| | - Hakho Lee
- Center for Systems Biology and Department of Radiology, Massachusetts General Hospital Research Institute, Harvard Medical School, Boston, MA 02114 USA.
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199
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Evaluation of the performance of SARS-CoV-2 serological tools and their positioning in COVID-19 diagnostic strategies. Diagn Microbiol Infect Dis 2020; 98:115181. [PMID: 32957073 PMCID: PMC7441068 DOI: 10.1016/j.diagmicrobio.2020.115181] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/14/2020] [Accepted: 08/16/2020] [Indexed: 01/04/2023]
Abstract
Rapid and accurate diagnosis is crucial for successful outbreak containment. During the current coronavirus disease 2019 (COVID-19) public health emergency, the gold standard for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection diagnosis is the detection of viral RNA. Additional diagnostic methods õenabling the detection of current or past SARS-CoV-2 infection would be highly beneficial. We assessed 2 immunochromatographic lateral flow assays (LFA-1, LFA-2) and 2 enzyme-linked immunosorbent assay kits (IgA/IgG ELISA-1, IgM/IgG ELISA-2) using 325 samples: serum samples from polymerase chain reaction-confirmed COVID-19 hospitalized patients (n = 55) and healthcare workers (n = 143) and 127 samples from negative controls. Diagnostic performances were assessed according to days after symptom onset (dso) and the antigenic format used by manufacturers. Clinical sensitivities varied greatly among the assays, showing poor mutual agreement. After 15 dso, ELISA-1 (Euroimmun) and LFA-1 (Biosynex) combining IgM and IgG detection showed the best performances. A thorough selection of serological assays for the detection of ongoing or past infections is advisable.
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Abstract
INTRODUCTION Background cross-reactivity with other coronaviruses may reduce the specificity of COVID-19 rapid serologic tests. The vast majority of women attend prenatal care, which is a unique source of population-based blood samples appropriate for validation studies. We used stored 2018 serum samples from an existing pregnancy cohort study to evaluate the specificity of COVID-19 serologic rapid diagnostic tests. METHODS We randomly selected 120 stored serum samples from pregnant women enrolled in a cohort in 2018 in Tegucigalpa, Honduras, at least 1 year before the COVID-19 pandemic. We used stored serum to evaluate four lateral flow rapid diagnostic tests, following manufacturers' instructions. Pictures were taken for all tests and read by two blinded trained evaluators. RESULTS We evaluated 120, 80, 90, and 90 samples, respectively. Specificity for both IgM and IgG was 100% for the first two tests (95% confidence intervals [CI] 97.0-100 and 95.5-100, respectively). The third test had a specificity of 98.9% (95% CI 94.0-100) for IgM and 94.4% (95% CI 87.5-98.2) for IgG. The fourth test had a specificity of 88.9% (95% CI 80.5-94.5) for IgM and 100% (95% CI 96.0-100) for IgG. DISCUSSION COVID-19 serologic rapid tests are of variable specificity. Blood specimens from sentinel prenatal clinics provide an opportunity to validate serologic tests with population-based samples.
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