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Llorente F, Pérez-Ramírez E, Pérez-Olmeda M, Dafouz-Bustos D, Fernández-Pinero J, Martínez-Cortés M, Jiménez-Clavero MÁ. The Detection of SARS-CoV-2 Antibodies in an Exposed Human Population Is Biased by the Immunoassay Used: Implications in Serosurveillance. Pathogens 2023; 12:1360. [PMID: 38003824 PMCID: PMC10675702 DOI: 10.3390/pathogens12111360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
The presence of SARS-CoV-2 antibodies was examined over 7 months in a population of essential service workers exposed during the first epidemic wave in Madrid (Spain). Results obtained with different serological assays were compared. Firstly, serum samples obtained in April 2020 were analyzed using eleven SARS-CoV-2 antibody detection methods, including seven ELISAs, two CLIAs and two LFAs. While all of the ELISA tests and the Roche eCLIA method showed good performance, it was poorer for the Abbott CLIA and LFA tests. Sera from 115 workers with serologically positive results in April were collected 2 and 7 months after the first sampling and were analyzed using five of the tests previously assessed. The results showed that while some ELISA tests consistently detected the presence of anti-SARS-CoV-2 antibodies even 7 months after first detection, other methods, such as the Abbott CLIA test, showed an important reduction in sensitivity for these mature antibodies. The sensitivity increased after establishing new cut-off values, calculated taking into account both recent and old infections, suggesting that an adjustment of assay parameters may improve the detection of individuals exposed to the infection.
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Affiliation(s)
- Francisco Llorente
- Centro de Investigación en Sanidad Animal (CISA-INIA), CSIC, Valdeolmos, 28130 Madrid, Spain (M.Á.J.-C.)
| | - Elisa Pérez-Ramírez
- Centro de Investigación en Sanidad Animal (CISA-INIA), CSIC, Valdeolmos, 28130 Madrid, Spain (M.Á.J.-C.)
| | - Mayte Pérez-Olmeda
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), 28029 Madrid, Spain
| | - Desirée Dafouz-Bustos
- Centro de Investigación en Sanidad Animal (CISA-INIA), CSIC, Valdeolmos, 28130 Madrid, Spain (M.Á.J.-C.)
| | - Jovita Fernández-Pinero
- Centro de Investigación en Sanidad Animal (CISA-INIA), CSIC, Valdeolmos, 28130 Madrid, Spain (M.Á.J.-C.)
| | | | - Miguel Ángel Jiménez-Clavero
- Centro de Investigación en Sanidad Animal (CISA-INIA), CSIC, Valdeolmos, 28130 Madrid, Spain (M.Á.J.-C.)
- Centro de Investigación Biomédica en Red de Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain
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Han J, Baek HJ, Noh E, Yoon K, Kim JA, Ryu S, Lee KO, Park NY, Jung E, Kim S, Lee H, Hwang YS, Jung J, Lee HJ, Cho SI, Oh S, Kim M, Oh CM, Yu B, Hong YS, Kim K, Jung S, Han MA, Lee MS, Lee JJ, Hwangbo Y, Yim HW, Kim YM, Lee J, Lee WY, Park JH, Oh S, Jo HS, Kim H, Kang G, Nam HS, Lee JH, Oh GJ, Shin MH, Ryu S, Hwang TY, Park SW, Kim SK, Seol R, Park KS, Kim SY, Kwon JW, Kim SS, Kim B, Lee JW, Jang EY, Kim AR, Nam J, Lee SY, Kim DH. Korea Seroprevalence Study of Monitoring of SARS-COV-2 Antibody Retention and Transmission (K-SEROSMART): findings from national representative sample. Epidemiol Health 2023; 45:e2023075. [PMID: 37591786 PMCID: PMC10728614 DOI: 10.4178/epih.e2023075] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/13/2023] [Indexed: 08/19/2023] Open
Abstract
OBJECTIVES We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.
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Affiliation(s)
- Jina Han
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Hye Jin Baek
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Eunbi Noh
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Kyuhyun Yoon
- Institute of Health and Environment, Seoul National University, Seoul, Korea
| | - Jung Ae Kim
- Department of Nursing, Kyungmin University, Uijeongbu, Korea
| | - Sukhyun Ryu
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea
| | | | - No Yai Park
- Graduate School of Public Health, Inje University, Seoul, Korea
| | - Eunok Jung
- Department of Mathematics, Konkuk University, Seoul, Korea
| | - Sangil Kim
- Department of Internal Medicine, College of Medicine, The Catholic University, Seoul, Korea
| | - Hyukmin Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | | | - Jaehun Jung
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Hun Jae Lee
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Korea
| | - Sung-il Cho
- Institute of Health and Environment, Seoul National University, Seoul, Korea
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | | | | | - Chang-Mo Oh
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Byengchul Yu
- Department of Preventive Medicine, Kosin University College of Medicine, Busan, Korea
| | - Young-Seoub Hong
- Department of Preventive Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Keonyeop Kim
- Department of Preventive Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sunjae Jung
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Mi Ah Han
- Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Moo-Sik Lee
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Jung-Jeung Lee
- Department of Preventive Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Young Hwangbo
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University, Seoul, Korea
| | - Yu-Mi Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
- School of Public Health, Hanyang University, Seoul, Korea
| | - Joongyub Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea
| | - Weon-Young Lee
- Department of Preventive Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jae-Hyun Park
- Department of Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Sungsoo Oh
- Department of Occupational & Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Heui Sug Jo
- Department of Health Policy and Management, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Hyeongsu Kim
- Department of Preventive Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Gilwon Kang
- Department of Health Information and Management, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hae-Sung Nam
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Ju-Hyung Lee
- Department of Preventive Medicine, Jeonbuk National University Medical School, Jeonju, Korea
| | - Gyung-Jae Oh
- Department of Preventive Medicine, Wonkwang University School of Medicine, Iksan, Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Soyeon Ryu
- Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Tae-Yoon Hwang
- Department of Preventive Medicine & Public Health, Yeungnam University College of Medicine, Gyeongsan, Korea
| | - Soon-Woo Park
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Gyeongsan, Korea
| | - Sang Kyu Kim
- Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea
| | - Roma Seol
- Department of Preventive Medicine, Inje University College of Medicine, Busan, Korea
| | - Ki-Soo Park
- Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Su Young Kim
- Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Jun-wook Kwon
- National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sung Soon Kim
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Byoungguk Kim
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - June-Woo Lee
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - Eun Young Jang
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - Ah-Ra Kim
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - Jeonghyun Nam
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - The Korea Community Health Survey Group
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
- Institute of Health and Environment, Seoul National University, Seoul, Korea
- Department of Nursing, Kyungmin University, Uijeongbu, Korea
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea
- Gallup Korea, Seoul, Korea
- Graduate School of Public Health, Inje University, Seoul, Korea
- Department of Mathematics, Konkuk University, Seoul, Korea
- Department of Internal Medicine, College of Medicine, The Catholic University, Seoul, Korea
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
- Seegene Medical Foundation, Seoul, Korea
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Korea
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
- MAPO-gu Public Health Center, Seoul, Korea
- GUNPO-si Public Health Center, Gunpo, Korea
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
- Department of Preventive Medicine, Kosin University College of Medicine, Busan, Korea
- Department of Preventive Medicine, Dong-A University College of Medicine, Busan, Korea
- Department of Preventive Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea
- Department of Preventive Medicine, Keimyung University School of Medicine, Daegu, Korea
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
- Department of Preventive Medicine, College of Medicine, The Catholic University, Seoul, Korea
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
- School of Public Health, Hanyang University, Seoul, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea
- Department of Preventive Medicine, Chung-Ang University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
- Department of Occupational & Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Health Policy and Management, Kangwon National University School of Medicine, Chuncheon, Korea
- Department of Preventive Medicine, Konkuk University School of Medicine, Seoul, Korea
- Department of Health Information and Management, Chungbuk National University College of Medicine, Cheongju, Korea
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea
- Department of Preventive Medicine, Jeonbuk National University Medical School, Jeonju, Korea
- Department of Preventive Medicine, Wonkwang University School of Medicine, Iksan, Korea
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
- Department of Preventive Medicine & Public Health, Yeungnam University College of Medicine, Gyeongsan, Korea
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Gyeongsan, Korea
- Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea
- Department of Preventive Medicine, Inje University College of Medicine, Busan, Korea
- Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea
- Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
- National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Korea
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea Disease Control and Prevention Agency, Cheongju, Korea
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Soon Young Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Dong-Hyun Kim
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea
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3
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Egger AE, Sahanic S, Gleiss A, Ratzinger F, Holzer B, Irsara C, Binder N, Winkler C, Binder CJ, Posch W, Loacker L, Hartmann B, Anliker M, Weiss G, Sonnweber T, Tancevski I, Griesmacher A, Löffler-Ragg J, Hoermann G. One-Year Follow-Up of COVID-19 Patients Indicates Substantial Assay-Dependent Differences in the Kinetics of SARS-CoV-2 Antibodies. Microbiol Spectr 2022; 10:e0059722. [PMID: 36222681 PMCID: PMC9784763 DOI: 10.1128/spectrum.00597-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 09/06/2022] [Indexed: 01/05/2023] Open
Abstract
Determination of antibody levels against the nucleocapsid (N) and spike (S) proteins of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are used to estimate the humoral immune response after SARS-CoV-2 infection or vaccination. Differences in the design and specification of antibody assays challenge the interpretation of test results, and comparative studies are often limited to single time points per patient. We determined the longitudinal kinetics of antibody levels of 145 unvaccinated coronavirus disease 2019 (COVID-19) patients at four visits over 1 year upon convalescence using 8 commercial SARS-CoV-2 antibody assays (from Abbott, DiaSorin, Roche, Siemens, and Technoclone), as well as a virus neutralization test (VNT). A linear regression model was used to investigate whether antibody results obtained in the first 6 months after disease onset could predict the VNT results at 12 months. Spike protein-specific antibody tests showed good correlation to the VNT at individual time points (rS, 0.74 to 0.92). While longitudinal assay comparison with the Roche Elecsys anti-SARS-CoV-2 S test showed almost constant antibody concentrations over 12 months, the VNT and all other tests indicated a decline in serum antibody levels (median decrease to 14% to 36% of baseline). The antibody level at 3 months was the best predictor of the VNT results at 12 months after disease onset. The current standardization to a WHO calibrator for normalization to binding antibody units (BAU) is not sufficient for the harmonization of SARS-CoV-2 antibody tests. Assay-specific differences in absolute values and trends over time need to be considered when interpreting the course of antibody levels in patients. IMPORTANCE Determination of antibodies against SARS-CoV-2 will play an important role in detecting a sufficient immune response. Although all the manufacturers expressed antibody levels in binding antibody units per milliliter, thus suggesting comparable results, we found discrepant behavior between the eight investigated assays when we followed the antibody levels in a cohort of 145 convalescent patients over 1 year. While one assay yielded constant antibody levels, the others showed decreasing antibody levels to a varying extent. Therefore, the comparability of the assays must be improved regarding the long-term kinetics of antibody levels. This is a prerequisite for establishing reliable antibody level cutoffs for sufficient individual protection against SARS-CoV-2.
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Affiliation(s)
- Alexander E. Egger
- Central Institute of Medical and Chemical Laboratory Diagnostics (ZIMCL), University Hospital of Innsbruck, Innsbruck, Austria
| | - Sabina Sahanic
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Andreas Gleiss
- Section for Clinical Biometrics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | | | - Barbara Holzer
- Austrian Agency for Health and Food Safety (AGES), Department for Animal Health, Moedling, Austria
| | - Christian Irsara
- Central Institute of Medical and Chemical Laboratory Diagnostics (ZIMCL), University Hospital of Innsbruck, Innsbruck, Austria
| | - Nikolaus Binder
- Technoclone Herstellung von Diagnostika und Arzneimitteln GmbH, Vienna, Austria
| | - Christoph Winkler
- Central Institute of Medical and Chemical Laboratory Diagnostics (ZIMCL), University Hospital of Innsbruck, Innsbruck, Austria
| | - Christoph J. Binder
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Wilfried Posch
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Lorin Loacker
- Central Institute of Medical and Chemical Laboratory Diagnostics (ZIMCL), University Hospital of Innsbruck, Innsbruck, Austria
| | - Boris Hartmann
- Austrian Agency for Health and Food Safety (AGES), Department for Animal Health, Moedling, Austria
| | - Markus Anliker
- Central Institute of Medical and Chemical Laboratory Diagnostics (ZIMCL), University Hospital of Innsbruck, Innsbruck, Austria
| | - Guenter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Sonnweber
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Ivan Tancevski
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrea Griesmacher
- Central Institute of Medical and Chemical Laboratory Diagnostics (ZIMCL), University Hospital of Innsbruck, Innsbruck, Austria
| | - Judith Löffler-Ragg
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Gregor Hoermann
- Central Institute of Medical and Chemical Laboratory Diagnostics (ZIMCL), University Hospital of Innsbruck, Innsbruck, Austria
- MLL (Munich Leukemia Laboratory), Munich, Germany
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4
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Neuhauser H, Rosario AS, Butschalowsky H, Haller S, Hoebel J, Michel J, Nitsche A, Poethko-Müller C, Prütz F, Schlaud M, Steinhauer HW, Wilking H, Wieler LH, Schaade L, Liebig S, Gößwald A, Grabka MM, Zinn S, Ziese T. Nationally representative results on SARS-CoV-2 seroprevalence and testing in Germany at the end of 2020. Sci Rep 2022; 12:19492. [PMID: 36376417 PMCID: PMC9662125 DOI: 10.1038/s41598-022-23821-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 11/07/2022] [Indexed: 11/16/2022] Open
Abstract
Pre-vaccine SARS-CoV-2 seroprevalence data from Germany are scarce outside hotspots, and socioeconomic disparities remained largely unexplored. The nationwide representative RKI-SOEP study (15,122 participants, 18-99 years, 54% women) investigated seroprevalence and testing in a supplementary wave of the Socio-Economic-Panel conducted predominantly in October-November 2020. Self-collected oral-nasal swabs were PCR-positive in 0.4% and Euroimmun anti-SARS-CoV-2-S1-IgG ELISA from dry-capillary-blood antibody-positive in 1.3% (95% CI 0.9-1.7%, population-weighted, corrected for sensitivity = 0.811, specificity = 0.997). Seroprevalence was 1.7% (95% CI 1.2-2.3%) when additionally correcting for antibody decay. Overall infection prevalence including self-reports was 2.1%. We estimate 45% (95% CI 21-60%) undetected cases and lower detection in socioeconomically deprived districts. Prior SARS-CoV-2 testing was reported by 18% from the lower educational group vs. 25% and 26% from the medium and high educational group (p < 0.001, global test over three categories). Symptom-triggered test frequency was similar across educational groups. Routine testing was more common in low-educated adults, whereas travel-related testing and testing after contact with infected persons was more common in highly educated groups. This countrywide very low pre-vaccine seroprevalence in Germany at the end of 2020 can serve to evaluate the containment strategy. Our findings on social disparities indicate improvement potential in pandemic planning for people in socially disadvantaged circumstances.
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Affiliation(s)
- Hannelore Neuhauser
- Robert Koch Institute, Berlin, Germany.
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101, Berlin, Germany.
| | | | | | | | | | | | | | | | | | | | - Hans W Steinhauer
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
| | | | | | | | - Stefan Liebig
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
- SOEP & Department of Political and Social Sciences, Free University, Berlin, Germany
| | | | - Markus M Grabka
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
| | - Sabine Zinn
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
- SOEP & Department of Social Sciences, Humboldt University, Berlin, Germany
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5
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Effectiveness of COVID-19 vaccination in healthcare workers in Shiga Prefecture, Japan. Sci Rep 2022; 12:17621. [PMID: 36271136 PMCID: PMC9586956 DOI: 10.1038/s41598-022-22682-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/18/2022] [Indexed: 01/13/2023] Open
Abstract
This study, which included serological and cellular immunity tests, evaluated whether coronavirus disease 2019 (COVID-19) vaccination adequately protected healthcare workers (HCWs) from COVID-19. Serological investigations were conducted among 1600 HCWs (mean ± standard deviation, 7.4 ± 1.4 months after the last COVID-19 vaccination). Anti-SARS-CoV-2 antibodies N-Ig, Spike-Ig (Roche), N-IgG, Spike-IgM, and -IgG (Abbott), were evaluated using a questionnaire of health condition. 161 HCWs were analyzed for cellular immunity using T-SPOT® SARS-CoV-2 kit before, and 52 HCWs were followed up until 138.3 ± 15.7 days after their third vaccination. Spike-IgG value was 954.4 ± 2282.6 AU/mL. Forty-nine of the 1600 HCWs (3.06%) had pre-existing SARS-CoV-2 infection. None of the infectious seropositive HCWs required hospitalization. T-SPOT value was 85.0 ± 84.2 SFU/106 cells before the third vaccination, which increased to 219.4 ± 230.4 SFU/106 cells immediately after, but attenuated later (to 111.1 ± 133.6 SFU/106 cells). Poor counts (< 40 SFU/106 cells) were present in 34.8% and 38.5% of HCWs before and after the third vaccination, respectively. Our findings provide insights into humoral and cellular immune responses to repeated COVID-19 vaccinations. COVID-19 vaccination was effective in protecting HCWs from serious illness during the original Wuhan-1, Alpha, Delta and also ongoing Omicron-predominance periods. However, repeated vaccinations using current vaccine versions may not induce sufficient cellular immunity in all HCWs.
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Serology suggests adequate safety measures to protect healthcare workers from COVID-19 in Shiga Prefecture, Japan. PLoS One 2022; 17:e0270334. [PMID: 35749426 PMCID: PMC9231724 DOI: 10.1371/journal.pone.0270334] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 06/08/2022] [Indexed: 01/24/2023] Open
Abstract
Healthcare workers (HCWs), especially frontline workers against coronavirus disease 2019 (COVID-19), are considered to be risky because of occupational exposure to infected patients. This study evaluated the correlation between seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies among HCWs and the implementation of personal protective equipment (PPE) & infection prevention and control (IPC). We recruited 1237 HCWs from nine public COVID-19-designated hospitals in Shiga Prefecture, central Japan, between 15-26 February 2021. All participants answered a self-administered questionnaire and provided blood samples to evaluate SARS-CoV-2 antibodies. A total of 22 cases (1·78%) were seropositive among the 1237 study participants. An unavoidable outbreak of SARS-CoV-2 had occurred at the terminal care unit of one hospital, before identifying and securely isolating this cluster of cases. Excluding with this cluster, 0·68% of HCWs were suspected to have had previous SARS-CoV-2 infections. Binomial logistic regression from individual questionnaires and seropositivity predicted a significant correlation with N95 mask implementation under aerosol conditions (p = 8.63e-06, aOR = 2.47) and work duration in a red zone (p = 2.61e-04, aOR = 1.99). The institutional questionnaire suggested that IPC education was correlated with reduced seropositivity at hospitals. Seroprevalence and questionnaire analyses among HCWs indicated that secure implementation of PPE and re-education of IPC are essential to prevent SARS-CoV-2 infection within healthcare facilities. Occupational infections from SARS-CoV-2 in healthcare settings could be prevented by adhering to adequate measures and appropriate use of PPE. With these measures securely implemented, HCWs should not be considered against as significantly risky or dirty by local communities.
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Lavezzo E, Pacenti M, Manuto L, Boldrin C, Cattai M, Grazioli M, Bianca F, Sartori M, Caldart F, Castelli G, Nicoletti M, Nieddu E, Salvadoretti E, Labella B, Fava L, Vanuzzo MC, Lisi V, Antonello M, Grimaldi CI, Zulian C, Del Vecchio C, Plebani M, Padoan A, Cirillo DM, Brazzale AR, Tonon G, Toppo S, Dorigatti I, Crisanti A. Neutralising reactivity against SARS-CoV-2 Delta and Omicron variants by vaccination and infection history. Genome Med 2022; 14:61. [PMID: 35689243 PMCID: PMC9185135 DOI: 10.1186/s13073-022-01066-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/01/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The continuous emergence of SARS-CoV-2 variants of concern (VOC) with immune escape properties, such as Delta (B.1.617.2) and Omicron (B.1.1.529), questions the extent of the antibody-mediated protection against the virus. Here we investigated the long-term antibody persistence in previously infected subjects and the extent of the antibody-mediated protection against B.1, B.1.617.2 and BA.1 variants in unvaccinated subjects previously infected, vaccinated naïve and vaccinated previously infected subjects. METHODS Blood samples collected 15 months post-infection from unvaccinated (n=35) and vaccinated (n=41) previously infected subjects (Vo' cohort) were tested for the presence of antibodies against the SARS-CoV-2 spike (S) and nucleocapsid (N) antigens using the Abbott, DiaSorin, and Roche immunoassays. The serum neutralising reactivity was assessed against B.1, B.1.617.2 (Delta), and BA.1 (Omicron) SARS-CoV-2 strains through micro-neutralisation. The antibody titres were compared to those from previous timepoints, performed at 2- and 9-months post-infection on the same individuals. Two groups of naïve subjects were used as controls, one from the same cohort (unvaccinated n=29 and vaccinated n=20) and a group of vaccinated naïve healthcare workers (n=61). RESULTS We report on the results of the third serosurvey run in the Vo' cohort. With respect to the 9-month time point, antibodies against the S antigen significantly decreased (P=0.0063) among unvaccinated subjects and increased (P<0.0001) in vaccinated individuals, whereas those against the N antigen decreased in the whole cohort. When compared with control groups (naïve Vo' inhabitants and naïve healthcare workers), vaccinated subjects that were previously infected had higher antibody levels (P<0.0001) than vaccinated naïve subjects. Two doses of vaccine elicited stronger anti-S antibody response than natural infection (P<0.0001). Finally, the neutralising reactivity of sera against B.1.617.2 and BA.1 was 4-fold and 16-fold lower than the reactivity observed against the original B.1 strain. CONCLUSIONS These results confirm that vaccination induces strong antibody response in most individuals, and even stronger in previously infected subjects. Neutralising reactivity elicited by natural infection followed by vaccination is increasingly weakened by the recent emergence of VOCs. While immunity is not completely compromised, a change in vaccine development may be required going forward, to generate cross-protective pan-coronavirus immunity in the global population.
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Affiliation(s)
- Enrico Lavezzo
- Department of Molecular Medicine, University of Padova, Padova, Italy.
| | | | - Laura Manuto
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | | | | | - Marco Grazioli
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Federico Bianca
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | | | - Federico Caldart
- Gastroenterology Unit, Department of Medicine, Verona B. Roma University Hospital, Verona, Italy
| | - Gioele Castelli
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Michele Nicoletti
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Eleonora Nieddu
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Elisa Salvadoretti
- Paediatrics Unit, Mother and Child Hospital, Surgery, Dentistry, Maternity and Infant Department, Verona University Hospital, Verona, Italy
| | - Beatrice Labella
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Ludovico Fava
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | | | | | - Maria Antonello
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | | | | | | | - Mario Plebani
- Department of Medicine, University of Padova, Padova, Italy
| | - Andrea Padoan
- Department of Medicine, University of Padova, Padova, Italy
| | - Daniela Maria Cirillo
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Giovanni Tonon
- Center for Omics Sciences, IRCCS Ospedale San Raffaele, Milan, Italy
- Functional Genomics of Cancer Unit, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Stefano Toppo
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Ilaria Dorigatti
- MRC Centre for Global Infectious Disease Analysis and Jameel Institute, School of Public Health, Imperial College London, London, UK
| | - Andrea Crisanti
- Department of Molecular Medicine, University of Padova, Padova, Italy.
- Azienda Ospedale Padova, Padova, Italy.
- Department of Life Sciences, Imperial College London, London, UK.
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Niedrist T, Drexler C, Torreiter PP, Matejka J, Strahlhofer-Augsten M, Kral S, Riegler S, Gülly C, Zurl C, Kriegl L, Krause R, Berghold A, Steinmetz I, Schlenke P, Herrmann M. Longitudinal comparison of automated SARS-CoV-2 serology assays in assessing virus neutralization capacity in COVID-19 convalescent sera. Arch Pathol Lab Med 2022; 146:538-546. [PMID: 35085385 DOI: 10.5858/arpa.2021-0604-sa] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 11/06/2022]
Abstract
CONTEXT.– Serological tests on automated immunology analyzers are increasingly used to monitor the acquired immunity against SARS-CoV-2. The heterogeneity of assays raises concerns about their diagnostic performance and comparability. OBJECTIVE.– To test sera from formerly infected individuals for SARS-Cov-2 antibodies utilizing six automated serology assays and a pseudoneutralization test (PNT). DESIGN.– Six SARS-CoV-2 serology assays were utilized to assess 954 samples collected during a 12 months period from 315 COVID-19 convalescents. The tests determined either antibodies against the viral nucleocapsid (anti-NC) or spike protein (anti-S). Two assays did not distinguish between antibody classes whereas the others selectively measured immunoglubulins G (IgG) antibodies. PNT was used to detect the presence of neutralizing antibodies. RESULTS.– Comparison of qualitative results showed only slight to moderate concordance between the assays (Cohen's kappa < 0.57). Significant correlations (P < .001) were observed between the antibody titers from all quantitative assays. However, titer changes were not detected equally. A total anti-S assay measured an increase in 128 out of 172 cases (74%) of a suitable subset, whereas all IgG anti-S tests reported decreases in at least 118 (69%). Regarding the PNT results, diagnostic sensitivities ≥89% were achieved with PPVs ≥93%. In contrast, specificity changed substantially over time varying from 20 to 100%. CONCLUSIONS.– Comparability of serological SARS-CoV-2 antibody tests is rather poor. Due to different diagnostic specificities, the tested assays were not equally capable of capturing changes in antibody titers. However, with thoroughly validated cut-offs, IgG-selective anti-S assays are a reliable surrogate test for SARS-CoV-2 neutralizing antibodies in former COVID-19 patients.
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Affiliation(s)
- Tobias Niedrist
- Clinical Institute of Medical and Chemical Laboratory Diagnostics (Niedrist, Herrmann), Medical University of Graz, Graz, Austria
| | - Camilla Drexler
- Department of Blood Group Serology and Transfusion Medicine (Drexler, Torreiter, Schlenke), Medical University of Graz, Graz, Austria
| | - Patrick Paul Torreiter
- Department of Blood Group Serology and Transfusion Medicine (Drexler, Torreiter, Schlenke), Medical University of Graz, Graz, Austria
| | - Julia Matejka
- Biobank Graz (Matejka, Strahlhofer-Augsten, Kral, Riegler, Gülly), Medical University of Graz, Graz, Austria
| | - Manuela Strahlhofer-Augsten
- Biobank Graz (Matejka, Strahlhofer-Augsten, Kral, Riegler, Gülly), Medical University of Graz, Graz, Austria
| | - Sabrina Kral
- Biobank Graz (Matejka, Strahlhofer-Augsten, Kral, Riegler, Gülly), Medical University of Graz, Graz, Austria
| | - Skaiste Riegler
- Biobank Graz (Matejka, Strahlhofer-Augsten, Kral, Riegler, Gülly), Medical University of Graz, Graz, Austria
| | - Christian Gülly
- Biobank Graz (Matejka, Strahlhofer-Augsten, Kral, Riegler, Gülly), Medical University of Graz, Graz, Austria.,Center for Medical Research (Gülly), Medical University of Graz, Graz, Austria
| | - Christoph Zurl
- Division of Infectious Diseases in the Department of Internal Medicine (Zurl, Kriegl, Krause), Medical University of Graz, Graz, Austria.,Division of General Paediatrics in the Department of Paediatrics and Adolescents Medicine (Zurl), Medical University of Graz, Graz, Austria
| | - Lisa Kriegl
- Division of Infectious Diseases in the Department of Internal Medicine (Zurl, Kriegl, Krause), Medical University of Graz, Graz, Austria
| | - Robert Krause
- Division of Infectious Diseases in the Department of Internal Medicine (Zurl, Kriegl, Krause), Medical University of Graz, Graz, Austria.,BioTechMed Graz, Graz, Austria (Krause)
| | - Andrea Berghold
- Institute for Medical Informatics, Statistics and Documentation (Berghold), Medical University of Graz, Graz, Austria
| | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine (Steinmetz), Medical University of Graz, Graz, Austria
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion Medicine (Drexler, Torreiter, Schlenke), Medical University of Graz, Graz, Austria
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics (Niedrist, Herrmann), Medical University of Graz, Graz, Austria
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