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Dimopoulou D, Charakida M, Marmarinos A, Karaviti D, Avgeris M, Gourgiotis D, Tsolia MN. SARS-CoV-2 Antibody Kinetics in Unvaccinated Hospitalized Children With COVID-19. Pediatr Infect Dis J 2024; 43:536-542. [PMID: 38372544 DOI: 10.1097/inf.0000000000004301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
BACKGROUND Antibody levels decline a few months post-acute COVID-19, but humoral memory persists in adults. Age and disease severity may affect antibody responses. This study aims to evaluate the presence and durability of antibody responses in children with COVID-19. METHODS A prospective, single-center study, involving unvaccinated children 0-16 years of age who were hospitalized with COVID-19 between October 2020 and December 2021, was conducted. Serological testing for anti-Spike severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG and neutralizing antibodies was performed at diagnosis and at 1-, 3-, 6- and 12-months post-infection. RESULTS A total of 65 immunocompetent children were enrolled [mean age (±SD): 6.7 (±6.4) years; males: 56.9%]. At 3 months, 40/44 (91%) children were seropositive; seropositivity persisted in 22/26 (85%) children at 6 months and in 10/12 (83%) children at 12 months. There was no evidence that age was modifying the prediction of variance of SARS-CoV-2 IgG levels. In contrast, SARS-CoV-2 IgG levels varied with time and disease severity. The association with time was non-linear, so that with increasing time there was a significant reduction in SARS-CoV-2 IgG levels [coef, 0.044 (95% confidence interval {CI}: 0.061-0.028), P < 0.001]. For each increment of time, the higher disease severity group was associated with 0.9 lower SARS-CoV-2 IgG levels. Everyone varied from the average effect of time with an SD of 0.01, suggesting that individuals may have different trajectories across time. CONCLUSION Disease severity, but not age, influences antibody titers among children hospitalized with COVID-19. SARS-CoV-2 infection induces durable seroconversion in these children with detectable IgG levels at 1 year after infection.
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Affiliation(s)
| | | | - Antonios Marmarinos
- Laboratory of Clinical Biochemistry-Molecular Diagnostics, Second Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens, Greece
| | | | - Margaritis Avgeris
- Laboratory of Clinical Biochemistry-Molecular Diagnostics, Second Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens, Greece
| | - Dimitrios Gourgiotis
- Laboratory of Clinical Biochemistry-Molecular Diagnostics, Second Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens, Greece
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2
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Jafari M, Asli S, Moghbeli F, Fesharaki MG, Hajiahmadi N, Mojtahedzadeh F, Amel Jamehdar S, Bamdad T. Persistence of SARS-CoV-2-antibodies against N, S and RBD after natural infection. IRANIAN JOURNAL OF MICROBIOLOGY 2023; 15:803-810. [PMID: 38156306 PMCID: PMC10751617 DOI: 10.18502/ijm.v15i6.14161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
Background and Objectives Coronavirus disease 2019 (COVID-19) pandemic has affected most countries in the world. Monitoring the humoral immune responses during the natural course of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection and the duration of them provide useful information for the development of vaccination strategies against this virus and its emerging variants. The importance of the antibody response especially neutralizing antibodies in long-term immunity to SARS-CoV-2 is significant. Materials and Methods The present study is a cross-sectional study of sero-epidemiological type that has been proposed to compare the persistence of Immunoglobulin G (IgG) against N (nucleocapsid), S (spike) and RBD (receptor-binding domain) proteins in the community after the time of primary disease. A total of 652 serum samples were collected from hospital staff working in COVID wards, as well as a number of community members with different occupations, among those with positive antibody titers, 86 participated in the resampling test before vaccination. Results There was no association between antibody titer and disease severity (p>0.05). A significant decrease in Ab levels was observed in the paired second samples. The highest rate of decrease was related to anti-N, then anti-RBD and anti-S IgG levels, respectively. There is a significant relationship between the initial antibody titer and its reduction over time (p-value <0.05). Conclusion Our data revealed that humoral immunity following natural infection of SARS-CoV-2 is detectable for at least 4 months, regardless of disease severity. The most decrease in antibody titer over time was related to anti-N IgG levels.
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Affiliation(s)
- Mitra Jafari
- Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Samira Asli
- Clinical Research Development, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fateme Moghbeli
- Department of Health Information Technology, Varastegan Institute for Medical Sciences, Mashhad, Iran
| | | | - Nazila Hajiahmadi
- Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Faezeh Mojtahedzadeh
- Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Saeid Amel Jamehdar
- Clinical Research Development, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Taravat Bamdad
- Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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3
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Wang L, Patrone PN, Kearsley AJ, Izac JR, Gaigalas AK, Prostko JC, Kwon HJ, Tang W, Kosikova M, Xie H, Tian L, Elsheikh EB, Kwee EJ, Kemp T, Jochum S, Thornburg N, McDonald LC, Gundlapalli AV, Lin-Gibson S. Monoclonal Antibodies as SARS-CoV-2 Serology Standards: Experimental Validation and Broader Implications for Correlates of Protection. Int J Mol Sci 2023; 24:15705. [PMID: 37958688 PMCID: PMC10650176 DOI: 10.3390/ijms242115705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
COVID-19 has highlighted challenges in the measurement quality and comparability of serological binding and neutralization assays. Due to many different assay formats and reagents, these measurements are known to be highly variable with large uncertainties. The development of the WHO international standard (WHO IS) and other pool standards have facilitated assay comparability through normalization to a common material but does not provide assay harmonization nor uncertainty quantification. In this paper, we present the results from an interlaboratory study that led to the development of (1) a novel hierarchy of data analyses based on the thermodynamics of antibody binding and (2) a modeling framework that quantifies the probability of neutralization potential for a given binding measurement. Importantly, we introduced a precise, mathematical definition of harmonization that separates the sources of quantitative uncertainties, some of which can be corrected to enable, for the first time, assay comparability. Both the theory and experimental data confirmed that mAbs and WHO IS performed identically as a primary standard for establishing traceability and bridging across different assay platforms. The metrological anchoring of complex serological binding and neuralization assays and fast turn-around production of an mAb reference control can enable the unprecedented comparability and traceability of serological binding assay results for new variants of SARS-CoV-2 and immune responses to other viruses.
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Affiliation(s)
- Lili Wang
- Biosystems and Biomaterials Division, National Institute of Standards and Technology (NIST), Gaithersburg, MD 20899, USA; (J.R.I.); (A.K.G.); (L.T.); (E.B.E.); (E.J.K.)
| | - Paul N. Patrone
- Applied and Computational Mathematics Division, National Institute of Standards and Technology (NIST), Gaithersburg, MD 20899, USA; (P.N.P.); (A.J.K.)
| | - Anthony J. Kearsley
- Applied and Computational Mathematics Division, National Institute of Standards and Technology (NIST), Gaithersburg, MD 20899, USA; (P.N.P.); (A.J.K.)
| | - Jerilyn R. Izac
- Biosystems and Biomaterials Division, National Institute of Standards and Technology (NIST), Gaithersburg, MD 20899, USA; (J.R.I.); (A.K.G.); (L.T.); (E.B.E.); (E.J.K.)
| | - Adolfas K. Gaigalas
- Biosystems and Biomaterials Division, National Institute of Standards and Technology (NIST), Gaithersburg, MD 20899, USA; (J.R.I.); (A.K.G.); (L.T.); (E.B.E.); (E.J.K.)
| | | | - Hyung Joon Kwon
- Laboratory of Pediatric and Respiratory Viral Diseases, Office of Vaccines Research and Review, Center for Biologics Evaluation, Food and Drug Administration (FDA), Silver Spring, MD 20993, USA; (H.J.K.); (W.T.); (M.K.); (H.X.)
| | - Weichun Tang
- Laboratory of Pediatric and Respiratory Viral Diseases, Office of Vaccines Research and Review, Center for Biologics Evaluation, Food and Drug Administration (FDA), Silver Spring, MD 20993, USA; (H.J.K.); (W.T.); (M.K.); (H.X.)
| | - Martina Kosikova
- Laboratory of Pediatric and Respiratory Viral Diseases, Office of Vaccines Research and Review, Center for Biologics Evaluation, Food and Drug Administration (FDA), Silver Spring, MD 20993, USA; (H.J.K.); (W.T.); (M.K.); (H.X.)
| | - Hang Xie
- Laboratory of Pediatric and Respiratory Viral Diseases, Office of Vaccines Research and Review, Center for Biologics Evaluation, Food and Drug Administration (FDA), Silver Spring, MD 20993, USA; (H.J.K.); (W.T.); (M.K.); (H.X.)
| | - Linhua Tian
- Biosystems and Biomaterials Division, National Institute of Standards and Technology (NIST), Gaithersburg, MD 20899, USA; (J.R.I.); (A.K.G.); (L.T.); (E.B.E.); (E.J.K.)
| | - Elzafir B. Elsheikh
- Biosystems and Biomaterials Division, National Institute of Standards and Technology (NIST), Gaithersburg, MD 20899, USA; (J.R.I.); (A.K.G.); (L.T.); (E.B.E.); (E.J.K.)
| | - Edward J. Kwee
- Biosystems and Biomaterials Division, National Institute of Standards and Technology (NIST), Gaithersburg, MD 20899, USA; (J.R.I.); (A.K.G.); (L.T.); (E.B.E.); (E.J.K.)
| | - Troy Kemp
- Vaccine, Immunity and Cancer Directorate, Frederick National Laboratory for Cancer Research (FNLCR), Frederick, MD 21702, USA;
| | - Simon Jochum
- Roche Diagnostics GmbH, 82377 Penzberg, Germany;
| | - Natalie Thornburg
- Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA; (N.T.); (L.C.M.); (A.V.G.)
| | - L. Clifford McDonald
- Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA; (N.T.); (L.C.M.); (A.V.G.)
| | - Adi V. Gundlapalli
- Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA; (N.T.); (L.C.M.); (A.V.G.)
| | - Sheng Lin-Gibson
- Biosystems and Biomaterials Division, National Institute of Standards and Technology (NIST), Gaithersburg, MD 20899, USA; (J.R.I.); (A.K.G.); (L.T.); (E.B.E.); (E.J.K.)
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Yari P, Liang S, Chugh VK, Rezaei B, Mostufa S, Krishna VD, Saha R, Cheeran MCJ, Wang JP, Gómez-Pastora J, Wu K. Nanomaterial-Based Biosensors for SARS-CoV-2 and Future Epidemics. Anal Chem 2023; 95:15419-15449. [PMID: 37826859 DOI: 10.1021/acs.analchem.3c01522] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Affiliation(s)
- Parsa Yari
- Department of Electrical and Computer Engineering, Texas Tech University, Lubbock, Texas 79409, United States
| | - Shuang Liang
- Department of Chemical Engineering and Materials Science, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Vinit Kumar Chugh
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Bahareh Rezaei
- Department of Electrical and Computer Engineering, Texas Tech University, Lubbock, Texas 79409, United States
| | - Shahriar Mostufa
- Department of Electrical and Computer Engineering, Texas Tech University, Lubbock, Texas 79409, United States
| | - Venkatramana Divana Krishna
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, Minnesota 55108, United States
| | - Renata Saha
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Maxim C-J Cheeran
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, Minnesota 55108, United States
| | - Jian-Ping Wang
- Department of Chemical Engineering and Materials Science, University of Minnesota, Minneapolis, Minnesota 55455, United States
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Jenifer Gómez-Pastora
- Department of Chemical Engineering, Texas Tech University, Lubbock, Texas 79409, United States
| | - Kai Wu
- Department of Electrical and Computer Engineering, Texas Tech University, Lubbock, Texas 79409, United States
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Kayalı GA, Durmaz S, Şahin İN, Akkul B, Durusoy R, Akarca FK, Ulukaya S, Çiçek C. COVID-19 Infection, Vaccination, and Antibody Levels: Investigating Correlations through a Cohort Study. Vaccines (Basel) 2023; 11:1258. [PMID: 37515073 PMCID: PMC10385857 DOI: 10.3390/vaccines11071258] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/30/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
AIM The objective of this study was to explore the potential correlation between COVID-19 infection or vaccination and levels of anti-nucleocapsid (anti-N) and anti-spike (anti-S) antibodies. METHODS Among 6050 healthcare workers at the Ege University Hospital, a cohort study with 162 participants divided into three arms with 54 participants each was conducted. The three groups were selected as follows: those diagnosed with COVID-19 and not vaccinated (group 1), those diagnosed with COVID-19 and subsequently vaccinated with CoronaVac (group 2), and those not diagnosed with COVID-19 but vaccinated with two doses of CoronaVac (group 3). Antibody levels measured at the sixth month of follow-up were defined as the primary outcome. RESULTS At the sixth month, all serum samples tested positive for anti-S. Anti-S levels were found to be significantly higher in group 2 than in the other groups (p < 0.001). There were no differences in antibody levels between groups 1 and 3 (p = 0.080). Average antibody levels were found to be lower in office workers and males. Anti-N antibodies were found to be positive in 85.1% of subjects at the sixth month. In group 2, anti-N antibodies were detected in all samples at the sixth month. Anti-N antibody levels were not significantly different between groups 1 and 2 (p = 0.165). Groups 1 and 2 had significantly higher antibody levels than group 3 (p < 0.001). CONCLUSIONS Vaccination or infection provide protection for at least 6 months. Those who have previously been diagnosed with COVID-19 do not need to be vaccinated in the early period before their antibody levels decrease.
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Affiliation(s)
- Gözde Akkuş Kayalı
- Department of Medical Microbiology, Faculty of Medicine, Ege University, Izmir 35100, Turkey
| | - Seyfi Durmaz
- Department of Public Health, Faculty of Medicine, Ege University, Izmir 35100, Turkey
| | - İrem Nur Şahin
- Department of Medical Microbiology, Faculty of Medicine, Ege University, Izmir 35100, Turkey
| | - Betül Akkul
- Department of Medical Microbiology, Faculty of Medicine, Ege University, Izmir 35100, Turkey
| | - Raika Durusoy
- Department of Public Health, Faculty of Medicine, Ege University, Izmir 35100, Turkey
| | - Funda Karbek Akarca
- Department of Emergency Medicine, Faculty of Medicine, Ege University, Izmir 35100, Turkey
| | - Sezgin Ulukaya
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Ege University, Izmir 35100, Turkey
| | - Candan Çiçek
- Department of Medical Microbiology, Faculty of Medicine, Ege University, Izmir 35100, Turkey
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6
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Yue H, Nowak RP, Overwijn D, Payne NC, Fischinger S, Atyeo C, Lam EC, St. Denis K, Brais LK, Konishi Y, Sklavenitis-Pistofidis R, Baden LR, Nilles EJ, Karlson EW, Yu XG, Li JZ, Woolley AE, Ghobrial IM, Meyerhardt JA, Balazs AB, Alter G, Mazitschek R, Fischer ES. Diagnostic TR-FRET assays for detection of antibodies in patient samples. CELL REPORTS METHODS 2023; 3:100421. [PMID: 37056371 PMCID: PMC10088089 DOI: 10.1016/j.crmeth.2023.100421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/15/2022] [Accepted: 02/14/2023] [Indexed: 02/22/2023]
Abstract
Serological assays are important diagnostic tools for surveying exposure to the pathogen, monitoring immune response post vaccination, and managing spread of the infectious agent among the population. Current serological laboratory assays are often limited because they require the use of specialized laboratory technology and/or work with a limited number of sample types. Here, we evaluate an alternative by developing time-resolved Förster resonance energy transfer (TR-FRET) homogeneous assays that exhibited exceptional versatility, scalability, and sensitivity and outperformed or matched currently used strategies in terms of sensitivity, specificity, and precision. We validated the performance of the assays measuring total immunoglobulin G (IgG) levels; antibodies against severe acute respiratory syndrome coronavirus (SARS-CoV) or Middle Eastern respiratory syndrome (MERS)-CoV spike (S) protein; and SARS-CoV-2 S and nucleocapsid (N) proteins and applied it to several large sample sets and real-world applications. We further established a TR-FRET-based ACE2-S competition assay to assess the neutralization propensity of the antibodies. Overall, these TR-FRET-based serological assays can be rapidly extended to other antigens and are compatible with commonly used plate readers.
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Affiliation(s)
- Hong Yue
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA 02115, USA
| | - Radosław P. Nowak
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA 02115, USA
| | - Daan Overwijn
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA 02115, USA
| | - N. Connor Payne
- Department of Chemistry & Chemical Biology, Harvard University, Cambridge, MA 02138, USA
- Center for Systems Biology, Massachusetts General Hospital (MGH), Boston, MA 02114, USA
| | - Stephanie Fischinger
- Ragon Institute of MGH, Massachusetts Institute of Technology (MIT), and Harvard, Cambridge, MA 02139, USA
| | - Caroline Atyeo
- Ragon Institute of MGH, Massachusetts Institute of Technology (MIT), and Harvard, Cambridge, MA 02139, USA
| | - Evan C. Lam
- Ragon Institute of MGH, Massachusetts Institute of Technology (MIT), and Harvard, Cambridge, MA 02139, USA
| | - Kerri St. Denis
- Ragon Institute of MGH, Massachusetts Institute of Technology (MIT), and Harvard, Cambridge, MA 02139, USA
| | - Lauren K. Brais
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Yoshinobu Konishi
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Romanos Sklavenitis-Pistofidis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Lindsey R. Baden
- Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Eric J. Nilles
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | | | - Xu G. Yu
- Ragon Institute of MGH, Massachusetts Institute of Technology (MIT), and Harvard, Cambridge, MA 02139, USA
| | - Jonathan Z. Li
- Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Ann E. Woolley
- Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Irene M. Ghobrial
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | | | - Alejandro B. Balazs
- Ragon Institute of MGH, Massachusetts Institute of Technology (MIT), and Harvard, Cambridge, MA 02139, USA
| | - Galit Alter
- Ragon Institute of MGH, Massachusetts Institute of Technology (MIT), and Harvard, Cambridge, MA 02139, USA
| | - Ralph Mazitschek
- Center for Systems Biology, Massachusetts General Hospital (MGH), Boston, MA 02114, USA
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Eric S. Fischer
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA 02115, USA
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Gass JD, Waite KB, Hill NJ, Dalton KR, Sawatzki K, Runstadler JA, Davis MF. A standardized instrument quantifying risk factors associated with bi-directional transmission of SARS-CoV-2 and other zoonotic pathogens: The COVID-19 human-animal interactions survey (CHAIS). One Health 2022; 15:100422. [PMID: 35910303 PMCID: PMC9327186 DOI: 10.1016/j.onehlt.2022.100422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/23/2022] [Accepted: 07/23/2022] [Indexed: 11/28/2022] Open
Abstract
Similar to many zoonotic pathogens which transmit from animals to humans, SARS-CoV-2 (CoV-2), the virus responsible for the COVID-19 pandemic, most likely originated in Rhinolophus bats before spreading among humans globally. Early into the pandemic, reports of CoV-2 diagnoses in animals from various countries emerged. While most CoV-2 positive animals were confirmed to have been in close contact with CoV-2 positive humans, there has been a paucity of published evidence to-date describing risk factors associated with CoV-2 transmission among humans and animals. The COVID-19 Human-Animal Interactions Survey (CHAIS) was developed to provide a standardized instrument describing human-animal interactions during the pandemic and to evaluate behavioral, spatiotemporal, and biological risk factors associated with bi-directional zoonotic transmission of CoV-2 within shared environments, predominantly households with limited information about human-wildlife or human-livestock interactions. CHAIS measures four broad domains of transmission risk: 1) risk and intensity of infection in human hosts, 2) spatial characteristics of shared environments, 3) behaviors and human-animal interactions, and 4) susceptible animal subpopulations. Following the development of CHAIS, with a One Health approach, a multidisciplinary group of experts (n = 20) was invited to review and provide feedback on the survey for content validity. Expert feedback was incorporated into two final survey formats—an extended version and an abridged version for which specific core questions addressing zoonotic and reverse zoonotic transmission were identified. Both versions are modularized, with each section having the capacity to serve as independent instruments, allowing researchers to customize the survey based on context and research-specific needs. Further adaptations for studies seeking to investigate other zoonotic pathogens with similar routes of transmission (i.e. respiratory, direct contact) are also possible. The CHAIS instrument is a standardized human-animal interaction survey developed to provide important data on risk factors that guide transmission of CoV-2, and other similar pathogens, among humans and animals. The CHAIS instrument is a standardized instrument evaluating risk factors for bi-directional CoV-2 zoonotic transmission It evaluates settings where humans and animals share close contact, mainly households It is highly adaptable for investigating other zoonotic pathogens such as influenza viruses It will enable pooling of data across studies for meta-analyses to improve predictive models It can help inform public health prevention and mitigation measures
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Affiliation(s)
- Jonathon D Gass
- Dept. of Infectious Disease and Global Health, Cummings School of Veterinary Medicine, Tufts University, United States
| | - Kaitlin B Waite
- Dept. of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, United States
| | - Nichola J Hill
- Department of Biology, University of Massachusetts Boston, United States
| | - Kathryn R Dalton
- Dept. of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, United States
| | - Kaitlin Sawatzki
- Dept. of Infectious Disease and Global Health, Cummings School of Veterinary Medicine, Tufts University, United States
| | - Jonathan A Runstadler
- Dept. of Infectious Disease and Global Health, Cummings School of Veterinary Medicine, Tufts University, United States
| | - Meghan F Davis
- Dept. of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, United States.,Dept. of Molecular and Comparative Pathobiology; Division of Infectious Diseases, Johns Hopkins School of Medicine, United States
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Baldanti F, Ganguly NK, Wang G, Möckel M, O’Neill LA, Renz H, dos Santos Ferreira CE, Tateda K, Van Der Pol B. Choice of SARS-CoV-2 diagnostic test: challenges and key considerations for the future. Crit Rev Clin Lab Sci 2022; 59:445-459. [PMID: 35289222 PMCID: PMC8935452 DOI: 10.1080/10408363.2022.2045250] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A plethora of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnostic tests are available, each with different performance specifications, detection methods, and targets. This narrative review aims to summarize the diagnostic technologies available and how they are best selected to tackle SARS-CoV-2 infection as the pandemic evolves. Seven key settings have been identified where diagnostic tests are being deployed: symptomatic individuals presenting for diagnostic testing and/or treatment of COVID-19 symptoms; asymptomatic individuals accessing healthcare for planned non-COVID-19-related reasons; patients needing to access emergency care (symptom status unknown); patients being discharged from healthcare following hospitalization for COVID-19; healthy individuals in both single event settings (e.g. airports, restaurants, hotels, concerts, and sporting events) and repeat access settings (e.g. workplaces, schools, and universities); and vaccinated individuals. While molecular diagnostics remain central to SARS-CoV-2 testing strategies, we have offered some discussion on the considerations for when other tools and technologies may be useful, when centralized/point-of-care testing is appropriate, and how the various additional diagnostics can be deployed in differently resourced settings. As the pandemic evolves, molecular testing remains important for definitive diagnosis, but increasingly widespread point-of-care testing is essential to the re-opening of society.
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Affiliation(s)
- Fausto Baldanti
- Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | | | - Guiqiang Wang
- The Center for Liver Diseases, Peking University First Hospital, Beijing, China
| | - Martin Möckel
- Charité – Universitätsmedizin, Berlin, Germany,CONTACT Martin Möckel Departments of Emergency Medicine and Chest Pain Units CVK/CCM, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, 13353, Germany
| | - Luke A. O’Neill
- Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Harald Renz
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University Marburg, University Hospital Giessen and Marburg GmbH, Giessen, Germany,Department of Clinical Immunology and Allergology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Kazuhiro Tateda
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Barbara Van Der Pol
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
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Bhuiyan NH, Uddin MJ, Lee J, Hong JH, Shim JS. An Internet-of-Disease System for COVID-19 Testing Using Saliva by an AI-Controlled Microfluidic ELISA Device. ADVANCED MATERIALS TECHNOLOGIES 2022; 7:2101690. [PMID: 35942252 PMCID: PMC9349700 DOI: 10.1002/admt.202101690] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 05/04/2022] [Indexed: 06/15/2023]
Abstract
Throughout coronavirus disease (COVID-19) outbreaks, the centers for disease control and prevention (CDCP) of a country require monitoring of particular territories to provide public health guidance. In this work, the Internet of Diseases (IoD) is suggested for continuous real-time monitoring of infectious diseases for public health. Because converging information and communication technologies (ICTs) with point-of-care (POC) devices to enable the IoD for continuous real-time health monitoring and processing of clinical records are crucial, an IoD platform associating a lab-on-a-chip (LOC) device to diagnose severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) from oropharyngeal saliva samples have been developed and uploaded the resulted diagnostic data into a cloud-based system to be connected with CDCP. Moreover, a choropleth IoD map to visualize provincial infection rate is proposed along with the IoD platform. The developed platform is applied for the quantification of SARS-CoV-2 N-protein antigen with a LOD as low as 0.013 ng mL-1 and the infection rate of various provinces is projected with the IoD map successfully. Thus, the proposed IoD system has the potential to become an imperative tool for the disease control and prevention centers to restrain COVID-19 outbreaks by identifying the severity of particular regions.
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Affiliation(s)
- Nabil Hossain Bhuiyan
- Bio‐IT Convergence LaboratoryDepartment of Electronic Convergence EngineeringKwangWoon UniversitySeoul01897Republic of Korea
| | - Md. Jalal Uddin
- Bio‐IT Convergence LaboratoryDepartment of Electronic Convergence EngineeringKwangWoon UniversitySeoul01897Republic of Korea
- BioGeneSys Inc., 20 Kwangwoon‐roNowon‐guSeoul01897Republic of Korea
| | - Joowon Lee
- Bio‐IT Convergence LaboratoryDepartment of Electronic Convergence EngineeringKwangWoon UniversitySeoul01897Republic of Korea
| | - Jun Hyeok Hong
- Bio‐IT Convergence LaboratoryDepartment of Electronic Convergence EngineeringKwangWoon UniversitySeoul01897Republic of Korea
| | - Joon Sub Shim
- Bio‐IT Convergence LaboratoryDepartment of Electronic Convergence EngineeringKwangWoon UniversitySeoul01897Republic of Korea
- BioGeneSys Inc., 20 Kwangwoon‐roNowon‐guSeoul01897Republic of Korea
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10
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Muecksch F, Wise H, Templeton K, Batchelor B, Squires M, McCance K, Jarvis L, Malloy K, Furrie E, Richardson C, MacGuire J, Godber I, Burns A, Mavin S, Zhang F, Schmidt F, Bieniasz PD, Jenks S, Hatziioannou T. Longitudinal variation in SARS-CoV-2 antibody levels and emergence of viral variants: a serological analysis. THE LANCET. MICROBE 2022; 3:e493-e502. [PMID: 35636436 PMCID: PMC9141682 DOI: 10.1016/s2666-5247(22)00090-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 03/14/2022] [Accepted: 03/28/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Serological assays are being used to monitor antibody responses in individuals who had SARS-CoV-2 infection and those who received a COVID-19 vaccine. We aimed to determine whether such assays can predict neutralising antibody titres as antibody levels wane and viral variants emerge. METHODS We measured antibody levels in serum samples from a cohort of 112 participants with SARS-CoV-2 infection using ten high-throughput serological tests and functional neutralisation assays. Serum samples were taken at baseline and at up to four subsequent visits. We assessed the effects of time and spike protein sequence variation on the performance and predictive value of the various assays. We did correlation analyses for individual timepoints using non-parametric Spearman correlation, and differences between timepoints were determined by use of a two-tailed Wilcoxon matched-pairs signed rank test. FINDINGS Neutralising antibody titres decreased over the first few months post-infection but stabilised thereafter, at about 30% of the level observed shortly after infection. Serological assays commonly used to measure antibodies against SARS-CoV-2 displayed a range of sensitivities that declined to varying extents over time. Quantitative measurements generated by serological assays based on the spike protein were better at predicting neutralising antibody titres than those based on nucleocapsid, but performance was variable, and manufacturer positivity thresholds were not able to predict the presence or absence of detectable neutralising activity. Although we observed some deterioration in correlation between serological measurements and functional neutralisation activity, some assays maintained an ability to predict neutralising titres, even against variants of concern. INTERPRETATION The ability of high-throughput serological assays to predict neutralising antibody titres is likely to be crucial for evaluation of immunity at the population scale. These data can facilitate the selection of the most suitable assays as surrogates of functional neutralising activity and suggest that such measurements might be useful in clinical practice. FUNDING US National Institutes of Health and National Health Service Research Scotland BioResource.
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Affiliation(s)
- Frauke Muecksch
- Laboratory of Retrovirology, The Rockefeller University, New York, NY, USA
| | - Helen Wise
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
| | - Kate Templeton
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
| | - Becky Batchelor
- Department of Blood Sciences, Western General Hospital, Edinburgh, UK
| | - Maria Squires
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
| | - Kirsty McCance
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
| | - Lisa Jarvis
- SNBTS Microbiology Reference Laboratory, The Jack Copland Centre, Edinburgh, UK
| | - Kristen Malloy
- SNBTS Microbiology Reference Laboratory, The Jack Copland Centre, Edinburgh, UK
| | - Elizabeth Furrie
- Department of Immunology, Ninewells Hospital and Medical School, NHS Tayside, Dundee, UK
| | - Claire Richardson
- Department of Biochemistry, University Hospital Monklands, NHS Lanarkshire, Airdrie, UK
| | - Jacqueline MacGuire
- Department of Biochemistry, University Hospital Monklands, NHS Lanarkshire, Airdrie, UK
| | - Ian Godber
- Department of Biochemistry, Queen Elizabeth University Hospital, Glasgow, UK
| | - Alana Burns
- Department of Biochemistry, Queen Elizabeth University Hospital, Glasgow, UK
| | - Sally Mavin
- Scottish Microbiology Reference Laboratory, NHS Highland, Inverness, UK
| | - Fengwen Zhang
- Laboratory of Retrovirology, The Rockefeller University, New York, NY, USA
| | - Fabian Schmidt
- Laboratory of Retrovirology, The Rockefeller University, New York, NY, USA
| | - Paul D Bieniasz
- Laboratory of Retrovirology, The Rockefeller University, New York, NY, USA; Howard Hughes Medical Institute, The Rockefeller University, New York, NY, USA.
| | - Sara Jenks
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK.
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11
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Card L, Litwin CM, Curry S, Mack EH, Nietert PJ, Meissner EG. Self-Administered, Remote Assessment of SARS-CoV-2 Seroprevalence in Health Care Workers. Am J Med Sci 2022; 364:281-288. [PMID: 35278364 PMCID: PMC8906004 DOI: 10.1016/j.amjms.2022.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/19/2021] [Accepted: 01/31/2022] [Indexed: 11/16/2022]
Abstract
Background Our objective was to safely and remotely assess longitudinal SARS-CoV-2 seroprevalence in at-risk health care workers at the onset of the epidemic. Methods Self-administered serologic testing was performed every 30 days up to 5 times using a point-of-care, lateral flow SARS-CoV-2 nucleocapsid IgG immunoassay in a cohort of at-risk health care workers (n = 339) and lower-risk controls (n = 100). Results Subjects were enrolled between 4/14/20–5/6/20 and most were clinicians (41%) or nurses (27%). Of 20 subjects who reported confirmed SARS-CoV-2 infection prior to (n = 5, 1%) or during the study (n = 15, 3%), half (10/20) were seropositive. Five additional subjects were seropositive and did not report documented infection. Estimated infection rates in health care workers did not differ from concurrent community rates. Conclusions This remotely conducted, contact-free study did not identify serologic evidence of widespread occupational SARS-CoV-2 infection in health care workers.
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Affiliation(s)
- Lauren Card
- South Carolina Clinical & Translational Research Institute, Medical University of South Carolina, Charleston, SC, USA
| | - Christine M Litwin
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Scott Curry
- Department of Medicine, Division of Infectious Diseases, Medical University of South Carolina, Charleston, SC, USA
| | - Elizabeth H Mack
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Paul J Nietert
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Eric G Meissner
- Department of Medicine, Division of Infectious Diseases, Medical University of South Carolina, Charleston, SC, USA; Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA.
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12
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Mousa ZS, Abdulamir AS. Application and Validation of SARS-CoV-2 RBD Neutralizing ELISA Assay. ARCHIVES OF RAZI INSTITUTE 2022; 77:391-402. [PMID: 35891753 PMCID: PMC9288645 DOI: 10.22092/ari.2021.356677.1890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 12/04/2021] [Indexed: 06/15/2023]
Abstract
The establishment of an approach for detecting the anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-receptor-binding domain (RBD) neutralizing antibodies (nAbs) by a safe, easy, and rapid technique without requiring the use of live viruses is essential for facing the coronavirus disease 2019 (COVID-19) pandemic. Depending on competitive enzyme-linked immunosorbent assay (ELISA) methodology, the current study assay was designed to simulate the virus-host interaction using purified SARS-COV-2-RBD from the spike protein and the host cell receptor human angiotensin-converting enzyme 2 protein. The performance of this in-house neutralizing ELISA assay was validated using freshly prepared standards with different known concentrations of the assay. In this regard, a cohort of 50 serum samples from convalescent COVID-19 individuals with different disease severity at different time points post-recovery and a cohort of 50 serum samples from healthy individuals were processed by the in-house developed assay for detecting SARS-CoV-2 nAbs, in comparison with a commercial total anti-SARS-CoV-2 IgG antibody assay as a gold standard. The assay obtained a sensitivity of 88% (95% CI: 75.69-95.47) and a specificity of 92% (95% CI: 80.77- 97.78%). A negative strong correlation was demonstrated in the standard curve between the optical density absorbance and log concentration of the nAbs with a statistical measure of r2 (coefficient of determination) = 0.9539. The SARS-COV-2-RBD neutralizing ELISA assay serves as a high throughput qualitative and quantitative tool that can be applied in most laboratory settings without special biosafety requirements to detect anti-RBD nAbs for seroprevalence, pre-clinical, and clinical evaluation of COVID-19 vaccines efficiency and the rapid selection of convalescent plasma donors for the treatment of COVID-19 patients.
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Affiliation(s)
- Z S Mousa
- Baghdad Veterinary Hospital, Baghdad, Iraq
| | - A S Abdulamir
- Department of Medical Microbiology, College of Medicine, Al-Nahrain University, Baghdad, Iraq
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13
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Sander I, Kespohl S, Zahradnik E, Göcke P, Hosbach I, Herrmann BL, Brüning T, Raulf M. Quantitative measurement of IgG to SARS-CoV-2 antigens using monoclonal antibody-based enzyme-linked immunosorbent assays. Clin Transl Immunology 2022; 11:e1369. [PMID: 35127087 PMCID: PMC8801209 DOI: 10.1002/cti2.1369] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Standardised quantitative analysis of the humoral immune response to SARS-CoV-2 antigens may be useful for estimating the extent and duration of immunity. The aim was to develop enzyme-linked immunosorbent assays (ELISAs) for the quantification of human IgG antibodies against SARS-CoV-2 antigens. METHODS Enzyme-linked immunosorbent assays were developed based on monoclonal antibodies against human IgG and recombinant SARS-CoV-2 antigens (Spike-S1 and Nucleocapsid). The WHO 67/086 immunoglobulin and WHO 20/136 SARS-CoV-2 references were used for standardisation. Sera of a study group of COVID-19-positive subjects (n = 144), pre-pandemic controls (n = 135) and individuals vaccinated with BioNTech-Pfizer BNT162b2 vaccine (n = 48) were analysed. The study group sera were also tested using EuroImmun SARS-CoV-2-ELISAs and a quantitative S1-specific fluorescence enzyme immunoassay (FEIA) from Thermo Fisher. RESULTS The ELISA results were repeatable and traceable to international units because of their parallelism to both WHO references. In the study group, median anti-S1-IgG concentrations were 102 BAU mL-1, compared to 100 and 1457 BAU mL-1 in the vaccination group after first and second vaccination, respectively. The ELISAs achieved an area under the curve (AUC) of 0.965 (S1) and 0.955 (Nucleocapsid) in receiver operating characteristic (ROC) analysis, and a specificity of 1 (S1) and 0.963 (Nucleocapsid) and sensitivity of 0.903 (S1) and 0.833 (Nucleocapsid) at the maximum Youden index. In comparison, the commercial assays (S1-FEIA, S1 and Nucleocapsid ELISA EuroImmun) achieved sensitivities of 0.764, 0.875 and 0.882 in the study group, respectively. CONCLUSIONS The quantitative ELISAs to measure IgG binding to SARS-CoV-2 antigens have good analytical and clinical performance characteristics and units traceable to international standards.
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Affiliation(s)
- Ingrid Sander
- Institute for Prevention and Occupational Medicine of the German Social Accident InsuranceInstitute of the Ruhr University Bochum (IPA)BochumGermany
| | - Sabine Kespohl
- Institute for Prevention and Occupational Medicine of the German Social Accident InsuranceInstitute of the Ruhr University Bochum (IPA)BochumGermany
| | - Eva Zahradnik
- Institute for Prevention and Occupational Medicine of the German Social Accident InsuranceInstitute of the Ruhr University Bochum (IPA)BochumGermany
| | - Philipp Göcke
- Practice for Laboratory Medicine and Microbiology BochumBochumGermany
| | - Ingolf Hosbach
- Institute for Prevention and Occupational Medicine of the German Social Accident InsuranceInstitute of the Ruhr University Bochum (IPA)BochumGermany
- BG University Hospital Bergmannsheil BochumBochumGermany
| | | | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident InsuranceInstitute of the Ruhr University Bochum (IPA)BochumGermany
| | - Monika Raulf
- Institute for Prevention and Occupational Medicine of the German Social Accident InsuranceInstitute of the Ruhr University Bochum (IPA)BochumGermany
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Mao S, Fu L, Yin C, Liu X, Karimi-Maleh H. The role of electrochemical biosensors in SARS-CoV-2 detection: a bibliometrics-based analysis and review. RSC Adv 2022; 12:22592-22607. [PMID: 36105989 PMCID: PMC9372877 DOI: 10.1039/d2ra04162f] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/03/2022] [Indexed: 12/16/2022] Open
Abstract
The global pandemic of COVID-19, which began in late 2019, has resulted in extremely high morbidity and severe mortality worldwide, with important implications for human health, international trade, and national politics. Severe acute respiratory syndrome coronavirus (SARS-CoV-2) is the primary pathogen causing COVID-19. Analytical chemistry played an important role in this global epidemic event, and detection of SARS-CoV-2 even became a part of daily life. Analytical chemists have devoted much effort and enthusiasm to this event, and different analytical techniques have shown very rapid development. Electrochemical biosensors are highly efficient, sensitive, and cost-effective and have been used to detect many highly pathogenic viruses long before this event. However, another fact is that electrochemical biosensors are not the technology of choice for most detection applications. This review describes for the first time the role played by electrochemical biosensors in SARS-CoV-2 detection from a bibliometric perspective. This paper analyzed 254 relevant research papers up to June 2022. The contributions of different countries and institutions to this topic were analyzed. Keyword analysis was used to explore different methodological attempts of electrochemical detection techniques. More importantly, we are trying to find an answer to the question: do electrochemical biosensors have the potential to become a genuinely employable detection technology in an outbreak of infectious disease? This review describes for the first time the role played by electrochemical biosensors in SARS-CoV-2 detection from a bibliometric perspective.![]()
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Affiliation(s)
- Shudan Mao
- Key Laboratory of Pollution Exposure and Health Intervention of Zhejiang Province, Interdisciplinary Research Academy, Zhejiang Shuren University, Hangzhou 310021, PR China
| | - Li Fu
- Key Laboratory of Novel Materials for Sensor of Zhejiang Province, College of Materials and Environmental Engineering, Hangzhou Dianzi University, Hangzhou 310018, China
| | - Chengliang Yin
- National Engineering Laboratory for Medical Big Data Application Technology, Chinese PLA General Hospital, Beijing, China
- Medical Big Data Research Center, Medical Innovation Research Division of PLA General Hospital, Beijing, China
| | - Xiaozhu Liu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Hassan Karimi-Maleh
- School of Resources and Environment, University of Electronic Science and Technology of China, Xiyuan Ave, 611731, Chengdu, China
- Department of Chemical Engineering, Quchan University of Technology, Quchan 9477177870, Iran
- Department of Chemical Sciences, University of Johannesburg, Doornfontein Campus, 2028, Johannesburg 17011, South Africa
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15
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Pallett SJ, Jones R, Abdulaal A, Pallett MA, Rayment M, Patel A, Denny SJ, Mughal N, Khan M, Rosadas de Oliveira C, Pantelidis P, Randell P, Toumazou C, O'Shea MK, Tedder R, McClure MO, Davies GW, Moore LS. Variability in detection of SARS-CoV-2-specific antibody responses following mild infection: a prospective multicentre cross-sectional study, London, United Kingdom, 17 April to 17 July 2020. Euro Surveill 2022; 27:2002076. [PMID: 35086612 PMCID: PMC8796290 DOI: 10.2807/1560-7917.es.2022.27.4.2002076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 07/03/2021] [Indexed: 12/13/2022] Open
Abstract
IntroductionImmunoassays targeting different SARS-CoV-2-specific antibodies are employed for seroprevalence studies. The degree of variability between immunoassays targeting anti-nucleocapsid (anti-NP; the majority) vs the potentially neutralising anti-spike antibodies (including anti-receptor-binding domain; anti-RBD), particularly in mild or asymptomatic disease, remains unclear.AimsWe aimed to explore variability in anti-NP and anti-RBD antibody detectability following mild symptomatic or asymptomatic SARS-CoV-2 infection and analyse antibody response for correlation with symptomatology.MethodsA multicentre prospective cross-sectional study was undertaken (April-July 2020). Paired serum samples were tested for anti-NP and anti-RBD IgG antibodies and reactivity expressed as binding ratios (BR). Multivariate linear regression was performed analysing age, sex, time since onset, symptomatology, anti-NP and anti-RBD antibody BR.ResultsWe included 906 adults. Antibody results (793/906; 87.5%; 95% confidence interval: 85.2-89.6) and BR strongly correlated (ρ = 0.75). PCR-confirmed cases were more frequently identified by anti-RBD (129/130) than anti-NP (123/130). Anti-RBD testing identified 83 of 325 (25.5%) cases otherwise reported as negative for anti-NP. Anti-NP presence (+1.75/unit increase; p < 0.001), fever (≥ 38°C; +1.81; p < 0.001) or anosmia (+1.91; p < 0.001) were significantly associated with increased anti-RBD BR. Age (p = 0.85), sex (p = 0.28) and cough (p = 0.35) were not. When time since symptom onset was considered, we did not observe a significant change in anti-RBD BR (p = 0.95) but did note decreasing anti-NP BR (p < 0.001).ConclusionSARS-CoV-2 anti-RBD IgG showed significant correlation with anti-NP IgG for absolute seroconversion and BR. Higher BR were seen in symptomatic individuals, particularly those with fever. Inter-assay variability (12.5%) was evident and raises considerations for optimising seroprevalence testing strategies/studies.
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Affiliation(s)
- Scott Jc Pallett
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Rachael Jones
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Ahmed Abdulaal
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Mitchell A Pallett
- Department of Infectious Disease, MRC Centre for Molecular Bacteriology and Infection, Imperial College London, United Kingdom
| | - Michael Rayment
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Aatish Patel
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Sarah J Denny
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Nabeela Mughal
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
- North West London Pathology, London, United Kingdom
| | - Maryam Khan
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, London, United Kingdom
| | - Carolina Rosadas de Oliveira
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, London, United Kingdom
| | | | - Paul Randell
- North West London Pathology, London, United Kingdom
| | - Christofer Toumazou
- Faculty of Engineering, Department of Electrical and Electronic Engineering, Imperial College London, South Kensington Campus, London, United Kingdom
| | - Matthew K O'Shea
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
- Institute of Immunology and Immunotherapy, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Richard Tedder
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, London, United Kingdom
| | - Myra O McClure
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, London, United Kingdom
| | - Gary W Davies
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Luke Sp Moore
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
- North West London Pathology, London, United Kingdom
- Imperial College London, NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, London, United Kingdom
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16
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Karamese M, Tutuncu EE. The effectiveness of inactivated SARS-CoV-2 vaccine (CoronaVac) on antibody response in participants aged 65 years and older. J Med Virol 2022; 94:173-177. [PMID: 34427924 PMCID: PMC8662297 DOI: 10.1002/jmv.27289] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/18/2021] [Indexed: 12/28/2022]
Abstract
In this study, it was aimed to determine the antibody responses after the two doses of inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations in people who were above 65 years old and to evaluate the factors affecting this response. A total of 235 participants aged 65 years and older were included. Blood samples were taken and data about age, gender, comorbid diseases, and presence of side effects after vaccination were noted. Anti-SARS-CoV-2 QuantiVac ELISA (IgG) test kit (catalogue number: EI-2606-9601-10-G, Euroimmun) was used. The mean age was 70.38 ± 4.76. Approximately 120 of 235 participants had at least one comorbid disease. The mean levels of anti-SARS-CoV-2 IgG antibody after 4 weeks from the first and second doses of vaccine were 37.70 ± 57.08 IU/ml, and 194.61 ± 174.88 IU/ml, respectively. Additionally, 134 of 235 participants (57.02%) had under 25.6 IU/ml antibody level (negative) after 4 weeks from the first vaccine dose while this rate was 11.48% (n = 27) after 4 weeks from the second vaccine dose. The 19 (70.4%) participants who had under had 25.6 IU/ml antibody level after 4 weeks from the first dose of vaccine had at least one comorbid disease including diabetes mellitus, and 8 (29.6%) participants had no comorbid disease (F = 2.352, p = 0.006). Lower rates of antibody response were detected in participants aged 65 years and older and those with comorbidities both in our study and similar studies in the current literature. Further studies should evaluate whether the low antibody titers are really associated with age and comorbidities or not. Finally, prospective studies are needed to determine how long the immunity provided by SARS-CoV-2 vaccines will continue.
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Affiliation(s)
- Murat Karamese
- Department of Medical Microbiology, Faculty of MedicineKafkas UniversityKarsTurkey
| | - Emin E. Tutuncu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of MedicineKafkas UniversityKarsTurkey
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17
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Klaczko ME, Lucas K, Salminen AT, McCloskey MC, Ozgurun B, Ward BM, Flax J, McGrath JL. Rapid and specific detection of intact viral particles using functionalized microslit silicon membranes as a fouling-based sensor. Analyst 2021; 147:213-222. [PMID: 34933322 DOI: 10.1039/d1an01504d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The COVID-19 pandemic demonstrated the public health benefits of reliable and accessible point-of-care (POC) diagnostic tests for viral infections. Despite the rapid development of gold-standard reverse transcription polymerase chain reaction (RT-PCR) assays for SARS-CoV-2 only weeks into the pandemic, global demand created logistical challenges that delayed access to testing for months and helped fuel the spread of COVID-19. Additionally, the extreme sensitivity of RT-PCR had a costly downside as the tests could not differentiate between patients with active infection and those who were no longer infectious but still shedding viral genomes. To address these issues for the future, we propose a novel membrane-based sensor that only detects intact virions. The sensor combines affinity and size based detection on a membrane-based sensor and does not require external power to operate or read. Specifically, the presence of intact virions, but not viral debris, fouls the membrane and triggers a macroscopically visible hydraulic switch after injection of a 40 μL sample with a pipette. The device, which we call the μSiM-DX (microfluidic device featuring a silicon membrane for diagnostics), features a biotin-coated microslit membrane with pores ∼2-3× larger than the intact virus. Streptavidin-conjugated antibody recognizing viral surface proteins are incubated with the sample for ∼1 hour prior to injection into the device, and positive/negative results are obtained within ten seconds of sample injection. Proof-of-principle tests have been performed using preparations of vaccinia virus. After optimizing slit pore sizes and porous membrane area, the fouling-based sensor exhibits 100% specificity and 97% sensitivity for vaccinia virus (n = 62). Moreover, the dynamic range of the sensor extends at least from 105.9 virions per mL to 1010.4 virions per mL covering the range of mean viral loads in symptomatic COVID-19 patients (105.6-107 RNA copies per mL). Forthcoming work will test the ability of our sensor to perform similarly in biological fluids and with SARS-CoV-2, to fully test the potential of a membrane fouling-based sensor to serve as a PCR-free alternative for POC containment efforts in the spread of infectious disease.
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Affiliation(s)
- Michael E Klaczko
- Department of Chemistry, University of Rochester, Rochester, NY, 14627 USA
| | - Kilean Lucas
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, 14627 USA.
| | - Alec T Salminen
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, 14627 USA.
| | - Molly C McCloskey
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, 14627 USA.
| | - Baturay Ozgurun
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, 14627 USA.
| | - Brian M Ward
- Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY, 14642 USA
| | - Jonathan Flax
- Department of Urology, University of Rochester Medical Center, Rochester, NY, 14642 USA
| | - James L McGrath
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, 14627 USA.
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Lustig Y, Cohen C, Biber A, Jaber H, Becker Ilany Y, Indenbaum V, Amit S, Mandelboim M, Mendelson E, Regev-Yochay G. Immunoglobulin (Ig)A seropositivity against SARS-CoV-2 in healthcare workers in Israel, 4 April to 13 July 2020: an observational study. Euro Surveill 2021; 26. [PMID: 34857065 PMCID: PMC8641069 DOI: 10.2807/1560-7917.es.2021.26.48.2001690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction The COVID-19 pandemic has put healthcare workers (HCW) at significant risk. Presence of antibodies can confirm prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Aim This study investigates the prevalence of IgA and IgG antibodies against SARS-CoV-2 in HCW. Methods Performance of IgA and IgG antibody ELISA assays were initially evaluated in positive and negative SARS-CoV-2 serum samples. IgA and IgG antibodies against SARS-CoV-2 were measured in 428 asymptomatic HCW. We assessed the risk of two groups: HCW with high exposure risk outside work (HROW) residing in areas where COVID-19 was endemic (n = 162) and HCW with high exposure risk at work (HRAW) in a COVID-19 intensive care unit (ICU) (n = 97). Results Sensitivities of 80% and 81.2% and specificities of 97.2% and 98% were observed for IgA and IgG antibodies, respectively. Of the 428 HCW, three were positive for IgG and 27 for IgA. Only 3/27 (11%) IgA-positive HCW had IgG antibodies compared with 50/62 (81%) in a group of previous SARS-CoV-2-PCR-positive individuals. Consecutive samples from IgA-positive HCW demonstrated IgA persistence 18–83 days in 12/20 samples and IgG seroconversion in 1/20 samples. IgA antibodies were present in 8.6% of HROW and 2% of HRAW. Conclusions SARS-CoV-2 exposure may lead to asymptomatic transient IgA response without IgG seroconversion. The significance of these findings needs further study. Out of work exposure is a possible risk of SARS-CoV-2 infection in HCW and infection in HCW can be controlled if adequate protective equipment is implemented.
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Affiliation(s)
- Yaniv Lustig
- Sackler Faculty of Medicine, Tel-Aviv University, Israel
- Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Israel
| | - Carmit Cohen
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat-Gan, Israel
| | - Asaf Biber
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Hanaa Jaber
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat-Gan, Israel
| | - Yael Becker Ilany
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat-Gan, Israel
| | | | - Sharon Amit
- Microbiology Laboratory, Sheba Medical Center, Ramat-Gan, Israel
| | - Michal Mandelboim
- Sackler Faculty of Medicine, Tel-Aviv University, Israel
- Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Israel
| | - Ella Mendelson
- Sackler Faculty of Medicine, Tel-Aviv University, Israel
- Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Israel
| | - Gili Regev-Yochay
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Israel
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Yusuf L, Appeaning M, Amole TG, Musa BM, Galadanci HS, Quashie PK, Aliyu IA. Rapid, Cheap, and Effective COVID-19 Diagnostics for Africa. Diagnostics (Basel) 2021; 11:diagnostics11112105. [PMID: 34829451 PMCID: PMC8625903 DOI: 10.3390/diagnostics11112105] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 09/27/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Although comprehensive public health measures such as mass quarantine have been taken internationally, this has generally been ineffective, leading to a high infection and mortality rate. Despite the fact that the COVID-19 pandemic has been downgraded to epidemic status in many countries, the real number of infections is unknown, particularly in low-income countries. However, precision shielding is used in COVID-19 management, and requires estimates of mass infection in key groups. As a result, rapid tests for the virus could be a useful screening tool for asymptomatic virus shedders who are about to come into contact with sensitive groups. In Africa and other low- and middle-income countries there is high rate of COVID-19 under-diagnosis, due to the high cost of molecular assays. Exploring alternate assays to the reverse transcriptase polymerase chain reaction (RT-PCR) for COVID-19 diagnosis is highly warranted. AIM This review explored the feasibility of using alternate molecular, rapid antigen, and serological diagnostic assays to accurately and precisely diagnose COVID-19 in African populations, and to mitigate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR diagnostic challenges in Africa. METHOD We reviewed publications from internet sources and searched for appropriate documents available in English. This included Medline, Google Scholar, and Ajol. We included primary literature and some review articles that presented knowledge on the current trends on SARS-CoV-2 diagnostics in Africa and globally. RESULTS Based on our analysis, we highlight the utility of four different alternatives to RT-PCR. These include two isothermal nucleic acid amplification assays (loop-mediated isothermal amplification (LAMP) and recombinase polymerase amplification (RPA)), rapid antigen testing, and antibody testing for tackling difficulties posed by SARS-CoV-2 RT-PCR testing in Africa. CONCLUSION The economic burden associated COVID-19 mass testing by RT-PCR will be difficult for low-income nations to meet. We provide evidence for the utility and deployment of these alternate testing methods in Africa and other LMICs.
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Affiliation(s)
- Lukman Yusuf
- Department of Medical Laboratory Science, College of Health Sciences, Bayero University Kano, Kano 700233, Nigeria;
| | - Mark Appeaning
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, P.O. Box LG54, Legon, Accra 23321, Ghana;
- Department of Medical Laboratory Science, Faculty of Health and Allied Sciences, Koforidua Technical University, P.O. Box KF981, Koforidua 03420, Ghana
| | - Taiwo Gboluwaga Amole
- Africa Center of Excellence for Population Health and Policy, Bayero University Kano (ACEPHAP), Kano 700233, Nigeria; (T.G.A.); (B.M.M.); (H.S.G.)
- Department of Community Medicine, Bayero University Kano, Aminu Kano Teaching Hospital, Kano 700233, Nigeria
| | - Baba Maiyaki Musa
- Africa Center of Excellence for Population Health and Policy, Bayero University Kano (ACEPHAP), Kano 700233, Nigeria; (T.G.A.); (B.M.M.); (H.S.G.)
- Department of Medicine, College of Health Sciences, Bayero University Kano, Aminu Kano Teaching Hospital, Kano 700233, Nigeria
| | - Hadiza Shehu Galadanci
- Africa Center of Excellence for Population Health and Policy, Bayero University Kano (ACEPHAP), Kano 700233, Nigeria; (T.G.A.); (B.M.M.); (H.S.G.)
- Department of Gynecology and Obstetrics, College of Health Sciences, Bayero University Kano, Kano 700233, Nigeria
| | - Peter Kojo Quashie
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, P.O. Box LG54, Legon, Accra 23321, Ghana;
- Correspondence: (P.K.Q.); (I.A.A.)
| | - Isah Abubakar Aliyu
- Department of Medical Laboratory Science, College of Health Sciences, Bayero University Kano, Kano 700233, Nigeria;
- Africa Center of Excellence for Population Health and Policy, Bayero University Kano (ACEPHAP), Kano 700233, Nigeria; (T.G.A.); (B.M.M.); (H.S.G.)
- Correspondence: (P.K.Q.); (I.A.A.)
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20
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Prudente TP, Castro RG, Candido MA, Rodrigues RL, de Souza LM, Roberti MDRF. Antibody response against SARS-CoV-2 in convalescent plasma donors: can we predict subjects' eligibility? Hematol Transfus Cell Ther 2021; 44:1-6. [PMID: 34751255 PMCID: PMC8566374 DOI: 10.1016/j.htct.2021.07.008] [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] [Received: 04/08/2021] [Accepted: 07/13/2021] [Indexed: 01/10/2023] Open
Abstract
Introduction As the Coronavirus Disease 2019 (COVID-19) pandemic unfolds around the world; answers related to the antibody response against the virus are necessary to develop treatment and prophylactic strategies. We attempted to understand part of the immune response of convalescent plasma donation candidates. Method We carried out a cross-sectional, observational, non-intervention study, testing 102 convalescent plasma donation candidates for antibodies against the virus, relating these data to the time interval between symptom onset and sample collection, age, disease severity, and gender. Results In our sample, the individuals who developed a greater antibody response were the ones who had a longer time interval between symptom onset and sample collection, the ones who had been hospitalized and the subjects above 35 years old. Moreover, 17 individuals did not present any reactive antibodies. Conclusion These results are important in that they raise questions about the role of the humoral response against the virus, as some individuals do not develop antibodies to fight it. In addition, they help develop recruitment strategies for convalescent plasma donors, who should be asymptomatic for at least 21 days and are possibly more likely to have reactive antibodies after 35 days without symptoms.
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Affiliation(s)
- Tiago Paiva Prudente
- Faculdade de Medicina da Universidade Federal de Goiás (FM-UFG), Goiânia, GO, Brazil
| | - Renato Gomes Castro
- Faculdade de Medicina da Universidade Federal de Goiás (FM-UFG), Goiânia, GO, Brazil
| | | | | | | | - Maria do Rosario Ferraz Roberti
- Faculdade de Medicina da Universidade Federal de Goiás (FM-UFG), Goiânia, GO, Brazil.,Hemocentro de Goiás (HEMOGO), Goiânia, GO, Brazil
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21
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Herzberg J, Vollmer T, Fischer B, Becher H, Becker AK, Sahly H, Honarpisheh H, Guraya SY, Strate T, Knabbe C. Half-Year Longitudinal Seroprevalence of SARS-CoV-2-Antibodies and Rule Compliance in German Hospital Employees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010972. [PMID: 34682719 PMCID: PMC8535494 DOI: 10.3390/ijerph182010972] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 01/02/2023]
Abstract
COVID-19, which is caused by SARS-CoV-2, is an occupational health risk, especially for healthcare employees due to their higher exposure and consequently higher risk of symptomatic and asymptomatic infections. This study was designed to determine the longitudinal seroprevalence of specific immunoglobulin-G (IgG) antibodies in employees in a hospital setting. All employees in a secondary care hospital, including healthcare and non-healthcare workers, were invited to participate in this single-center study. After an initial screening, a 6-month follow-up was carried out, which included serological examination for SARS-CoV-2 IgG antibodies and a questionnaire for self-reported symptoms, self-perception, and thoughts about local and national hygiene and pandemic plans. The seroprevalence of SARS-CoV-2 IgG antibodies was 0.74% among 406 hospital employees (0.75% in healthcare workers, 0.72% in non-healthcare workers), initially recruited in April 2020, in their follow-up blood specimens in October 2020. In this study, 30.54% of the participants reported using the official German coronavirus mobile application and the majority were content with the local and national rules in relation to coronavirus-related restrictions. At the 6-month follow-up, the 0.74% seroprevalence was below the reported seroprevalence of 1.35% in the general German population. The prevalence in healthcare workers in direct patient care compared with that in workers without direct patient contact did not differ significantly. Further follow-up to monitor the seroprevalence in the high-risk healthcare sector during the ongoing global pandemic is essential.
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Affiliation(s)
- Jonas Herzberg
- Department of Surgery, Krankenhaus Reinbek St. Adolf-Stift, Hamburger Strasse 41, 21465 Reinbek, Germany; (H.H.); (T.S.)
- Correspondence: ; Tel.: +49-40-7280-5375
| | - Tanja Vollmer
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Georgstrasse 11, 32545 Bad Oeynhausen, Germany; (T.V.); (B.F.); (C.K.)
| | - Bastian Fischer
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Georgstrasse 11, 32545 Bad Oeynhausen, Germany; (T.V.); (B.F.); (C.K.)
| | - Heiko Becher
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany;
| | - Ann-Kristin Becker
- Asklepios Klinik Harburg Abteilung für Psychiatrie und Psychotherapie, Eißendorfer Pferdeweg 52, 21075 Hamburg, Germany;
| | - Hany Sahly
- Labor Lademannbogen MVZ Hamburg, Lademannbogen 61, 22339 Hamburg, Germany;
| | - Human Honarpisheh
- Department of Surgery, Krankenhaus Reinbek St. Adolf-Stift, Hamburger Strasse 41, 21465 Reinbek, Germany; (H.H.); (T.S.)
| | - Salman Yousuf Guraya
- Clinical Sciences Department, College of Medicine, University of Sharjah, P.O. Box 27272, Sharjah, United Arab Emirates;
| | - Tim Strate
- Department of Surgery, Krankenhaus Reinbek St. Adolf-Stift, Hamburger Strasse 41, 21465 Reinbek, Germany; (H.H.); (T.S.)
| | - Cornelius Knabbe
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Georgstrasse 11, 32545 Bad Oeynhausen, Germany; (T.V.); (B.F.); (C.K.)
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22
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Knoop A, Geyer H, Lerch O, Rubio A, Schrader Y, Thevis M. Detection of anti‐SARS‐CoV‐2 antibodies in dried blood spots utilizing manual or automated spot extraction and electrochemiluminescence immunoassay (ECLIA). ANALYTICAL SCIENCE ADVANCES 2021; 2:440-446. [PMID: 35098125 PMCID: PMC8250974 DOI: 10.1002/ansa.202100009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/11/2021] [Accepted: 03/11/2021] [Indexed: 11/11/2022]
Abstract
Serological test methods to detect anti‐SARS‐CoV‐2 antibodies represent a major measure to manage the pandemic caused by the coronavirus disease 2019 (COVID‐19). In this communication, test results obtained from minimal‐invasively collected dried blood spot (DBS) specimens, which can be sampled ‘at home’ without the need of medically trained personnel, are compared to conventionally collected venous blood samples. DBS samples were prepared for analysis either manually or by a card extraction robot, and electrochemiluminescence assay (ECLIA) characteristics, assay readout values as well as stability data covering a period of more than 200 days are provided. Constant anti‐SARS‐CoV‐2 antibody readouts of quality control DBS were obtained over the entire test period using DBS specimens stored under dry and dark conditions. In addition, test results obtained from individuals tested twice within 10 months post‐infection indicated a consistent presence of antibodies.
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Affiliation(s)
- Andre Knoop
- Institute of Biochemistry, Center for Preventive Doping Research German Sport University Cologne Cologne Germany
| | - Hans Geyer
- Institute of Biochemistry, Center for Preventive Doping Research German Sport University Cologne Cologne Germany
| | - Oliver Lerch
- Gerstel GmbH & Co. KG Muelheim an der Ruhr Germany
| | - Ana Rubio
- Institute of Biochemistry, Center for Preventive Doping Research German Sport University Cologne Cologne Germany
| | - Yvonne Schrader
- Institute of Biochemistry, Center for Preventive Doping Research German Sport University Cologne Cologne Germany
| | - Mario Thevis
- Institute of Biochemistry, Center for Preventive Doping Research German Sport University Cologne Cologne Germany
- European Monitoring Center for Emerging Doping Agents (EuMoCEDA) Cologne/Bonn Germany
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23
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Castro Dopico X, Muschiol S, Christian M, Hanke L, Sheward DJ, Grinberg NF, Rorbach J, Bogdanovic G, Mcinerney GM, Allander T, Wallace C, Murrell B, Albert J, Karlsson Hedestam GB. Seropositivity in blood donors and pregnant women during the first year of SARS-CoV-2 transmission in Stockholm, Sweden. J Intern Med 2021; 290:666-676. [PMID: 34008203 PMCID: PMC8242905 DOI: 10.1111/joim.13304] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/25/2021] [Accepted: 04/07/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND In Sweden, social restrictions to contain SARS-CoV-2 have primarily relied upon voluntary adherence to a set of recommendations. Strict lockdowns have not been enforced, potentially affecting viral dissemination. To understand the levels of past SARS-CoV-2 infection in the Stockholm population before the start of mass vaccinations, healthy blood donors and pregnant women (n = 5,100) were sampled at random between 14 March 2020 and 28 February 2021. METHODS In this cross-sectional prospective study, otherwise-healthy blood donors (n = 2,600) and pregnant women (n = 2,500) were sampled for consecutive weeks (at four intervals) throughout the study period. Sera from all participants and a cohort of historical (negative) controls (n = 595) were screened for IgG responses against stabilized trimers of the SARS-CoV-2 spike (S) glycoprotein and the smaller receptor-binding domain (RBD). As a complement to standard analytical approaches, a probabilistic (cut-off independent) Bayesian framework that assigns likelihood of past infection was used to analyse data over time. SETTING Healthy participant samples were randomly selected from their respective pools through Karolinska University Hospital. The study was carried out in accordance with Swedish Ethical Review Authority: registration number 2020-01807. PARTICIPANTS No participants were symptomatic at sampling, and blood donors were all over the age of 18. No additional metadata were available from the participants. RESULTS Blood donors and pregnant women showed a similar seroprevalence. After a steep rise at the start of the pandemic, the seroprevalence trajectory increased steadily in approach to the winter second wave of infections, approaching 15% of all individuals surveyed by 13 December 2020. By the end of February 2021, 19% of the population tested seropositive. Notably, 96% of seropositive healthy donors screened (n = 56) developed neutralizing antibody responses at titres comparable to or higher than those observed in clinical trials of SARS-CoV-2 spike mRNA vaccination, supporting that mild infection engenders a competent B-cell response. CONCLUSIONS These data indicate that in the first year since the start of community transmission, seropositivity levels in metropolitan in Stockholm had reached approximately one in five persons, providing important baseline seroprevalence information prior to the start of vaccination.
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Affiliation(s)
- X. Castro Dopico
- From theDepartment of Microbiology, Tumor and Cell BiologyKarolinska InstitutetStockholmSweden
| | - S. Muschiol
- From theDepartment of Microbiology, Tumor and Cell BiologyKarolinska InstitutetStockholmSweden
- Department of Clinical MicrobiologyKarolinska University HospitalStockholmSweden
| | - M. Christian
- From theDepartment of Microbiology, Tumor and Cell BiologyKarolinska InstitutetStockholmSweden
| | - L. Hanke
- From theDepartment of Microbiology, Tumor and Cell BiologyKarolinska InstitutetStockholmSweden
| | - D. J. Sheward
- From theDepartment of Microbiology, Tumor and Cell BiologyKarolinska InstitutetStockholmSweden
| | - N. F. Grinberg
- Cambridge Institute of Therapeutic Immunology & Infectious DiseaseUniversity of CambridgeCambridgeUK
| | - J. Rorbach
- Department of Medical Biochemistry and BiophysicsKarolinska InstitutetStockholmSweden
- Max Planck Institute Biology of Ageing‐Karolinska Institutet LaboratoryKarolinska InstitutetStockholmSweden
| | - G. Bogdanovic
- Department of Clinical MicrobiologyKarolinska University HospitalStockholmSweden
| | - G. M. Mcinerney
- From theDepartment of Microbiology, Tumor and Cell BiologyKarolinska InstitutetStockholmSweden
| | - T. Allander
- From theDepartment of Microbiology, Tumor and Cell BiologyKarolinska InstitutetStockholmSweden
- Department of Clinical MicrobiologyKarolinska University HospitalStockholmSweden
| | - C. Wallace
- Cambridge Institute of Therapeutic Immunology & Infectious DiseaseUniversity of CambridgeCambridgeUK
- Biostatistics Unit, Cambridge Institute of Public HealthUniversity of CambridgeCambridgeUK
| | - B. Murrell
- From theDepartment of Microbiology, Tumor and Cell BiologyKarolinska InstitutetStockholmSweden
| | - J. Albert
- From theDepartment of Microbiology, Tumor and Cell BiologyKarolinska InstitutetStockholmSweden
- Department of Clinical MicrobiologyKarolinska University HospitalStockholmSweden
| | - G. B. Karlsson Hedestam
- From theDepartment of Microbiology, Tumor and Cell BiologyKarolinska InstitutetStockholmSweden
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24
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Thakkar A, Mishra S, Warner JL. COVID-19 Vaccine among Actively-Treated People with Cancer: A Glimpse into the Known Unknowns? J Natl Cancer Inst 2021; 114:169-171. [PMID: 34453849 DOI: 10.1093/jnci/djab175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 08/24/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Astha Thakkar
- Department of Medicine, Division of Oncology, Montefiore Medical Center, Bronx, NY, USA
| | - Sanjay Mishra
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jeremy L Warner
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Medicine, Division of Hematology/Oncology, Vanderbilt University, Nashville, TN, USA.,Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA
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25
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Assessing the Quality of Serological Testing in the COVID-19 Pandemic: Results of a European External Quality Assessment (EQA) Scheme for Anti-SARS-CoV-2 Antibody Detection. J Clin Microbiol 2021; 59:e0055921. [PMID: 34190575 PMCID: PMC8373014 DOI: 10.1128/jcm.00559-21] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
External quality assessment (EQA) is a key instrument for achieving harmonization, and thus a high quality, of diagnostic procedures. As reliable test results are crucial for accurate assessment of SARS-CoV-2 infection prevalence, vaccine response, and immunity, and thus for successful management of the ongoing COVID-19 pandemic, the Reference Institute for Bioanalytics (RfB) was the first EQA provider to offer an open scheme for anti-SARS-CoV-2 antibody detection. The main objectives of this EQA were (i) to gain insights into the current diagnostic landscape and the performance of serological tests in Europe and (ii) to provide recommendations for diagnostic improvements. Within the EQA, a blinded panel of precharacterized human serum samples with variable anti-SARS-CoV-2 antibody titers was provided for detection of anti-SARS-CoV-2 IgG, IgA, and IgM antibodies. Across the three distribution rounds in 2020, 284 laboratories from 22 countries reported a total of 3,744 results for anti-SARS-CoV-2 antibody detection using more than 24 different assays for IgG. Overall, 97/3,004 results were false for anti-SARS-CoV-2 IgG, 88/248 for IgA, and 34/124 for IgM. Regarding diagnostic sensitivity and specificity, substantial differences were found between the different assays used, as well as between certified and noncertified tests. For cutoff samples, a drop in the diagnostic sensitivity to 46.3% and high interlaboratory variability were observed. In general, this EQA highlights the current variability of anti-SARS-CoV-2 antibody detection, technical limitations with respect to cutoff samples, and the lack of harmonization of testing procedures. Recommendations are provided to help laboratories and manufacturers further improve the quality of anti-SARS-CoV-2 serological diagnostics.
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26
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Kalkeri R, Cai Z, Lin S, Farmer J, Kuzmichev YV, Koide F. SARS-CoV-2 Spike Pseudoviruses: A Useful Tool to Study Virus Entry and Address Emerging Neutralization Escape Phenotypes. Microorganisms 2021; 9:1744. [PMID: 34442823 PMCID: PMC8398529 DOI: 10.3390/microorganisms9081744] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/06/2021] [Accepted: 08/06/2021] [Indexed: 12/12/2022] Open
Abstract
SARS-CoV-2 genetic variants are emerging around the globe. Unfortunately, several SARS-CoV-2 variants, especially variants of concern (VOCs), are less susceptible to neutralization by the convalescent and post-vaccination sera, raising concerns of increased disease transmissibility and severity. Recent data suggests that SARS-CoV-2 neutralizing antibody levels are a reliable correlate of vaccine-mediated protection. However, currently used BSL3-based virus micro-neutralization (MN) assays are more laborious, time-consuming, and expensive, underscoring the need for BSL2-based, cost-effective neutralization assays against SARS-CoV-2 variants. In light of this unmet need, we have developed a BSL-2 pseudovirus-based neutralization assay (PBNA) in cells expressing the human angiotensin-converting enzyme-2 (hACE2) receptor for SARS-CoV-2. The assay is reproducible (R2 = 0.96), demonstrates a good dynamic range and high sensitivity. Our data suggest that the biological Anti-SARS-CoV-2 research reagents such as NIBSC 20/130 show lower neutralization against B.1.351 SA (South Africa) and B.1.1.7 UK (United Kingdom) VOC, whereas a commercially available monoclonal antibody MM43 retains activity against both these variants. SARS-CoV-2 spike PBNAs for VOCs would be useful tools to measure the neutralization ability of candidate vaccines in both preclinical models and clinical trials and would further help develop effective prophylactic countermeasures against emerging neutralization escape phenotypes.
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Affiliation(s)
- Raj Kalkeri
- Department of Infectious Disease Research, Drug Development Division, Southern Research, 431 Aviation Way, Frederick, MD 21701, USA; (Z.C.); (S.L.); (Y.V.K.)
| | - Zhaohui Cai
- Department of Infectious Disease Research, Drug Development Division, Southern Research, 431 Aviation Way, Frederick, MD 21701, USA; (Z.C.); (S.L.); (Y.V.K.)
| | - Shuling Lin
- Department of Infectious Disease Research, Drug Development Division, Southern Research, 431 Aviation Way, Frederick, MD 21701, USA; (Z.C.); (S.L.); (Y.V.K.)
| | - John Farmer
- Department of Infectious Disease Research, Drug Development Division, Southern Research, 2000 Ninth Avenue South, Birmingham, AL 35205, USA;
| | - Yury V. Kuzmichev
- Department of Infectious Disease Research, Drug Development Division, Southern Research, 431 Aviation Way, Frederick, MD 21701, USA; (Z.C.); (S.L.); (Y.V.K.)
| | - Fusataka Koide
- Department of Infectious Disease Research, Drug Development Division, Southern Research, 431 Aviation Way, Frederick, MD 21701, USA; (Z.C.); (S.L.); (Y.V.K.)
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27
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Sciacovelli L, Padoan A, Secchiero S, Plebani M. Serological diagnostic for SARS-CoV-2: an experimental External Quality Assessment Scheme. Clin Chem Lab Med 2021; 59:1878-1884. [PMID: 34348424 DOI: 10.1515/cclm-2021-0662] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/08/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Numerous analytical systems, rapidly made available on the market throughout the SARS-CoV-2 pandemic, aim to detect COVID-19, and to continuously update and improve the same systems. Medical laboratory professionals have also developed in-house analytical procedures in order to satisfy the enormous volume of requests for tests. These developments have highlighted the need control the analytical procedures used in order to guarantee patient safety. The External Quality Assessment (EQA) Scheme, an important quality assurance tool, aims to guarantee high standard performance for laboratory and analytical procedures. The aim of the present study was to report on the results collected in an experimental EQA scheme for the serological diagnosis of SARS-CoV-2. METHODS All qualitative results collected in the different EQA surveys were summarized in order to identify the percentage of laboratory results in relation to typology of antibodies, results and samples. RESULTS A total of 4,867 data sets were collected. The analysis of EQA data made, demonstrates a better agreement among laboratories results for total Ig than single immunoglobulins (IgG, IgM, IgA) in the case samples positive for SARS-CoV-2, and a wide divergence between IgM results for positive samples (only 34.9% were correct). Results for negative controls and specificity controls demonstrated a better overall agreement than results for positive samples. CONCLUSIONS Working in collaboration with the IVD manufacturers, laboratory professionals must strive to achieve harmonization of results, and to develop well-defined protocols complying with the ISO 15189 requirements.
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Affiliation(s)
- Laura Sciacovelli
- Centre of Biomedical Research for Quality in Laboratory Medicine, Department of Laboratory Medicine, University Hospital of Padua, Padua, Italy.,Department of Medicine DIMED, University of Padua, Padua, Italy
| | - Andrea Padoan
- Department of Medicine DIMED, University of Padua, Padua, Italy
| | - Sandra Secchiero
- Centre of Biomedical Research for Quality in Laboratory Medicine, Department of Laboratory Medicine, University Hospital of Padua, Padua, Italy
| | - Mario Plebani
- Centre of Biomedical Research for Quality in Laboratory Medicine, Department of Laboratory Medicine, University Hospital of Padua, Padua, Italy.,Department of Medicine DIMED, University of Padua, Padua, Italy
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Muecksch F, Wise H, Templeton K, Batchelor B, Squires M, McCance K, Jarvis L, Malloy K, Furrie E, Richardson C, MacGuire J, Godber I, Burns A, Mavin S, Zhang F, Schmidt F, Bieniasz P, Jenks S, Hatziioannou T. Longitudinal variation in SARS-CoV-2 antibody levels and emergence of viral variants: implications for the ability of serological assays to predict immunity. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.07.02.21259939. [PMID: 34268524 PMCID: PMC8282113 DOI: 10.1101/2021.07.02.21259939] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Serological assays are being deployed to monitor antibody responses in SARS-CoV-2 convalescents and vaccine recipients. There is a need to determine whether such assays can predict immunity, as antibody levels wane and viral variants emerge. METHODS We measured antibodies in a cohort of SARS-CoV-2 infected patients using several high-throughput serological tests and functional neutralization assays. The effects of time and spike protein sequence variation on the performance and predictive value of the various assays was assessed. FINDINGS Neutralizing antibody titers decreased over the first few months post-infection but stabilized thereafter, at about 30% of the level observed shortly after infection. Serological assays commonly used to measure antibodies against SARS-CoV-2 displayed a range of sensitivities that declined to varying extents over time. Quantitative measurements generated by serological assays based on the spike protein were better at predicting neutralizing antibody titers than assays based on nucleocapsid, but performance was variable and manufacturer positivity thresholds were not able to predict the presence or absence of detectable neutralizing activity. Even though there was some deterioration in correlation between serological measurements and functional neutralization activity, some assays maintained an ability to predict neutralizing titers, even against variants of concern. INTERPRETATION The ability of high throughput serological assays to predict neutralizing antibody titers is likely crucial for evaluation of immunity at the population scale. These data will facilitate the selection of the most suitable assays as surrogates of functional neutralizing activity and suggest that such measurements may have utility in clinical practice.
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Affiliation(s)
- Frauke Muecksch
- Laboratory of Retrovirology, The Rockefeller University, 1230 York Avenue, New York NY 10065
| | - Helen Wise
- Royal Infirmary of Edinburgh, NHS Lothian, 51 Little France Crescent, Edinburgh EH16 4SA
| | - Kate Templeton
- Royal Infirmary of Edinburgh, NHS Lothian, 51 Little France Crescent, Edinburgh EH16 4SA
| | - Becky Batchelor
- Western General Hospital, Crewe Road South, Edinburgh, EH4 2XU
| | - Maria Squires
- Royal Infirmary of Edinburgh, NHS Lothian, 51 Little France Crescent, Edinburgh EH16 4SA
| | - Kirsty McCance
- Royal Infirmary of Edinburgh, NHS Lothian, 51 Little France Crescent, Edinburgh EH16 4SA
| | - Lisa Jarvis
- SNBTS Microbiology Reference Laboratory, The Jack Copland Centre, 52 Research Avenue North, Heriot Watt Research Park, Edinburgh, EH14 4AP
| | - Kristen Malloy
- SNBTS Microbiology Reference Laboratory, The Jack Copland Centre, 52 Research Avenue North, Heriot Watt Research Park, Edinburgh, EH14 4AP
| | - Elizabeth Furrie
- Ninewells Hospital and Medical School, NHS Tayside, Dundee, DD1 9SY
| | | | | | - Ian Godber
- Queen Elizabeth University Hospital, Govan Road, Glasgow, G51 4TF
| | - Alana Burns
- Queen Elizabeth University Hospital, Govan Road, Glasgow, G51 4TF
| | - Sally Mavin
- Scottish Microbiology Reference Laboratory, NHS Highland, Inverness, IV2 3UJ
| | - Fengwen Zhang
- Laboratory of Retrovirology, The Rockefeller University, 1230 York Avenue, New York NY 10065
| | - Fabian Schmidt
- Laboratory of Retrovirology, The Rockefeller University, 1230 York Avenue, New York NY 10065
| | - Paul Bieniasz
- Laboratory of Retrovirology, The Rockefeller University, 1230 York Avenue, New York NY 10065
- Howard Hughes Medical Institute, The Rockefeller University, 1230 York Avenue, New York NY 10065
| | - Sara Jenks
- Royal Infirmary of Edinburgh, NHS Lothian, 51 Little France Crescent, Edinburgh EH16 4SA
| | - Theodora Hatziioannou
- Laboratory of Retrovirology, The Rockefeller University, 1230 York Avenue, New York NY 10065
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29
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Murhekar MV, Bhatnagar T, Thangaraj JWV, Saravanakumar V, Kumar MS, Selvaraju S, Rade K, Kumar CPG, Sabarinathan R, Turuk A, Asthana S, Balachandar R, Bangar SD, Bansal AK, Chopra V, Das D, Deb AK, Devi KR, Dhikav V, Dwivedi GR, Khan SMS, Kumar MS, Laxmaiah A, Madhukar M, Mahapatra A, Rangaraju C, Turuk J, Yadav R, Andhalkar R, Arunraj K, Bharadwaj DK, Bharti P, Bhattacharya D, Bhat J, Chahal AS, Chakraborty D, Chaudhury A, Deval H, Dhatrak S, Dayal R, Elantamilan D, Giridharan P, Haq I, Hudda RK, Jagjeevan B, Kalliath A, Kanungo S, Krishnan NN, Kshatri JS, Kumar A, Kumar N, Kumar VGV, Lakshmi GGJN, Mehta G, Mishra NK, Mitra A, Nagbhushanam K, Nimmathota A, Nirmala AR, Pandey AK, Prasad GV, Qurieshi MA, Reddy SD, Robinson A, Sahay S, Saxena R, Sekar K, Shukla VK, Singh HB, Singh PK, Singh P, Singh R, Srinivasan N, Varma DS, Viramgami A, Wilson VC, Yadav S, Yadav S, Zaman K, Chakrabarti A, Das A, Dhaliwal RS, Dutta S, Kant R, Khan AM, Narain K, Narasimhaiah S, Padmapriyadarshini C, Pandey K, Pati S, Patil S, Rajkumar H, Ramarao T, Sharma YK, Singh S, Panda S, Reddy DCS, Bhargava B. SARS-CoV-2 seroprevalence among the general population and healthcare workers in India, December 2020-January 2021. Int J Infect Dis 2021; 108:145-155. [PMID: 34022338 PMCID: PMC8132496 DOI: 10.1016/j.ijid.2021.05.040] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/12/2021] [Accepted: 05/16/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Earlier serosurveys in India revealed seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) of 0.73% in May-June 2020 and 7.1% in August-September 2020. A third serosurvey was conducted between December 2020 and January 2021 to estimate the seroprevalence of SARS-CoV-2 infection among the general population and healthcare workers (HCWs) in India. METHODS The third serosurvey was conducted in the same 70 districts as the first and second serosurveys. For each district, at least 400 individuals aged ≥10 years from the general population and 100 HCWs from subdistrict-level health facilities were enrolled. Serum samples from the general population were tested for the presence of immunoglobulin G (IgG) antibodies against the nucleocapsid (N) and spike (S1-RBD) proteins of SARS-CoV-2, whereas serum samples from HCWs were tested for anti-S1-RBD. Weighted seroprevalence adjusted for assay characteristics was estimated. RESULTS Of the 28,598 serum samples from the general population, 4585 (16%) had IgG antibodies against the N protein, 6647 (23.2%) had IgG antibodies against the S1-RBD protein, and 7436 (26%) had IgG antibodies against either the N protein or the S1-RBD protein. Weighted and assay-characteristic-adjusted seroprevalence against either of the antibodies was 24.1% [95% confidence interval (CI) 23.0-25.3%]. Among 7385 HCWs, the seroprevalence of anti-S1-RBD IgG antibodies was 25.6% (95% CI 23.5-27.8%). CONCLUSIONS Nearly one in four individuals aged ≥10 years from the general population as well as HCWs in India had been exposed to SARS-CoV-2 by December 2020.
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Affiliation(s)
- Manoj V Murhekar
- ICMR National Institute of Epidemiology, Chennai, Tamil Nadu, India.
| | - Tarun Bhatnagar
- ICMR National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | - V Saravanakumar
- ICMR National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | - Sriram Selvaraju
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Kiran Rade
- WHO Country Office for India, New Delhi, India
| | - C P Girish Kumar
- ICMR National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - R Sabarinathan
- ICMR National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Alka Turuk
- Indian Council of Medical Research, New Delhi, India
| | - Smita Asthana
- ICMR National Institute of Cancer Prevention and Research, NOIDA, Uttar Pradesh, India
| | - Rakesh Balachandar
- ICMR National Institute of Occupational Health, Ahmedabad, Gujarat, India
| | | | - Avi Kumar Bansal
- ICMR National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, India
| | - Vishal Chopra
- State TB Training and Demonstration Centre, Patiala, Punjab, India
| | - Dasarathi Das
- ICMR Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Alok Kumar Deb
- ICMR National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India
| | - Kangjam Rekha Devi
- ICMR Regional Medical Research Centre, N.E. Region, Dibrugarh, Assam, India
| | - Vikas Dhikav
- ICMR National Institute for Implementation Research on Non-Communicable Diseases, Jodhpur, Rajasthan, India
| | | | | | - M Sunil Kumar
- State TB Training and Demonstration Centre, Thiruvananthapuram, Kerala, India
| | - Avula Laxmaiah
- ICMR National Institute of Nutrition, Hyderabad, Telangana, India
| | - Major Madhukar
- ICMR Rajendra Memorial Research Institute of Medical Sciences, Patna, Bihar, India
| | | | - Chethana Rangaraju
- National Tuberculosis Institute, Bangalore and Lady Willingdon State TB Centre, Bengaluru, Karnataka, India
| | | | - Rajiv Yadav
- ICMR National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Rushikesh Andhalkar
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - K Arunraj
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | | - Pravin Bharti
- ICMR National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | | | - Jyothi Bhat
- ICMR National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | | | - Debjit Chakraborty
- ICMR National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India
| | - Anshuman Chaudhury
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Hirawati Deval
- ICMR Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - Sarang Dhatrak
- ICMR National Institute of Occupational Health, Ahmedabad, Gujarat, India
| | - Rakesh Dayal
- State TB Training and Demonstration Centre, Ranchi, Jharkhand, India
| | - D Elantamilan
- ICMR National Institute for Implementation Research on Non-Communicable Diseases, Jodhpur, Rajasthan, India
| | | | - Inaamul Haq
- Government Medical College Srinagar, Srinagar, Jammu, India
| | - Ramesh Kumar Hudda
- ICMR National Institute for Implementation Research on Non-Communicable Diseases, Jodhpur, Rajasthan, India
| | - Babu Jagjeevan
- ICMR National Institute of Nutrition, Hyderabad, Telangana, India
| | - Arshad Kalliath
- State TB Training and Demonstration Centre, Thiruvananthapuram, Kerala, India
| | - Srikanta Kanungo
- ICMR Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | | | - Alok Kumar
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Niraj Kumar
- ICMR Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - V G Vinoth Kumar
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | | - Ganesh Mehta
- ICMR National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, India
| | - Nandan Kumar Mishra
- ICMR National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, India
| | - Anindya Mitra
- State TB Training and Demonstration Centre, Ranchi, Jharkhand, India
| | - K Nagbhushanam
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | | - A R Nirmala
- National Tuberculosis Institute, Bangalore and Lady Willingdon State TB Centre, Bengaluru, Karnataka, India
| | | | | | | | | | - Aby Robinson
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Seema Sahay
- ICMR National AIDS Research Institute, Pune, Maharashtra, India
| | - Rochak Saxena
- State TB Training and Demonstration Centre, Raipur, Chhattisgarh, India
| | - Krithikaa Sekar
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | | - Hari Bhan Singh
- ICMR National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, India
| | - Prashant Kumar Singh
- ICMR National Institute of Cancer Prevention and Research, NOIDA, Uttar Pradesh, India
| | - Pushpendra Singh
- ICMR National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Rajeev Singh
- ICMR Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - Nivetha Srinivasan
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | | - Ankit Viramgami
- ICMR National Institute of Occupational Health, Ahmedabad, Gujarat, India
| | | | - Surabhi Yadav
- ICMR National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Suresh Yadav
- ICMR National Institute for Implementation Research on Non-Communicable Diseases, Jodhpur, Rajasthan, India
| | - Kamran Zaman
- ICMR Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - Amit Chakrabarti
- ICMR National Institute of Occupational Health, Ahmedabad, Gujarat, India
| | - Aparup Das
- ICMR National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - R S Dhaliwal
- ICMR National Institute for Implementation Research on Non-Communicable Diseases, Jodhpur, Rajasthan, India
| | - Shanta Dutta
- ICMR National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India
| | - Rajni Kant
- ICMR Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - A M Khan
- Indian Council of Medical Research, New Delhi, India
| | - Kanwar Narain
- ICMR Regional Medical Research Centre, N.E. Region, Dibrugarh, Assam, India
| | - Somashekar Narasimhaiah
- National Tuberculosis Institute, Bangalore and Lady Willingdon State TB Centre, Bengaluru, Karnataka, India
| | | | - Krishna Pandey
- ICMR Rajendra Memorial Research Institute of Medical Sciences, Patna, Bihar, India
| | - Sanghamitra Pati
- ICMR Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Shripad Patil
- ICMR National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, India
| | | | | | - Y K Sharma
- State TB Training and Demonstration Centre, Raipur, Chhattisgarh, India
| | - Shalini Singh
- ICMR National Institute of Cancer Prevention and Research, NOIDA, Uttar Pradesh, India
| | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India
| | - D C S Reddy
- Independent Consultant, Lucknow, Uttar Pradesh, India
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Rezaei M, Sadeghi M, Korourian A, Tabarsi P, Porabdollah M, Askari E, Mortaz E, Mahmoudi S, Marjani M, Velayati AA. Comparative evaluation of SARS-CoV-2 IgG assays against nucleocapsid and spike antigens. Hum Antibodies 2021; 29:109-113. [PMID: 33720878 DOI: 10.3233/hab-210440] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND There are few studies to compare antibody response against anti-spike (S) and anti- nucleoprotein (N) SARS-CoV-2. OBJECTIVE The aim of this study was to evaluate the IgG antibody production against S and N antigens of the virus and their correlation with the time and severity of the disease. METHODS The IgG antibodies against S and N antigens of SARS-CoV-2 in serum specimens of 72 symptomatic patients who tested real-time reverse transcription polymerase chain reaction positive for SARS-CoV-2 were detected using the ELISA technique. Different antibody response was compared and the correlation with the time from disease onset and the severity was evaluated. RESULTS Forty-eight of 72 (67%) patients tested positive for anti-SARS-CoV-2 antibodies, while 24 (33%) did not have detectable antibodies. Comparison of antibody levels for N and S antibodies showed that they correlate with each other well (r= 0.81; P< 0.001). However, sensitivity of anti-S SARS-CoV-2 IgG and anti-N SARS-CoV-2 IgG was 30% and 60%, during the first 7 days after symptom onset (r= 0.53; P= 0.111), but increased to 73% and 68% at more than 1-week post symptom onset (r= 0.89, P= 0.111), respectively. Cases with positive IgG response showed a decreased CD8+ T cells percentage compared to the negative IgG groups (26 ± 14 vs. 58 ± 32, p= 0.066 in anti-N IgG group and 28 ± 15 vs. 60 ± 45, p= 0.004 in anti-S IgG group, respectively). CONCLUSION Nearly one-third of the confirmed COVID-19 patients had negative serology results. Lower percent positivity at early time points after symptom onset (less than 1 week) was seen using anti-S SARS-COV-2 IgG kit compare to the anti-N SARS-CoV-2 IgG; therefore, clinicians should interpret negative serology results of especially anti-S SARS-CoV-2 IgG with caution.
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Affiliation(s)
- Mitra Rezaei
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Virology Research Center, National Research Institute of Tuberculosis and Lung diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadhadi Sadeghi
- Virology Research Center, National Research Institute of Tuberculosis and Lung diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Payam Tabarsi
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mihan Porabdollah
- Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Askari
- Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mortaz
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shima Mahmoudi
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Marjani
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Akbar Velayati
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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31
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Evaluation of a Pseudovirus Neutralization Assay for SARS-CoV-2 and Correlation with Live Virus-Based Micro Neutralization Assay. Diagnostics (Basel) 2021; 11:diagnostics11060994. [PMID: 34070824 PMCID: PMC8226551 DOI: 10.3390/diagnostics11060994] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/25/2021] [Accepted: 05/28/2021] [Indexed: 11/16/2022] Open
Abstract
The unusual cases of pneumonia outbreak were reported from Wuhan city in late December 2019. Serological testing provides a powerful tool for the identification of prior infection and for epidemiological studies. Pseudotype virus neutralization assays are widely used for many viruses and applications in the fields of serology. The accuracy of pseudotype neutralizing assay allows for its use in low biosafety lab and provides a safe and effective alternative to the use of wild-type viruses. In this study, we evaluated the performance of this assay compared to the standard microneutralization assay as a reference. The lentiviral pseudotype particles were generated harboring the Spike gene of SARS-CoV-2. The generated pseudotype particles assay was used to evaluate the activity of neutralizing antibodies in 300 human serum samples from a COVID-19 sero-epidemiological study. Testing of these samples resulted in 55 positive samples and 245 negative samples by pseudotype viral particles assay while microneutralization assay resulted in 64 positive and 236 negative by MN assay. Compared to the MN, the pseudotyped viral particles assay showed a sensitivity of 85.94% and a specificity of 100%. Based on the data generated from this study, the pseudotype-based neutralization assay showed a reliable performance for the detection of neutralizing antibodies against SARS-CoV-2 and can be used safely and efficiently as a diagnostic tool in a biosafety level 2 laboratory.
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32
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Wang X, Yang P, Zheng J, Liu P, Wei C, Guo J, Zhang Y, Zhao D. Dynamic changes of acquired maternal SARS-CoV-2 IgG in infants. Sci Rep 2021; 11:8021. [PMID: 33850202 PMCID: PMC8044122 DOI: 10.1038/s41598-021-87535-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 03/30/2021] [Indexed: 01/06/2023] Open
Abstract
At present, there are still ambiguous reports about the perinatal infection of infants born to mothers infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The dynamic characteristics of infantile serum antibodies born to mother with SARS-CoV-2 has not been well described. In this study, we analyzed the seroconversion of 27 newborns born to 26 pregnant women infected with SARS-CoV-2. The SARS-CoV-2 IgG positive rate of parturient was 80.8%, and half of their infants obtained maternal IgG. IgG transfer rates were 18.8% and 81.8% in those infants whose mother infected less and more than 2 weeks before delivery. In the first two months of life, the IgG level of infants dropped sharply to one tenth of that at birth. These results suggest that maternal SARS-CoV-2 IgG provides limited protection for infants.
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Affiliation(s)
- Xia Wang
- Department of Pediatrics, Children's Digital Health and Data Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Pu Yang
- Department of Pediatrics, Children's Digital Health and Data Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Junwen Zheng
- Department of Pediatrics, Children's Digital Health and Data Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Pin Liu
- Department of Pediatrics, Children's Digital Health and Data Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Cong Wei
- Department of Pediatrics, Children's Digital Health and Data Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Juanjuan Guo
- Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Clinical Medicine Research Center of Prenatal Diagnosis, Birth Health in Hubei Province, Wuhan, China
| | - Yuanzhen Zhang
- Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Clinical Medicine Research Center of Prenatal Diagnosis, Birth Health in Hubei Province, Wuhan, China
| | - Dongchi Zhao
- Department of Pediatrics, Children's Digital Health and Data Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
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33
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Jiang C, Li X, Ge C, Ding Y, Zhang T, Cao S, Meng L, Lu S. Molecular detection of SARS-CoV-2 being challenged by virus variation and asymptomatic infection. J Pharm Anal 2021; 11:257-264. [PMID: 33815862 PMCID: PMC7997641 DOI: 10.1016/j.jpha.2021.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/17/2021] [Accepted: 03/22/2021] [Indexed: 02/07/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has been a pandemic for more than a year. With the expanding second wave of the pandemic in winter, the continuous evolution of SARS-CoV-2 has brought new issues, including the significance of virus mutations in infection and the detection of asymptomatic infection. In this review, we first introduced several major SARS-CoV-2 mutations since the COVID-19 outbreak and then mentioned the widely used molecular detection techniques to diagnose COVID-19, primarily focusing on their strengths and limitations. We further discussed the effects of viral genetic variation and asymptomatic infection on the molecular detection of SARS-CoV-2 infection. The review finally summarized useful insights into the molecular diagnosis of COVID-19 under the special situation being challenged by virus mutation and asymptomatic infection. The widely used molecular diagnostic techniques for COVID-19 are reviewed, with a special focus on their strengths and limitations. The genetic variation of the viral genome and silent asymptomatic infection during the global battle against the nCoV epidemic are discussed. Some diagnosis strategies for those within the quarantine period at home or the assembly site are recommended.
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Affiliation(s)
- Congshan Jiang
- Institute of Molecular and Translational Medicine (IMTM); Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, Shaanxi, 710061, PR China.,Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, 710061, PR China
| | - Xiaowei Li
- Institute of Molecular and Translational Medicine (IMTM); Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, Shaanxi, 710061, PR China.,Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, 710061, PR China
| | - Changrong Ge
- Section for Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Yuanyuan Ding
- School of Pharmacy, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, Shaanxi, 710061, PR China
| | - Tao Zhang
- School of Pharmacy, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, Shaanxi, 710061, PR China
| | - Shuai Cao
- Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, PR China
| | - Liesu Meng
- Institute of Molecular and Translational Medicine (IMTM); Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, Shaanxi, 710061, PR China.,Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, 710061, PR China
| | - Shemin Lu
- Institute of Molecular and Translational Medicine (IMTM); Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, Shaanxi, 710061, PR China.,Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, 710061, PR China
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34
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Boum Y, Fai KN, Nikolay B, Mboringong AB, Bebell LM, Ndifon M, Abbah A, Essaka R, Eteki L, Luquero F, Langendorf C, Mbarga NF, Essomba RG, Buri BD, Corine TM, Kameni BT, Mandeng N, Fanne M, Bisseck ACZK, Ndongmo CB, Eyangoh S, Hamadou A, Ouamba JP, Koku MT, Njouom R, Claire OM, Esso L, Epée E, Mballa GAE. Performance and operational feasibility of antigen and antibody rapid diagnostic tests for COVID-19 in symptomatic and asymptomatic patients in Cameroon: a clinical, prospective, diagnostic accuracy study. THE LANCET. INFECTIOUS DISEASES 2021; 21:1089-1096. [PMID: 33773618 PMCID: PMC7993929 DOI: 10.1016/s1473-3099(21)00132-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/05/2021] [Accepted: 02/19/2021] [Indexed: 12/16/2022]
Abstract
Background Real-time PCR is recommended to detect SARS-CoV-2 infection. However, PCR availability is restricted in most countries. Rapid diagnostic tests are considered acceptable alternatives, but data are lacking on their performance. We assessed the performance of four antibody-based rapid diagnostic tests and one antigen-based rapid diagnostic test for detecting SARS-CoV-2 infection in the community in Cameroon. Methods In this clinical, prospective, diagnostic accuracy study, we enrolled individuals aged at least 21 years who were either symptomatic and suspected of having COVID-19 or asymptomatic and presented for screening. We tested peripheral blood for SARS-CoV-2 antibodies using the Innovita (Biological Technology; Beijing, China), Wondfo (Guangzhou Wondfo Biotech; Guangzhou, China), SD Biosensor (SD Biosensor; Gyeonggi-do, South Korea), and Runkun tests (Runkun Pharmaceutical; Hunan, China), and nasopharyngeal swabs for SARS-CoV-2 antigen using the SD Biosensor test. Antigen rapid diagnostic tests were compared with Abbott PCR testing (Abbott; Abbott Park, IL, USA), and antibody rapid diagnostic tests were compared with Biomerieux immunoassays (Biomerieux; Marcy l'Etoile, France). We retrospectively tested two diagnostic algorithms that incorporated rapid diagnostic tests for symptomatic and asymptomatic patients using simulation modelling. Findings 1195 participants were enrolled in the study. 347 (29%) tested SARS-CoV-2 PCR-positive, 223 (19%) rapid diagnostic test antigen-positive, and 478 (40%) rapid diagnostic test antibody-positive. Antigen-based rapid diagnostic test sensitivity was 80·0% (95% CI 71·0–88·0) in the first 7 days after symptom onset, but antibody-based rapid diagnostic tests had only 26·8% sensitivity (18·3–36·8). Antibody rapid diagnostic test sensitivity increased to 76·4% (70·1–82·0) 14 days after symptom onset. Among asymptomatic participants, the sensitivity of antigen-based and antibody-based rapid diagnostic tests were 37·0% (27·0–48·0) and 50·7% (42·2–59·1), respectively. Cohen's κ showed substantial agreement between Wondfo antibody rapid diagnostic test and gold-standard ELISA (κ=0·76; sensitivity 0·98) and between Biosensor and ELISA (κ=0·60; sensitivity 0·94). Innovita (κ=0·47; sensitivity 0·93) and Runkun (κ=0·43; sensitivity 0·76) showed moderate agreement. An antigen-based retrospective algorithm applied to symptomatic patients showed 94·0% sensitivity and 91·0% specificity in the first 7 days after symptom onset. For asymptomatic participants, the algorithm showed a sensitivity of 34% (95% CI 23·0–44·0) and a specificity of 92·0% (88·0–96·0). Interpretation Rapid diagnostic tests had good overall sensitivity for diagnosing SARS-CoV-2 infection. Rapid diagnostic tests could be incorporated into efficient testing algorithms as an alternative to PCR to decrease diagnostic delays and onward viral transmission. Funding Médecins Sans Frontières WACA and Médecins Sans Frontières OCG. Translations For the French and Spanish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Yap Boum
- Epicentre, Yaoundé, Cameroon; Public Health Emergency Operation Center, Ministry of Public Health, Yaoundé, Cameroon.
| | | | | | | | - Lisa M Bebell
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Aristide Abbah
- Public Health Emergency Operation Center, Ministry of Public Health, Yaoundé, Cameroon
| | | | | | | | | | | | | | | | | | | | - Nadia Mandeng
- Public Health Emergency Operation Center, Ministry of Public Health, Yaoundé, Cameroon
| | - Mahamat Fanne
- Public Health Emergency Operation Center, Ministry of Public Health, Yaoundé, Cameroon
| | | | | | | | | | | | | | | | | | - Linda Esso
- Public Health Emergency Operation Center, Ministry of Public Health, Yaoundé, Cameroon
| | - Emilienne Epée
- Public Health Emergency Operation Center, Ministry of Public Health, Yaoundé, Cameroon
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35
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Miyakawa K, Jeremiah SS, Ohtake N, Matsunaga S, Yamaoka Y, Nishi M, Morita T, Saji R, Nishii M, Kimura H, Hasegawa H, Takeuchi I, Ryo A. Rapid quantitative screening assay for SARS-CoV-2 neutralizing antibodies using HiBiT-tagged virus-like particles. J Mol Cell Biol 2021; 12:987-990. [PMID: 32931563 PMCID: PMC7543420 DOI: 10.1093/jmcb/mjaa047] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Kei Miyakawa
- Department of Microbiology, Yokohama City University School of Medicine, Kanagawa 236-0004, Japan
| | | | - Norihisa Ohtake
- Advanced Medical Research Center, Yokohama City University, Kanagawa 236-0004, Japan.,Bioscience Division, Reagent Development Department, Tosoh Corporation, Kanagawa 252-1123, Japan
| | - Satoko Matsunaga
- Department of Microbiology, Yokohama City University School of Medicine, Kanagawa 236-0004, Japan
| | - Yutaro Yamaoka
- Department of Microbiology, Yokohama City University School of Medicine, Kanagawa 236-0004, Japan.,Life Science Laboratory, Technology and Development Division, Kanto Chemical Co., Inc., Kanagawa 259-1146, Japan
| | - Mayuko Nishi
- Department of Microbiology, Yokohama City University School of Medicine, Kanagawa 236-0004, Japan
| | - Takeshi Morita
- Department of Microbiology, Yokohama City University School of Medicine, Kanagawa 236-0004, Japan
| | - Ryo Saji
- Department of Emergency Medicine, Yokohama City University Hospital, Kanagawa 236-0004, Japan
| | - Mototsugu Nishii
- Department of Emergency Medicine, Yokohama City University Hospital, Kanagawa 236-0004, Japan
| | - Hirokazu Kimura
- School of Medical Technology, Faculty of Health Sciences, Gunma Paz University, Gunma 370-0006, Japan
| | - Hideki Hasegawa
- Influenza Research Center, National Institute of Infectious Diseases, Tokyo 208-0011, Japan
| | - Ichiro Takeuchi
- Department of Emergency Medicine, Yokohama City University Hospital, Kanagawa 236-0004, Japan
| | - Akihide Ryo
- Department of Microbiology, Yokohama City University School of Medicine, Kanagawa 236-0004, Japan.,Advanced Medical Research Center, Yokohama City University, Kanagawa 236-0004, Japan
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36
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Jahrsdörfer B, Kroschel J, Ludwig C, Corman VM, Schwarz T, Körper S, Rojewski M, Lotfi R, Weinstock C, Drosten C, Seifried E, Stamminger T, Groß HJ, Schrezenmeier H. Independent Side-by-Side Validation and Comparison of 4 Serological Platforms for SARS-CoV-2 Antibody Testing. J Infect Dis 2021; 223:796-801. [PMID: 33064789 PMCID: PMC7665624 DOI: 10.1093/infdis/jiaa656] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/14/2020] [Indexed: 01/09/2023] Open
Abstract
Highly sensitive and specific platforms for the detection of anti-SARS-CoV-2 antibodies are becoming increasingly important for (1) evaluating potential SARS-CoV-2 convalescent plasma donors, (2) studying the spread of SARS-CoV-2 infections and (3) identifying individuals with seroconversion. This study provides a comparative validation of four anti-SARS-CoV-2 platforms. Unique feature of this study is the use of a representative cohort of COVID-19-convalescent patients with mild-to-moderate disease course. All platforms showed significant correlations with a SARS-CoV-2 plaque-reduction-neutralization test, with highest sensitivities for the Euroimmun and the Roche platforms, suggesting their preferential use for screening of persons at increased risk of SARS-CoV-2 infections.
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Affiliation(s)
- Bernd Jahrsdörfer
- Department of Transfusion Medicine, Ulm University, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
| | - Joris Kroschel
- Institute of Clinical Chemistry, Ulm University, Ulm, Germany
| | - Carolin Ludwig
- Department of Transfusion Medicine, Ulm University, Ulm, Germany
| | - Victor Max Corman
- Institute of Virology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Tatjana Schwarz
- Institute of Virology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Sixten Körper
- Department of Transfusion Medicine, Ulm University, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
| | - Markus Rojewski
- Department of Transfusion Medicine, Ulm University, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
| | - Ramin Lotfi
- Department of Transfusion Medicine, Ulm University, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
| | - Christof Weinstock
- Department of Transfusion Medicine, Ulm University, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
| | - Christian Drosten
- Institute of Virology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Erhard Seifried
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen, Frankfurt, Germany
| | | | | | - Hubert Schrezenmeier
- Department of Transfusion Medicine, Ulm University, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
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37
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Neerukonda SN, Vassell R, Herrup R, Liu S, Wang T, Takeda K, Yang Y, Lin TL, Wang W, Weiss CD. Establishment of a well-characterized SARS-CoV-2 lentiviral pseudovirus neutralization assay using 293T cells with stable expression of ACE2 and TMPRSS2. PLoS One 2021; 16:e0248348. [PMID: 33690649 PMCID: PMC7946320 DOI: 10.1371/journal.pone.0248348] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/24/2021] [Indexed: 12/12/2022] Open
Abstract
Pseudoviruses are useful surrogates for highly pathogenic viruses because of their safety, genetic stability, and scalability for screening assays. Many different pseudovirus platforms exist, each with different advantages and limitations. Here we report our efforts to optimize and characterize an HIV-based lentiviral pseudovirus assay for screening neutralizing antibodies for SARS-CoV-2 using a stable 293T cell line expressing human angiotensin converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2). We assessed different target cells, established conditions that generate readouts over at least a two-log range, and confirmed consistent neutralization titers over a range of pseudovirus input. Using reference sera and plasma panels, we evaluated assay precision and showed that our neutralization titers correlate well with results reported in other assays. Overall, our lentiviral assay is relatively simple, scalable, and suitable for a variety of SARS-CoV-2 entry and neutralization screening assays.
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Affiliation(s)
- Sabari Nath Neerukonda
- US Food and Drug Administration, Office of Vaccine Research and Review, Center for Biologics Evaluation and Research and Review, Silver Spring, Maryland, United States of America
| | - Russell Vassell
- US Food and Drug Administration, Office of Vaccine Research and Review, Center for Biologics Evaluation and Research and Review, Silver Spring, Maryland, United States of America
| | - Rachel Herrup
- US Food and Drug Administration, Office of Vaccine Research and Review, Center for Biologics Evaluation and Research and Review, Silver Spring, Maryland, United States of America
| | - Shufeng Liu
- US Food and Drug Administration, Office of Vaccine Research and Review, Center for Biologics Evaluation and Research and Review, Silver Spring, Maryland, United States of America
| | - Tony Wang
- US Food and Drug Administration, Office of Vaccine Research and Review, Center for Biologics Evaluation and Research and Review, Silver Spring, Maryland, United States of America
| | - Kazuyo Takeda
- US Food and Drug Administration, Office of Blood Research and Review, Center for Biologics Evaluation and Research and Review, Silver Spring, Maryland, United States of America
| | - Ye Yang
- US Food and Drug Administration, Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research and Review, Silver Spring, Maryland, United States of America
| | - Tsai-Lien Lin
- US Food and Drug Administration, Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research and Review, Silver Spring, Maryland, United States of America
| | - Wei Wang
- US Food and Drug Administration, Office of Vaccine Research and Review, Center for Biologics Evaluation and Research and Review, Silver Spring, Maryland, United States of America
| | - Carol D. Weiss
- US Food and Drug Administration, Office of Vaccine Research and Review, Center for Biologics Evaluation and Research and Review, Silver Spring, Maryland, United States of America
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38
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Kuster AC, Overgaard HJ. A novel comprehensive metric to assess effectiveness of COVID-19 testing: Inter-country comparison and association with geography, government, and policy response. PLoS One 2021; 16:e0248176. [PMID: 33667280 PMCID: PMC7935311 DOI: 10.1371/journal.pone.0248176] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 02/20/2021] [Indexed: 12/16/2022] Open
Abstract
Testing and case identification are key strategies in controlling the COVID-19 pandemic. Contact tracing and isolation are only possible if cases have been identified. The effectiveness of testing should be assessed, but a single comprehensive metric is not available to assess testing effectiveness, and no timely estimates of case detection rate are available globally, making inter-country comparisons difficult. The purpose of this paper was to propose a single, comprehensive metric, called the COVID-19 Testing Index (CovTI) scaled from 0 to 100, derived from epidemiological indicators of testing, and to identify factors associated with this outcome. The index was based on case-fatality rate, test positivity rate, active cases, and an estimate of the detection rate. It used parsimonious modeling to estimate the true total number of COVID-19 cases based on deaths, testing, health system capacity, and government transparency. Publicly reported data from 165 countries and territories that had reported at least 100 confirmed cases by June 3, 2020 were included in the index. Estimates of detection rates aligned satisfactorily with previous estimates in literature (R2 = 0.44). As of June 3, 2020, the states with the highest CovTI included Hong Kong (93.7), Australia (93.5), Iceland (91.8), Cambodia (91.3), New Zealand (90.6), Vietnam (90.2), and Taiwan (89.9). Bivariate analyses showed the mean CovTI in countries with open public testing policies (66.9, 95% CI 61.0-72.8) was significantly higher than in countries with no testing policy (29.7, 95% CI 17.6-41.9) (p<0.0001). A multiple linear regression model assessed the association of independent grouping variables with CovTI. Open public testing and extensive contact tracing were shown to significantly increase CovTI, after adjusting for extrinsic factors, including geographic isolation and centralized forms of government. The correlation of testing and contact tracing policies with improved outcomes demonstrates the validity of this model to assess testing effectiveness and also suggests these policies were effective at improving health outcomes. This tool can be combined with other databases to identify other factors or may be useful as a standalone tool to help inform policymakers.
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Affiliation(s)
| | - Hans J. Overgaard
- Faculty of Science and Technology, Norwegian University of Life Sciences, Ås, Norway
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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39
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Villarreal A, Rangel G, Zhang X, Wong D, Britton G, Fernandez PL, Pérez A, Oviedo D, Restrepo C, Carreirra MB, Sambrano D, Eskildsen GA, De La Guardia C, Flores-Cuadra J, Carrera JP, Zaldivar Y, Franco D, López-Vergès S, Zhang D, Fan F, Wang B, Sáez-Llorens X, DeAntonio R, Torres-Atencio I, Blanco I, Subía FD, Mudarra L, Benzadon A, Valverde W, López L, Hurtado N, Rivas N, Jurado J, Carvallo A, Rodriguez J, Perez Y, Morris J, Luque O, Cortez D, Ortega-Barria E, Kosagisharaf R, Lleonart R, Li C, Goodridge A. Performance of a Point of Care Test for Detecting IgM and IgG Antibodies Against SARS-CoV-2 and Seroprevalence in Blood Donors and Health Care Workers in Panama. Front Med (Lausanne) 2021; 8:616106. [PMID: 33748157 PMCID: PMC7968482 DOI: 10.3389/fmed.2021.616106] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 01/28/2021] [Indexed: 12/12/2022] Open
Abstract
Novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiologic agent of the ongoing coronavirus disease 2019 (COVID-19) pandemic, which has reached 28 million cases worldwide in 1 year. The serological detection of antibodies against the virus will play a pivotal role in complementing molecular tests to improve diagnostic accuracy, contact tracing, vaccine efficacy testing, and seroprevalence surveillance. Here, we aimed first to evaluate a lateral flow assay's ability to identify specific IgM and IgG antibodies against SARS-CoV-2 and second, to report the seroprevalence estimates of these antibodies among health care workers and healthy volunteer blood donors in Panama. We recruited study participants between April 30th and July 7th, 2020. For the test validation and performance evaluation, we analyzed serum samples from participants with clinical symptoms and confirmed positive RT-PCR for SARS-CoV-2, and a set of pre-pandemic serum samples. We used two by two table analysis to determine the test positive and negative percentage agreement as well as the Kappa agreement value with a 95% confidence interval. Then, we used the lateral flow assay to determine seroprevalence among serum samples from COVID-19 patients, potentially exposed health care workers, and healthy volunteer donors. Our results show this assay reached a positive percent agreement of 97.2% (95% CI 84.2-100.0%) for detecting both IgM and IgG. The assay showed a Kappa of 0.898 (95%CI 0.811-0.985) and 0.918 (95% CI 0.839-0.997) for IgM and IgG, respectively. The evaluation of serum samples from hospitalized COVID-19 patients indicates a correlation between test sensitivity and the number of days since symptom onset; the highest positive percent agreement [87% (95% CI 67.0-96.3%)] was observed at ≥15 days post-symptom onset (PSO). We found an overall antibody seroprevalence of 11.6% (95% CI 8.5-15.8%) among both health care workers and healthy blood donors. Our findings suggest this lateral flow assay could contribute significantly to implementing seroprevalence testing in locations with active community transmission of SARS-CoV-2.
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Affiliation(s)
- Alcibiades Villarreal
- Centro de Biología Celular y Molecular de las Enfermedades, City of Knowledge, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panama
| | - Giselle Rangel
- Centro de Biología Celular y Molecular de las Enfermedades, City of Knowledge, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panama
| | - Xu Zhang
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
- Beijing Zhongke Jianlan Biotechnology Co. Ltd., Beijing, China
- Zhongke Jianlan International Medical Research Institute, Melbourne, VIC, Australia
| | - Digna Wong
- Centro de Biología Celular y Molecular de las Enfermedades, City of Knowledge, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panama
| | - Gabrielle Britton
- Centro de Biología Celular y Molecular de las Enfermedades, City of Knowledge, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panama
| | - Patricia L. Fernandez
- Centro de Biología Celular y Molecular de las Enfermedades, City of Knowledge, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panama
| | - Ambar Pérez
- Centro de Biología Celular y Molecular de las Enfermedades, City of Knowledge, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panama
| | - Diana Oviedo
- Centro de Biología Celular y Molecular de las Enfermedades, City of Knowledge, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panama
- Escuela de Psicología, Universidad Santa María La Antigua, Panama City, Panama
| | - Carlos Restrepo
- Centro de Biología Celular y Molecular de las Enfermedades, City of Knowledge, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panama
| | - María B. Carreirra
- Centro de Biología Celular y Molecular de las Enfermedades, City of Knowledge, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panama
| | - Dilcia Sambrano
- Centro de Biología Celular y Molecular de las Enfermedades, City of Knowledge, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panama
| | - Gilberto A. Eskildsen
- Centro de Biología Celular y Molecular de las Enfermedades, City of Knowledge, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panama
- Facultad de Medicina, Universidad de Panamá, Panama City, Panama
| | - Carolina De La Guardia
- Centro de Biología Celular y Molecular de las Enfermedades, City of Knowledge, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panama
| | - Julio Flores-Cuadra
- Centro de Neurociencia, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología, AIP (INDICASAT AIP), Panama City, Panama
| | - Jean-Paul Carrera
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Yamitzel Zaldivar
- Department of Research in Surveillance and Biologic Risk 3, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Danilo Franco
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Sandra López-Vergès
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Dexi Zhang
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
- Beijing Zhongke Jianlan Biotechnology Co. Ltd., Beijing, China
- Zhongke Jianlan International Medical Research Institute, Melbourne, VIC, Australia
| | - Fangjing Fan
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
- Beijing Zhongke Jianlan Biotechnology Co. Ltd., Beijing, China
- Zhongke Jianlan International Medical Research Institute, Melbourne, VIC, Australia
| | - Baojun Wang
- Beijing Kewei Clinical Diagnostic Reagent Inc., Beijing, China
| | - Xavier Sáez-Llorens
- Centro de Vacunación e Investigación, Centro de Vacunación e Investigación Panama Clinic, Panama City, Panama
| | - Rodrigo DeAntonio
- Centro de Vacunación e Investigación, Centro de Vacunación e Investigación Panama Clinic, Panama City, Panama
| | | | - Isabel Blanco
- Medical Research Center, Pacifica Salud, Hospital Punta Pacifica, Panama City, Panama
| | - Fernando Diaz Subía
- Medical Research Center, Pacifica Salud, Hospital Punta Pacifica, Panama City, Panama
| | - Laiss Mudarra
- Departamento de Microbiología Humana/Inmunología, Facultad de Medicina, Universidad de Panamá, Panama City, Panama
| | - Aron Benzadon
- Servicio de Neurología. Complejo Hospitalario Dr. AAM, Universidad Nacional de Panamá, Panama City, Panama
| | - Walter Valverde
- Complejo Hospitalario Metropolitano Dr. Arnulfo Arias Madrid, Caja de Seguro Social, Panama City, Panama
| | - Lineth López
- Servicio de Hematología. Complejo Hospitalario Metropolitano Dr. Arnulfo Arias Madrid, Caja de Seguro Social, Panama City, Panama
| | - Nicolás Hurtado
- Compleo Hospitalario Manuel Amador Guerrero, Caja de Seguro Social, Colón, Panama
| | - Neyla Rivas
- Compleo Hospitalario Manuel Amador Guerrero, Caja de Seguro Social, Colón, Panama
| | - Julio Jurado
- Compleo Hospitalario Manuel Amador Guerrero, Caja de Seguro Social, Colón, Panama
| | - Aixa Carvallo
- Compleo Hospitalario Manuel Amador Guerrero, Caja de Seguro Social, Colón, Panama
| | - Juan Rodriguez
- Compleo Hospitalario Manuel Amador Guerrero, Caja de Seguro Social, Colón, Panama
| | - Yaseikiry Perez
- Servicio de Hematología, Banco de Sangre. Complejo Hospitalario Metropolitano Dr. Arnulfo Arias Madrid, Caja de Seguro Social, Panama City, Panama
| | - Johanna Morris
- Servicio de Hematología. Complejo Hospitalario Metropolitano Dr. Arnulfo Arias Madrid, Caja de Seguro Social, Panama City, Panama
| | - Odemaris Luque
- Compleo Hospitalario Manuel Amador Guerrero, Caja de Seguro Social, Colón, Panama
| | - David Cortez
- Dirección Nacional de Laboratorios Clínicos, Ministerio de Salud, Panama City, Panama
| | | | - Rao Kosagisharaf
- Centro de Biología Celular y Molecular de las Enfermedades, City of Knowledge, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panama
| | - Ricardo Lleonart
- Centro de Biología Celular y Molecular de las Enfermedades, City of Knowledge, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panama
| | - Chong Li
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
- Beijing Zhongke Jianlan Biotechnology Co. Ltd., Beijing, China
- Zhongke Jianlan International Medical Research Institute, Melbourne, VIC, Australia
| | - Amador Goodridge
- Centro de Biología Celular y Molecular de las Enfermedades, City of Knowledge, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panama
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Oguntuyo KY, Stevens CS, Hung CT, Ikegame S, Acklin JA, Kowdle SS, Carmichael JC, Chiu HP, Azarm KD, Haas GD, Amanat F, Klingler J, Baine I, Arinsburg S, Bandres JC, Siddiquey MNA, Schilke RM, Woolard MD, Zhang H, Duty AJ, Kraus TA, Moran TM, Tortorella D, Lim JK, Gamarnik AV, Hioe CE, Zolla-Pazner S, Ivanov SS, Kamil JP, Krammer F, Lee B. Quantifying Absolute Neutralization Titers against SARS-CoV-2 by a Standardized Virus Neutralization Assay Allows for Cross-Cohort Comparisons of COVID-19 Sera. mBio 2021; 12:e02492-20. [PMID: 33593976 PMCID: PMC8545089 DOI: 10.1128/mbio.02492-20] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/15/2021] [Indexed: 02/04/2023] Open
Abstract
The global coronavirus disease 2019 (COVID-19) pandemic has mobilized efforts to develop vaccines and antibody-based therapeutics, including convalescent-phase plasma therapy, that inhibit viral entry by inducing or transferring neutralizing antibodies (nAbs) against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike glycoprotein (CoV2-S). However, rigorous efficacy testing requires extensive screening with live virus under onerous biosafety level 3 (BSL3) conditions, which limits high-throughput screening of patient and vaccine sera. Myriad BSL2-compatible surrogate virus neutralization assays (VNAs) have been developed to overcome this barrier. Yet, there is marked variability between VNAs and how their results are presented, making intergroup comparisons difficult. To address these limitations, we developed a standardized VNA using CoV2-S pseudotyped particles (CoV2pp) based on vesicular stomatitis virus bearing the Renilla luciferase gene in place of its G glycoprotein (VSVΔG); this assay can be robustly produced at scale and generate accurate neutralizing titers within 18 h postinfection. Our standardized CoV2pp VNA showed a strong positive correlation with CoV2-S enzyme-linked immunosorbent assay (ELISA) results and live-virus neutralizations in confirmed convalescent-patient sera. Three independent groups subsequently validated our standardized CoV2pp VNA (n > 120). Our data (i) show that absolute 50% inhibitory concentration (absIC50), absIC80, and absIC90 values can be legitimately compared across diverse cohorts, (ii) highlight the substantial but consistent variability in neutralization potency across these cohorts, and (iii) support the use of the absIC80 as a more meaningful metric for assessing the neutralization potency of a vaccine or convalescent-phase sera. Lastly, we used our CoV2pp in a screen to identify ultrapermissive 293T clones that stably express ACE2 or ACE2 plus TMPRSS2. When these are used in combination with our CoV2pp, we can produce CoV2pp sufficient for 150,000 standardized VNAs/week.IMPORTANCE Vaccines and antibody-based therapeutics like convalescent-phase plasma therapy are premised upon inducing or transferring neutralizing antibodies that inhibit SARS-CoV-2 entry into cells. Virus neutralization assays (VNAs) for measuring neutralizing antibody titers (NATs) are an essential part of determining vaccine or therapeutic efficacy. However, such efficacy testing is limited by the inherent dangers of working with the live virus, which requires specialized high-level biocontainment facilities. We therefore developed a standardized replication-defective pseudotyped particle system that mimics the entry of live SARS-CoV-2. This tool allows for the safe and efficient measurement of NATs, determination of other forms of entry inhibition, and thorough investigation of virus entry mechanisms. Four independent labs across the globe validated our standardized VNA using diverse cohorts. We argue that a standardized and scalable assay is necessary for meaningful comparisons of the myriad of vaccines and antibody-based therapeutics becoming available. Our data provide generalizable metrics for assessing their efficacy.
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Affiliation(s)
- Kasopefoluwa Y Oguntuyo
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Christian S Stevens
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Chuan Tien Hung
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Satoshi Ikegame
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Joshua A Acklin
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Shreyas S Kowdle
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jillian C Carmichael
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Hsin-Ping Chiu
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kristopher D Azarm
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Griffin D Haas
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Fatima Amanat
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jéromine Klingler
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- James J. Peters VA Medical Center, Bronx, New York, USA
| | - Ian Baine
- Department of Pathology, Molecular, and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Suzanne Arinsburg
- Department of Pathology, Molecular, and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Juan C Bandres
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- James J. Peters VA Medical Center, Bronx, New York, USA
| | - Mohammed N A Siddiquey
- Department of Microbiology and Immunology, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, USA
| | - Robert M Schilke
- Department of Microbiology and Immunology, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, USA
| | - Matthew D Woolard
- Department of Microbiology and Immunology, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, USA
| | - Hongbo Zhang
- Department of Microbiology and Immunology, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, USA
| | - Andrew J Duty
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Thomas A Kraus
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Thomas M Moran
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Domenico Tortorella
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jean K Lim
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Andrea V Gamarnik
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- COVIDAR Argentina Consortium, Buenos Aires, Argentina
| | - Catarina E Hioe
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- James J. Peters VA Medical Center, Bronx, New York, USA
| | - Susan Zolla-Pazner
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Stanimir S Ivanov
- Department of Microbiology and Immunology, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, USA
| | - Jeremy P Kamil
- Department of Microbiology and Immunology, Louisiana State University Health Science Center Shreveport, Shreveport, Louisiana, USA
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Benhur Lee
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Muecksch F, Wise H, Batchelor B, Squires M, Semple E, Richardson C, McGuire J, Clearly S, Furrie E, Greig N, Hay G, Templeton K, Lorenzi JCC, Hatziioannou T, Jenks S, Bieniasz PD. Longitudinal Serological Analysis and Neutralizing Antibody Levels in Coronavirus Disease 2019 Convalescent Patients. J Infect Dis 2021; 223:389-398. [PMID: 33140086 PMCID: PMC7665595 DOI: 10.1093/infdis/jiaa659] [Citation(s) in RCA: 183] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/15/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Understanding the longitudinal trajectory of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies is crucial for diagnosis of prior infection and predicting future immunity. METHODS We conducted a longitudinal analysis of coronavirus disease 2019 convalescent patients, with neutralizing antibody assays and SARS-CoV-2 serological assay platforms using SARS-CoV-2 spike (S) or nucleocapsid (N) antigens. RESULTS Sensitivities of serological assays in diagnosing prior SARS-CoV-2 infection changed with time. One widely used commercial platform that had an initial sensitivity of >95% declined to 71% at 81-100 days after diagnosis. The trajectories of median binding antibody titers measured over approximately 3-4 months were not dependent on the use of SARS-CoV-2 N or S proteins as antigen. The median neutralization titer decreased by approximately 45% per month. Each serological assay gave quantitative antibody titers that were correlated with SARS-CoV-2 neutralization titers, but S-based serological assay measurements better predicted neutralization potency. Correlation between S-binding and neutralization titers deteriorated with time, and decreases in neutralization titers were not predicted by changes in S-binding antibody titers. CONCLUSIONS Different SARS-CoV-2 serological assays are more or less well suited for surveillance versus prediction of serum neutralization potency. Extended follow-up should facilitate the establishment of appropriate serological correlates of protection against SARS-CoV-2 reinfection.
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Affiliation(s)
- Frauke Muecksch
- Laboratory of Retrovirology, The Rockefeller University, New York, New York, USA
| | - Helen Wise
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland
| | - Becky Batchelor
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland
| | - Maria Squires
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland
| | | | | | | | - Sarah Clearly
- University Hospital Monklands, NHS Lanarkshire, Airdrie, Scotland
| | - Elizabeth Furrie
- Ninewells Hospital and Medical School, NHS Tayside, Dundee, Scotland
| | - Neil Greig
- Ninewells Hospital and Medical School, NHS Tayside, Dundee, Scotland
| | - Gordon Hay
- Ninewells Hospital and Medical School, NHS Tayside, Dundee, Scotland
| | - Kate Templeton
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland
| | - Julio C C Lorenzi
- Laboratory of Molecular Immunology, The Rockefeller University, New York, New York, USA
| | | | - Sara Jenks
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland
| | - Paul D Bieniasz
- Laboratory of Retrovirology, The Rockefeller University, New York, New York, USA
- Howard Hughes Medical Institute, The Rockefeller University, New York, New York, USA
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Abstract
Serodiagnosis of SARS-CoV-2 infection is impeded by immunological cross-reactivity among the human coronaviruses (HCoVs): SARS-CoV-2, SARS-CoV-1, MERS-CoV, OC43, 229E, HKU1, and NL63. Here we report the identification of humoral immune responses to SARS-CoV-2 peptides that may enable discrimination between exposure to SARS-CoV-2 and other HCoVs. We used a high-density peptide microarray and plasma samples collected at two time points from 50 subjects with SARS-CoV-2 infection confirmed by qPCR, samples collected in 2004–2005 from 11 subjects with IgG antibodies to SARS-CoV-1, 11 subjects with IgG antibodies to other seasonal human coronaviruses (HCoV), and 10 healthy human subjects. Through statistical modeling with linear regression and multidimensional scaling we identified specific peptides that were reassembled to identify 29 linear SARS-CoV-2 epitopes that were immunoreactive with plasma from individuals who had asymptomatic, mild or severe SARS-CoV-2 infections. Larger studies will be required to determine whether these peptides may be useful in serodiagnostics. Mishra, Huang et al. identify 29 linear SARS-CoV-2 epitopes that are immunoreactive with the plasma from individuals who had asymptomatic, mild, or severe SARS-CoV-2 infections. This study suggests the possibility of using these peptides to discriminate the exposure to SARS-CoV-2 and other human coronaviruses.
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43
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Djukic T, Mladenovic M, Stanic-Vucinic D, Radosavljevic J, Smiljanic K, Sabljic L, Devic M, Cujic D, Vasovic T, Simovic A, Radomirovic M, Cirkovic Velickovic T. Expression, purification and immunological characterization of recombinant nucleocapsid protein fragment from SARS-CoV-2. Virology 2021; 557:15-22. [PMID: 33582454 PMCID: PMC7871913 DOI: 10.1016/j.virol.2021.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/11/2021] [Indexed: 01/18/2023]
Abstract
Serological testing is important method for diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Nucleocapsid (N) protein is the most abundant virus derived protein and strong immunogen. We aimed to find its efficient, low-cost production. SARS-CoV-2 recombinant fragment of nucleocapsid protein (rfNP; 58-419 aa) was expressed in E. coli in soluble form, purified and characterized biochemically and immunologically. Purified rfNP has secondary structure of full-length recombinant N protein, with high percentage of disordered structure (34.2%) and of β-sheet (40.7%). rfNP was tested in immunoblot using sera of COVID-19 convalescent patients. ELISA was optimized with sera of RT-PCR confirmed positive symptomatic patients and healthy individuals. IgG detection sensitivity was 96% (47/50) and specificity 97% (67/68), while IgM detection was slightly lower (94% and 96.5%, respectively). Cost-effective approach for soluble recombinant N protein fragment production was developed, with reliable IgG and IgM antibodies detection of SARS-CoV-2 infection.
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Affiliation(s)
- Teodora Djukic
- University of Belgrade-Faculty of Chemistry, Department of Biochemistry, Centre of Excellence for Molecular Food Sciences, Belgrade, Serbia
| | - Maja Mladenovic
- University of Belgrade-Faculty of Chemistry, Department of Biochemistry, Centre of Excellence for Molecular Food Sciences, Belgrade, Serbia
| | - Dragana Stanic-Vucinic
- University of Belgrade-Faculty of Chemistry, Department of Biochemistry, Centre of Excellence for Molecular Food Sciences, Belgrade, Serbia
| | - Jelena Radosavljevic
- University of Belgrade-Faculty of Chemistry, Department of Biochemistry, Centre of Excellence for Molecular Food Sciences, Belgrade, Serbia
| | - Katarina Smiljanic
- University of Belgrade-Faculty of Chemistry, Department of Biochemistry, Centre of Excellence for Molecular Food Sciences, Belgrade, Serbia
| | - Ljiljana Sabljic
- University of Belgrade, Institute for the Application of Nuclear Energy - INEP, Belgrade, Serbia
| | - Marija Devic
- University of Belgrade, Institute for the Application of Nuclear Energy - INEP, Belgrade, Serbia
| | - Danica Cujic
- University of Belgrade, Institute for the Application of Nuclear Energy - INEP, Belgrade, Serbia
| | - Tamara Vasovic
- University of Belgrade-Faculty of Chemistry, Department of Biochemistry, Centre of Excellence for Molecular Food Sciences, Belgrade, Serbia
| | - Ana Simovic
- University of Belgrade-Faculty of Chemistry, Department of Biochemistry, Centre of Excellence for Molecular Food Sciences, Belgrade, Serbia
| | - Mirjana Radomirovic
- University of Belgrade-Faculty of Chemistry, Department of Biochemistry, Centre of Excellence for Molecular Food Sciences, Belgrade, Serbia
| | - Tanja Cirkovic Velickovic
- University of Belgrade-Faculty of Chemistry, Department of Biochemistry, Centre of Excellence for Molecular Food Sciences, Belgrade, Serbia; Ghent University Global Campus, Incheon, South Korea; Ghent University, Faculty of Bioscience Engineering, Ghent, Belgium; Serbian Academy of Sciences and Arts, Belgrade, Serbia.
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44
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Rodriguez-Moncayo R, Cedillo-Alcantar DF, Guevara-Pantoja PE, Chavez-Pineda OG, Hernandez-Ortiz JA, Amador-Hernandez JU, Rojas-Velasco G, Sanchez-Muñoz F, Manzur-Sandoval D, Patino-Lopez LD, May-Arrioja DA, Posadas-Sanchez R, Vargas-Alarcon G, Garcia-Cordero JL. A high-throughput multiplexed microfluidic device for COVID-19 serology assays. LAB ON A CHIP 2021; 21:93-104. [PMID: 33319882 DOI: 10.1039/d0lc01068e] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The applications of serology tests to the virus SARS-CoV-2 are diverse, ranging from diagnosing COVID-19, understanding the humoral response to this disease, and estimating its prevalence in a population, to modeling the course of the pandemic. COVID-19 serology assays will significantly benefit from sensitive and reliable technologies that can process dozens of samples in parallel, thus reducing costs and time; however, they will also benefit from biosensors that can assess antibody reactivities to multiple SARS-CoV-2 antigens. Here, we report a high-throughput microfluidic device that can assess antibody reactivities against four SARS-CoV-2 antigens from up to 50 serum samples in parallel. This semi-automatic platform measures IgG and IgM levels against four SARS-CoV-2 proteins: the spike protein (S), the S1 subunit (S1), the receptor-binding domain (RBD), and the nucleocapsid (N). After assay optimization, we evaluated sera from infected individuals with COVID-19 and a cohort of archival samples from 2018. The assay achieved a sensitivity of 95% and a specificity of 91%. Nonetheless, both parameters increased to 100% when evaluating sera from individuals in the third week after symptom onset. To further assess our platform's utility, we monitored the antibody titers from 5 COVID-19 patients over a time course of several weeks. Our platform can aid in global efforts to control and understand COVID-19.
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Affiliation(s)
- Roberto Rodriguez-Moncayo
- Laboratory of Microtechnologies for Biomedicine, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (Cinvestav), Monterrey, NL, Mexico.
| | - Diana F Cedillo-Alcantar
- Laboratory of Microtechnologies for Biomedicine, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (Cinvestav), Monterrey, NL, Mexico.
| | - Pablo E Guevara-Pantoja
- Laboratory of Microtechnologies for Biomedicine, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (Cinvestav), Monterrey, NL, Mexico.
| | - Oriana G Chavez-Pineda
- Laboratory of Microtechnologies for Biomedicine, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (Cinvestav), Monterrey, NL, Mexico.
| | - Jose A Hernandez-Ortiz
- Laboratory of Microtechnologies for Biomedicine, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (Cinvestav), Monterrey, NL, Mexico.
| | - Josue U Amador-Hernandez
- Laboratory of Microtechnologies for Biomedicine, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (Cinvestav), Monterrey, NL, Mexico.
| | - Gustavo Rojas-Velasco
- Intensive Care Unit, Instituto Nacional de Cardiología "Ignacio Chávez", Ciudad de México, Mexico
| | - Fausto Sanchez-Muñoz
- Department of Immunology, Instituto Nacional de Cardiología "Ignacio Chávez", Ciudad de México, Mexico
| | - Daniel Manzur-Sandoval
- Intensive Care Unit, Instituto Nacional de Cardiología "Ignacio Chávez", Ciudad de México, Mexico
| | - Luis D Patino-Lopez
- Department of Renewable Energy, Centro de Investigación Científica de Yucatán (CICY), Mérida, Yucatán, Mexico
| | - Daniel A May-Arrioja
- Fiber and Integrated Optics Laboratory, Centro de Investigaciones en Óptica (CIO), Aguascalientes, Mexico
| | | | - Gilberto Vargas-Alarcon
- Department of Endocrinology, Instituto Nacional de Cardiología "Ignacio Chávez", Ciudad de México, Mexico
| | - Jose L Garcia-Cordero
- Laboratory of Microtechnologies for Biomedicine, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (Cinvestav), Monterrey, NL, Mexico.
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45
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Humble RM, Merrill AE, Ford BA, Diekema DJ, Krasowski MD. Practical Considerations for Implementation of SARS-CoV-2 Serological Testing in the Clinical Laboratory: Experience at an Academic Medical Center. Acad Pathol 2021; 8:23742895211002802. [PMID: 33889715 PMCID: PMC8040556 DOI: 10.1177/23742895211002802] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 01/16/2021] [Accepted: 02/06/2021] [Indexed: 12/19/2022] Open
Abstract
Molecular techniques, especially reverse transcriptase polymerase chain reaction (RT-PCR), have been the gold standard for the diagnosis of acute severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Serological tests for SARS-CoV-2 have been widely used for serosurveys, epidemiology, and identification of potential convalescent plasma donors. However, the clinical role of serologic testing is still limited and evolving. In this report, we describe the experience of selecting, validating, and implementing SARS-CoV-2 serologic testing for clinical purposes at an academic medical center in a rural state. Successful implementation involved close collaboration between pathology, infectious diseases, and outpatient clinics. The most common clinician concerns were appropriateness/utility of testing, patient charges/insurance coverage, and assay specificity. In analyzing test utilization, serologic testing in the first month after go-live was almost entirely outpatient and appeared to be strongly driven by patient interest (including health care workers and others in high-risk occupations for exposure to SARS-CoV-2), with little evidence that the results impacted clinical decision-making. Test volumes for serology declined steadily through October 31, 2020, with inpatient ordering assuming a steadily higher percentage of the total. In a 5-month period, SARS-CoV-2 serology test volumes amounted to only 1.3% of that of reverse transcriptase polymerase chain reaction. Unlike reverse transcriptase polymerase chain reaction, supply chain challenges and reagent availability were not major issues for serology testing. We also discuss the most recent challenge of requirements for SARS-CoV-2 testing in international travel protocols. Overall, our experience at an academic medical center shows that SARS-CoV-2 serology testing assumed a limited clinical role.
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Affiliation(s)
- Robert M. Humble
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Anna E. Merrill
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Bradley A. Ford
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Daniel J. Diekema
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
- Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Matthew D. Krasowski
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Valdivia A, Torres I, Latorre V, Francés-Gómez C, Ferrer J, Forqué L, Costa R, de la Asunción CS, Huntley D, Gozalbo-Rovira R, Buesa J, Giménez E, Rodríguez-Díaz J, Geller R, Navarro D. Suitability of two rapid lateral flow immunochromatographic assays for predicting SARS-CoV-2 neutralizing activity of sera. J Med Virol 2020; 93:2301-2306. [PMID: 33236799 PMCID: PMC7753337 DOI: 10.1002/jmv.26697] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/21/2020] [Accepted: 11/23/2020] [Indexed: 01/09/2023]
Abstract
Assessment of commercial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoassays for their capacity to provide reliable information on sera neutralizing activity is an emerging need. We evaluated the performance of two commercially available lateral flow immunochromatographic assays (LFIC; Wondfo SARS-CoV-2 Antibody test and the INNOVITA 2019-nCoV Ab test) in comparison with a SARS-CoV-2 neutralization pseudotyped assay for coronavirus disease 2019 (COVID-19) diagnosis in hospitalized patients and investigate whether the intensity of the test band in LFIC associates with neutralizing antibody (NtAb) titers. Ninety sera were included from 51 patients with moderate to severe COVID-19. A green fluorescent protein (GFP) reporter-based pseudotyped neutralization assay (vesicular stomatitis virus coated with SARS-CoV-2 spike protein) was used. Test line intensity was scored using a 4-level scale (0 to 3+). The overall sensitivity of LFIC assays was 91.1% for the Wondfo SARS-CoV-2 Antibody test, 72.2% for the INNOVITA 2019-nCoV IgG, 85.6% for the INNOVITA 2019-nCoV IgM, and 92.2% for the NtAb assay. Sensitivity increased for all assays in sera collected beyond day 14 after symptoms onset (93.9%, 79.6%, 93.9%, and 93.9%, respectively). Reactivities equal to or more intense than the positive control line (≥2+) in the Wondfo assay had a negative predictive value of 100% and a positive predictive value of 96.4% for high NtAb50 titers (≥1/160). Our findings support the use of LFIC assays evaluated herein, particularly the Wondfo test, for COVID-19 diagnosis. We also find evidence that these rapid immunoassays can be used to predict high SARS-CoV-2-S NtAb50 titers.
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Affiliation(s)
- Arantxa Valdivia
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain
| | - Ignacio Torres
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain
| | - Víctor Latorre
- Institute for Integrative Systems Biology (I2SysBio), Universitat de Valencia-CSIC, Valencia, Spain
| | - Clara Francés-Gómez
- Institute for Integrative Systems Biology (I2SysBio), Universitat de Valencia-CSIC, Valencia, Spain
| | - Josep Ferrer
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain
| | - Lorena Forqué
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain
| | - Rosa Costa
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain
| | | | - Dixie Huntley
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain
| | | | - Javier Buesa
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain.,School of Medicine, Department of Microbiology, University of Valencia, Valencia, Spain
| | - Estela Giménez
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain
| | - Jesús Rodríguez-Díaz
- School of Medicine, Department of Microbiology, University of Valencia, Valencia, Spain
| | - Ron Geller
- Institute for Integrative Systems Biology (I2SysBio), Universitat de Valencia-CSIC, Valencia, Spain
| | - David Navarro
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain.,School of Medicine, Department of Microbiology, University of Valencia, Valencia, Spain
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Clinical performance evaluation of a SARS-CoV-2 Rapid Antibody Test for determining past exposure to SARS-CoV-2. Int J Infect Dis 2020; 103:636-641. [PMID: 33227517 PMCID: PMC7677675 DOI: 10.1016/j.ijid.2020.11.164] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/12/2020] [Accepted: 11/15/2020] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Due to the number of asymptomatic infections and limited access to high-performance antibody tests, the true prevalence and seropositivity of SARS-CoV-2 infection remains unknown. To fill this gap, the clinical performance of a point-of-care SARS-CoV-2 Rapid Antibody Assay, a chromatographic immunoassay for detecting IgM/IgG antibodies, in near patient settings was assessed. METHODS Forty-two anti-SARS-Cov-2 positive (CoV+) and 92 anti-SARS-Cov-2 negative (CoV-) leftover samples from before December 2019 were assessed; the Elecsys® Anti-SARS-CoV-2 was used as the reference assay. Analytical specificity was tested using leftover samples collected before December 2019 from patients with common cold symptoms. RESULTS The SARS-CoV-2 Rapid Antibody Test was 100.0% (95% CI 91.59-100.0) sensitive and 96.74% (95% CI 90.77-99.32) specific, with 0.00% assay failure rate. No cross-reactivity was observed against the common cold panel. Method comparison was additionally conducted by two external laboratories, using 100 CoV+ and 275 CoV- samples, also comparing whole blood versus plasma matrix. The comparison demonstrated 96.00% positive and 96.36% negative percent agreement for plasma with the Elecsys Anti-SARS-CoV-2 and 99.20% percent overall agreement between whole blood and EDTA plasma. CONCLUSION The SARS-CoV-2 Rapid Antibody Test demonstrated similar performance to the manufacturer's data and a centralised automated immunoassay, with no cross-reactivity with common cold panels.
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An Anti-Nucleocapsid Antigen Sars-Cov-2 Total Antibody Assay Finds Comparable Results in Edta-Anticoagulated Whole Blood Obtained from Capillary and Venous Blood Sampling. DATA 2020. [DOI: 10.3390/data5040105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Although SARS-CoV-2 antibody assays have been found to provide valid results in EDTA-anticoagulated whole blood, so far, they have not demonstrated that antibody levels in whole blood originating from capillary blood samples are comparable to antibody levels measured in blood from a venous origin. Here, blood is drawn simultaneously by capillary and venous blood sampling. Antibody titers are determined by an assay employing electrochemiluminescence (ECLIA) and SARS-CoV-2 total immunoglobulins are detected with specificity directed against the nucleocapsid antigen. Six individuals with confirmed COVID-19 and six individuals without COVID-19 are analyzed. Antibody titers in capillary venous whole blood did not show significant differences, and when corrected for hematocrit, they did not differ from the results obtained from serum. In conclusion, capillary sampled EDTA-anticoagulated whole blood seems to be an attractive alternative matrix for the evaluation of SARS-CoV-2 antibodies when employing ECLIA for detecting total antibodies directed against nucleocapsid antibodies.
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Bošnjak B, Stein SC, Willenzon S, Cordes AK, Puppe W, Bernhardt G, Ravens I, Ritter C, Schultze-Florey CR, Gödecke N, Martens J, Kleine-Weber H, Hoffmann M, Cossmann A, Yilmaz M, Pink I, Hoeper MM, Behrens GMN, Pöhlmann S, Blasczyk R, Schulz TF, Förster R. Low serum neutralizing anti-SARS-CoV-2 S antibody levels in mildly affected COVID-19 convalescent patients revealed by two different detection methods. Cell Mol Immunol 2020; 18:936-944. [PMID: 33139905 PMCID: PMC7604543 DOI: 10.1038/s41423-020-00573-9] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/07/2020] [Indexed: 12/31/2022] Open
Abstract
Neutralizing antibodies targeting the receptor-binding domain (RBD) of the SARS-CoV-2 spike (S) block severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry into cells via surface-expressed angiotensin-converting enzyme 2 (ACE2). We used a surrogate virus neutralization test (sVNT) and SARS-CoV-2 S protein-pseudotyped vesicular stomatitis virus (VSV) vector-based neutralization assay (pVNT) to assess the degree to which serum antibodies from coronavirus disease 2019 (COVID-19) convalescent patients interfere with the binding of SARS-CoV-2 S to ACE2. Both tests revealed neutralizing anti-SARS-CoV-2 S antibodies in the sera of ~90% of mildly and 100% of severely affected COVID-19 convalescent patients. Importantly, sVNT and pVNT results correlated strongly with each other and to the levels of anti-SARS-CoV-2 S1 IgG and IgA antibodies. Moreover, levels of neutralizing antibodies correlated with the duration and severity of clinical symptoms but not with patient age. Compared to pVNT, sVNT is less sophisticated and does not require any biosafety labs. Since this assay is also much faster and cheaper, sVNT will not only be important for evaluating the prevalence of neutralizing antibodies in a population but also for identifying promising plasma donors for successful passive antibody therapy.
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Affiliation(s)
- Berislav Bošnjak
- Institute of Immunology, Hannover Medical School, Hannover, Germany.
| | | | | | | | - Wolfram Puppe
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | - Günter Bernhardt
- Institute of Immunology, Hannover Medical School, Hannover, Germany
| | - Inga Ravens
- Institute of Immunology, Hannover Medical School, Hannover, Germany
| | | | - Christian R Schultze-Florey
- Institute of Immunology, Hannover Medical School, Hannover, Germany.,Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Nina Gödecke
- Institute of Transfusion Medicine and Transplant Engineering, Hannover Medical School, Hannover, Germany
| | - Jörg Martens
- Institute of Transfusion Medicine and Transplant Engineering, Hannover Medical School, Hannover, Germany
| | - Hannah Kleine-Weber
- German Primate Center-Leibniz Institute for Primate Research, Göttingen, Germany.,Faculty of Biology and Psychology, University Göttingen, Göttingen, Germany
| | - Markus Hoffmann
- German Primate Center-Leibniz Institute for Primate Research, Göttingen, Germany.,Faculty of Biology and Psychology, University Göttingen, Göttingen, Germany
| | - Anne Cossmann
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | | | - Isabelle Pink
- Department of Pneumology and German Centre of Lung Research (DZL), Hannover Medical School, Hannover, Germany
| | - Marius M Hoeper
- Department of Pneumology and German Centre of Lung Research (DZL), Hannover Medical School, Hannover, Germany
| | - Georg M N Behrens
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany.,German Center for Infection Research (DZIF), partner site Hannover-Braunschweig, Hannover, Germany
| | - Stefan Pöhlmann
- German Primate Center-Leibniz Institute for Primate Research, Göttingen, Germany.,Faculty of Biology and Psychology, University Göttingen, Göttingen, Germany
| | - Rainer Blasczyk
- Institute of Transfusion Medicine and Transplant Engineering, Hannover Medical School, Hannover, Germany
| | - Thomas F Schulz
- Institute of Virology, Hannover Medical School, Hannover, Germany.,German Center for Infection Research (DZIF), partner site Hannover-Braunschweig, Hannover, Germany.,Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany
| | - Reinhold Förster
- Institute of Immunology, Hannover Medical School, Hannover, Germany. .,Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany.
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Antibody responses to SARS-CoV-2 in patients with differing severities of coronavirus disease 2019. PLoS One 2020; 15:e0240502. [PMID: 33035234 PMCID: PMC7546485 DOI: 10.1371/journal.pone.0240502] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/28/2020] [Indexed: 12/13/2022] Open
Abstract
Background A greater understanding of the antibody response to SARS-CoV-2 in an infected population is important for the development of a vaccination. Aim To investigate SARS-CoV-2 IgA and IgG antibodies in Thai patients with differing severities of COVID-19. Methods Plasma from the following patient groups was examined: 118 adult patients with confirmed SARS-CoV-2 infections, 49 patients under investigation (without confirmed infections), 20 patients with other respiratory infections, and 102 healthy control patients. Anti-SARS-CoV-2 enzyme-linked immunosorbent assay (ELISA) from EUROIMMUN was performed to assess for IgA and IgG antibodies. The optical density (OD) ratio cutoff for a positive result was 1.1 for IgA and 0.8 for IgG. Additionally, the association of the antibody response with both the severity of disease and the date after onset of symptoms was analyzed. Results A total of 289 participants were enrolled and 384 samples analyzed from March 10 to May 31, 2020. Patients were categorized, based on their clinical manifestations, as mild (n = 59), moderate (n = 27), or severe (n = 32). The overall sensitivity of IgA and IgG from the samples collected after day 7 of the symptoms was 87.9% (95% CI: 79.8–93.6) and 84.8% (95% CI: 76.2–91.3), respectively. Compared to the mild group, the severe group had significantly higher levels of spike 1 (S1) antigen-specific IgA and IgG. All patients in the moderate and severe groups had S1-specific IgG, while 20% of the patients in the mild group did not have any IgG detected after two weeks after the onset of symptoms. Interestingly, in the severe group, the SARS-CoV-2 IgG level was significantly higher in males than females (p = 0.003). Conclusion The serological test for SARS-CoV-2 has a high sensitivity more than two weeks after the onset of illness. Additionally, the serological response differs among patients based on sex as well as the severity of infection.
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