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Leon J, Merrill AE, Rogers K, Kurt J, Dempewolf S, Ehlers A, Jackson JB, Knudson CM. SARS-CoV-2 antibody changes in patients receiving COVID-19 convalescent plasma from normal and vaccinated donors. Transfus Apher Sci 2022; 61:103326. [PMID: 34862140 PMCID: PMC8608660 DOI: 10.1016/j.transci.2021.103326] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/18/2021] [Accepted: 11/21/2021] [Indexed: 01/25/2023]
Abstract
Vaccination has been shown to stimulate remarkably high antibody levels in donors who have recovered from COVID-19. Our objective was to measure patient antibody levels before and after transfusion with COVID-19 Convalescent Plasma (CCP) and compare the antibody levels following transfusion of CCP from vaccinated and nonvaccinated donors. Plasma samples before and after transfusion were obtained from 25 recipients of CCP and COVID-19 antibody levels measured. Factors that effect changes in antibody levels were examined. In the 21 patients who received CCP from nonvaccinated donors, modest increases in antibody levels were observed. Patients who received two units were more likely to seroconvert than those receiving just one unit. The strongest predictor of changes in patient antibody level was the CCP dose, calculated by the unit volume multiplied by the donor antibody level. Using patient plasma volume and donor antibody level, the post-transfusion antibody level could be predicted with reasonable accuracy(R2> 0.90). In contrast, the 4 patients who received CCP from vaccinated donors all had dramatic increases in antibody levels following transfusion of a single unit. In this subset of recipients, antibody levels observed after transfusion of CCP were comparable to those seen in donors who had fully recovered from COVID-19. If available, CCP from vaccinated donors with very high antibody levels should be used. One unit of CCP from vaccinated donors increases patient antibody levels much more than 1 or 2 units of CCP from unvaccinated donors.
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Affiliation(s)
| | | | | | | | | | | | | | - C. Michael Knudson
- Corresponding author at: Department of Pathology, University of Iowa Hospitals and Clinics, 200 Hawkins Dr., C250 GH, United States
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2
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Zaid I, Essaad O, El Aidouni G, Aabdi M, Berrichi S, Taouihar S, Marbouh M, Bkiyer H, Abda N, Housni B. Therapeutic plasma exchange in patients with COVID-19 pneumonia in intensive care unit: Cases series. Ann Med Surg (Lond) 2021; 71:102920. [PMID: 34642602 PMCID: PMC8495054 DOI: 10.1016/j.amsu.2021.102920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/03/2021] [Accepted: 10/03/2021] [Indexed: 01/15/2023] Open
Abstract
Introduction COVID 19 pneumonia can lead to an inappropriate inflammatory response, and can be complicated by acute respiratory distress syndrome, multivisceral failure with a high mortality rate. Objective To observe the effect of therapeutic plasma exchange on the excessive inflammatory response. Materials and methods In this study, we included 7 confirmed cases of COVID-19 in the intensive care unit (ICU) department of the university hospital of Oujda. COVID-19 cases were confirmed by RT PCR (reverse transcription-polymerase chain) and CT (computerized tomography) imaging according to WHO guidelines. Therapeutic plasma exchange was performed decrease cytokine storm-induced ARDS (Acute respiratory distress syndrome). Inflammation marker assays were performed before and after therapeutic plasma exchange to assess its efficacy. Results Levels of inflammatory cytokines (IL-6) and acute phase response proteins, including ferritin and CRP, were elevated before therapeutic plasma exchange.After therapeutic plasma exchange, levels of acute phase reactants, inflammatory mediators, were significantly reduced (p < 0.05). Conclusion Our data suggest that therapeutic plasma exchange reduces the inflammatory response in patients with severe COVID-19 not undergoing mechanical ventilation. Further studies are needed to explore the efficacy of therapeutic plasma exchange in patients with COVID-19.
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Affiliation(s)
- Ikram Zaid
- Department of Intensive Care Unit, Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Ounci Essaad
- Department of Intensive Care Unit, Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Ghizlane El Aidouni
- Department of Intensive Care Unit, Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Mohammed Aabdi
- Department of Intensive Care Unit, Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Samia Berrichi
- Department of Intensive Care Unit, Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Salma Taouihar
- Department of Intensive Care Unit, Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Manal Marbouh
- Department of Intensive Care Unit, Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Houssam Bkiyer
- Department of Intensive Care Unit, Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Naima Abda
- Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco.,Department of Community Medicine, Mohammed VI University Hospital, Oujda, Morocco
| | - Brahim Housni
- Department of Intensive Care Unit, Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco.,Mohammed First University Oujda, FMP Oujda, LAMCESM, Oujda, Morocco
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3
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Lung T, Sakem B, Hemmerle A, Nydegger M, Risch M, Risch L, Nydegger U. Autoimmune diseases - New insights into a troublesome field. J Transl Autoimmun 2021; 4:100108. [PMID: 34179743 PMCID: PMC8188057 DOI: 10.1016/j.jtauto.2021.100108] [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: 05/21/2021] [Revised: 05/26/2021] [Accepted: 05/26/2021] [Indexed: 11/25/2022] Open
Abstract
Recent updates in the diagnosis and management of chronic inflammatory conditions can be brought together to better understand autoimmune diseases (ADs). With organ-specific or organ-limited and systemic ADs, physicians often are faced with a dilemma when making a diagnosis and may feel a kind of embarrassment when a more distinct nosological entity cannot be found. ADs often overlap with other diseases and good diagnostic procedures for ADs only become evidence-based when refined histopathologic, immunopathologic, and general laboratory analyses are available. Immunofluorescence analyses, Western blotting, CUT & RUN technology allow localization of the site of autoantibody-reactivity on the relevant DNA sequence. The Polymerase chain reaction technology and CRISPR-Cas9, the new gene editor using pools of synthetic non-coding RNAs in screening experiments, are expected to lead to advances in the diagnosis of ADs. The current use of mRNA as a vaccine against COVID-19 has increased confidence in the use of mRNA or long non-coding RNAs in the treatment strategy for ADs. The integration of new knowledge about innate immunity, the complement system, vaccinology, and senescence into the care of patients with ADs expands the therapeutic arsenal of disease-modifying drugs and allows for the repurposing of anti-cytokine monoclonal/biosimilar antibodies, originally designed for chronic inflammatory diseases, for ADs. This review article brings together some of the most relevant ideas; a case report included in this review highlights the difficulty of distinguishing between ADs, chronic inflammation, and/or granular disease.
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Affiliation(s)
- Thomas Lung
- Center for Laboratory Medicine Dr Risch, Vaduz, Liechtenstein
| | - Benjamin Sakem
- Center for Laboratory Medicine Dr Risch, Vaduz, Liechtenstein
| | | | - Michèle Nydegger
- Institute of Anesthesiology and Intensive Care Medicine, Triemli City Hospital, Zurich, Switzerland
| | - Martin Risch
- Center for Laboratory Medicine Dr Risch, Vaduz, Liechtenstein
- Central Laboratory, Kantonsspital Graubünden, Chur, Switzerland
| | - Lorenz Risch
- Center for Laboratory Medicine Dr Risch, Vaduz, Liechtenstein
- University of Berne, Berne, Switzerland
| | - Urs Nydegger
- Center for Laboratory Medicine Dr Risch, Vaduz, Liechtenstein
- University of Berne, Berne, Switzerland
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4
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Valdez-Cruz NA, García-Hernández E, Espitia C, Cobos-Marín L, Altamirano C, Bando-Campos CG, Cofas-Vargas LF, Coronado-Aceves EW, González-Hernández RA, Hernández-Peralta P, Juárez-López D, Ortega-Portilla PA, Restrepo-Pineda S, Zelada-Cordero P, Trujillo-Roldán MA. Integrative overview of antibodies against SARS-CoV-2 and their possible applications in COVID-19 prophylaxis and treatment. Microb Cell Fact 2021; 20:88. [PMID: 33888152 PMCID: PMC8061467 DOI: 10.1186/s12934-021-01576-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/03/2021] [Indexed: 02/06/2023] Open
Abstract
SARS-CoV-2 is a novel β-coronavirus that caused the COVID-19 pandemic disease, which spread rapidly, infecting more than 134 million people, and killing almost 2.9 million thus far. Based on the urgent need for therapeutic and prophylactic strategies, the identification and characterization of antibodies has been accelerated, since they have been fundamental in treating other viral diseases. Here, we summarized in an integrative manner the present understanding of the immune response and physiopathology caused by SARS-CoV-2, including the activation of the humoral immune response in SARS-CoV-2 infection and therefore, the synthesis of antibodies. Furthermore, we also discussed about the antibodies that can be generated in COVID-19 convalescent sera and their associated clinical studies, including a detailed characterization of a variety of human antibodies and identification of antibodies from other sources, which have powerful neutralizing capacities. Accordingly, the development of effective treatments to mitigate COVID-19 is expected. Finally, we reviewed the challenges faced in producing potential therapeutic antibodies and nanobodies by cell factories at an industrial level while ensuring their quality, efficacy, and safety.
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Affiliation(s)
- Norma A Valdez-Cruz
- Programa de Investigación de Producción de Biomoléculas, Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México.
| | - Enrique García-Hernández
- Instituto de Química, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Clara Espitia
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Laura Cobos-Marín
- Facultad de Medicina Veterinaria Y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Claudia Altamirano
- Escuela de Ingeniería Bioquímica, Pontificia Universidad Católica de Valparaíso, Av. Brasil N° 2950, Valparaíso, Chile
| | - Carlos G Bando-Campos
- Programa de Investigación de Producción de Biomoléculas, Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Luis F Cofas-Vargas
- Instituto de Química, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Enrique W Coronado-Aceves
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Ricardo A González-Hernández
- Programa de Investigación de Producción de Biomoléculas, Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Pablo Hernández-Peralta
- Facultad de Medicina Veterinaria Y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Daniel Juárez-López
- Programa de Investigación de Producción de Biomoléculas, Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Paola A Ortega-Portilla
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Sara Restrepo-Pineda
- Programa de Investigación de Producción de Biomoléculas, Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Patricio Zelada-Cordero
- Programa de Investigación de Producción de Biomoléculas, Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Mauricio A Trujillo-Roldán
- Programa de Investigación de Producción de Biomoléculas, Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México.
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5
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Vickers MA, Sariol A, Leon J, Ehlers A, Locher AV, Dubay KA, Collins L, Voss D, Odle AE, Holida M, Merrill AE, Perlman S, Knudson CM. Exponential increase in neutralizing and spike specific antibodies following vaccination of COVID-19 convalescent plasma donors. Transfusion 2021; 61:2099-2106. [PMID: 33829513 PMCID: PMC8251132 DOI: 10.1111/trf.16401] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/22/2021] [Accepted: 03/26/2021] [Indexed: 12/18/2022]
Abstract
Background With the recent approval of COVID‐19 vaccines, recovered COVID‐19 subjects who are vaccinated may be ideal candidates to donate COVID‐19 convalescent plasma (CCP). Case Series Eleven recovered COVID‐19 patients were screened to donate CCP. All had molecularly confirmed COVID‐19, and all but one were antibody positive by chemiluminescence immunoassay (DiaSorin) prior to vaccination. All were tested again for antibodies 11–21 days after they were vaccinated (Pfizer/Moderna). All showed dramatic increases (~50‐fold) in spike‐specific antibody levels and had at least a 20‐fold increase in the IC50 neutralizing antibody titer based on plaque reduction neutralization testing (PRNT). The spike‐specific antibody levels following vaccination were significantly higher than those seen in any non‐vaccinated COVID‐19 subjects tested to date at our facility. Conclusion Spike‐specific and neutralizing antibodies demonstrated dramatic increases following a single vaccination after COVID‐19 infection, which significantly exceeded values seen with COVID‐19 infection alone. Recovered COVID‐19 subjects who are vaccinated may make ideal candidates for CCP donation.
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Affiliation(s)
- Molly A Vickers
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa
| | - Alan Sariol
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa
| | - Judith Leon
- Department of Pathology, University of Iowa, Iowa City, Iowa
| | | | - Aaron V Locher
- Department of Pathology, University of Iowa, Iowa City, Iowa
| | - Kerry A Dubay
- Department of Pathology, University of Iowa, Iowa City, Iowa
| | - Laura Collins
- Department of Pathology, University of Iowa, Iowa City, Iowa
| | - Dena Voss
- Department of Pathology, University of Iowa, Iowa City, Iowa
| | - Abby E Odle
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa
| | - Myrl Holida
- Department of Pediatrics, University of Iowa, Iowa City, Iowa
| | - Anna E Merrill
- Department of Pathology, University of Iowa, Iowa City, Iowa
| | - Stanley Perlman
- Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa.,Department of Pediatrics, University of Iowa, Iowa City, Iowa
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6
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Peng HT, Rhind SG, Beckett A. Convalescent Plasma for the Prevention and Treatment of COVID-19: A Systematic Review and Quantitative Analysis. JMIR Public Health Surveill 2021; 7:e25500. [PMID: 33825689 PMCID: PMC8245055 DOI: 10.2196/25500] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/19/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic, caused by a novel coronavirus termed SARS-CoV-2, has spread quickly worldwide. Convalescent plasma (CP) obtained from patients following recovery from COVID-19 infection and development of antibodies against the virus is an attractive option for either prophylactic or therapeutic treatment, since antibodies may have direct or indirect antiviral activities and immunotherapy has proven effective in principle and in many clinical reports. OBJECTIVE We seek to characterize the latest advances and evidence in the use of CP for COVID-19 through a systematic review and quantitative analysis, identify knowledge gaps in this setting, and offer recommendations and directives for future research. METHODS PubMed, Web of Science, and Embase were continuously searched for studies assessing the use of CP for COVID-19, including clinical studies, commentaries, reviews, guidelines or protocols, and in vitro testing of CP antibodies. The screening process and data extraction were performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Quality appraisal of all clinical studies was conducted using a universal tool independent of study designs. A meta-analysis of case-control and randomized controlled trials (RCTs) was conducted using a random-effects model. RESULTS Substantial literature has been published covering various aspects of CP therapy for COVID-19. Of the references included in this review, a total of 243 eligible studies including 64 clinical studies, 79 commentary articles, 46 reviews, 19 guidance and protocols, and 35 in vitro testing of CP antibodies matched the criteria. Positive results have been mostly observed so far when using CP for the treatment of COVID-19. There were remarkable heterogeneities in the CP therapy with respect to patient demographics, donor antibody titers, and time and dose of CP administration. The studies assessing the safety of CP treatment reported low incidence of adverse events. Most clinical studies, in particular case reports and case series, had poor quality. Only 1 RCT was of high quality. Randomized and nonrandomized data were found in 2 and 11 studies, respectively, and were included for meta-analysis, suggesting that CP could reduce mortality and increase viral clearance. Despite promising pilot studies, the benefits of CP treatment can only be clearly established through carefully designed RCTs. CONCLUSIONS There is developing support for CP therapy, particularly for patients who are critically ill or mechanically ventilated and resistant to antivirals and supportive care. These studies provide important lessons that should inform the planning of well-designed RCTs to generate more robust knowledge for the efficacy of CP in patients with COVID-19. Future research is necessary to fill the knowledge gap regarding prevention and treatment for patients with COVID-19 with CP while other therapeutics are being developed.
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Affiliation(s)
- Henry T Peng
- Defence Research and Development Canada, Toronto Research Centre, Toronto, ON, Canada
| | - Shawn G Rhind
- Defence Research and Development Canada, Toronto Research Centre, Toronto, ON, Canada
| | - Andrew Beckett
- St. Michael's Hospital, Toronto, ON, Canada
- Royal Canadian Medical Services, Ottawa, ON, Canada
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7
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How should we use convalescent plasma therapies for the management of COVID-19? Blood 2021; 137:1573-1581. [PMID: 33202419 PMCID: PMC7992504 DOI: 10.1182/blood.2020008903] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/09/2020] [Indexed: 12/28/2022] Open
Abstract
Convalescent plasma (CP) from blood donors with antibodies to severe acute respiratory syndrome coronavirus 2 may benefit patients with COVID-19 by providing immediate passive immunity via transfusion or by being used to manufacture hyperimmune immunoglobulin preparations. Optimal product characteristics (including neutralizing antibody titers), transfusion volume, and administration timing remain to be determined. Preliminary COVID-19 CP safety data are encouraging, but establishing the clinical efficacy of CP requires an ongoing international collaborative effort. Preliminary results from large, high-quality randomized trials have recently started to be reported.
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8
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Lung T, Sakem B, Risch M, Nydegger U. Convalescent blood plasma (CBP) donated by recovered COVID-19 patients - A comment. Transfus Apher Sci 2021; 60:103108. [PMID: 33678561 PMCID: PMC7923855 DOI: 10.1016/j.transci.2021.103108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/18/2021] [Accepted: 02/25/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Th Lung
- Center for Laboratory Medicine Dr Risch, Vaduz, Principality of Liechtenstein, University of Bern, Switzerland
| | - B Sakem
- Center for Laboratory Medicine Dr Risch, Vaduz, Principality of Liechtenstein, University of Bern, Switzerland
| | - M Risch
- Center for Laboratory Medicine Dr Risch, Vaduz, Principality of Liechtenstein, University of Bern, Switzerland
| | - U Nydegger
- Center for Laboratory Medicine Dr Risch, Vaduz, Principality of Liechtenstein, University of Bern, Switzerland.
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9
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Schaffner A, Risch L, Aeschbacher S, Risch C, Weber MC, Thiel SL, Jüngert K, Pichler M, Grossmann K, Wohlwend N, Lung T, Hillmann D, Bigler S, Bodmer T, Imperiali M, Renz H, Kohler P, Vernazza P, Kahlert CR, Twerenbold R, Paprotny M, Conen D, Risch M. Characterization of a Pan-Immunoglobulin Assay Quantifying Antibodies Directed against the Receptor Binding Domain of the SARS-CoV-2 S1-Subunit of the Spike Protein: A Population-Based Study. J Clin Med 2020; 9:E3989. [PMID: 33317059 PMCID: PMC7764650 DOI: 10.3390/jcm9123989] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/01/2020] [Accepted: 12/01/2020] [Indexed: 12/23/2022] Open
Abstract
Pan-immunoglobulin assays can simultaneously detect IgG, IgM and IgA directed against the receptor binding domain (RBD) of the S1 subunit of the spike protein (S) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 S1-RBD Ig). In this work, we aim to evaluate a quantitative SARS-CoV-2 S1-RBD Ig electrochemiluminescence immunoassay (ECLIA) regarding analytical, diagnostic, operational and clinical characteristics. Our work takes the form of a population-based study in the principality of Liechtenstein, including 125 cases with clinically well-described and laboratory confirmed SARS-CoV-2 infection and 1159 individuals without evidence of coronavirus disease 2019 (COVID-19). SARS-CoV-2 cases were tested for antibodies in sera taken with a median of 48 days (interquartile range, IQR, 43-52) and 139 days (IQR, 129-144) after symptom onset. Sera were also tested with other assays targeting antibodies against non-RBD-S1 and -S1/S2 epitopes. Sensitivity was 97.6% (95% confidence interval, CI, 93.2-99.1), whereas specificity was 99.8% (95% CI, 99.4-99.9). Antibody levels linearly decreased from hospitalized patients to symptomatic outpatients and SARS-CoV-2 infection without symptoms (p < 0.001). Among cases with SARS-CoV-2 infection, smokers had lower antibody levels than non-smokers (p = 0.04), and patients with fever had higher antibody levels than patients without fever (p = 0.001). Pan-SARS-CoV-2 S1-RBD Ig in SARS-CoV-2 infection cases significantly increased from first to second follow-up (p < 0.001). A substantial proportion of individuals without evidence of past SARS-CoV-2 infection displayed non-S1-RBD antibody reactivities (248/1159, i.e., 21.4%, 95% CI, 19.1-23.4). In conclusion, a quantitative SARS-CoV-2 S1-RBD Ig assay offers favorable and sustained assay characteristics allowing the determination of quantitative associations between clinical characteristics (e.g., disease severity, smoking or fever) and antibody levels. The assay could also help to identify individuals with antibodies of non-S1-RBD specificity with potential clinical cross-reactivity to SARS-CoV-2.
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Affiliation(s)
- Anna Schaffner
- Landesspital Liechtenstein, Heiligkreuz, 9490 Vaduz, Liechtenstein; (A.S.); (M.C.W.); (S.L.T.); (K.J.); (M.P.); (M.P.)
| | - Lorenz Risch
- Labormedizinisches Zentrum Dr Risch, Wuhrstrasse 14, 9490 Vaduz, Liechtenstein; (L.R.); (C.R.); (K.G.); (N.W.); (T.L.); (D.H.)
- Faculty of Medical Sciences, Private Universität im Fürstentum Liechtenstein, Dorfstrasse 24, 9495 Triesen, Liechtenstein
- Center of Laboratory Medicine, University Institute of Clinical Chemistry, University of Bern, Inselspital, 3010 Bern, Switzerland
| | - Stefanie Aeschbacher
- Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Spitalstrasse 2, 4056 Basel, Switzerland; (S.A.); (R.T.)
| | - Corina Risch
- Labormedizinisches Zentrum Dr Risch, Wuhrstrasse 14, 9490 Vaduz, Liechtenstein; (L.R.); (C.R.); (K.G.); (N.W.); (T.L.); (D.H.)
| | - Myriam C. Weber
- Landesspital Liechtenstein, Heiligkreuz, 9490 Vaduz, Liechtenstein; (A.S.); (M.C.W.); (S.L.T.); (K.J.); (M.P.); (M.P.)
| | - Sarah L. Thiel
- Landesspital Liechtenstein, Heiligkreuz, 9490 Vaduz, Liechtenstein; (A.S.); (M.C.W.); (S.L.T.); (K.J.); (M.P.); (M.P.)
| | - Katharina Jüngert
- Landesspital Liechtenstein, Heiligkreuz, 9490 Vaduz, Liechtenstein; (A.S.); (M.C.W.); (S.L.T.); (K.J.); (M.P.); (M.P.)
| | - Michael Pichler
- Landesspital Liechtenstein, Heiligkreuz, 9490 Vaduz, Liechtenstein; (A.S.); (M.C.W.); (S.L.T.); (K.J.); (M.P.); (M.P.)
| | - Kirsten Grossmann
- Labormedizinisches Zentrum Dr Risch, Wuhrstrasse 14, 9490 Vaduz, Liechtenstein; (L.R.); (C.R.); (K.G.); (N.W.); (T.L.); (D.H.)
- Faculty of Medical Sciences, Private Universität im Fürstentum Liechtenstein, Dorfstrasse 24, 9495 Triesen, Liechtenstein
| | - Nadia Wohlwend
- Labormedizinisches Zentrum Dr Risch, Wuhrstrasse 14, 9490 Vaduz, Liechtenstein; (L.R.); (C.R.); (K.G.); (N.W.); (T.L.); (D.H.)
| | - Thomas Lung
- Labormedizinisches Zentrum Dr Risch, Wuhrstrasse 14, 9490 Vaduz, Liechtenstein; (L.R.); (C.R.); (K.G.); (N.W.); (T.L.); (D.H.)
| | - Dorothea Hillmann
- Labormedizinisches Zentrum Dr Risch, Wuhrstrasse 14, 9490 Vaduz, Liechtenstein; (L.R.); (C.R.); (K.G.); (N.W.); (T.L.); (D.H.)
| | - Susanna Bigler
- Labormedizinisches Zentrum Dr Risch, Waldeggstrasse 37, 3097 Liebefeld, Switzerland; (S.B.); (T.B.)
| | - Thomas Bodmer
- Labormedizinisches Zentrum Dr Risch, Waldeggstrasse 37, 3097 Liebefeld, Switzerland; (S.B.); (T.B.)
| | - Mauro Imperiali
- Centro Medicina di Laboratorio Dr Risch, Via Arbostra 2, 6963 Pregassona, Switzerland;
| | - Harald Renz
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, University Hospital Giessen and Marburg, Philipps University Marburg, Baldingerstraße, 35043 Marburg, Germany;
| | - Philipp Kohler
- Department of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, Rohrschacherstrasse 95, 9007 St. Gallen, Switzerland; (P.K.); (P.V.); (C.R.K.)
| | - Pietro Vernazza
- Department of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, Rohrschacherstrasse 95, 9007 St. Gallen, Switzerland; (P.K.); (P.V.); (C.R.K.)
| | - Christian R. Kahlert
- Department of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, Rohrschacherstrasse 95, 9007 St. Gallen, Switzerland; (P.K.); (P.V.); (C.R.K.)
- Department of Infectious Diseases and Hospital Epidemiology, Children’s Hospital of Eastern Switzerland, Claudiusstrasse 6, 9006 St. Gallen, Switzerland
| | - Raphael Twerenbold
- Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Spitalstrasse 2, 4056 Basel, Switzerland; (S.A.); (R.T.)
- Clinic of Cardiology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland
| | - Matthias Paprotny
- Landesspital Liechtenstein, Heiligkreuz, 9490 Vaduz, Liechtenstein; (A.S.); (M.C.W.); (S.L.T.); (K.J.); (M.P.); (M.P.)
| | - David Conen
- Population Health Research Institute, McMaster University, 237 Barton Street East, Hamilton, ON L8L 2X2, Canada;
| | - Martin Risch
- Central Laboratory, Kantonsspital Graubünden, Loësstrasse 170, 7000 Chur, Switzerland
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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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