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de Lima VA, Nunes JPS, Rosa DS, Ferreira R, Oliva MLV, Andreata‐Santos R, Duarte‐Barbosa M, Janini LMR, Maricato JT, Akamatsu MA, Ho PL, Schenkman S. Development and characterization of a multimeric recombinant protein using the spike protein receptor binding domain as an antigen to induce SARS-CoV-2 neutralization. Immun Inflamm Dis 2024; 12:e1353. [PMID: 39056544 PMCID: PMC11273545 DOI: 10.1002/iid3.1353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 07/01/2024] [Accepted: 07/06/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND SARS-CoV2 virus, responsible for the COVID-19 pandemic, has four structural proteins and 16 nonstructural proteins. S-protein is one of the structural proteins exposed on the virus surface and is the main target for producing neutralizing antibodies and vaccines. The S-protein forms a trimer that can bind the angiotensin-converting enzyme 2 (ACE2) through its receptor binding domain (RBD) for cell entry. AIMS The goal of this study was to express in HEK293 cells a new RBD recombinant protein in a constitutive and stable manner in order to use it as an alternative immunogen and diagnostic tool for COVID-19. MATERIALS & METHODS The protein was designed to contain an immunoglobulin signal sequence, an explanded C-terminal section of the RBD, a region responsible for the bacteriophage T4 trimerization inducer, and six histidines in the pCDNA-3.1 plasmid. Following transformation, the cells were selected with geneticin-G418 and purified from serum-fre culture supernatants using Ni2+-agarand size exclusion chromatography. The protein was structurally identified by cross-linking and circular dichroism experiments, and utilized to immunize mice in conjuction with AS03 or alum adjuvants. The mice sera were examined for antibody recognition, receptor-binding inhibition, and virus neutralization, while spleens were evaluated for γ-interferon production in the presence of RBD. RESULTS The protein released in the culture supernatant of cells, and exhibited a molecular mass of 135 kDa with a secondary structure like the monomeric and trimeric RBD. After purification, it formed a multimeric structure comprising trimers and hexamers, which were able to bind the ACE2 receptor. It generated high antibody titers in mice when combined with AS03 adjuvant (up to 1:50,000). The sera were capable of inhibiting binding of biotin-labeled ACE2 to the virus S1 subunit and could neutralize the entry of the Wuhan virus strain into cells at dilutions up to 1:2000. It produced specific IFN-γ producing cells in immunized mouse splenocytes. DISCUSSION Our data describe a new RBD containing protein, forming trimers and hexamers, which are able to induce a protective humoral and cellular response against SARS-CoV2. CONCLUSION These results add a new arsenal to combat COVID-19, as an alternative immunogen or antigen for diagnosis.
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Affiliation(s)
- Veronica A. de Lima
- Department of Microbiology, Immunology and ParasitologyUniversidade Federal de São PauloSão PauloSão PauloBrazil
| | - João P. S. Nunes
- Department of Microbiology, Immunology and ParasitologyUniversidade Federal de São PauloSão PauloSão PauloBrazil
| | - Daniela S. Rosa
- Department of Microbiology, Immunology and ParasitologyUniversidade Federal de São PauloSão PauloSão PauloBrazil
| | - Rodrigo Ferreira
- Department of Biochemistry, Escola Paulista de MedicinaUniversidade Federal de São PauloSão PauloSão PauloBrazil
| | - Maria L. V. Oliva
- Department of Biochemistry, Escola Paulista de MedicinaUniversidade Federal de São PauloSão PauloSão PauloBrazil
| | - Robert Andreata‐Santos
- Department of Microbiology, Immunology and ParasitologyUniversidade Federal de São PauloSão PauloSão PauloBrazil
| | - Marcia Duarte‐Barbosa
- Department of Microbiology, Immunology and ParasitologyUniversidade Federal de São PauloSão PauloSão PauloBrazil
| | - Luiz M. R. Janini
- Department of Microbiology, Immunology and ParasitologyUniversidade Federal de São PauloSão PauloSão PauloBrazil
| | - Juliana T. Maricato
- Department of Microbiology, Immunology and ParasitologyUniversidade Federal de São PauloSão PauloSão PauloBrazil
| | - Milena A. Akamatsu
- Núcleo de Produção de Vacinas Bacterianas, Centro BioIndustrial, Instituto ButantanSão PauloSão PauloBrazil
| | - Paulo L. Ho
- Núcleo de Produção de Vacinas Bacterianas, Centro BioIndustrial, Instituto ButantanSão PauloSão PauloBrazil
| | - Sergio Schenkman
- Department of Microbiology, Immunology and ParasitologyUniversidade Federal de São PauloSão PauloSão PauloBrazil
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2
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Souza MS, Farias JP, Andreata-Santos R, Silva MP, Brito RDDS, Duarte Barbosa da Silva M, Peter CM, Cirilo MVDF, Luiz WB, Birbrair A, Vidal PO, de Castro-Amarante MF, Candido ED, Munhoz AS, de Mello Malta F, Dorlass EG, Machado RRG, Pinho JRR, Oliveira DBL, Durigon EL, Maricato JT, Braconi CT, Ferreira LCDS, Janini LMR, Amorim JH. Neutralizing antibody response after immunization with a COVID-19 bivalent vaccine: Insights to the future. J Med Virol 2024; 96:e29416. [PMID: 38285457 DOI: 10.1002/jmv.29416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/06/2023] [Accepted: 01/09/2024] [Indexed: 01/30/2024]
Abstract
The raising of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants led to the use of COVID-19 bivalent vaccines, which include antigens of the wild-type (WT) virus, and of the Omicron strain. In this study, we aimed to evaluate the impact of bivalent vaccination on the neutralizing antibody (NAb) response. We enrolled 93 volunteers who had received three or four doses of monovalent vaccines based on the original virus (n = 61), or a booster shot with the bivalent vaccine (n = 32). Serum samples collected from volunteers were subjected to neutralization assays using the WT SARS-CoV-2, and Omicron subvariants. In addition, immunoinformatics to quantify and localize highly conserved NAb epitopes were performed. As main result, we observed that the neutralization titers of samples from individuals vaccinated with the bivalent vaccine were higher for the original virus, in comparison to their capacity of neutralizing the Omicron variant and its subvariants. NAb that recognize epitopes mostly conserved in the WT SARS-CoV-2 were boosted, while those that recognize epitopes mostly present in the Omicron variant, and subvariants were primed. These results indicate that formulation of future vaccines shall consider to target present viruses, and not viruses that no longer circulate.
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Affiliation(s)
- Milena Silva Souza
- Center of Biological Sciences and Health, Western Bahia Virology Institute, Federal University of Western Bahia, Barreiras, Bahia, Brazil
- Department of Biological Sciences, Laboratory of Applied Pathology and Genetics, State University of Santa Cruz, Ilhéus, Bahia, Brazil
| | - Jéssica Pires Farias
- Center of Biological Sciences and Health, Western Bahia Virology Institute, Federal University of Western Bahia, Barreiras, Bahia, Brazil
- Department of Microbiology, Vaccine Development Laboratory, Biomedical Sciences Institute, University of São Paulo, São Paulo, State of Sao Paulo, Brazil
| | - Robert Andreata-Santos
- Department of Microbiology, Vaccine Development Laboratory, Biomedical Sciences Institute, University of São Paulo, São Paulo, State of Sao Paulo, Brazil
- Department of Microbiology, Immunology and Parasitology, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), Sao Paulo, State of Sao Paulo, Brazil
| | - Marianne Pereira Silva
- Center of Biological Sciences and Health, Western Bahia Virology Institute, Federal University of Western Bahia, Barreiras, Bahia, Brazil
| | - Ruth Dálety da Silva Brito
- Center of Biological Sciences and Health, Western Bahia Virology Institute, Federal University of Western Bahia, Barreiras, Bahia, Brazil
| | - Marcia Duarte Barbosa da Silva
- Department of Microbiology, Immunology and Parasitology, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), Sao Paulo, State of Sao Paulo, Brazil
| | - Cristina Mendes Peter
- Department of Microbiology, Immunology and Parasitology, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), Sao Paulo, State of Sao Paulo, Brazil
| | - Marcus Vinícius de França Cirilo
- Center of Biological Sciences and Health, Western Bahia Virology Institute, Federal University of Western Bahia, Barreiras, Bahia, Brazil
| | - Wilson Barros Luiz
- Department of Biological Sciences, Laboratory of Applied Pathology and Genetics, State University of Santa Cruz, Ilhéus, Bahia, Brazil
| | - Alexander Birbrair
- Department of Dermatology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Radiology, Columbia University Medical Center, New York City, New York, USA
| | - Paloma Oliveira Vidal
- Center of Biological Sciences and Health, Western Bahia Virology Institute, Federal University of Western Bahia, Barreiras, Bahia, Brazil
| | - Maria Fernanda de Castro-Amarante
- Department of Microbiology, Vaccine Development Laboratory, Biomedical Sciences Institute, University of São Paulo, São Paulo, State of Sao Paulo, Brazil
| | - Erika Donizetti Candido
- Department of Microbiology, Laboratory of Clinical and Molecular Virology, Institute of Biomedical science, University of Sao Paulo, Sao Paulo, Brazil
| | | | | | | | - Rafael Rahal Guaragna Machado
- Department of Microbiology, Laboratory of Clinical and Molecular Virology, Institute of Biomedical science, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Danielle Bruna Leal Oliveira
- Department of Microbiology, Laboratory of Clinical and Molecular Virology, Institute of Biomedical science, University of Sao Paulo, Sao Paulo, Brazil
- Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Edison Luiz Durigon
- Department of Microbiology, Laboratory of Clinical and Molecular Virology, Institute of Biomedical science, University of Sao Paulo, Sao Paulo, Brazil
| | - Juliana Terzi Maricato
- Department of Microbiology, Immunology and Parasitology, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), Sao Paulo, State of Sao Paulo, Brazil
| | - Carla Torres Braconi
- Department of Microbiology, Immunology and Parasitology, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), Sao Paulo, State of Sao Paulo, Brazil
| | - Luís Carlos de Souza Ferreira
- Department of Microbiology, Vaccine Development Laboratory, Biomedical Sciences Institute, University of São Paulo, São Paulo, State of Sao Paulo, Brazil
- Scientific Platform Pasteur USP, University of Sao Paulo, Sao Paulo, State of Sao Paulo, Brazil
| | - Luiz Mário Ramos Janini
- Department of Microbiology, Immunology and Parasitology, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), Sao Paulo, State of Sao Paulo, Brazil
- Department of Medicine, Division of Infectology, Federal University of Sao Paulo, Sao Paulo, State of Sao Paulo, Brazil
| | - Jaime Henrique Amorim
- Center of Biological Sciences and Health, Western Bahia Virology Institute, Federal University of Western Bahia, Barreiras, Bahia, Brazil
- Department of Biological Sciences, Laboratory of Applied Pathology and Genetics, State University of Santa Cruz, Ilhéus, Bahia, Brazil
- Department of Microbiology, Vaccine Development Laboratory, Biomedical Sciences Institute, University of São Paulo, São Paulo, State of Sao Paulo, Brazil
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3
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Machado RRG, Candido ÉD, Aguiar AS, Chalup VN, Sanches PR, Dorlass EG, Amgarten DE, Pinho JRR, Durigon EL, Oliveira DBL. Immune Evasion of SARS-CoV-2 Omicron Subvariants XBB.1.5, XBB.1.16 and EG.5.1 in a Cohort of Older Adults after ChAdOx1-S Vaccination and BA.4/5 Bivalent Booster. Vaccines (Basel) 2024; 12:144. [PMID: 38400128 PMCID: PMC10892985 DOI: 10.3390/vaccines12020144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 12/15/2023] [Accepted: 01/03/2024] [Indexed: 02/25/2024] Open
Abstract
The recently emerged SARS-CoV-2 Omicron sublineages, including the BA.2-derived XBB.1.5 (Kraken), XBB.1.16 (Arcturus), and EG.5.1 (Eris), have accumulated several spike mutations that may increase immune escape, affecting vaccine effectiveness. Older adults are an understudied group at significantly increased risk of severe COVID-19. Here we report the neutralizing activities of 177 sera samples from 59 older adults, aged 62-97 years, 1 and 4 months after vaccination with a 4th dose of ChAdOx1-S (Oxford/AstraZeneca) and 3 months after a 5th dose of Comirnaty Bivalent Original/Omicron BA.4/BA.5 vaccine (Pfizer-BioNTech). The ChAdOx1-S vaccination-induced antibodies neutralized efficiently the ancestral D614G and BA.4/5 variants, but to a much lesser extent the XBB.1.5, XBB.1.16, and EG.5.1 variants. The results showed similar neutralization titers between XBB.1.16 and EG.5.1 and were lower compared to XBB.1.5. Sera from the same individuals boosted with the bivalent mRNA vaccine contained higher neutralizing antibody titers, providing a better cross-protection against Omicron XBB.1.5, XBB.1.16 and EG.5.1 variants. Previous history of infection during the epidemiological waves of BA.1/BA.2 and BA.4/BA.5, poorly enhanced neutralization activity of serum samples against XBBs and EG.5.1 variants. Our data highlight the continued immune evasion of recent Omicron subvariants and support the booster administration of BA.4/5 bivalent vaccine, as a continuous strategy of updating future vaccine booster doses to match newly emerged SARS-CoV-2 variants.
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Affiliation(s)
- Rafael Rahal Guaragna Machado
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, SP, Brazil
| | - Érika Donizetti Candido
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, SP, Brazil
| | - Andressa Simoes Aguiar
- Dom Pedro II Geriatric and Convalescent Hospital, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo 02265-002, SP, Brazil
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, SP, Brazil
| | - Vanessa Nascimento Chalup
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, SP, Brazil
| | - Patricia Romão Sanches
- Dom Pedro II Geriatric and Convalescent Hospital, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo 02265-002, SP, Brazil
| | - Erick Gustavo Dorlass
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, SP, Brazil
- Hospital Israelita Albert Einstein, São Paulo 05652-900, SP, Brazil
| | | | - João Renato Rebello Pinho
- Hospital Israelita Albert Einstein, São Paulo 05652-900, SP, Brazil
- Laboratório de Medicina Laboratorial (LIM03), Department of Pathology, School of Medicine, University of São Paulo, São Paulo 01246-903, SP, Brazil
- Laboratório de Gastroenterologia Clínica e Experimental (LIM07), Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo 01246-903, SP, Brazil
| | - Edison Luiz Durigon
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, SP, Brazil
- Scientific Platform Pasteur-USP, São Paulo 05508-020, SP, Brazil
| | - Danielle Bruna Leal Oliveira
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, SP, Brazil
- Hospital Israelita Albert Einstein, São Paulo 05652-900, SP, Brazil
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4
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Russo M, Mendes-Corrêa MC, Lins BB, Kersten V, Pernambuco Filho PCA, Martins TR, Tozetto-Mendoza TR, Vilas Boas LS, Gomes BM, Dati LMM, Duarte-Neto AN, Reigado GR, Frederico ABT, de Brito e Cunha DRDA, de Paula AV, da Silva JIG, Vasconcelos CFM, Chambergo FS, Nunes VA, Ano Bom APD, Castilho LR, Martins RAP, Hirata MH, Mirotti L. Intranasal Liposomal Formulation of Spike Protein Adjuvanted with CpG Protects and Boosts Heterologous Immunity of hACE2 Transgenic Mice to SARS-CoV-2 Infection. Vaccines (Basel) 2023; 11:1732. [PMID: 38006064 PMCID: PMC10675295 DOI: 10.3390/vaccines11111732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/05/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Mucosal vaccination appears to be suitable to protect against SARS-CoV-2 infection. In this study, we tested an intranasal mucosal vaccine candidate for COVID-19 that consisted of a cationic liposome containing a trimeric SARS-CoV-2 spike protein and CpG-ODNs, a Toll-like receptor 9 agonist, as an adjuvant. In vitro and in vivo experiments indicated the absence of toxicity following the intranasal administration of this vaccine formulation. First, we found that subcutaneous or intranasal vaccination protected hACE-2 transgenic mice from infection with the wild-type (Wuhan) SARS-CoV-2 strain, as shown by weight loss and mortality indicators. However, when compared with subcutaneous administration, the intranasal route was more effective in the pulmonary clearance of the virus and induced higher neutralizing antibodies and anti-S IgA titers. In addition, the intranasal vaccination afforded protection against gamma, delta, and omicron virus variants of concern. Furthermore, the intranasal vaccine formulation was superior to intramuscular vaccination with a recombinant, replication-deficient chimpanzee adenovirus vector encoding the SARS-CoV-2 spike glycoprotein (Oxford/AstraZeneca) in terms of virus lung clearance and production of neutralizing antibodies in serum and bronchial alveolar lavage (BAL). Finally, the intranasal liposomal formulation boosted heterologous immunity induced by previous intramuscular vaccination with the Oxford/AstraZeneca vaccine, which was more robust than homologous immunity.
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Affiliation(s)
- Momtchilo Russo
- Department of Immunology, Institute of Biomedical Science, University of São Paulo (ICB-USP), São Paulo 05508-000, Brazil
| | - Maria Cássia Mendes-Corrêa
- Laboratório de Virologia (LIM52), Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina da Universidade de São Paulo (FM-USP), São Paulo 05403-000, Brazil; (M.C.M.-C.); (T.R.M.)
| | - Bruna B. Lins
- Department of Immunology, Institute of Biomedical Science, University of São Paulo (ICB-USP), São Paulo 05508-000, Brazil
| | - Victor Kersten
- Department of Immunology, Institute of Biomedical Science, University of São Paulo (ICB-USP), São Paulo 05508-000, Brazil
| | - Paulo C. A. Pernambuco Filho
- Department of Immunology, Institute of Biomedical Science, University of São Paulo (ICB-USP), São Paulo 05508-000, Brazil
| | - Toni Ricardo Martins
- Laboratório de Virologia (LIM52), Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina da Universidade de São Paulo (FM-USP), São Paulo 05403-000, Brazil; (M.C.M.-C.); (T.R.M.)
- Faculdade de Ciências Farmacêuticas, Universidade Federal do Amazonas (UFAM), Manaus 69080-900, Brazil
| | - Tânia Regina Tozetto-Mendoza
- Laboratório de Virologia (LIM52), Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina da Universidade de São Paulo (FM-USP), São Paulo 05403-000, Brazil; (M.C.M.-C.); (T.R.M.)
| | - Lucy Santos Vilas Boas
- Laboratório de Virologia (LIM52), Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina da Universidade de São Paulo (FM-USP), São Paulo 05403-000, Brazil; (M.C.M.-C.); (T.R.M.)
| | - Brisa Moreira Gomes
- Department of Immunology, Institute of Biomedical Science, University of São Paulo (ICB-USP), São Paulo 05508-000, Brazil
| | - Livia Mendonça Munhoz Dati
- Departamento de Analises Clinicas e Toxicologicas, Faculdade de Ciências Farmacêuticas da Universidade de Sao Paulo (FCF-USP), São Paulo 05508-000, Brazil (M.H.H.)
| | - Amaro Nunes Duarte-Neto
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo (FM-USP), São Paulo 05403-000, Brazil
| | - Gustavo Roncoli Reigado
- Laboratório de Biotecnologia, Escola de Artes, Ciências e Humanidades, Universidade de São Paulo (EACH-USP), São Paulo 03828-000, Brazil (F.S.C.); (V.A.N.)
| | - Ana Beatriz T. Frederico
- Immunological Technology Laboratory, Institute of Immunobiological Technology (Bio-Manguinhos), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro 21040-900, Brazil (A.P.D.A.B.)
| | - Danielle R. de A. de Brito e Cunha
- Immunological Technology Laboratory, Institute of Immunobiological Technology (Bio-Manguinhos), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro 21040-900, Brazil (A.P.D.A.B.)
| | - Anderson Vicente de Paula
- Laboratório de Virologia (LIM52), Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina da Universidade de São Paulo (FM-USP), São Paulo 05403-000, Brazil; (M.C.M.-C.); (T.R.M.)
| | - José Igor G. da Silva
- Programa de Biologia Celular e do Desenvolvimento, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil (R.A.P.M.)
| | - Carlos F. Moreira Vasconcelos
- Programa de Biologia Celular e do Desenvolvimento, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil (R.A.P.M.)
| | - Felipe S. Chambergo
- Laboratório de Biotecnologia, Escola de Artes, Ciências e Humanidades, Universidade de São Paulo (EACH-USP), São Paulo 03828-000, Brazil (F.S.C.); (V.A.N.)
| | - Viviane Abreu Nunes
- Laboratório de Biotecnologia, Escola de Artes, Ciências e Humanidades, Universidade de São Paulo (EACH-USP), São Paulo 03828-000, Brazil (F.S.C.); (V.A.N.)
| | - Ana Paula Dinis Ano Bom
- Immunological Technology Laboratory, Institute of Immunobiological Technology (Bio-Manguinhos), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro 21040-900, Brazil (A.P.D.A.B.)
| | - Leda R. Castilho
- Cell Culture Engineering Laboratory, COPPE, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-598, Brazil;
| | - Rodrigo A. P. Martins
- Programa de Biologia Celular e do Desenvolvimento, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil (R.A.P.M.)
| | - Mario Hiroyuki Hirata
- Departamento de Analises Clinicas e Toxicologicas, Faculdade de Ciências Farmacêuticas da Universidade de Sao Paulo (FCF-USP), São Paulo 05508-000, Brazil (M.H.H.)
| | - Luciana Mirotti
- Institute of Science and Technology in Biomodels (ICTB), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro 21040-900, Brazil
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5
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Cioffi VB, de Castro-Amarante MF, Lulla A, Andreata-Santos R, Cruz MC, Moreno ACR, de Oliveira Silva M, de Miranda Peres B, de Freitas Junior LHG, Moraes CB, Durigon EL, Gordon NC, Hyvönen M, de Souza Ferreira LC, Balan A. SARS-CoV-2 Spike protein peptides displayed in the Pyrococcus furiosus RAD system preserve epitopes antigenicity, immunogenicity, and virus-neutralizing activity of antibodies. Sci Rep 2023; 13:16821. [PMID: 37798298 PMCID: PMC10556064 DOI: 10.1038/s41598-023-43720-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/27/2023] [Indexed: 10/07/2023] Open
Abstract
Amongst the potential contribution of protein or peptide-display systems to study epitopes with relevant immunological features, the RAD display system stands out as a highly stable scaffold protein that allows the presentation of constrained target peptides. Here, we employed the RAD display system to present peptides derived from the SARS-CoV-2 Spike (S) protein as a tool to detect specific serum antibodies and to generate polyclonal antibodies capable of inhibiting SARS-CoV-2 infectivity in vitro. 44 linear S-derived peptides were genetically fused with the RAD scaffold (RAD-SCoV-epitopes) and screened for antigenicity with sera collected from COVID-19-infected patients. In a second step, selected RAD-SCoV-epitopes were used to immunize mice and generate antibodies. Phenotypic screening showed that some of these antibodies were able to recognize replicating viral particles in VERO CCL-81 and most notably seven of the RAD-SCoV-epitopes were able to induce antibodies that inhibited viral infection. Our findings highlight the RAD display system as an useful platform for the immunological characterization of peptides and a potentially valuable strategy for the design of antigens for peptide-based vaccines, for epitope-specific antibody mapping, and for the development of antibodies for diagnostic and therapeutic purposes.
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Affiliation(s)
- Victor Bolsanelli Cioffi
- Laboratory of Applied Structural Biology, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 1374, São Paulo, 05508-000, Brazil
| | - Maria Fernanda de Castro-Amarante
- Laboratory of Vaccine Development, Department of Microbiology, University of São Paulo, Institute of Biomedical Sciences, Av. Prof. Lineu Prestes, 1374, São Paulo, 05508-000, Brazil
| | - Aleksei Lulla
- Department of Biochemistry, University of Cambridge, 80 Tennis Court Road, Cambridge, CB2 1GA, UK
| | - Robert Andreata-Santos
- Laboratory of Vaccine Development, Department of Microbiology, University of São Paulo, Institute of Biomedical Sciences, Av. Prof. Lineu Prestes, 1374, São Paulo, 05508-000, Brazil
| | - Mario Costa Cruz
- Core Facilities to Support Research (CEFAP), Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, São Paulo, 173005508-000, Brazil
| | - Ana Carolina Ramos Moreno
- Laboratory of Vaccine Development, Department of Microbiology, University of São Paulo, Institute of Biomedical Sciences, Av. Prof. Lineu Prestes, 1374, São Paulo, 05508-000, Brazil
- Vaccine Development Laboratory, Butantan Institute, Av. Vital Brasil, 1500, São Paulo, SP, 05503-900, Brazil
| | - Mariângela de Oliveira Silva
- Phenotypic Screening Platform, Department of Microbiology, University of São Paulo, Institute of Biomedical Sciences, Av. Prof. Lineu Prestes, 1374, São Paulo, 05508-000, Brazil
| | - Bianca de Miranda Peres
- Phenotypic Screening Platform, Department of Microbiology, University of São Paulo, Institute of Biomedical Sciences, Av. Prof. Lineu Prestes, 1374, São Paulo, 05508-000, Brazil
| | - Lucio Holanda Gondim de Freitas Junior
- Phenotypic Screening Platform, Department of Microbiology, University of São Paulo, Institute of Biomedical Sciences, Av. Prof. Lineu Prestes, 1374, São Paulo, 05508-000, Brazil
| | - Carolina Borsoi Moraes
- Phenotypic Screening Platform, Department of Microbiology, University of São Paulo, Institute of Biomedical Sciences, Av. Prof. Lineu Prestes, 1374, São Paulo, 05508-000, Brazil
| | - Edison Luiz Durigon
- Laboratory of Clinical and Molecular Virology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 1374, São Paulo, 05508-000, Brazil
- Institut Pasteur de São Paulo, Av. Prof. Lucio Martins Rodrigues, 370, São Paulo, 05508-020, Brazil
| | - Nicola Coker Gordon
- Department of Biochemistry, University of Cambridge, 80 Tennis Court Road, Cambridge, CB2 1GA, UK
| | - Marko Hyvönen
- Department of Biochemistry, University of Cambridge, 80 Tennis Court Road, Cambridge, CB2 1GA, UK
| | - Luís Carlos de Souza Ferreira
- Laboratory of Vaccine Development, Department of Microbiology, University of São Paulo, Institute of Biomedical Sciences, Av. Prof. Lineu Prestes, 1374, São Paulo, 05508-000, Brazil
- Institut Pasteur de São Paulo, Av. Prof. Lucio Martins Rodrigues, 370, São Paulo, 05508-020, Brazil
| | - Andrea Balan
- Laboratory of Applied Structural Biology, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 1374, São Paulo, 05508-000, Brazil.
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6
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de Lima TM, Martins RB, Miura CS, Souza MVO, Cassiano MHA, Rodrigues TS, Veras FP, Sousa JDF, Gomes R, de Almeida GM, Melo SR, da Silva GC, Dias M, Capato CF, Silva ML, Luiz VEDDB, Carenzi LR, Zamboni DS, Jorge DMDM, Cunha FDQ, Tamashiro E, Anselmo-Lima WT, Valera FCP, Arruda E. Tonsils are major sites of persistence of SARS-CoV-2 in children. Microbiol Spectr 2023; 11:e0134723. [PMID: 37737615 PMCID: PMC10581087 DOI: 10.1128/spectrum.01347-23] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 08/01/2023] [Indexed: 09/23/2023] Open
Abstract
In the present study, we show that SARS-CoV-2 can infect palatine tonsils, adenoids, and secretions in children without symptoms of COVID-19, with no history of recent upper airway infection. We studied 48 children undergoing tonsillectomy due to snoring/OSA or recurrent tonsillitis between October 2020 and September 2021. Nasal cytobrushes, nasal washes, and tonsillar tissue fragments obtained at surgery were tested by RT-qPCR, immunohistochemistry (IHC), flow cytometry, and neutralization assay. We detected the presence of SARS-CoV-2 in at least one specimen tested in 27% of patients. IHC revealed the presence of the viral nucleoprotein in epithelial surface and in lymphoid cells in both extrafollicular and follicular regions, in adenoids and palatine tonsils. Also, IHC for the SARS-CoV-2 non-structural protein NSP-16 indicated the presence of viral replication in 53.8% of the SARS-CoV-2-infected tissues. Flow cytometry showed that CD20+ B lymphocytes were the most infected phenotypes, followed by CD4+ lymphocytes and CD123 dendritic cells, CD8+ T lymphocytes, and CD14+ macrophages. Additionally, IF indicated that infected tonsillar tissues had increased expression of ACE2 and TMPRSS2. NGS sequencing demonstrated the presence of different SARS-CoV-2 variants in tonsils from different tissues. SARS-CoV-2 antigen detection was not restricted to tonsils but was also detected in nasal cells from the olfactory region. Palatine tonsils and adenoids are sites of prolonged RNA presence by SARS-CoV-2 in children, even without COVID-19 symptoms. IMPORTANCE This study shows that SRS-CoV-2 of different lineages can infect tonsils and adenoids in one quarter of children undergoing tonsillectomy. These findings bring advancement to the area of SARS-CoV-2 pathogenesis, by showing that tonsils may be sites of prolonged infection, even without evidence of recent COVID-19 symptoms. SARS-CoV-2 infection of B and T lymphocytes, macrophages, and dendritic cells may interfere with the mounting of immune responses in these secondary lymphoid organs. Moreover, the shedding of SARS-CoV-2 RNA in respiratory secretions from silently infected children raises concern about possible diagnostic confusion in the presence of symptoms of acute respiratory infections caused by other etiologies.
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Affiliation(s)
- Thais Melquiades de Lima
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Ronaldo Bragança Martins
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
- Department of Clinical, Toxicological and Bromatological Analysis, University of São Paulo School of Pharmaceutical Sciences, Ribeirão Preto, São Paulo, Brazil
| | - Carolina Sponchiado Miura
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Maria Vitória Oliveira Souza
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Murilo Henrique Anzolini Cassiano
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Tamara Silva Rodrigues
- Department of Biochemistry and Immunology, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Flávio Protásio Veras
- Department of BioMolecular Sciences, University of São Paulo School of Pharmaceutical Sciences, Ribeirão Preto, São Paulo, Brazil
| | - Josane de Freitas Sousa
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Rogério Gomes
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Glaucia Maria de Almeida
- Department of Biochemistry and Immunology, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Stella Rezende Melo
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Gabriela Condé da Silva
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Matheus Dias
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Carlos Fabiano Capato
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Maria Lúcia Silva
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Veridiana Ester Dias de Barros Luiz
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Lucas Rodrigues Carenzi
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Dario Simões Zamboni
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
- Department of Biochemistry and Immunology, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Daniel Macedo de Melo Jorge
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Fernando de Queiroz Cunha
- Department of Pharmacology, University of Sao Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Edwin Tamashiro
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Wilma Terezinha Anselmo-Lima
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Fabiana Cardoso Pereira Valera
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Eurico Arruda
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
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7
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Dermatological Manifestations in COVID-19: A Case Study of SARS-CoV-2 Infection in a Genetic Thrombophilic Patient with Mthfr Mutation. Pathogens 2023; 12:pathogens12030438. [PMID: 36986360 PMCID: PMC10058784 DOI: 10.3390/pathogens12030438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/23/2022] [Accepted: 01/18/2023] [Indexed: 03/16/2023] Open
Abstract
The present case study describes the dermatological manifestations of COVID-19 in a patient with genetic thrombophilia (MTHFR–C677T mutation) and the identification of a SARS-CoV-2 variant of interest (VOI). A female patient, 47 years old, unvaccinated, with thrombophilia, was diagnosed with COVID-19. She presented with urticarial and maculopapular eruptions from the seventh day of symptoms, which progressed to multiple lesions with dark centers (D-dimer value > 1450 ng/mL). The dermatological manifestations disappeared after 30 days, corroborating the reduction in D-dimer levels. Viral genome sequencing revealed infection by the VOI Zeta (P.2). Antibody testing, performed 30 days after the onset of symptoms, detected only IgG. The virus neutralization test showed the highest neutralizing titer for a P.2 strain, validating the genotypic identification. Lesions were suggested to be due to infection in skin cells causing a direct cytopathic effect or release of pro-inflammatory cytokines triggering erythematous and urticarial eruptions. In addition, vascular complications are also proposed to be due to the MTHFR mutation and increased D-dimer values. This case report is an alert about COVID-19 in patients with pre-existing vascular diseases, especially in unvaccinated patients, by VOI.
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8
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Farias JP, Pinheiro JR, Andreata-Santos R, Fogaça MMC, da Silva Brito RD, da Cruz EF, de Castro-Amarante MF, Pereira SS, Dos Santos Almeida S, Moreira LM, da Conceição Simões R, Luiz WB, Birbrair A, Belmok A, Ribeiro BM, Maricato JT, Braconi CT, de Souza Ferreira LC, Janini LMR, Amorim JH. The third vaccine dose significantly reduces susceptibility to the B.1.1.529 (Omicron) SARS-CoV-2 variant. J Med Virol 2023; 95:e28481. [PMID: 36609686 DOI: 10.1002/jmv.28481] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/15/2022] [Accepted: 12/30/2022] [Indexed: 01/09/2023]
Abstract
The main coronavirus disease 2019 (COVID-19) vaccine formulations used today are mainly based on the wild-type severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike glycoprotein as an antigen. However, new virus variants capable of escaping neutralization activity of serum antibodies elicited in vaccinated individuals have emerged. The Omicron (B.1.1.529) variant caused epidemics in regions of the world in which most of the population has been vaccinated. In this study, we aimed to understand what determines individual's susceptibility to Omicron in a scenario of extensive vaccination. For that purpose, we collected nasopharynx swab (n = 286) and blood samples (n = 239) from flu-like symptomatic patients, as well as their vaccination history against COVID-19. We computed the data regarding vaccine history, COVID-19 diagnosis, COVID-19 serology, and viral genome sequencing to evaluate their impact on the number of infections. As main results, we showed that vaccination in general did not reduce the number of individuals infected by Omicron, even with an increased immune response found among vaccinated, noninfected individuals. Nonetheless, we found that individuals who received the third vaccine dose showed significantly reduced susceptibility to Omicron infections. A relevant evidence that support this finding was the higher virus neutralization capacity of serum samples of most patients who received the third vaccine dose. In summary, this study shows that boosting immune responses after a third vaccine dose reduces susceptibility to COVID-19 caused by the Omicron variant. Results presented in this study are useful for future formulations of COVID-19 vaccination policies.
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Affiliation(s)
- Jéssica P Farias
- Center of Biological Sciences and Health, Federal University of Western Bahia, Barreiras, Brazil
| | - Josilene R Pinheiro
- Center of Biological Sciences and Health, Federal University of Western Bahia, Barreiras, Brazil.,Department of Biological Sciences, State University of Santa Cruz, Ilhéus, Brazil
| | - Robert Andreata-Santos
- Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Mayanna M C Fogaça
- Center of Biological Sciences and Health, Federal University of Western Bahia, Barreiras, Brazil
| | - Ruth D da Silva Brito
- Center of Biological Sciences and Health, Federal University of Western Bahia, Barreiras, Brazil
| | - Edgar F da Cruz
- Division of Infectology, Medicine Department, Federal University of São Paulo, São Paulo, Brazil
| | - Maria F de Castro-Amarante
- Vaccine Development Laboratory, Microbiology Department, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil.,Scientific Platform Pasteur USP, University of São Paulo, São Paulo, SP, Brazil
| | - Samuel S Pereira
- Vaccine Development Laboratory, Microbiology Department, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil
| | - Shirley Dos Santos Almeida
- Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Ludimila M Moreira
- Center of Biological Sciences and Health, Federal University of Western Bahia, Barreiras, Brazil
| | | | - Wilson B Luiz
- Department of Biological Sciences, State University of Santa Cruz, Ilhéus, Brazil
| | - Alexander Birbrair
- Department of Dermatology, School of Medicine and Public Health, University of Wisconsin-Madison, Wisconsin, Madison, USA.,Department of Pathology, Federal University of Minas Gerais, Belo Horizonte, Brazil.,Department of Radiology, Columbia University Medical Center, New York, New York, USA
| | - Aline Belmok
- Laboratory of Baculoviruses, Cell Biology Department, University of Brasilia, Brasília, Brazil
| | - Bergmann M Ribeiro
- Laboratory of Baculoviruses, Cell Biology Department, University of Brasilia, Brasília, Brazil
| | - Juliana T Maricato
- Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Carla T Braconi
- Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Luís C de Souza Ferreira
- Vaccine Development Laboratory, Microbiology Department, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil.,Scientific Platform Pasteur USP, University of São Paulo, São Paulo, SP, Brazil
| | - Luiz M R Janini
- Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Division of Infectology, Medicine Department, Federal University of São Paulo, São Paulo, Brazil
| | - Jaime Henrique Amorim
- Center of Biological Sciences and Health, Federal University of Western Bahia, Barreiras, Brazil.,Department of Biological Sciences, State University of Santa Cruz, Ilhéus, Brazil
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9
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Oliveira JR, Ruiz CMR, Machado RRG, Magawa JY, Daher IP, Urbanski AH, Schmitz GJH, Arcuri HA, Ferreira MA, Sasahara GL, de Medeiros GX, Júnior RCVS, Durigon EL, Boscardin SB, Rosa DS, Schechtman D, Nakaya HI, Cunha-Neto E, Gadermaier G, Kalil J, Coelho V, Santos KS. Immunodominant antibody responses directed to SARS-CoV-2 hotspot mutation sites and risk of immune escape. Front Immunol 2023; 13:1010105. [PMID: 36685521 PMCID: PMC9849925 DOI: 10.3389/fimmu.2022.1010105] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 12/13/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Considering the likely need for the development of novel effective vaccines adapted to emerging relevant CoV-2 variants, the increasing knowledge of epitope recognition profile among convalescents and afterwards vaccinated with identification of immunodominant regions may provide important information. Methods We used an RBD peptide microarray to identify IgG and IgA binding regions in serum of 71 COVID-19 convalescents and 18 vaccinated individuals. Results We found a set of immunodominant RBD antibody epitopes, each recognized by more than 30% of the tested cohort, that differ among the two different groups and are within conserved regions among betacoronavirus. Of those, only one peptide, P44 (S415-429), recognized by 68% of convalescents, presented IgG and IgA antibody reactivity that positively correlated with nAb titers, suggesting that this is a relevant RBD region and a potential target of IgG/IgA neutralizing activity. Discussion This peptide is localized within the area of contact with ACE-2 and harbors the mutation hotspot site K417 present in gamma (K417T), beta (K417N), and omicron (K417N) variants of concern. The epitope profile of vaccinated individuals differed from convalescents, with a more diverse repertoire of immunodominant peptides, recognized by more than 30% of the cohort. Noteworthy, immunodominant regions of recognition by vaccinated coincide with mutation sites at Omicron BA.1, an important variant emerging after massive vaccination. Together, our data show that immune pressure induced by dominant antibody responses may favor hotspot mutation sites and the selection of variants capable of evading humoral response.
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Affiliation(s)
- Jamille Ramos Oliveira
- Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
- Laboratório de Imunologia, LIM19, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP) São Paulo da Universidade de São Paulo, São Paulo, Brazil
- Instituto de Investigação em Imunologia–Instituto Nacional de Ciências e Tecnologia – instituto de investigação em imunologia - Instituto Nacional de Ciências e Tecnologia (iii-INCT), São Paulo, Brazil
| | - Cesar Manuel Remuzgo Ruiz
- Laboratório de Imunologia, LIM19, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP) São Paulo da Universidade de São Paulo, São Paulo, Brazil
| | | | - Jhosiene Yukari Magawa
- Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
- Laboratório de Imunologia, LIM19, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP) São Paulo da Universidade de São Paulo, São Paulo, Brazil
- Instituto de Investigação em Imunologia–Instituto Nacional de Ciências e Tecnologia – instituto de investigação em imunologia - Instituto Nacional de Ciências e Tecnologia (iii-INCT), São Paulo, Brazil
| | - Isabela Pazotti Daher
- Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
- Laboratório de Imunologia, LIM19, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP) São Paulo da Universidade de São Paulo, São Paulo, Brazil
- Instituto de Investigação em Imunologia–Instituto Nacional de Ciências e Tecnologia – instituto de investigação em imunologia - Instituto Nacional de Ciências e Tecnologia (iii-INCT), São Paulo, Brazil
| | - Alysson Henrique Urbanski
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Gabriela Justamante Händel Schmitz
- Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
- Laboratório de Imunologia, LIM19, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP) São Paulo da Universidade de São Paulo, São Paulo, Brazil
| | - Helen Andrade Arcuri
- Centro de Estudos de Insetos Sociais, Departamento de Biologia, Instituto de Biociências de Rio Claro, Universidade Estadual Paulista, Rio Claro, SP, Brazil
| | - Marcelo Alves Ferreira
- Laboratório de Biologia Celular, Laboratório de Investigação Médica 59 (LIM59), Departamento de Patologia, Faculdade de Medicina Faculdade de Medicina da Universidade de São Paulo (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Greyce Luri Sasahara
- Laboratório de Imunologia, LIM19, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP) São Paulo da Universidade de São Paulo, São Paulo, Brazil
| | - Giuliana Xavier de Medeiros
- Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Roberto Carlos Vieira Silva Júnior
- Laboratório de Imunologia, LIM19, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP) São Paulo da Universidade de São Paulo, São Paulo, Brazil
| | - Edison Luiz Durigon
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, SP, Brazil
- Plataforma Científica Pasteur-USP, São Paulo, SP, Brazil
| | - Silvia Beatriz Boscardin
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Daniela Santoro Rosa
- Laboratório de Imunologia, LIM19, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP) São Paulo da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo (UNIFESP/EPM, São Paulo, SP, Brazil
| | - Deborah Schechtman
- Departamento de Bioquímica, instituto de Química, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Helder I. Nakaya
- Plataforma Científica Pasteur-USP, São Paulo, SP, Brazil
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Edecio Cunha-Neto
- Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
- Laboratório de Imunologia, LIM19, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP) São Paulo da Universidade de São Paulo, São Paulo, Brazil
- Instituto de Investigação em Imunologia–Instituto Nacional de Ciências e Tecnologia – instituto de investigação em imunologia - Instituto Nacional de Ciências e Tecnologia (iii-INCT), São Paulo, Brazil
| | - Gabriele Gadermaier
- Department of Biosciences and Medical Biology, Paris Lodron University Salzburg, Salzburg, Brazil
| | - Jorge Kalil
- Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
- Laboratório de Imunologia, LIM19, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP) São Paulo da Universidade de São Paulo, São Paulo, Brazil
- Instituto de Investigação em Imunologia–Instituto Nacional de Ciências e Tecnologia – instituto de investigação em imunologia - Instituto Nacional de Ciências e Tecnologia (iii-INCT), São Paulo, Brazil
| | - Verônica Coelho
- Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
- Laboratório de Imunologia, LIM19, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP) São Paulo da Universidade de São Paulo, São Paulo, Brazil
- Instituto de Investigação em Imunologia–Instituto Nacional de Ciências e Tecnologia – instituto de investigação em imunologia - Instituto Nacional de Ciências e Tecnologia (iii-INCT), São Paulo, Brazil
| | - Keity Souza Santos
- Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
- Laboratório de Imunologia, LIM19, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP) São Paulo da Universidade de São Paulo, São Paulo, Brazil
- Instituto de Investigação em Imunologia–Instituto Nacional de Ciências e Tecnologia – instituto de investigação em imunologia - Instituto Nacional de Ciências e Tecnologia (iii-INCT), São Paulo, Brazil
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10
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Holtkamp C, Schöler L, Anastasiou OE, Brune B, Fessmann K, Elsner C, Möhlendick B, Čiučiulkaitė I, Dudda M, Trilling M, Dittmer U, Spors J, Le-Trilling VTK. Antibody responses elicited by mRNA vaccination in firefighters persist six months and correlate inversely with age and directly with BMI. Heliyon 2023; 9:e12746. [PMID: 36597483 PMCID: PMC9801692 DOI: 10.1016/j.heliyon.2022.e12746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 08/18/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Abstract
Knowledge regarding the sustainability of immune responses after COVID-19 vaccination is important, e.g., to decide whom and when to booster. Thus, we analyzed antibody titers in firefighters six months after vaccination with the mRNA-based vaccine Comirnaty. SARS-CoV-2 spike-binding antibodies (bAb) were quantified and compared to peak responses determined in healthcare workers (HCW). For the firefighters, neutralizing antibodies (nAb) were also analyzed. Six months after the second vaccine dose, all analyzed firefighters had detectable bAb, and 91% exhibited nAb titers above 1:16. However, actual titers six months after vaccination were over 12-fold lower than in the HCW control group four weeks after vaccination. bAb and nAb responses showed a significant correlation, and age correlated inversely with antibody responses. Unexpectedly, participants with a body mass index over 25 had higher neutralization titers after six months. All participants with very low neutralization titers were offered booster vaccination. The booster vaccination improved the extent and sustainability of antibody responses.
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Affiliation(s)
- Caroline Holtkamp
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lara Schöler
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Olympia E. Anastasiou
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Bastian Brune
- Emergency Medical Services, Fire Brigade Essen, Essen, Germany,Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Kai Fessmann
- Emergency Medical Services, Fire Brigade Essen, Essen, Germany,Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Carina Elsner
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Birte Möhlendick
- Institute of Pharmacogenetics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ieva Čiučiulkaitė
- Institute of Pharmacogenetics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Marcel Dudda
- Emergency Medical Services, Fire Brigade Essen, Essen, Germany,Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Mirko Trilling
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ulf Dittmer
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jörg Spors
- Emergency Medical Services, Fire Brigade Essen, Essen, Germany
| | - Vu Thuy Khanh Le-Trilling
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany,Corresponding author. University Hospital Essen, University of Duisburg-Essen, Institute for Virology, Virchowstr. 179, 45147 Essen, Germany
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11
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Elkhatib WF, Abdelkareem SS, Khalaf WS, Shahin MI, Elfadil D, Alhazmi A, El-Batal AI, El-Sayyad GS. Narrative review on century of respiratory pandemics from Spanish flu to COVID-19 and impact of nanotechnology on COVID-19 diagnosis and immune system boosting. Virol J 2022; 19:167. [PMID: 36280866 PMCID: PMC9589879 DOI: 10.1186/s12985-022-01902-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 09/26/2022] [Indexed: 12/15/2022] Open
Abstract
The rise of the highly lethal severe acute respiratory syndrome-2 (SARS-2) as corona virus 2019 (COVID-19) reminded us of the history of other pandemics that happened in the last century (Spanish flu) and stayed in the current century, which include Severe-Acute-Respiratory-Syndrome (SARS), Middle-East-Respiratory-Syndrome (MERS), Corona Virus 2019 (COVID-19). We review in this report the newest findings and data on the origin of pandemic respiratory viral diseases, reservoirs, and transmission modes. We analyzed viral adaption needed for host switch and determinants of pathogenicity, causative factors of pandemic viruses, and symptoms and clinical manifestations. After that, we concluded the host factors associated with pandemics morbidity and mortality (immune responses and immunopathology, ages, and effect of pandemics on pregnancy). Additionally, we focused on the burdens of COVID-19, non-pharmaceutical interventions (quarantine, mass gatherings, facemasks, and hygiene), and medical interventions (antiviral therapies and vaccines). Finally, we investigated the nanotechnology between COVID-19 analysis and immune system boosting (Nanoparticles (NPs), antimicrobial NPs as antivirals and immune cytokines). This review presents insights about using nanomaterials to treat COVID-19, improve the bioavailability of the abused drugs, diminish their toxicity, and improve their performance.
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Affiliation(s)
- Walid F Elkhatib
- Microbiology and Immunology Department, Faculty of Pharmacy, Ain Shams University, African Union Organization St., Abbassia, Cairo, 11566, Egypt.
- Department of Microbiology and Immunology, Faculty of Pharmacy, Galala University, New Galala City, Suez, Egypt.
| | - Shereen S Abdelkareem
- Department of Alumni, School of Pharmacy and Pharmaceutical Industries, Badr University in Cairo (BUC), Entertainment Area, Badr City, Cairo, Egypt
| | - Wafaa S Khalaf
- Department of Microbiology and Immunology, Faculty of Pharmacy (Girls), Al-Azhar University, Nasr City, Cairo, 11751, Egypt
| | - Mona I Shahin
- Zoology Department, Faculty of Tymaa, Tabuk University, Tymaa, 71491, Kingdom of Saudi Arabia
| | - Dounia Elfadil
- Biology and Chemistry Department, Hassan II University of Casablanca, Casablanca, Morocco
| | - Alaa Alhazmi
- Medical Laboratory Technology Department, Jazan University, Jazan, Saudi Arabia
- SMIRES for Consultation in Specialized Medical Laboratories, Jazan University, Jazan, Saudi Arabia
| | - Ahmed I El-Batal
- Drug Microbiology Laboratory, Drug Radiation Research Department, National Center for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority (EAEA), Cairo, Egypt
| | - Gharieb S El-Sayyad
- Department of Microbiology and Immunology, Faculty of Pharmacy, Galala University, New Galala City, Suez, Egypt.
- Drug Microbiology Laboratory, Drug Radiation Research Department, National Center for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority (EAEA), Cairo, Egypt.
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12
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Rodrigues-Jesus MJ, Teixeira de Pinho Favaro M, Venceslau-Carvalho AA, de Castro-Amarante MF, da Silva Almeida B, de Oliveira Silva M, Andreata-Santos R, Gomes Barbosa C, Brito SCM, Freitas-Junior LH, Boscardin SB, de Souza Ferreira LC. Nano-multilamellar lipid vesicles promote the induction of SARS-CoV-2 immune responses by a protein-based vaccine formulation. NANOMEDICINE: NANOTECHNOLOGY, BIOLOGY AND MEDICINE 2022; 45:102595. [PMID: 36031045 PMCID: PMC9420030 DOI: 10.1016/j.nano.2022.102595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/25/2022] [Accepted: 08/08/2022] [Indexed: 11/15/2022]
Abstract
The development of safe and effective vaccine formulations against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents a hallmark in the history of vaccines. Here we report a COVID-19 subunit vaccine based on a SARS-CoV-2 Spike protein receptor binding domain (RBD) incorporated into nano-multilamellar vesicles (NMV) associated with monophosphoryl lipid A (MPLA). The results based on immunization of C57BL/6 mice demonstrated that recombinant antigen incorporation into NMVs improved antibody and T-cell responses without inducing toxic effects under both in vitro and in vivo conditions. Administration of RBD-NMV-MPLA formulations modulated antigen avidity and IgG subclass responses, whereas MPLA incorporation improved the activation of CD4+/CD8+ T-cell responses. In addition, immunization with the complete vaccine formulation reduced the number of doses required to achieve enhanced serum virus-neutralizing antibody titers. Overall, this study highlights NMV/MPLA technology, displaying the performance improvement of subunit vaccines against SARS-CoV-2, as well as other infectious diseases.
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Affiliation(s)
- Monica Josiane Rodrigues-Jesus
- Laboratory of Vaccine Development, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil; Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Marianna Teixeira de Pinho Favaro
- Laboratory of Vaccine Development, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil; Scientific Platform Pasteur/USP, University of São Paulo, São Paulo, Brazil
| | - Aléxia Adrianne Venceslau-Carvalho
- Laboratory of Vaccine Development, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil; Scientific Platform Pasteur/USP, University of São Paulo, São Paulo, Brazil
| | - Maria Fernanda de Castro-Amarante
- Laboratory of Vaccine Development, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil; Scientific Platform Pasteur/USP, University of São Paulo, São Paulo, Brazil
| | - Bianca da Silva Almeida
- Laboratory of Antigen Targeting for Dendritic Cells, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Mariângela de Oliveira Silva
- Laboratory of Vaccine Development, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil; Scientific Platform Pasteur/USP, University of São Paulo, São Paulo, Brazil; Laboratory of Antigen Targeting for Dendritic Cells, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Robert Andreata-Santos
- Retrovirology Laboratory, Immunology and Microbiology Department, Federal University of São Paulo, São Paulo, Brazil
| | - Cecilia Gomes Barbosa
- Phenotypic Screening Platform of the Institute of Biomedical Sciences of the University of São Paulo, São Paulo, Brazil
| | - Samantha Carvalho Maia Brito
- Laboratory of Vaccine Development, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Lucio H Freitas-Junior
- Phenotypic Screening Platform of the Institute of Biomedical Sciences of the University of São Paulo, São Paulo, Brazil
| | - Silvia Beatriz Boscardin
- Laboratory of Antigen Targeting for Dendritic Cells, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Luís Carlos de Souza Ferreira
- Laboratory of Vaccine Development, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil; Scientific Platform Pasteur/USP, University of São Paulo, São Paulo, Brazil.
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13
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Madureira R, Ferreira SA, Marion MAL, Bettoni F, Ganem F, Camargo AA, Morinaga CV. Seroprevalence of SARS-CoV-2 in Emergency Department Healthcare Workers at Sírio-Libanês Hospital, Brazil. Health Secur 2022; 20:359-367. [PMID: 35960271 DOI: 10.1089/hs.2022.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
COVID-19 has spread rapidly worldwide. Information on its prevalence and factors associated with infection are important for protecting both professionals and patients in healthcare centers. This study evaluated the seroprevalence of antibodies against SARS-CoV-2 and its association with the degree of exposure and use of personal protective equipment by healthcare professionals dedicated to the treatment of patients with flu-like illnesses in the emergency room. The research team included an analysis of healthcare professionals who underwent enzyme-linked immunosorbent assay serological testing for SARS-CoV-2 between May 28 and June 26, 2020, in the emergency room of Sírio-Libanês Hospital in São Paulo, Brazil. Participants answered individual questionnaires on occupational information, medical health history, and factors associated with exposure to the novel coronavirus. The questionnaire variables were compared based on the serological results. Of the 164 study participants, 96 (58.54%) reported at least 1 flu-like symptom and 42 (25.61%) presented serology results that were compatible with SARS-CoV-2 infection. The asymptomatic declared group accounted for 62 participants; of these, 8 (12.90%) had positive serology results (neutralizing antibody and IgG) for SARS-CoV-2. Data analysis showed a positive correlation with duration of work, safety in wearing and reusing personal protective equipment, and presence of anosmia, and showed a negative relationship with duration of mask use. Our findings suggest that the perception of symptoms by healthcare professionals is not a good screening parameter for the diagnosis of an infectious disease with respiratory symptoms, such as COVID-19. The main influencing factor for the control of infection is the elaboration of workflows and safety protocols based on simple and clear rules as well as investments in team training.
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Affiliation(s)
- Ricardo Madureira
- Ricardo Madureira, MD, is a Physician, Emergency Department, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Silvia Aparecida Ferreira
- Silvia Aparecida Ferreira, BSN, is a Nurse Care Coordinator, Emergency Department, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Magali Aldrin Lopes Marion
- Magali Aldrin Lopes Marion, BSN, is Nurse Manager, Emergency Department, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Fabiana Bettoni
- Fabiana Bettoni, PhD, is a Researcher, Molecular Oncology Center, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Fernando Ganem
- Fernando Ganem, MD, PhD, is Hospital Director, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Anamaria Aranha Camargo
- Anamaria Aranha Camargo, PhD, is Research Manager, Molecular Oncology Center, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Christian Valle Morinaga
- Christian Valle Morinaga, MD, PhD, is Physician Practice Manager, Emergency Department, Hospital Sírio-Libanês, São Paulo, Brazil
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14
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Benites BD, Costa-Lima C, Pinto FBR, da Costa VA, Duarte ADSS, Zangirolami AB, Amaro EC, Granja F, Proenca-Modena JL, Saad STO, Addas-Carvalho M. Selection of plasma donors for the production of anti-SARS-CoV-2 immunoglobulin-based therapies: Strategies for quantitative antibody measurements. Transfus Apher Sci 2022; 61:103513. [PMID: 35871137 PMCID: PMC9293395 DOI: 10.1016/j.transci.2022.103513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/02/2022] [Accepted: 07/16/2022] [Indexed: 01/04/2023]
Abstract
Even after two years of the pandemic, a completely effective treatment against SARS-CoV-2 has not yet been established. Considering this fact and the emergence of successive new viral variants, the development of therapies based on natural polyclonal antibodies recovered from convalescent plasma remains relevant. This study presents a comparison between different methods of screening antibodies in samples of 41 individuals previously diagnosed with COVID-19. We found a significant correlation between Abbot Architect anti-SARS-CoV-2 IgG and Abbott Allinity SARS-CoV-2 IgG II Quantitative assay intensity of reactivity and neutralizing antibody (nAb) titers. Thus, we propose an initial antibody screening with IgG anti-N Abbott Architect test, with an index of, for example, > 3.25 or SARS-CoV-2 IgG II Quantitative Abbott Allinity assay > 137.65 AU/mL as good predictors of Nab ≥ 1:80. For the quantitative method, this threshold demonstrated a 100 % sensitivity and 80 % specificity, with 97.3 % accuracy. An interesting observation was the increase in the neutralizing activity of the anti-SARS-CoV-2 antibodies with the longest interval between the end of the symptoms and the collection, demonstrating that the delay in plasma collection does not affect the achievement of adequate nAbs levels. These results demonstrate the possibility of using faster and more widely available commercial serological tests with a good correlation with viral neutralization tests in culture, allowing for optimized large-scale donor selection, which will be of utmost importance for the development of therapies such as hyperimmune immunoglobulin.
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Affiliation(s)
| | | | | | | | | | | | | | - Fabiana Granja
- Laboratory of Emerging Viruses (LEVE), Department of Genetics, Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas, Brazil; Biodiversity Research Centre, Federal University of Roraima, Boa Vista, Brazil
| | - José Luiz Proenca-Modena
- Laboratory of Emerging Viruses (LEVE), Department of Genetics, Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas, Brazil
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15
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Andreata-Santos R, Machado RRG, Alves RPDS, Sales NS, Soares CP, Rodrigues KB, Silva MO, Favaro MTDP, Rodrigues-Jesus MJ, Yamamoto MM, de Andrade JB, Fock RA, Margarido PFR, Carvalho CRG, Boscardin SB, Durigon EL, Ferreira LCS. Validation of Serological Methods for COVID-19 and Retrospective Screening of Health Employees and Visitors to the São Paulo University Hospital, Brazil. Front Cell Infect Microbiol 2022; 12:787411. [PMID: 35719329 PMCID: PMC9202673 DOI: 10.3389/fcimb.2022.787411] [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: 09/30/2021] [Accepted: 05/02/2022] [Indexed: 01/08/2023] Open
Abstract
Reliable serological tests for the detection of SARS-CoV-2 antibodies among infected or vaccinated individuals are important for epidemiological and clinical studies. Low-cost approaches easily adaptable to high throughput screenings, such as Enzyme-Linked Immunosorbent Assays (ELISA) or electrochemiluminescence immunoassay (ECLIA), can be readily validated using different SARS-CoV-2 antigens. A total of 1,119 serum samples collected between March and July of 2020 from health employees and visitors to the University Hospital at the University of São Paulo were screened with the Elecsys® Anti-SARS-CoV-2 immunoassay (Elecsys) (Roche Diagnostics) and three in-house ELISAs that are based on different antigens: the Nucleoprotein (N-ELISA), the Receptor Binding Domain (RBD-ELISA), and a portion of the S1 protein (ΔS1-ELISA). Virus neutralization test (CPE-VNT) was used as the gold standard to validate the serological assays. We observed high sensitivity and specificity values with the Elecsys (96.92% and 98.78%, respectively) and N-ELISA (93.94% and 94.40%, respectively), compared with RBD-ELISA (90.91% sensitivity and 88.80% specificity) and the ΔS1-ELISA (77.27% sensitivity and 76% specificity). The Elecsys® proved to be a reliable SARS-CoV-2 serological test. Similarly, the recombinant SARS-CoV-2 N protein displayed good performance in the ELISA tests. The availability of reliable diagnostic tests is critical for the precise determination of infection rates, particularly in countries with high SARS-CoV-2 infection rates, such as Brazil. Collectively, our results indicate that the development and validation of new serological tests based on recombinant proteins may provide new alternatives for the SARS-CoV-2 diagnostic market.
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Affiliation(s)
- Robert Andreata-Santos
- Vaccine Development Laboratory, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil
- Retrovirology Laboratory, Immunology and Microbiology Department, Federal University of São Paulo, São Paulo, Brazil
| | - Rafael Rahal Guaragna Machado
- Clinical and Molecular Virology Laboratory, Microbiology Department, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | | | - Natiely Silva Sales
- Vaccine Development Laboratory, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil
| | - Camila Pereira Soares
- Clinical and Molecular Virology Laboratory, Microbiology Department, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | | | - Mariângela Oliveira Silva
- Vaccine Development Laboratory, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil
| | | | | | - Márcio Massao Yamamoto
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Juliana Bannwart de Andrade
- School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
- Clinical Laboratory Division, Pharmacy and Clinical Laboratory Department, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Ricardo Ambrósio Fock
- School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
- Clinical Laboratory Division, Pharmacy and Clinical Laboratory Department, University Hospital, University of São Paulo, São Paulo, Brazil
| | | | - Cristiane Rodrigues Guzzo Carvalho
- Molecular and Structural Biology, Secretion Systems and c-di-GMP Signalling Laboratory, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Silvia Beatriz Boscardin
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Edison Luiz Durigon
- Clinical and Molecular Virology Laboratory, Microbiology Department, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Luís C. S. Ferreira
- Vaccine Development Laboratory, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil
- Scientific Platform Pasteur/USP, University of São Paulo, São Paulo, Brazil
- *Correspondence: Luís C. S. Ferreira,
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16
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Burnouf T, Gathof B, Bloch EM, Bazin R, de Angelis V, Patidar GK, Rastvorceva RMG, Oreh A, Goel R, Rahimi-Levene N, Hindawi S, Al-Riyami AZ, So-Osman C. Production and Quality Assurance of Human Polyclonal Hyperimmune Immunoglobulins against SARS-CoV-2. Transfus Med Rev 2022; 36:125-132. [PMID: 35879213 PMCID: PMC9183240 DOI: 10.1016/j.tmrv.2022.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Thierry Burnouf
- College of Biomedical Engineering, Graduate Institute of Biomedical Materials and Tissue Engineering, Taipei Medical University, Taipei, Taiwan; International PhD Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan.
| | - Birgit Gathof
- Department of Transfusion Medicine, University Hospital of Cologne, Köln, Germany.
| | - Evan M Bloch
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Renée Bazin
- Héma-Québec, Medical Affairs and Innovation, Québec, Canada
| | | | - Gopal Kumar Patidar
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rada M Grubovic Rastvorceva
- Institute for Transfusion Medicine of RNM, Skopje, North Macedonia; Faculty of Medical Sciences, University Goce Delcev, Štip, North Macedonia
| | - Adaeze Oreh
- Department of Planning, Research and Statistics, National Blood Service Commission, Federal Ministry of Health, Abuja, Nigeria
| | - Ruchika Goel
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Hematology/Oncology, Simmons Cancer Institute at SIU School of Medicine and ImpactLife Blood Center, Springfield, IL, USA
| | | | - Salwa Hindawi
- Haematology Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Arwa Z Al-Riyami
- Department of Hematology, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman
| | - Cynthia So-Osman
- Department of Haematology, Erasmus Medical Centre, Rotterdam, The Netherlands; Unit Transfusion Medicine, Sanquin Blood Supply Foundation, Amsterdam, The Netherlands
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17
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Gupta D, Ahmed F, Tandel D, Parthasarathy H, Vedagiri D, Sah V, Krishna Mohan B, Khan RA, Kondiparthi C, Savari P, Jain S, Reddy S, Kumar JM, Khan N, Harshan KH. Equine immunoglobulin fragment F(ab') 2 displays high neutralizing capability against multiple SARS-CoV-2 variants. Clin Immunol 2022; 237:108981. [PMID: 35306171 PMCID: PMC8926440 DOI: 10.1016/j.clim.2022.108981] [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: 11/08/2021] [Revised: 02/02/2022] [Accepted: 03/12/2022] [Indexed: 01/04/2023]
Abstract
Neutralizing antibody-based passive immunotherapy could be an important therapeutic option against COVID-19. Herein, we demonstrate that equines hyper-immunized with chemically inactivated SARS-CoV-2 elicited high antibody titers with a strong virus-neutralizing potential, and F(ab')2 fragments purified from them displayed strong neutralization potential against five different SARS-CoV-2 variants. F(ab')2 fragments purified from the plasma of hyperimmunized horses showed high antigen-specific affinity. Experiments in rabbits suggested that the F(ab')2 displays a linear pharmacokinetics with approximate plasma half-life of 47 h. In vitro microneutralization assays using the purified F(ab')2 displayed high neutralization titers against five different variants of SARS-CoV-2 including the Delta variant, demonstrating its potential efficacy against the emerging viral variants. In conclusion, this study demonstrates that F(ab')2 generated against SARS-CoV-2 in equines have high neutralization titers and have broad target-range against the evolving variants, making passive immunotherapy a potential regimen against the existing and evolving SARS-CoV-2 variants in combating COVID-19.
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Affiliation(s)
- Divya Gupta
- Centre for Cellular and Molecular Biology, Hyderabad 500007, Telangana, India
| | - Farhan Ahmed
- School of Life Sciences, Department of Animal Biology, University of Hyderabad, Hyderabad 500046, Telangana, India
| | - Dixit Tandel
- Centre for Cellular and Molecular Biology, Hyderabad 500007, Telangana, India,Academy for Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | | | - Dhiviya Vedagiri
- Centre for Cellular and Molecular Biology, Hyderabad 500007, Telangana, India,Academy for Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Vishal Sah
- Centre for Cellular and Molecular Biology, Hyderabad 500007, Telangana, India,Academy for Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | | | - Rafiq Ahmad Khan
- School of Life Sciences, Department of Animal Biology, University of Hyderabad, Hyderabad 500046, Telangana, India
| | | | | | - Sandesh Jain
- VINS Bio Products Limited, Hyderabad 500034, Telangana, India
| | - Shashikala Reddy
- Department of Microbiology, Osmania Medical College, Koti, Hyderabad 500096, Telangana, India
| | - Jerald Mahesh Kumar
- Centre for Cellular and Molecular Biology, Hyderabad 500007, Telangana, India
| | - Nooruddin Khan
- School of Life Sciences, Department of Animal Biology, University of Hyderabad, Hyderabad 500046, Telangana, India,Corresponding authors
| | - Krishnan Harinivas Harshan
- Centre for Cellular and Molecular Biology, Hyderabad 500007, Telangana, India,Academy for Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India,Corresponding authors
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18
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Medeiros GX, Sasahara GL, Magawa JY, Nunes JPS, Bruno FR, Kuramoto AC, Almeida RR, Ferreira MA, Scagion GP, Candido ÉD, Leal FB, Oliveira DBL, Durigon EL, Silva RCV, Rosa DS, Boscardin SB, Coelho V, Kalil J, Santos KS, Cunha-Neto E. Reduced T Cell and Antibody Responses to Inactivated Coronavirus Vaccine Among Individuals Above 55 Years Old. Front Immunol 2022; 13:812126. [PMID: 35300337 PMCID: PMC8921991 DOI: 10.3389/fimmu.2022.812126] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 02/04/2022] [Indexed: 12/26/2022] Open
Abstract
CoronaVac is an inactivated SARS-CoV-2 vaccine that has been rolled out in several low and middle-income countries including Brazil, where it was the mainstay of the first wave of immunization of healthcare workers and the elderly population. We aimed to assess the T cell and antibody responses of vaccinated individuals as compared to convalescent patients. We detected IgG against SARS-CoV-2 antigens, neutralizing antibodies against the reference Wuhan SARS-CoV-2 strain and used SARS-CoV-2 peptides to detect IFN-g and IL-2 specific T cell responses in a group of CoronaVac vaccinated individuals (N = 101) and convalescent (N = 72) individuals. The frequency among vaccinated individuals, of whom 96% displayed T cell and/or antibody responses to SARS-CoV-2, is comparable to 98.5% responses of convalescent individuals. We observed that among vaccinated individuals, men and individuals 55 years or older developed significantly lower anti-RBD, anti-NP and neutralization titers against the Wuhan strain and antigen-induced IL-2 production by T cells. Neutralizing antibody responses for Gamma variant were even lower than for the Wuhan strain. Even though some studies indicated CoronaVac helped reduce mortality among elderly people, considering the appearance of novel variants of concern, CoronaVac vaccinated individuals above 55 years old are likely to benefit from a heterologous third dose/booster vaccine to increase immune response and likely protection.
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Affiliation(s)
- Giuliana X Medeiros
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, São Paulo, Brazil.,Laboratório de Imunologia, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
| | - Greyce Luri Sasahara
- Laboratório de Imunologia, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
| | - Jhosiene Y Magawa
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, São Paulo, Brazil.,Laboratório de Imunologia, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
| | - João Paulo S Nunes
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, São Paulo, Brazil.,Laboratório de Imunologia, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
| | - Fernanda R Bruno
- Laboratório de Imunologia, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
| | - Andreia C Kuramoto
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, São Paulo, Brazil.,Laboratório de Imunologia, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
| | - Rafael R Almeida
- Laboratório de Imunologia, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
| | - Marcelo A Ferreira
- Laboratório de Biologia Celular, LIM59, Departamento de Patologia da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Guilherme P Scagion
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Érika D Candido
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Fabyano B Leal
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Danielle B L Oliveira
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil.,Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Edison L Durigon
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil.,Laboratório de Virologia, Plataforma Científica Pasteur da Universidade de São Paulo, São Paulo, Brazil
| | - Roberto Carlos V Silva
- Laboratório de Imunologia, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
| | - Daniela S Rosa
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo (UNIFESP-EPM), São Paulo, Brazil.,Instituto de Investigação em Imunologia (iii), Instituto Nacional de Ciências e Tecnologia (INCT), São Paulo, Brazil
| | - Silvia B Boscardin
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil.,Instituto de Investigação em Imunologia (iii), Instituto Nacional de Ciências e Tecnologia (INCT), São Paulo, Brazil
| | - Verônica Coelho
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, São Paulo, Brazil.,Laboratório de Imunologia, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil.,Instituto de Investigação em Imunologia (iii), Instituto Nacional de Ciências e Tecnologia (INCT), São Paulo, Brazil
| | - Jorge Kalil
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, São Paulo, Brazil.,Laboratório de Imunologia, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil.,Instituto de Investigação em Imunologia (iii), Instituto Nacional de Ciências e Tecnologia (INCT), São Paulo, Brazil
| | - Keity S Santos
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, São Paulo, Brazil.,Laboratório de Imunologia, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil.,Instituto de Investigação em Imunologia (iii), Instituto Nacional de Ciências e Tecnologia (INCT), São Paulo, Brazil
| | - Edecio Cunha-Neto
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, São Paulo, Brazil.,Laboratório de Imunologia, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil.,Instituto de Investigação em Imunologia (iii), Instituto Nacional de Ciências e Tecnologia (INCT), São Paulo, Brazil
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da Silva AR, Villas-Boas LS, Tozetto-Mendoza TR, Honorato L, de Paula A, Witkin SS, Mendes-Correa MC. Generation of neutralizing antibodies against Omicron, Gamma and Delta SARS-CoV-2 variants following CoronaVac vaccination. Rev Inst Med Trop Sao Paulo 2022; 64:e19. [PMID: 35239863 PMCID: PMC8901116 DOI: 10.1590/s1678-9946202264019] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 11/29/2022] Open
Abstract
Vaccination is a fundamental tool to prevent SARS-CoV-2 infection and to limit the COVID-19 pandemic. The emergence of SARS-CoV-2 variants with multiple mutations has raised serious concerns about the ability of neutralizing antibody responses elicited by prior vaccination to effectively combat these variants. The neutralizing capacity against the Gamma, Delta and Omicron variants of sera from individuals immunized with the CoronaVac vaccine remains incompletely determined. The present study evaluated 41 health care workers at the Faculdade de Medicina of the Universidade de Sao Paulo, in Sao Paulo, Brazil, naive to previous SARS- CoV-2 infection, who were vaccinated with two doses of the CoronaVac SARS-CoV-2 vaccine 28 days apart. Neutralizing antibody levels against the Gamma, Delta, and Omicron variants were measured at 32 and 186 days after the second vaccination. We also measured neutralizing antibodies against Omicron in 34 of these individuals following a subsequent booster immunization with the Pfizer vaccine. Quantification of neutralizing antibodies was performed using the Cytopathic Effect-based Virus Neutralization test. Neutralization antibody activity against the Gamma, Delta and Omicron variants was observed in 78.0%, 65.9% and 58.5% of serum samples, respectively, obtained at a mean of 32 days after the second immunization. This decreased to 17.1%, 24.4% and 2.4% of sera having activity against Delta, Gamma and Omicron, respectively, at 186 days post-vaccination. The median neutralizing antibody titers at 32 days were 1:40, 1:20 and 1:20 against Gamma, Delta and Omicron, respectively, and decreased to an undetectable median level against all variants at the later time. A booster immunization with the Pfizer vaccine elicited neutralizing antibodies against Omicron in 85% of subjects tested 60 days after vaccination. We conclude that two doses of the CoronaVac vaccine results in limited protection of short duration against the Gamma, Delta and Omicron SARS-CoV-2 variants. A booster dose with the Pfizer vaccine induced antibody neutralizing activity against Omicron in most patients which was measurable 60 days after the booster.
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Affiliation(s)
- Almir Ribeiro da Silva
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil
- Universidade de Sao Paulo, Faculdade de Medicina, Laboratorio de Investigação Médica em Virologia (LIM 52), São Paulo, São Paulo, Brazil
| | - Lucy Santos Villas-Boas
- Universidade de Sao Paulo, Faculdade de Medicina, Laboratorio de Investigação Médica em Virologia (LIM 52), São Paulo, São Paulo, Brazil
| | - Tania Regina Tozetto-Mendoza
- Universidade de Sao Paulo, Faculdade de Medicina, Laboratorio de Investigação Médica em Virologia (LIM 52), São Paulo, São Paulo, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Layla Honorato
- Universidade de Sao Paulo, Faculdade de Medicina, Laboratorio de Investigação Médica em Virologia (LIM 52), São Paulo, São Paulo, Brazil
| | - Anderson de Paula
- Universidade de Sao Paulo, Faculdade de Medicina, Laboratorio de Investigação Médica em Virologia (LIM 52), São Paulo, São Paulo, Brazil
| | - Steven S. Witkin
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil
- Universidade de Sao Paulo, Faculdade de Medicina, Laboratorio de Investigação Médica em Virologia (LIM 52), São Paulo, São Paulo, Brazil
- Weill Cornel Medicine, Department of Obstetrics and Gynecology, New York, New York, USA
| | - Maria Cassia Mendes-Correa
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil
- Universidade de Sao Paulo, Faculdade de Medicina, Laboratorio de Investigação Médica em Virologia (LIM 52), São Paulo, São Paulo, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
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20
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Anti-SARS-CoV-2 Antibody Screening in Healthcare Workers and Its Correlation with Clinical Presentation in Tertiary Care Hospital, Kathmandu, Nepal, from November 2020 to January 2021. Interdiscip Perspect Infect Dis 2022; 2022:8515051. [PMID: 35116064 PMCID: PMC8805447 DOI: 10.1155/2022/8515051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 12/28/2021] [Accepted: 01/06/2022] [Indexed: 12/20/2022] Open
Abstract
Background Antibody titer and the life span of antibodies against SARS-CoV-2 have been found to be associated with the clinical presentation in individuals. The extent of exposure of healthcare workers and the general public to SARS-CoV-2 needs to be assessed to monitor the COVID-19 pandemic. Thus, this study is an attempt in assessing the anti-SARS-CoV-2 antibody in health care workers. Methods This laboratory-based cross-sectional study was performed in Manmohan Memorial Medical College and Teaching Hospital, Kathmandu from November 2020 to January 2021. A total of 185 HCWs were enrolled in this study. Their serum samples were screened for anti-SARS-CoV-2 antibodies, and a structured questionnaire was administered to collect further information. Anti-SARS-CoV-2 antibody screening was performed using lateral flow immunoassay. The data were analyzed using SPSS version 20. Results Among 185 HCWs that participated in the study, 41 (22.2%) tested positive for the anti-SARS-CoV-2 antibody. Of these 41 HCWs, 37 tested positive for IgG only and 4 of them tested positive for both IgM and IgG antibodies. The presence of the previous history of SARS-CoV-2 infection (p < 0.001), the presence of flu-like symptoms within the last 6 months (p < 0.001), and the presence of positive contact history (p=0.002) were statistically significant with the presence of the antibody among HCWs. Conclusion Healthcare workers carry a high burden of SARS-CoV-2 infection and are at risk of acquiring infection from their workplace. Anti-SARS-CoV-2 antibody screening among healthcare workers is highly recommended in multiple healthcare settings as it can help in monitoring transmission dynamics and evaluation of infection control policies.
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21
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De Santis GC, Oliveira LC, Garibaldi PMM, Almado CEL, Croda J, Arcanjo GGA, Oliveira ÉAF, Tonacio AC, Langhi DM, Bordin JO, Gilio RN, Palma LC, Santos EV, Haddad SK, Prado BPA, Pontelli MC, Gomes R, Miranda CH, Auxiliadora Martins M, Covas DT, Arruda E, Fonseca BAL, Calado RT. High-Dose Convalescent Plasma for Treatment of Severe COVID-19. Emerg Infect Dis 2022; 28:548-555. [PMID: 35081022 PMCID: PMC8888205 DOI: 10.3201/eid2803.212299] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
To assess whether high-dose coronavirus disease (COVID-19) convalescent plasma (CCP) transfusion may benefit patients with severe COVID-19, we conducted a multicenter randomized trial in Brazil. Patients with severe COVID-19 who were within 10 days of initial symptom onset were eligible. Patients in the CCP group received 3 daily doses of CCP (600 mL/d) in addition to standard treatment; control patients received standard treatment only. Primary outcomes were death rates at days 30 and 60 of study randomization. Secondary outcomes were ventilator-free days and hospital-free days. We enrolled 107 patients: 36 CCP and 71 control. At day 30, death rates were 22% for CCP and 25% for the control group; at day 60, rates were 31% for CCP and 35% for control. Needs for invasive mechanical ventilation and durations of hospital stay were similar between groups. We conclude that high-dose CCP transfused within 10 days of symptom onset provided no benefit for patients with severe COVID-19.
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22
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Villas-Boas LS, Paula AVD, Silva ARD, Paiao HGO, Tozetto-Mendoza TR, Manuli ER, Leal FE, Ferraz ADBC, Sabino EC, Bierrenbach AL, Witkin SS, Mendes-Correa MC. Absence of neutralizing antibodies against the Omicron SARS-CoV-2 variant in convalescent sera from individuals infected with the ancestral SARS-CoV-2 virus or its Gamma variant. Clinics (Sao Paulo) 2022; 77:100068. [PMID: 35767900 PMCID: PMC9212906 DOI: 10.1016/j.clinsp.2022.100068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 05/23/2022] [Accepted: 06/06/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The aim of the present study was to evaluate if neutralizing antibody responses induced by infection with the SARS-CoV-2 strain that was dominant at the beginning of the pandemic or by the Gamma variant was effective against the Omicron variant. METHODS Convalescent sera from 109 individuals, never exposed to a SARS-CoV-2 vaccine, who had mild or moderate symptoms not requiring hospitalization following either a documented SARS-CoV-2 ancestral strain infection or a Gamma variant infection, were assayed for in vitro neutralizing antibody activity against their original strains and the Omicron variant. RESULTS Following an infection with the ancestral strain, 56 (93.3%), 45 (77.6%) and 1 (1.7%) serum sample were positive for neutralizing antibodies against the ancestral, Gamma variant, and Omicron variant, respectively. After infection with the Gamma variant, 43 (87.8%) and 2 (4.1%) sera were positive for neutralizing antibodies against the Gamma and Omicron variants, respectively. CONCLUSIONS Neutralizing antibodies generated following mild or moderate infection with the SARS-CoV-2 ancestral strain or the Gamma variant are not protective against the Omicron variant.
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Affiliation(s)
- Lucy Santos Villas-Boas
- Instituto de Medicina Tropical de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, SP, Brazil; Departamento de Moléstias Infecciosas e Parasitarias da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Anderson Vicente de Paula
- Instituto de Medicina Tropical de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, SP, Brazil; Departamento de Moléstias Infecciosas e Parasitarias da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Almir Ribeiro da Silva
- Instituto de Medicina Tropical de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, SP, Brazil; Departamento de Moléstias Infecciosas e Parasitarias da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Heuder Gustavo Oliveira Paiao
- Instituto de Medicina Tropical de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, SP, Brazil; Departamento de Moléstias Infecciosas e Parasitarias da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Tania Regina Tozetto-Mendoza
- Instituto de Medicina Tropical de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, SP, Brazil; Departamento de Moléstias Infecciosas e Parasitarias da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Erika Regina Manuli
- Instituto de Medicina Tropical de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, SP, Brazil; Faculdade de Medicina da Universidade Municipal de Sao Caetano do Sul, São Caetano, SP, Brazil
| | - Fábio Eudes Leal
- Faculdade de Medicina da Universidade Municipal de Sao Caetano do Sul, São Caetano, SP, Brazil
| | | | - Ester Cerdeira Sabino
- Instituto de Medicina Tropical de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, SP, Brazil; Departamento de Moléstias Infecciosas e Parasitarias da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil; Faculdade de Medicina da Universidade Municipal de Sao Caetano do Sul, São Caetano, SP, Brazil
| | | | - Steven Sol Witkin
- Instituto de Medicina Tropical de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, SP, Brazil; Weill Cornell Medicine, USA
| | - Maria Cassia Mendes-Correa
- Instituto de Medicina Tropical de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, SP, Brazil; Departamento de Moléstias Infecciosas e Parasitarias da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
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23
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Zucherato VS, Evaristo M, Santos EV, Mello R, Donizetti Candido É, Araujo DB, de Oliveira DBL, Durigon EL, Giovanetti M, Alcantâra LCJ, Cilião-Alves DC, Haddad R, Covas DT, Kashima S, Slavov SN. SARS-CoV-2 serological cross-reactivity testing in Brazilian blood donors, October-December, 2019. J Infect 2022; 84:e1-e2. [PMID: 34979220 DOI: 10.1016/j.jinf.2021.12.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 12/28/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Victoria Simionatto Zucherato
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Mariane Evaristo
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Elaine Vieira Santos
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Ralyria Mello
- Department of Microbiology, Laboratory of Clinical and Molecular Virology, Institute of Biomedical Sciences, São Paulo, Brazil
| | - Érika Donizetti Candido
- Department of Microbiology, Laboratory of Clinical and Molecular Virology, Institute of Biomedical Sciences, São Paulo, Brazil
| | - Danielle Bastos Araujo
- Department of Microbiology, Laboratory of Clinical and Molecular Virology, Institute of Biomedical Sciences, São Paulo, Brazil
| | - Danielle Bruna Leal de Oliveira
- Department of Microbiology, Laboratory of Clinical and Molecular Virology, Institute of Biomedical Sciences, São Paulo, Brazil
| | - Edson Luiz Durigon
- Department of Microbiology, Laboratory of Clinical and Molecular Virology, Institute of Biomedical Sciences, São Paulo, Brazil
| | - Marta Giovanetti
- Flavivirus Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil; Laboratory of Celular and Molecular Genetics, Federal University of Belo Horizonte, Belo Horizonte, Brazil
| | - Luiz Carlos Júnior Alcantâra
- Flavivirus Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil; Laboratory of Celular and Molecular Genetics, Federal University of Belo Horizonte, Belo Horizonte, Brazil
| | | | - Rodrigo Haddad
- Faculty of Ceilândia, University of Brasilia, Federal District, Brasilia, Brazil; Center for Tropical Medicine, University of Brasilia, Federal District, Brazil
| | - Dimas Tadeu Covas
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil; Center for Biotechnology (NuCel), Butantan Institute, São Paulo, São Paulo, Brazil
| | - Simone Kashima
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Svetoslav Nanev Slavov
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil; Center for Biotechnology (NuCel), Butantan Institute, São Paulo, São Paulo, Brazil.
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24
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Karaca A, Guncikan MN, Sozmen NN, Karadag GG, Yilmaz M, Kinik K, Yilmaz FM. Longitudinal SARS-CoV-2 Seroconversion Course and Antibody Levels by Blood Groups in Convalescent Plasma Donors in Turkey. Medeni Med J 2021; 36:185-192. [PMID: 34915675 PMCID: PMC8565586 DOI: 10.5222/mmj.2021.00921] [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: 06/04/2021] [Accepted: 08/30/2021] [Indexed: 11/08/2022] Open
Abstract
Objective The present study investigates the seroconversion time course of the IgG antibody against SARS-CoV-2 and ascertains whether its levels change according to the patient’s ABO blood group. Method A total of 36,003-convalescent plasma (CP) donations of 12,315 Turkish Red Crescent CP donors were analyzed. The ABO blood group of the CP donors was determined by Gel Centrifugation; and IgG was measured using the Euroimmun anti-SARS-CoV-2 ELISA. The differences in the distributions of mean IgG ratios among the different ABO blood groups were analyzed with One-Way ANOVA and Independent Samples T-test. Results Among the CP donors, 98.4% were male. An antibody response to SARS-CoV-2 was noted-although in a few CP donors- on the 244th day, and a significant association between the ABO blood groups and the mean IgG ratios was noted (p: 0.001). The highest (mean±SD) antibody level was observed in the AB blood group (39.5±15.7), followed by the B (37.9±11.5) and the A blood groups (36.6±10.7), while the lowest value was recorded in the O blood group (34.4±11.5). Significant differences between all paired groups were noted in pairwise comparisons. The Rh (-) blood group (37.4±13.6) had a significantly higher antibody level than the Rh (+) blood group (36.3±11.2) (p: 0.005). Conclusion An antibody response to SARS-CoV-2 was noted in a CP donor on the 244th day. The average IgG ratios were higher in the CP donors with the AB blood group, but lower in the O blood group. These results may be considered a valuable indication of the effectiveness of CP therapy used for the treatment of COVID-19 patients with clinically relevant blood types.
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Affiliation(s)
- Aziz Karaca
- Turkish Red Crescent, General Directorate of Blood Services, Directorate of Medical Management, Ankara, Turkey
| | - Mustafa Nuri Guncikan
- Turkish Red Crescent, General Directorate of Blood Services, Directorate of Medical Management, Ankara, Turkey
| | - Nazlı Nadire Sozmen
- Turkish Red Crescent, General Directorate of Blood Services, Directorate of Medical Management, Ankara, Turkey
| | - Gizem Gokce Karadag
- Turkish Red Crescent, General Directorate of Blood Services, Directorate of Medical Management, Ankara, Turkey
| | - Mustafa Yilmaz
- Turkish Red Crescent, General Directorate of Blood Services, Directorate of Medical Management, Ankara, Turkey
| | - Kerem Kinik
- Turkish Red Crescent, Managing Board, Ankara, Turkey
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25
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Wendel S, Fachini R, Fontão-Wendel RCL, Mello R, Velasquez CV, Machado RRG, Brito MA, Amaral M, Soares CP, Achkar R, Scuracchio P, Miyaji SC, Erdens MS, Durigon EL. Surrogate test performance for SARS-CoV-2 neutralizing antibodies (nAbs) for convalescent plasma (CCP): How useful could they be? Transfusion 2021; 61:3455-3467. [PMID: 34674284 PMCID: PMC8661940 DOI: 10.1111/trf.16714] [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: 08/04/2021] [Revised: 09/14/2021] [Accepted: 09/20/2021] [Indexed: 12/23/2022]
Abstract
Background COVID‐19 high‐titer CCP selection is a concern, because neutralizing antibody (nAb) testing requires sophisticated labs and methods. Surrogate tests are an alternative for measuring nAb levels in plasma bags, including those that are pathogen‐reduced. Study design/methods We studied a panel consisting of 191 samples from convalescent donors tested by nAb (CPE‐VNT), obtained from 180 CCP donations (collection: March 20–January 21) and 11 negative controls, with a total of 80 and 111 serum and plasma samples (71 amotosalen/UV treated), with nAb titers ranging from negative to 10,240. Samples were blindly tested for several surrogates: one anti‐RBD, two anti‐spike, and four anti‐nucleocapsid tests, either isolated or combined to improve their positive predictive values as predictors of the presence of high‐titer nAbs, defined as those with titers ≥160. Results Except for combined and anti‐IgA/M tests, all isolated surrogate tests showed excellent performance for nAb detection: sensitivity (98.3%–100%), specificity (85.7%–100%), PPV (98.9%–100%), NPV (81.3%–100%), and AUC (0.93–0.96), with a variable decrease in sensitivity and considerably lower specificity when using FDA authorization and concomitant nAb titers ≥160. All surrogates had AUCs that were statistically different from CPE‐VNT if nAb≥160, including when using combined, orthogonal approaches. Conclusions Surrogate tests (isolated or in combination) have an indirect good performance in detecting the presence of nAb, with lower sensitivity and specificity when high nAb titer samples are used, possibly accepting a considerable number of donors whose nAb titers are actually low, which should be evaluated by each laboratory responsible for CCP collection.
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Affiliation(s)
| | | | | | - Ralyria Mello
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, USP, São Paulo, Brazil
| | | | | | | | | | - Camila Pereira Soares
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, USP, São Paulo, Brazil
| | - Ruth Achkar
- Blood Bank, Hospital Sírio-Libanês, São Paulo, Brazil
| | | | | | | | - Edison Luiz Durigon
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, USP, São Paulo, Brazil
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26
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High SARS-CoV-2 seroprevalence in persons experiencing homelessness and shelter workers from a day-shelter in São Paulo, Brazil. PLoS Negl Trop Dis 2021; 15:e0009754. [PMID: 34665803 PMCID: PMC8525740 DOI: 10.1371/journal.pntd.0009754] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 08/23/2021] [Indexed: 12/29/2022] Open
Abstract
Brazil presents one of the highest COVID-19 death tolls in the world. The initial SARS-CoV-2 epicenter was São Paulo city. As of 2019, the homeless population of São Paulo city was estimated at 24,344 individuals, the largest national homeless population. The present study aimed to concomitantly assess the molecular and serological prevalence and associated risk factors of SARS-CoV-2 infection in a homeless population and related shelter workers from a day-shelter. Serum samples, nasopharyngeal and oropharyngeal swabs of persons who are homeless and shelter workers collected from August 25th to 27th, 2020 were tested for the presence of anti-SARS-CoV-2 IgM and IgG antibodies by ELISA and SARS-CoV-2 RNA by RT-qPCR, respectively. All swab samples tested negative by RT-qPCR. Seropositivity of IgM and IgG was 5/203 (2.5%) and 111/203 (54.7%) in persons who are homeless, and 5/87 (5.7%) and 41/87 (47.1%) in shelter workers, respectively, with no statistical differences between groups. The high seroprevalence found herein indicates early environmental and urban spreading of SARS-CoV-2, associated with sociodemographic and economic vulnerability. Brazil is one of the world’s most social-economically unequal countries, with a rising homeless population potentialized by the SARS-CoV-2 pandemic, particularly in its largest city, São Paulo. While few studies, mostly in high-income countries, have addressed the impact of the coronavirus pandemic on homeless populations, none has been carried out in Brazil. Herein, we report a high SARS-CoV-2 IgG seroprevalence in a homeless population, with 111/203 (54.7%) seropositive individuals. At the time of the study (August 25th- 27th 2020), both homeless and social worker populations showed no active SARS-CoV-2 infection, indicating that they were likely exposed sometime within the pandemic’s first peak in the city. Our study has also shown significant risk and protective factors for SARS-CoV-2 infection, including that Black shelter workers were at higher risk of SARS-CoV-2 infection when compared with the white shelter workers.
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27
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Sekine L, Arns B, Fabro BR, Cipolatt MM, Machado RRG, Durigon EL, Parolo E, Pellegrini JAS, Viana MV, Schwarz P, Lisboa TC, Dora JMS, Portich JP, Paz AA, Silla L, Balsan AM, Schirmer FDS, Franz JPM, da-Silveira LM, Breunig RC, Petersen V, Sosnoski M, Mesquita NF, Volpato FCZ, Sganzerla D, Falavigna M, Rosa RG, Zavascki AP. Convalescent plasma for COVID-19 in hospitalised patients: an open-label, randomised clinical trial. Eur Respir J 2021; 59:13993003.01471-2021. [PMID: 34244316 PMCID: PMC8287736 DOI: 10.1183/13993003.01471-2021] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/16/2021] [Indexed: 01/05/2023]
Abstract
Background The effects of convalescent plasma (CP) therapy in hospitalised patients with coronavirus disease 2019 (COVID-19) remain uncertain. This study investigates the effect of CP on clinical improvement in these patients. Methods This is an investigator-initiated, randomised, parallel arm, open-label, superiority clinical trial. Patients were randomly (1:1) assigned to two infusions of CP plus standard of care (SOC) or SOC alone. The primary outcome was the proportion of patients with clinical improvement 28 days after enrolment. Results A total of 160 (80 in each arm) patients (66.3% critically ill, 33.7% severely ill) completed the trial. The median (interquartile range (IQR)) age was 60.5 (48–68) years; 58.1% were male and the median (IQR) time from symptom onset to randomisation was 10 (8–12) days. Neutralising antibody titres >1:80 were present in 133 (83.1%) patients at baseline. The proportion of patients with clinical improvement on day 28 was 61.3% in the CP+SOC group and 65.0% in the SOC group (difference −3.7%, 95% CI −18.8–11.3%). The results were similar in the severe and critically ill subgroups. There was no significant difference between CP+SOC and SOC groups in pre-specified secondary outcomes, including 28-day mortality, days alive and free of respiratory support and duration of invasive ventilatory support. Inflammatory and other laboratory marker values on days 3, 7 and 14 were similar between groups. Conclusions CP+SOC did not result in a higher proportion of clinical improvement on day 28 in hospitalised patients with COVID-19 compared to SOC alone. In this open-label, randomised clinical trial, two infusions of convalescent plasma therapy plus standard of care compared to standard of care did not result in higher proportion of clinical improvement on day 28 in patients with severe COVID-19https://bit.ly/2TXuB6S
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Affiliation(s)
- Leo Sekine
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Brazil.,Medical Sciences Post-Graduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Beatriz Arns
- Infectious Diseases Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Bruna R Fabro
- Infectious Diseases Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Murillo M Cipolatt
- Infectious Diseases Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Rafael R G Machado
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Edison L Durigon
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.,Scientific Platform Pasteur USP, São Paulo, Brazil
| | - Edino Parolo
- Critical Care Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Marina V Viana
- Critical Care Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Patrícia Schwarz
- Critical Care Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Thiago C Lisboa
- Critical Care Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - José Miguel S Dora
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Brazil.,Internal Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Júlia P Portich
- Clinical Hematology and Bone Marrow Transplantation Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Alessandra A Paz
- Clinical Hematology and Bone Marrow Transplantation Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Lucia Silla
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Brazil.,Clinical Hematology and Bone Marrow Transplantation Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Almeri M Balsan
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Felipe da-Silva Schirmer
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Clinical Hematology and Bone Marrow Transplantation Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Juliana P M Franz
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Luciana M da-Silveira
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Raquel C Breunig
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Viviana Petersen
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Monalisa Sosnoski
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Nanci F Mesquita
- Transfusion Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Fabiana Caroline Z Volpato
- Laboratório de Diagnóstico de SARS-CoV-2, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.,Laboratório de Pesquisa em Resistência Bacteriana (LABRESIS), Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Daniel Sganzerla
- Research Projects Office, Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil
| | - Maicon Falavigna
- Research Projects Office, Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil
| | - Regis G Rosa
- Intensive Care Service, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Alexandre P Zavascki
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Brazil.,Infectious Diseases Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Yokoyama APH, Wendel S, Bonet-Bub C, Fachini RM, Dametto APF, Blumm F, Dutra VF, Candelaria GTP, Sakashita AM, Machado RRG, Fontão-Wendel R, Hamerschlak N, Achkar R, Assunção MSC, Scuracchio P, Nudelman V, Pastore L, Pinho JRR, Ben MD, Filho RK, Marra AR, Amano MT, Kallás EG, Helito AS, de Carvalho CRR, Araujo DB, Durigon EL, Camargo AA, Rizzo LV, Reis LFL, Kutner JM. COVID-19 convalescent plasma cohort study: Evaluation of the association between both donor and recipient neutralizing antibody titers and patient outcomes. Transfusion 2021; 61:2295-2306. [PMID: 34173248 PMCID: PMC8447313 DOI: 10.1111/trf.16573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/05/2021] [Accepted: 05/17/2021] [Indexed: 01/09/2023]
Abstract
Background Current evidence regarding COVID‐19 convalescent plasma (CCP) transfusion practices is limited and heterogeneous. We aimed to determine the impact of the use of CCP transfusion in patients with previous circulating neutralizing antibodies (nAbs) in COVID‐19. Methods Prospective cohort including 102 patients with COVID‐19 transfused with ABO compatible CCP on days 0–2 after enrollment. Clinical status of patients was assessed using the adapted World Health Organization (WHO) ordinal scale on days 0, 5, and 14. The nAbs titration was performed using the cytopathic effect‐based virus neutralization test with SARS‐CoV‐2 (GenBank MT126808.1). The primary outcome was clinical improvement on day 14, defined as a reduction of at least two points on the adapted WHO ordinal scale. Secondary outcomes were the number of intensive care unit (ICU)‐free days and the number of invasive mechanical ventilation‐free days. Results Both nAbs of CCP units transfused (p < 0.001) and nAbs of patients before CCP transfusions (p = 0.028) were associated with clinical improvements by day 14. No significant associations between nAbs of patients or CCP units transfused were observed in the number of ICU or mechanical ventilation‐free days. Administration of CCP units after 10 days of symptom onset resulted in a decrease in ICU‐free days (p < 0.001) and mechanical ventilation‐free days (p < 0.001). Conclusion Transfusion of high titer nAbs CCP units may be a determinant in clinical strategies against COVID‐19. We consider these data as useful parameters to guide future CCP transfusion practices.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Ruth Achkar
- Hospital Sírio-Libanês Blood Bank, São Paulo, Brazil
| | | | | | | | | | | | | | - Roberto Kalil Filho
- Hospital Sírio-Libanês, São Paulo, Brazil.,University of São Paulo - Heart Institute (Incor), São Paulo, Brazil
| | - Alexandre R Marra
- Hospital Israelita Albert Einstein, São Paulo, Brazil.,Office of Clinical Quality, Safety, and Performance Improvement, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | | | - Esper G Kallás
- Hospital Sírio-Libanês, São Paulo, Brazil.,Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Carlos Roberto Ribeiro de Carvalho
- Hospital Sírio-Libanês, São Paulo, Brazil.,Cardio-Pulmonary Department, Pulmonary Division, Heart Institute (Incor), University of São Paulo, São Paulo, Brazil
| | - Danielle Bastos Araujo
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Edison Luiz Durigon
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.,Scientific Platform Pasteur USP, São Paulo, Brazil
| | | | - Luiz V Rizzo
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Jose M Kutner
- Hospital Israelita Albert Einstein, São Paulo, Brazil
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Focosi D, Franchini M. Clinical predictors of SARS-CoV-2 neutralizing antibody titers in COVID-19 convalescents: Implications for convalescent plasma donor recruitment. Eur J Haematol 2021; 107:24-28. [PMID: 33780551 PMCID: PMC8250676 DOI: 10.1111/ejh.13630] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 12/23/2022]
Abstract
While COVID-19 convalescent plasma (CCP) efficacy is still under investigation in randomized controlled trials (RCT), CCP collections continue worldwide with largely variable criteria. Since it is well known that only a minority of patients develop high-titer neutralizing antibodies (nAb), as assessed by the viral neutralization tests (VNT), strategies to maximize cost-effectiveness of CCP collection are urgently needed. A growing amount of the population is having exposure to the virus and is hence becoming a candidate CCP donor. Laboratory screening with high-throughput serology has good correlations with the VNT titer, but upstream screening using clinical surrogates would be advisable. We review here the existing literature on clinical predictors of high-titer nAb. Older age, male sex, and hospitalization are the main proxies of high VNT and should drive CCP donor recruitment.
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Affiliation(s)
- Daniele Focosi
- North‐Western Tuscany Blood BankPisa University HospitalPisaItaly
| | - Massimo Franchini
- Department of Hematology and Transfusion MedicineCarlo Poma HospitalMantuaItaly
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30
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Laterza R, Schirinzi A, Bruno R, Genco R, Contino R, Ostuni A, Di Serio F. SARS-CoV-2 antibodies: Comparison of three high-throughput immunoassays versus the neutralization test. Eur J Clin Invest 2021; 51:e13573. [PMID: 33870493 PMCID: PMC8250358 DOI: 10.1111/eci.13573] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 12/13/2022]
Affiliation(s)
| | | | - Rossella Bruno
- Immunohaematology and Transfusion Medicine Service, University Hospital of Bari, Bari, Italy
| | - Rosa Genco
- Clinic Pathology Unit, University Hospital of Bari, Bari, Italy
| | - Renato Contino
- Clinic Pathology Unit, University Hospital of Bari, Bari, Italy
| | - Angelo Ostuni
- Immunohaematology and Transfusion Medicine Service, University Hospital of Bari, Bari, Italy
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Izak M, Gendelman V, Bransburg-Zabary S, Stoyanov E, Gat R, Cohen D, Chen J, Maor Y, Benov A, Lev B, Zimhony O, Shinar E. Qualifying coronavirus disease 2019 convalescent plasma donors in Israel. Vox Sang 2021; 117:185-192. [PMID: 34125976 PMCID: PMC8447161 DOI: 10.1111/vox.13162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/18/2021] [Accepted: 05/18/2021] [Indexed: 12/19/2022]
Abstract
Background and Objectives Passive immunization using investigational COVID‐19 convalescent plasma (CCP) is a promising therapeutic strategy and could improve outcome if transfused early and contain high levels of anti‐SARS‐CoV‐2 antibodies. We report the management of a national CCP collection and distribution program in Israel. Materials and Methods From 1 April 2020 to 15 January 2021, 4020 volunteer donors donated 5221 CCP units and 837 (20.8%) donors donated more than once. Anti‐nucleocapsid IgG antibodies were determined using chemiluminescent immunoassay method (Abbott). A statistical model based on repeated IgG tests in sequential donations was created to predict the time of antibody decline below sample/cut‐off (S/CO) level of 4.0. Results Ninety‐six percent of CCP donors suffered a mild disease or were asymptomatic. Older donors had higher antibody levels. Higher antibody levels (S/CO ≥4) were detected in 35.2% of the donors. Low positive (S/CO ≥1.4–3.99) were found in 37%, and 27.8% had undetectable antibodies (S/CO ≤1.4). The model predicted decrease antibody thresholds of 0.55%/day since the first CCP donation, providing guidance for the effective timing of future collections from donors with high antibody levels. Conclusions An efficient CCP collection and distribution program was achieved, based on performing initial and repeated plasma collections, preferably from donors with higher antibody levels, and only antibody‐rich units were supplied for therapeutic use. The inventory met the quantity and quality standards of the authorities, enabled to respond to the growing demand of the medical system and provide a product that may contribute to improve prognosis in patients with COVID‐19.
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Affiliation(s)
- Marina Izak
- National Blood Services, Magen David Adom, Ramat Gan, Israel
| | | | | | | | - Roni Gat
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.,Clinical Research Center, Soroka University Medical Center, Beer Sheva, Israel
| | - Daniel Cohen
- School of Public Health, Tel Aviv University, Tel Aviv, Israel
| | - Jacob Chen
- Trauma and Combat Medicine Branch, Israel Defense Forces Medical Corps, Ramat Gan, Israel.,Hospital Management, Meir Medical Center, KfarSaba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yasmin Maor
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Infectious Disease Unit, Wolfson Medical Center, Holon, Israel
| | - Avi Benov
- Trauma and Combat Medicine Branch, Israel Defense Forces Medical Corps, Ramat Gan, Israel.,The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Boaz Lev
- Epidemic Unit, Ministry of Health, Jerusalem, Israel
| | - Oren Zimhony
- Infectious Disease Unit, Kaplan Medical Center, Rehovot, Israel
| | - Eilat Shinar
- National Blood Services, Magen David Adom, Ramat Gan, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Cimolai N. Passive Immunity Should and Will Work for COVID-19 for Some Patients. Clin Hematol Int 2021; 3:47-68. [PMID: 34595467 PMCID: PMC8432400 DOI: 10.2991/chi.k.210328.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 03/02/2021] [Indexed: 12/12/2022] Open
Abstract
In the absence of effective antiviral chemotherapy and still in the context of emerging vaccines for severe acute respiratory syndrome-CoV-2 infections, passive immunotherapy remains a key treatment and possible prevention strategy. What might initially be conceived as a simplified donor-recipient process, the intricacies of donor plasma, IV immunoglobulins, and monoclonal antibody modality applications are becoming more apparent. Key targets of such treatment have largely focused on virus neutralization and the specific viral components of the attachment Spike protein and its constituents (e.g., receptor binding domain, N-terminal domain). The cumulative laboratory and clinical experience suggests that beneficial protective and treatment outcomes are possible. Both a dose- and a time-dependency emerge. Lesser understood are the concepts of bioavailability and distribution. Apart from direct antigen binding from protective immunoglobulins, antibody effector functions have potential roles in outcome. In attempting to mimic the natural but variable response to infection or vaccination, a strong functional polyclonal approach attracts the potential benefits of attacking antigen diversity, high antibody avidity, antibody persistence, and protection against escape viral mutation. The availability and ease of administration for any passive immunotherapy product must be considered in the current climate of need. There is never a perfect product, but yet there is considerable room for improving patient outcomes. Given the variability of human genetics, immunity, and disease, and given the nuances of the virus and its potential for change, passive immunotherapy can be developed that will be effective for some but not all patients. An understanding of such patient variability and limitations is just as important as the understanding of the direct interactions between immunotherapy and virus.
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Affiliation(s)
- Nevio Cimolai
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, Children’s and Women’s Health Centre of British Columbia, 4480 Oak Street, Vancouver, BC, Canada V6H 3V4
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Arkhipova-Jenkins I, Helfand M, Armstrong C, Gean E, Anderson J, Paynter RA, Mackey K. Antibody Response After SARS-CoV-2 Infection and Implications for Immunity : A Rapid Living Review. Ann Intern Med 2021; 174:811-821. [PMID: 33721517 PMCID: PMC8025942 DOI: 10.7326/m20-7547] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The clinical significance of the antibody response after SARS-CoV-2 infection remains unclear. PURPOSE To synthesize evidence on the prevalence, levels, and durability of detectable antibodies after SARS-CoV-2 infection and whether antibodies to SARS-CoV-2 confer natural immunity. DATA SOURCES MEDLINE (Ovid), Embase, CINAHL, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, World Health Organization global literature database, and Covid19reviews.org from 1 January through 15 December 2020, limited to peer-reviewed publications available in English. STUDY SELECTION Primary studies characterizing the prevalence, levels, and duration of antibodies in adults with SARS-CoV-2 infection confirmed by reverse transcriptase polymerase chain reaction (RT-PCR); reinfection incidence; and unintended consequences of antibody testing. DATA EXTRACTION Two investigators sequentially extracted study data and rated quality. DATA SYNTHESIS Moderate-strength evidence suggests that most adults develop detectable levels of IgM and IgG antibodies after infection with SARS-CoV-2 and that IgG levels peak approximately 25 days after symptom onset and may remain detectable for at least 120 days. Moderate-strength evidence suggests that IgM levels peak at approximately 20 days and then decline. Low-strength evidence suggests that most adults generate neutralizing antibodies, which may persist for several months like IgG. Low-strength evidence also suggests that older age, greater disease severity, and presence of symptoms may be associated with higher antibody levels. Some adults do not develop antibodies after SARS-CoV-2 infection for reasons that are unclear. LIMITATIONS Most studies were small and had methodological limitations; studies used immunoassays of variable accuracy. CONCLUSION Most adults with SARS-CoV-2 infection confirmed by RT-PCR develop antibodies. Levels of IgM peak early in the disease course and then decline, whereas IgG peaks later and may remain detectable for at least 120 days. PRIMARY FUNDING SOURCE Agency for Healthcare Research and Quality. (PROSPERO: CRD42020207098).
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Affiliation(s)
- Irina Arkhipova-Jenkins
- Scientific Resource Center for the AHRQ Evidence-based Practice Center Program, Portland VA Research Foundation, and VA Portland Health Care System, Portland, Oregon (I.A.J., C.A., E.G., R.A.P.)
| | - Mark Helfand
- Scientific Resource Center for the AHRQ Evidence-based Practice Center Program, Portland VA Research Foundation, VA Evidence Synthesis Program, and VA Portland Health Care System, Portland, Oregon (M.H.)
| | - Charlotte Armstrong
- Scientific Resource Center for the AHRQ Evidence-based Practice Center Program, Portland VA Research Foundation, and VA Portland Health Care System, Portland, Oregon (I.A.J., C.A., E.G., R.A.P.)
| | - Emily Gean
- Scientific Resource Center for the AHRQ Evidence-based Practice Center Program, Portland VA Research Foundation, and VA Portland Health Care System, Portland, Oregon (I.A.J., C.A., E.G., R.A.P.)
| | - Joanna Anderson
- VA Evidence Synthesis Program and VA Portland Health Care System, Portland, Oregon (J.A., K.M.)
| | - Robin A Paynter
- Scientific Resource Center for the AHRQ Evidence-based Practice Center Program, Portland VA Research Foundation, and VA Portland Health Care System, Portland, Oregon (I.A.J., C.A., E.G., R.A.P.)
| | - Katherine Mackey
- VA Evidence Synthesis Program and VA Portland Health Care System, Portland, Oregon (J.A., K.M.)
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Al-Riyami AZ, Burnouf T, Yazer M, Triulzi D, Kumaş LT, Sağdur L, Pelit NB, Bazin R, Hindawi SI, Badawi MA, Patidar GK, Pandey HC, Chaurasia R, Fachini RM, Scuracchio P, Wendel S, Ang AL, Ong KH, Young P, Ihalainen J, Vierikko A, Qiu Y, Yang R, Xu H, Rahimi-Levene N, Shinar E, Izak M, Gonzalez CA, Ferrari DM, Cini PV, Aditya RN, Sharma RR, Sachdev S, Hans R, Lamba DS, Nissen-Meyer LSH, Devine DV, Lee CK, Leung JNS, Hung IFN, Tiberghien P, Gallian P, Morel P, Al Maamari K, Al-Hinai Z, Vrielink H, So-Osman C, De Angelis V, Berti P, Ostuni A, Marano G, Nevessignsky MT, El Ekiaby M, Daly J, Hoad V, Kim S, van den Berg K, Vermeulen M, Glatt TN, Schäfer R, Reik R, Gammon R, Lopez M, Estcourt L, MacLennan S, Roberts D, Louw V, Dunbar N. International Forum on the Collection and Use of COVID-19 Convalescent Plasma: Protocols, Challenges and Lessons Learned: Summary. Vox Sang 2021; 116:1117-1135. [PMID: 34013968 PMCID: PMC8242386 DOI: 10.1111/vox.13113] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 12/27/2022]
Affiliation(s)
| | - Thierry Burnouf
- College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nancy Dunbar
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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Al-Riyami AZ, Burnouf T, Yazer M, Triulzi D, Kumaş LT, Sağdur L, Pelit NB, Bazin R, Hindawi SI, Badawi MA, Patidar GK, Pandey HC, Chaurasia R, Fachini RM, Scuracchio P, Wendel S, Ang AL, Ong KH, Young P, Ihalainen J, Vierikko A, Qiu Y, Yang R, Xu H, Rahimi-Levene N, Shinar E, Izak M, Gonzalez CA, Ferrari DM, Cini PV, Aditya RN, Sharma RR, Sachdev S, Hans R, Lamba DS, Nissen-Meyer LSH, Devine DV, Lee CK, Leung JNS, Hung IFN, Tiberghien P, Gallian P, Morel P, Al Maamari K, Al-Hinai Z, Vrielink H, So-Osman C, De Angelis V, Berti P, Ostuni A, Marano G, Nevessignsky MT, El Ekiaby M, Daly J, Hoad V, Kim S, van den Berg K, Vermeulen M, Glatt TN, Schäfer R, Reik R, Gammon R, Lopez M, Estcourt L, MacLennan S, Roberts D, Louw V, Dunbar N. International Forum on the Collection and Use of COVID-19 Convalescent Plasma: Responses. Vox Sang 2021; 116:e71-e120. [PMID: 34013981 PMCID: PMC8242651 DOI: 10.1111/vox.13114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 01/09/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | - Salwa I Hindawi
- King Abdulaziz University and King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Maha A Badawi
- King Abdulaziz University and King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | | | | | | | | | | | | | - Ai Leen Ang
- Health Sciences Authority, Singapore City, Singapore
| | - Kiat Hoe Ong
- Tan Tock Seng Hospital, Singapore City, Singapore
| | | | | | | | - Yan Qiu
- Beijing Red Cross Blood Centre, Beijing, China
| | - Ru Yang
- Wuhan Blood Centre, Wuhan, China
| | - Hua Xu
- Shaanxi Blood Center, Shaanxi, China
| | | | - Eilat Shinar
- Magen David Adom National Blood Services, Tel Aviv, Israel
| | - Marina Izak
- Magen David Adom National Blood Services, Tel Aviv, Israel
| | | | | | | | - Robby Nur Aditya
- Central Blood Transfusion Service Indonesia Red Cross (PMI), Jakarta, Indonesia
| | - Ratti Ram Sharma
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Suchet Sachdev
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rekha Hans
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Divjot Singh Lamba
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | - Cheuk Kwong Lee
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong SAR, China
| | | | - Ivan Fan Ngai Hung
- Department of Medicine, the University of Hong Kong, Hong Kong SAR, China
| | | | - Pierre Gallian
- Etablissement Français du Sang, La Plaine St Denis, France
| | - Pascal Morel
- Etablissement Français du Sang, La Plaine St Denis, France
| | | | - Zaid Al-Hinai
- Sultan Qaboos University Hospital, Seeb, Sultanate of Oman
| | | | | | | | - Pierluigi Berti
- Italian Society for Hemapheresis cell Manipulation (SIdEM), Bari, Italy
| | - Angelo Ostuni
- Italian Society for Hemapheresis cell Manipulation (SIdEM), Bari, Italy
| | | | | | | | - James Daly
- Australian Red Cross Lifeblood, Melbourne, Vic., Australia
| | - Veronica Hoad
- Australian Red Cross Lifeblood, Melbourne, Vic., Australia
| | - Sinyoung Kim
- Yonsei University College of Medicine, Seoul, South Korea
| | - Karin van den Berg
- South African National Blood Service, University of Cape Town, Cape Town, South Africa
| | - Marion Vermeulen
- South African National Blood Service, University of Cape Town, Cape Town, South Africa
| | - Tanya Nadia Glatt
- South African National Blood Service, University of Cape Town, Cape Town, South Africa
| | - Richard Schäfer
- German Red Cross Blood Donor Service Baden-Württemberg-Hessen, Frankfurt, Germany
| | | | | | | | | | | | | | - Vernon Louw
- Western Cape Blood Service, Cape Town, South Africa
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de Freitas Dutra V, Bonet‐Bub C, Yokoyama APH, Achkar R, Machado RRG, Assunção M, Candelária G, Soares CP, Fachini RM, Fontão‐Wendel R, Hamerschlak N, Reis LFL, Araujo DB, Nudelman V, Pinho JRR, Rizzo LV, Sakashita AM, Scuracchio P, Durigon EL, Wendel S, Kutner JM. Anti-A and SARS-CoV-2: an intriguing association. Vox Sang 2021; 116:557-563. [PMID: 33650690 PMCID: PMC8013368 DOI: 10.1111/vox.13044] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/13/2020] [Accepted: 11/15/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Blood groups and anti-A isohemagglutinin may be involved in susceptibility to SARS-CoV-2 infection. MATERIALS AND METHODS We retrospectively studied 268 COVID-19 convalescent plasma donors and 162 COVID-19 inpatients (total 430 subjects, confirmed by RT-PCR) and 2,212 healthy volunteer first-time blood donors as a control group. These were further divided into two groups: those with anti-A (blood types O and B) and those without it (types A and AB). Titres of nucleoproteins, and neutralizing SARS-CoV-2 antibody were measured in the convalescent plasma donors and inpatients. Multivariate logistic regression and non-parametric tests were applied. RESULTS Persons having types O or B showed less infection prevalence than those of types A or AB (OR = 0·62, 95% CI 0·50-0·78; P < 0·001), but there was no difference when COVID-19 inpatients were analysed. Immunoglobulins M, G and A were lower in COVID-19 subjects of types O or B group than those of A or AB (0·16 vs. 0·19; P = 0·03, 2·11 vs. 2·55; P = 0·02, 0·23 vs. 0·32; P = 0·03, respectively). CONCLUSION In this retrospective cohort, COVID-19 individuals were less likely to belong to blood types O and B, and also had lower SARS-CoV-2 antibody titres than A and AB individuals. COVID-19 severity did not associate with the blood groups.
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Affiliation(s)
| | | | | | | | | | | | | | - Camila Pereira Soares
- Department of MicrobiologyInstitute of Biomedical SciencesUniversity of Sao PauloSão PauloBrazil
| | | | | | | | | | - Danielle Bastos Araujo
- Hospital Israelita Albert EinsteinSão PauloBrazil
- Department of MicrobiologyInstitute of Biomedical SciencesUniversity of Sao PauloSão PauloBrazil
| | | | | | | | | | | | - Edison Luiz Durigon
- Department of MicrobiologyInstitute of Biomedical SciencesUniversity of Sao PauloSão PauloBrazil
- Scientific Platform Pasteur USPSão PauloBrazil
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Körper S, Jahrsdörfer B, Corman VM, Pilch J, Wuchter P, Blasczyk R, Müller R, Tonn T, Bakchoul T, Schäfer R, Juhl D, Schwarz T, Gödecke N, Burkhardt T, Schmidt M, Appl T, Eichler H, Klüter H, Drosten C, Seifried E, Schrezenmeier H. Donors for SARS-CoV-2 Convalescent Plasma for a Controlled Clinical Trial: Donor Characteristics, Content and Time Course of SARS-CoV-2 Neutralizing Antibodies. Transfus Med Hemother 2021; 48:137-147. [PMID: 34177417 PMCID: PMC8216018 DOI: 10.1159/000515610] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/28/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Convalescent plasma is one of the treatment options for COVID-19 which is currently being investigated in many clinical trials. Understanding of donor and product characteristics is important for optimization of convalescent plasma. METHODS Patients who had recovered from CO-VID-19 were recruited as donors for COVID-19 convalescent plasma (CCP) for a randomized clinical trial of CCP for treatment of severe COVID-19 (CAPSID Trial). Titers of neutralizing antibodies were measured by a plaque-reduction neutralization test (PRNT). Correlation of antibody titers with host factors and evolution of neutralizing antibody titers over time in repeat donors were analysed. RESULTS A series of 144 donors (41% females, 59% males; median age 40 years) underwent 319 plasmapheresis procedures providing a median collection volume of 850 mL and a mean number of 2.7 therapeutic units per plasmapheresis. The majority of donors had a mild or moderate course of COVID-19. The titers of neutralizing antibodies varied greatly between CCP donors (from <1:20 to >1:640). Donor factors (gender, age, ABO type, body weight) did not correlate significantly with the titer of neutralizing antibodies. We observed a significant positive correlation of neutralization titers with the number of reported COVID-19 symptoms and with the time from SARS-CoV-2 diagnosis to plasmapheresis. Neutralizing antibody levels were stable or increased over time in 58% of repeat CCP donors. Mean titers of neutralizing antibodies of first donation and last donation of repeat CCP donors did not differ significantly (1:86 at first compared to 1:87 at the last donation). There was a significant correlation of neutralizing antibodies measured by PRNT and anti-SARS-CoV-2 IgG and IgA antibodies which were measured by ELISA. CCP donations with an anti-SARS-CoV-2 IgG antibody content above the 25th percentile were substantially enriched for CCP donations with higher neutralizing antibody levels. CONCLUSION We demonstrate the feasibility of collection of a large number of CCP products under a harmonized protocol for a randomized clinical trial. Titers of neutralizing antibodies were stable or increased over time in a subgroup of repeat donors. A history of higher number of COVID-19 symptoms and higher levels of anti-SARS-CoV-2 IgG and IgA antibodies in immunoassays can preselect donations with higher neutralizing capacity.
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Affiliation(s)
- Sixten Körper
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
- Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
| | - Bernd Jahrsdörfer
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
- Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
| | - Victor M. Corman
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health and German Centre for Infection Research, Berlin, Germany
| | - Jan Pilch
- Institute of Clinical Hemostaseology and Transfusion Medicine, University Hospital and University of the Saarland, Homburg, Germany
| | - Patrick Wuchter
- Institute of Transfusion Medicine and Immunology, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen, Medical Faculty of Medicine Mannheim, University Mannheim, Mannheim, Germany
| | - Rainer Blasczyk
- Institute of Transfusion Medicine and Transplant Engineering, Hannover Medical School, Hannover, Germany
| | - Rebecca Müller
- Institute of Transfusion Medicine and Immunology, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen, Medical Faculty of Medicine Mannheim, University Mannheim, Mannheim, Germany
| | - Torsten Tonn
- Experimental Transfusion Medicine, Technical University of Dresden, German Red Cross Blood Transfusion Service Nord-Ost gGmbH Dresden, Dresden, Germany
| | - Tamam Bakchoul
- Institute of Clinical and Experimental Transfusion Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Richard Schäfer
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Transfusion Service Baden-Württemberg − Hessen, Frankfurt, Germany
| | - David Juhl
- Institute of Transfusion Medicine, University Hospital Schleswig-Holstein, Kiel and Lübeck, Germany
| | - Tatjana Schwarz
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health and German Centre for Infection Research, Berlin, Germany
| | - Nina Gödecke
- Institute of Transfusion Medicine and Transplant Engineering, Hannover Medical School, Hannover, Germany
| | - Thomas Burkhardt
- Experimental Transfusion Medicine, Technical University of Dresden, German Red Cross Blood Transfusion Service Nord-Ost gGmbH Dresden, Dresden, Germany
| | - Michael Schmidt
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Transfusion Service Baden-Württemberg − Hessen, Frankfurt, Germany
| | - Thomas Appl
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
- Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
| | - Hermann Eichler
- Institute of Clinical Hemostaseology and Transfusion Medicine, University Hospital and University of the Saarland, Homburg, Germany
| | - Harald Klüter
- Institute of Transfusion Medicine and Immunology, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen, Medical Faculty of Medicine Mannheim, University Mannheim, Mannheim, Germany
| | - Christian Drosten
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health and German Centre for Infection Research, Berlin, Germany
| | - Erhard Seifried
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Transfusion Service Baden-Württemberg − Hessen, Frankfurt, Germany
| | - Hubert Schrezenmeier
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
- Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
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Wendel S, Fontão‐Wendel R, Fachini R, Candelaria G, Scuracchio P, Achkar R, Brito M, Reis LF, Camargo A, Amano M, Machado R, Araujo D, Soares C, Durigon E. A longitudinal study of convalescent plasma (CCP) donors and correlation of ABO group, initial neutralizing antibodies (nAb), and body mass index (BMI) with nAb and anti-nucleocapsid (NP) SARS-CoV-2 antibody kinetics: Proposals for better quality of CCP collections. Transfusion 2021; 61:1447-1460. [PMID: 33604884 PMCID: PMC8013380 DOI: 10.1111/trf.16323] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/29/2020] [Accepted: 01/20/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Little is known about the neutralizing (nAb) and binding antibody kinetics in COVID-19 convalescent plasma donors, especially during the first 100 days after disease onset. MATERIALS AND METHODS A cohort of previously RT-PCR positive (detected by nasopharyngeal swab during the acute phase), male convalescent patients, all with mild symptoms, were enrolled in serial blood sample collection for a longitudinal nAb titers and anti-nucleocapsid (NP) antibodies (IgM, IgG and IgA) evaluation. NAbs were detected by a cytopathic effect-based virus neutralization test (CPE-based VNT), carried out with SARS-CoV-2 (GenBank: MT350282). RESULTS A total of 78 male volunteers provided 316 samples, spanning a total of 4820 days of study. Although only 25% of donors kept nAb titers ≥160 within 100 days after the onset of disease, there was >75% probability of sustaining nAb titers ≥160 in volunteers whose initial nAb titer was ≥1280, weight ≥ 90 kg or obese, according to their body mass index (BMI), as evidenced by Kaplan-Meier analysis and Cox hazard regression (all p < .02). There was no correlation between the ABO group, ABO antibody titers and persistent high nAb titers. High IgG anti-NP (S/CO ≥5.0) is a good surrogate for detecting nAb ≥ 160, defined by the ROC curve (sensitivity = 90.5%; CI95%: 84.5%-94.7%). CONCLUSION Selection of CCP donors for multiple collections based on initial high nAb titers (≥1280) or BMI ≥ 30 kg/m2 provides a simple strategy to achieve higher quality in CCP programs. High IgG anti-NP levels can also be used as surrogate markers for high nAb screening.
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Affiliation(s)
| | | | | | | | | | - Ruth Achkar
- Hospital Sírio‐Libanês Blood BankSão PauloBrazil
| | - Mayra Brito
- Hospital Sírio‐Libanês Blood BankSão PauloBrazil
| | | | | | | | - Rafael Machado
- Departamento de MicrobiologiaInstituto de Ciências Biomédicas, USPSão PauloBrazil
| | - Danielle Araujo
- Departamento de MicrobiologiaInstituto de Ciências Biomédicas, USPSão PauloBrazil
- Hospital Israelita Albert EinsteinSão PauloBrazil
| | - Camila Soares
- Departamento de MicrobiologiaInstituto de Ciências Biomédicas, USPSão PauloBrazil
| | - Edison Durigon
- Departamento de MicrobiologiaInstituto de Ciências Biomédicas, USPSão PauloBrazil
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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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40
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Wendel S, Land K, Devine DV, Daly J, Bazin R, Tiberghien P, Lee CK, Arora S, Patidar GK, Khillan K, Smid WM, Vrielink H, Oreh A, Al-Riyami AZ, Hindawi S, Vermeulen M, Louw V, Burnouf T, Bloch EM, Goel R, Townsend M, So-Osman C. Lessons learned in the collection of convalescent plasma during the COVID-19 pandemic. Vox Sang 2021; 116:872-879. [PMID: 33772791 PMCID: PMC8250874 DOI: 10.1111/vox.13096] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 12/22/2022]
Abstract
Background The lack of definitive treatment or preventative options for COVID‐19 led many clinicians early on to consider convalescent plasma (CCP) as potentially therapeutic. Regulators, blood centres and hospitals worldwide worked quickly to get CCP to the bedside. Although response was admirable, several areas have been identified to help improve future pandemic management. Materials and methods A multidisciplinary, multinational subgroup from the ISBT Working Group on COVID‐19 was tasked with drafting a manuscript that describes the lessons learned pertaining to procurement and administration of CCP, derived from a comprehensive questionnaire within the subgroup. Results While each country’s responses and preparedness for the pandemic varied, there were shared challenges, spanning supply chain disruptions, staffing, impact of social distancing on the collection of regular blood and CCP products, and the availability of screening and confirmatory SARS‐CoV‐2 testing for donors and patients. The lack of a general framework to organize data gathering across clinical trials and the desire to provide a potentially life‐saving therapeutic through compassionate use hampered the collection of much‐needed safety and outcome data worldwide. Communication across all stakeholders was identified as being central to reducing confusion. Conclusion The need for flexibility and adaptability remains paramount when dealing with a pandemic. As the world approaches the first anniversary of the COVID‐19 pandemic with rising rates worldwide and over 115 million cases and 2·55 million deaths, respectively, it is important to reflect on how to better prepare for future pandemics as we continue to combat the current one.
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Affiliation(s)
| | - Kevin Land
- Corporate Medical Affairs, Vitalant, Scottsdale, AZ, USA.,Department of Pathology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Dana V Devine
- UBC Centre for Blood Research, Canadian Blood Services, Vancouver, BC, Canada
| | - James Daly
- Transfusion Medicine, Australian Red Cross, Brisbane, Australia
| | - Renée Bazin
- Research and Development, Héma-Québec, Quebec, Canada
| | | | - Cheuk-Kwong Lee
- Blood Collection and Donor Recruitment Department, Hong Kong Red Cross Blood Transfusion Service, Kowloon, Hong Kong
| | - Satyam Arora
- Transfusion Medicine, Super Speciality Paediatric Hospital and Postgraduate Teaching Institute, Noida, India
| | - Gopal K Patidar
- Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kamini Khillan
- Transfusion Medicine, Sir GangaRam Hospital, New Delhi, India
| | - Willem Martin Smid
- Consulting Services, Sanquin Blood Supply, Amsterdam, Netherlands.,Academic Institute IDTM, Groningen, Netherlands
| | - Hans Vrielink
- Clinical Service, Sanquin Blood Bank Northwest Region, Amsterdam, Netherlands
| | - Adaeze Oreh
- Federal Ministry of Health, National Blood Transfusion Service, Nigeria, Nigeria
| | | | - Salwa Hindawi
- Transfusion Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Vernon Louw
- Department of Medicine, Clinical Hematology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Thierry Burnouf
- College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Evan M Bloch
- Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Pathology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ruchika Goel
- Transfusion Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - Cynthia So-Osman
- Unit Transfusion Medicine, Sanquin Blood Supply Foundation, Amsterdam, Netherlands.,Haematology, Erasmus Medical Center, Rotterdam, Netherlands
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41
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Sekiya EJ, Bellesso M, Alves A. CHALLENGES IN THE PRODUCTION OF COVID19 CONVALESCENT PLASMA - ANALYSIS OF DONOR RECRUITMENT. Hematol Transfus Cell Ther 2021; 43:382-384. [PMID: 33817558 PMCID: PMC7997595 DOI: 10.1016/j.htct.2021.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/24/2021] [Indexed: 10/25/2022] Open
Affiliation(s)
| | - Marcelo Bellesso
- Instituto de Ensino e Pesquisas São Lucas, São Paulo, SP, Brazil.,Hemomed Instituto de Oncologia e Hematologia, São Paulo, SP, Brazil
| | - Adelson Alves
- Hemocentro São Lucas - Terapia Celular, São Paulo, SP, Brazil
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42
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Lopes AGD, Celestino CSH, Barros TTA, Fevereiro AG, Gejer DH, Oliveira FMF, Brasil JM, Bossolan RM, Pinto GCC, Santos ACEZ, Divan LA, Alves IAB, Oliveira DBL, Machado RRG, Thomazelli LM, Hiyane MI, Brelaz-Abreu L, Bragança-Jardim E, Heinen LBS, Barrientos ACM, Mau LB, Camara NOS, Bueno DF, Amano MT. Case Report: A Severe SARS-CoV-2 Infection in a Teenager With Angelman Syndrome. Front Med (Lausanne) 2021; 8:629112. [PMID: 33777976 PMCID: PMC7994262 DOI: 10.3389/fmed.2021.629112] [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: 11/13/2020] [Accepted: 01/22/2021] [Indexed: 11/25/2022] Open
Abstract
Teenagers generally present mild to no symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In the present report, we present the case of a 14-year-old boy with Angelman syndrome (AS) who presented with severe COVID-19 symptoms. He spent 20 days in the ICU with elevated inflammatory biomarkers (C-reactive protein and D-dimer) and increased peaks of neutrophil-to-lymphocyte ratio, which is uncommon for teenagers diagnosed with COVID-19. Although he showed physiological instability, he was able to produce neutralizing antibodies, suggesting a functional immune response. The literature concerning the immune response to infections in patients with AS is still poor, and to our knowledge, this was the first report of a patient with AS diagnosed with COVID-19. As such, the present study may alert other patients with AS or other rare diseases that they lack a competent immune response and could suffer severe consequences of SARS-CoV-2 infection.
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Affiliation(s)
| | | | - Tiago T A Barros
- Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil.,Hospital Sírio-Libanês, São Paulo, Brazil
| | | | - Debora H Gejer
- Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil
| | | | | | | | | | | | - Luis A Divan
- Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil
| | | | - Danielle B L Oliveira
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil.,Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Rafael R G Machado
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Luciano M Thomazelli
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Meire I Hiyane
- Departamento de Imunologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | | | - Luciana B Mau
- Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil
| | - Niels O S Camara
- Departamento de Imunologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Daniela F Bueno
- Hospital Municipal Infantil Menino Jesus, São Paulo, Brazil.,Hospital Sírio-Libanês, São Paulo, Brazil
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43
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Schlickeiser S, Schwarz T, Steiner S, Wittke K, Al Besher N, Meyer O, Kalus U, Pruß A, Kurth F, Zoller T, Witzenrath M, Sander LE, Müller MA, Scheibenbogen C, Volk HD, Drosten C, Corman VM, Hanitsch LG. Disease Severity, Fever, Age, and Sex Correlate With SARS-CoV-2 Neutralizing Antibody Responses. Front Immunol 2021; 11:628971. [PMID: 33584731 PMCID: PMC7878374 DOI: 10.3389/fimmu.2020.628971] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 12/29/2020] [Indexed: 12/15/2022] Open
Abstract
Clinical trials on the use of COVID-19 convalescent plasma remain inconclusive. While data on safety is increasingly available, evidence for efficacy is still sparse. Subgroup analyses hint to a dose-response relationship between convalescent plasma neutralizing antibody levels and mortality. In particular, patients with primary and secondary antibody deficiency might benefit from this approach. However, testing of neutralizing antibodies is limited to specialized biosafety level 3 laboratories and is a time- and labor-intense procedure. In this single center study of 206 COVID-19 convalescent patients, clinical data, results of commercially available ELISA testing of SARS-CoV-2 spike-IgG and -IgA, and levels of neutralizing antibodies, determined by plaque reduction neutralization testing (PRNT), were analyzed. At a medium time point of 58 days after symptom onset, only 12.6% of potential plasma donors showed high levels of neutralizing antibodies (PRNT50 ≥ 1:320). Multivariable proportional odds logistic regression analysis revealed need for hospitalization due to COVID-19 (odds ratio 6.87; p-value 0.0004) and fever (odds ratio 3.00; p-value 0.0001) as leading factors affecting levels of SARS-CoV-2 neutralizing antibody titers in convalescent plasma donors. Using penalized estimation, a predictive proportional odds logistic regression model including the most important variables hospitalization, fever, age, sex, and anosmia or dysgeusia was developed. The predictive discrimination for PRNT50 ≥ 1:320 was reasonably good with AUC: 0.86 (with 95% CI: 0.79-0.92). Combining clinical and ELISA-based pre-screening, assessment of neutralizing antibodies could be spared in 75% of potential donors with a maximal loss of 10% of true positives (PRNT50 ≥ 1:320).
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Affiliation(s)
- Stephan Schlickeiser
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tatjana Schwarz
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Institute of Virology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, and German Centre for Infection Research (DZIF), Partner Site Charité, Berlin, Germany
| | - Sophie Steiner
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Kirsten Wittke
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Nabeel Al Besher
- Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Oliver Meyer
- Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrich Kalus
- Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Axel Pruß
- Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Florian Kurth
- Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Thomas Zoller
- Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Martin Witzenrath
- Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Center for Lung Research (DZL), Partner Site Charité, Berlin, Germany
| | - Leif Erik Sander
- Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Center for Lung Research (DZL), Partner Site Charité, Berlin, Germany
| | - Marcel A. Müller
- Institute of Virology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, and German Centre for Infection Research (DZIF), Partner Site Charité, Berlin, Germany
| | - Carmen Scheibenbogen
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Hans-Dieter Volk
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Center for Advanced Therapies (BeCAT), Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Drosten
- Institute of Virology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, and German Centre for Infection Research (DZIF), Partner Site Charité, Berlin, Germany
| | - Victor M. Corman
- Institute of Virology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, and German Centre for Infection Research (DZIF), Partner Site Charité, Berlin, Germany
| | - Leif G. Hanitsch
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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44
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Mendrone-Junior A, Dinardo CL, Ferreira SC, Nishya A, Salles NA, de Almeida Neto C, Hamasaki DT, Facincani T, de Oliveira Alves LB, Machado RRG, Araujo DB, Durigon EL, Rocha V, Sabino EC. Correlation between SARS-COV-2 antibody screening by immunoassay and neutralizing antibody testing. Transfusion 2021; 61:1181-1190. [PMID: 33491194 PMCID: PMC8013621 DOI: 10.1111/trf.16268] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/13/2020] [Accepted: 11/16/2020] [Indexed: 12/18/2022]
Abstract
Background The efficacy of convalescent plasma (CP), an alternative for the treatment of COVID‐19, depends on high titers of neutralizing antibodies (nAbs), but assays for quantifying nAbs are not widely available. Our goal was to develop a strategy to predict high titers of nAbs based on the results of anti‐SARS‐CoV‐2 immunoassays and the clinical characteristics of CP donors. Study Design and Methods A total of 214 CP donors were enrolled and tested for the presence of anti‐SARS‐CoV‐2 antibodies (IgG) using two commercial immunoassays: EUROIMMUN (ELISA) and Abbott (Chemiluminescence). Quantification of nAbs was performed using the Cytopathic Effect‐based Virus Neutralization test. Three criteria for identifying donors with nAbs ≥ 1:160 were tested: – C1: Curve ROC; − C2: Conditional decision tree considering only the IA results and – C3: Conditional decision tree including both the IA results and the clinical variables. Results The performance of the immunoassays was similar referring to both S/CO and predictive value for identifying nAbs titers ≥1:160. Regarding the studied criteria for identifying CP donors with high nAbs titers: (a) C1 showed 76.1% accuracy if S/CO = 4.65, (b) C2 presented 76.1% accuracy if S/CO ≥4.57 and (c) C3 had 71.6% accuracy if S/CO was ≥4.57 or if S/CO was between 2.68‐4.57 and the last COVID‐19‐related symptoms were recent (within 19 days). Conclusion SARS‐CoV‐2 IgG immunoassays (S/CO) can be used to predict high anti‐SARS‐CoV‐2 nAbs titers. This study has proposed different criteria for identifying donors with ≥1:160 nAbs titers, all with high efficacy.
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Affiliation(s)
- Alfredo Mendrone-Junior
- undação Pro Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31) HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Carla Luana Dinardo
- undação Pro Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Instituto de Medicina Tropical, FMUSP, São Paulo, Brazil
| | | | - Anna Nishya
- undação Pro Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | | | | | | | - Tila Facincani
- undação Pro Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | | | | | - Danielle Bastos Araujo
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Edison Luiz Durigon
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil.,Scientific Platform Pasteur USP, São Paulo, Brazil
| | - Vanderson Rocha
- undação Pro Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31) HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil.,Serviço de Hematologia, Hemoterapia e Terapia Celular - HCFMUSP, São Paulo, Brazil
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45
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Wendel S, Kutner JM, Machado R, Fontão‐Wendel R, Bub C, Fachini R, Yokoyama A, Candelaria G, Sakashita A, Achkar R, Hamerschlak N, Scuracchio P, Amaral M, Dal Ben M, Araujo D, Soares C, Camargo A, Kallás E, Durigon E, Reis LF, Rizzo LV. Screening for SARS-CoV-2 antibodies in convalescent plasma in Brazil: Preliminary lessons from a voluntary convalescent donor program. Transfusion 2020; 60:2938-2951. [PMID: 32935877 PMCID: PMC7756544 DOI: 10.1111/trf.16065] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/02/2020] [Accepted: 08/02/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) collection began in two Brazilian hospitals for treatment of severe/critical patients. METHODS AND MATERIALS Mild/moderate COVID-19 convalescents were selected as CCP donors after reverse transcription polymerase chain reaction (RT-PCR) confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and absence of symptoms for ≥14 days plus (a) age (18-60 years), body weight greater than 55 kg; (b) immunohematological studies; (c) no infectious markers of hepatitis B virus, hepatitis C virus, human immunodeficiency virus, human T-lymphotropic virus-1/2, Chagas and syphilis infection; (d) no HLA antibodies (multiparous); (e) second RT-PCR (nasopharyngeal swab and/or blood) negativity; (f) virus neutralization test (cytopathic effect-based virus neutralization test neutralizing antibody) and anti-nucleocapsid protein SARS-CoV-2 IgM, IgG, and IgA enzyme-linked immunosorbent assays. RESULTS Among 271 donors (41 females, 230 males), 250 presented with neutralizing antibodies. Final RT-PCR was negative on swab (77.0%) or blood (88.4%; P = .46). Final definition of RT-PCR was only defined at more than 28 days after full recovery in 59 of 174 (33.9%) RT-PCR -ve, and 25/69 RT-PCR +ve (36.2%; 13 between 35 and 48 days). Neutralizing antibody titers of 160 or greater were found in 63.6%. Correlation between IgG signal/cutoff of 5.0 or greater and neutralizing antibody of 160 or greater was 82.4%. Combination of final RT-PCR -ve with neutralizing antibody ≥160 was 41.3% (112/271). Serial plasma collection showed decline in neutralizing antibody titers and IgA levels (P < .05), probably denoting a "golden period" for CCP collection (≤28 days after joining the program); IgA might have an important role as neutralizing antibody. Donor's weight, days between disease onset and serial plasma collection, and IgG and IgM levels are important predictors for neutralizing antibody titer. CONCLUSIONS RT-PCR +ve cases are still detected in 36.2% within 28 to 48 days after recovery. High anti-nucleocapsid protein IgG levels may be used as a surrogate marker to neutralizing antibody.
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Affiliation(s)
| | | | - Rafael Machado
- Department of MicrobiologyInstitute of Biomedical Sciences, University of Sao PauloSão PauloBrazil
| | | | - Carolina Bub
- Hospital Israelita Albert Einstein Blood BankSão PauloBrazil
| | | | - Ana Yokoyama
- Hospital Israelita Albert Einstein Blood BankSão PauloBrazil
| | | | - Araci Sakashita
- Hospital Israelita Albert Einstein Blood BankSão PauloBrazil
| | - Ruth Achkar
- Hospital Sírio‐Libanês Blood BankSão PauloBrazil
| | | | | | | | | | - Danielle Araujo
- Department of MicrobiologyInstitute of Biomedical Sciences, University of Sao PauloSão PauloBrazil
| | - Camila Soares
- Department of MicrobiologyInstitute of Biomedical Sciences, University of Sao PauloSão PauloBrazil
| | | | - Esper Kallás
- Infectious Disease DepartmentUniversity of São Paulo Medical SchoolSão PauloBrazil
| | - Edison Durigon
- Department of MicrobiologyInstitute of Biomedical Sciences, University of Sao PauloSão PauloBrazil
| | | | - Luiz Vicente Rizzo
- Albert Einstein Jewish Institute for Education and ResearchSão PauloBrazil
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