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Pathirana SL, Deepachandi B, Gunasekara P, Fernando N, Perera IC, Gangani D, Thambyarajah J, Dasanayake D, de Silva R, Premawansa S, Nitsche A, Handunnetti SM. Development and Evaluation of In-House ELISAs for the Detection of SARS-CoV-2-Specific Antibodies in COVID-19 Patients in Sri Lanka. Int J Microbiol 2024; 2024:1331067. [PMID: 39346702 PMCID: PMC11427722 DOI: 10.1155/2024/1331067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/29/2024] [Accepted: 08/27/2024] [Indexed: 10/01/2024] Open
Abstract
COVID-19 serological tests complement the molecular diagnostics and can be used as important tool for serosurveillance and vaccine efficiency evaluation. The aim of this study was to develop and evaluate the diagnostic performance of an in-house ELISA for retrospective serosurveillance of SARS-CoV-2. Total IgG and IgM levels in sera of PCR positive SARS-CoV-2 patients (n = 50) from North Colombo Teaching Hospital were evaluated and compared with sera (n = 50) collected from prepandemic healthy individuals as controls. Patient sample collection was initiated before vaccination programme was widely started within the country. Seropositivity of 94.0% (n = 47/50) was observed for either IgG or IgM anti-SARS-CoV-2 antibodies against receptor binding domain of spike protein or nucleocapsid protein in confirmed cases while none of controls were seropositive. In contrast, the seropositivity of only 48.0% (n = 24/50) was demonstrated with commercial ELISA kits for detection of IgG or IgM. All samples detected seropositive by commercially available kits remained seropositive with either in-house IgM or IgG ELISA. Significant correlations (p ≤ 0.001) were observed between Ab levels and day of sampling from the onset of illness. The overall sensitivity values of the in-house assays were 66.7%, 96.9%, and 100.0% for the first, second, and third week or longer after onset of symptoms for either in-house IgM or IgG ELISAs. Majority of the patients (>80.0%) were seropositive, regardless of age (<60 vs. >60 years), gender (male vs. female), or clinical severity (mild vs. moderate/severe). These data suggest that the developed in-house ELISAs can be applied to assess anti-SARS-CoV-2 antibody levels induced by either natural infections or vaccination.
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Affiliation(s)
- Sisira L Pathirana
- Institute of Biochemistry Molecular Biology and Biotechnology University of Colombo, Colombo, Sri Lanka
| | - Bhagya Deepachandi
- Institute of Biochemistry Molecular Biology and Biotechnology University of Colombo, Colombo, Sri Lanka
- Department of Life Sciences Faculty of Science, NSBM Green University, Mahenwaththa, Pitipana, Homagama, Sri Lanka
| | - Peshala Gunasekara
- Institute of Biochemistry Molecular Biology and Biotechnology University of Colombo, Colombo, Sri Lanka
| | - Narmada Fernando
- Institute of Biochemistry Molecular Biology and Biotechnology University of Colombo, Colombo, Sri Lanka
| | - Inoka C Perera
- Department of Zoology and Environment Sciences Faculty of Science University of Colombo, Colombo, Sri Lanka
| | - Dakshika Gangani
- Institute of Biochemistry Molecular Biology and Biotechnology University of Colombo, Colombo, Sri Lanka
| | - James Thambyarajah
- Institute of Biochemistry Molecular Biology and Biotechnology University of Colombo, Colombo, Sri Lanka
| | | | - Rajiva de Silva
- Department of Immunology Medical Research Institute, Colombo, Sri Lanka
| | - Sunil Premawansa
- Department of Zoology and Environment Sciences Faculty of Science University of Colombo, Colombo, Sri Lanka
| | - Andreas Nitsche
- Center for Biological Threats and Special Pathogens Robert Koch Institute, Berlin, Germany
| | - Shiroma M Handunnetti
- Institute of Biochemistry Molecular Biology and Biotechnology University of Colombo, Colombo, Sri Lanka
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Perkmann T, Koller T, Perkmann-Nagele N, Ozsvar-Kozma M, Eyre D, Matthews P, Bown A, Stoesser N, Breyer MK, Breyer-Kohansal R, Burghuber OC, Hartl S, Aletaha D, Sieghart D, Quehenberger P, Marculescu R, Mucher P, Radakovics A, Klausberger M, Duerkop M, Holzer B, Hartmann B, Strassl R, Leitner G, Grebien F, Gerner W, Grabherr R, Wagner OF, Binder CJ, Haslacher H. Increasing test specificity without impairing sensitivity: lessons learned from SARS-CoV-2 serology. J Clin Pathol 2023; 76:770-777. [PMID: 36041815 DOI: 10.1136/jcp-2022-208171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 08/12/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Serological tests are widely used in various medical disciplines for diagnostic and monitoring purposes. Unfortunately, the sensitivity and specificity of test systems are often poor, leaving room for false-positive and false-negative results. However, conventional methods were used to increase specificity and decrease sensitivity and vice versa. Using SARS-CoV-2 serology as an example, we propose here a novel testing strategy: the 'sensitivity improved two-test' or 'SIT²' algorithm. METHODS SIT² involves confirmatory retesting of samples with results falling in a predefined retesting zone of an initial screening test, with adjusted cut-offs to increase sensitivity. We verified and compared the performance of SIT² to single tests and orthogonal testing (OTA) in an Austrian cohort (1117 negative, 64 post-COVID-positive samples) and validated the algorithm in an independent British cohort (976 negatives and 536 positives). RESULTS The specificity of SIT² was superior to single tests and non-inferior to OTA. The sensitivity was maintained or even improved using SIT² when compared with single tests or OTA. SIT² allowed correct identification of infected individuals even when a live virus neutralisation assay could not detect antibodies. Compared with single testing or OTA, SIT² significantly reduced total test errors to 0.46% (0.24-0.65) or 1.60% (0.94-2.38) at both 5% or 20% seroprevalence. CONCLUSION For SARS-CoV-2 serology, SIT² proved to be the best diagnostic choice at both 5% and 20% seroprevalence in all tested scenarios. It is an easy to apply algorithm and can potentially be helpful for the serology of other infectious diseases.
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Affiliation(s)
- Thomas Perkmann
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - Thomas Koller
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | | | - Maria Ozsvar-Kozma
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - David Eyre
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Abbie Bown
- Public Health England Porton Down, Salisbury, UK
| | - Nicole Stoesser
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Marie-Kathrin Breyer
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Robab Breyer-Kohansal
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Otto C Burghuber
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Sigmund Freud Private University Vienna, Vienna, Austria
| | - Slyvia Hartl
- Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Sigmund Freud Private University Vienna, Vienna, Austria
| | - Daniel Aletaha
- Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Daniela Sieghart
- Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Peter Quehenberger
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - Rodrig Marculescu
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - Patrick Mucher
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - Astrid Radakovics
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - Miriam Klausberger
- Institute of Molecular Biotechnology, Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Vienna, Austria
| | - Mark Duerkop
- Institute of Bioprocess Science and Engineering, Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Vienna, Austria
| | - Barba Holzer
- Institute for Veterinary Disease Control, Austrian Agency for Health and Food Safety (AGES), Moedling, Austria
| | - Boris Hartmann
- Institute for Veterinary Disease Control, Austrian Agency for Health and Food Safety (AGES), Moedling, Austria
| | - Robert Strassl
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - Gerda Leitner
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
| | - Florian Grebien
- Institute for Medical Biochemistry, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Wilhelm Gerner
- Institute of Immunology, University of Veterinary Medicine Vienna, Vienna, Austria
- Christian Doppler Laboratory for an Optimized Prediction of Vaccination Success in Pigs, University of Veterinary Medicine Vienna, Vienna, Austria
- The Pirbright Institute, Pirbright, UK (current)
| | - Reingard Grabherr
- Institute of Molecular Biotechnology, Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Vienna, Austria
| | - Oswald F Wagner
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - Christoph J Binder
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
| | - Helmuth Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Wien, Austria
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Edelstein M, Wiegler Beiruti K, Ben-Amram H, Beer N, Sussan C, Batya P, Zarka S, Abu Jabal K. Vaccine-induced and hybrid immunity to SARS-CoV-2 after three or four doses of BNT162b2 - results from 22 months follow-up of a healthcare workers cohort, Israel, 2020-2022. Int J Infect Dis 2023; 135:57-62. [PMID: 37572957 DOI: 10.1016/j.ijid.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/14/2023] Open
Abstract
OBJECTIVES SARS-CoV-2 remains a global health concern 3 years after its emergence. Safe and effective vaccines mitigate the pandemic impact, but the optimal schedule remains unclear, especially in a context where a high proportion of the population is infected. METHODS We periodically measured anti-spike SARS-CoV-2 immunoglobulin (Ig)G titers using a quantitative assay in an Israeli healthcare worker cohort who all received at least two BNT162b2 doses and either received further doses and/or were subsequently infected up to 22 months after dose two, and compared geometric mean concentrations according to number of doses received and infection status using analysis of variance. RESULTS Among the 993 included participants, infection after dose two led to higher geometric mean concentration IgG titers than a third dose (4285 vs 2845 arbitrary unit/ml 1-2 months after infection/vaccination, P = 0.03). In 16-18 months after dose two, those infected and those who received three or four vaccine doses all had IgG geometric mean concentration levels above 500 arbitrary unit/ml with no significant differences among groups (P = 0.6). IgG levels plateaued 16-22 months after dose two. CONCLUSION Three BNT162b2 doses provide long-term immunogenicity comparable to breakthrough infection after dose two. Dose four transiently increases IgG levels and may be especially important for providing additional protection to vulnerable individuals during periods of increased transmission risk.
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Affiliation(s)
- Michael Edelstein
- Ziv Medical Center, Safed, Israel; Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
| | | | | | | | | | | | - Salman Zarka
- Ziv Medical Center, Safed, Israel; Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Kamal Abu Jabal
- Ziv Medical Center, Safed, Israel; Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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Delgado JF, Vidal M, Julià G, Navarro G, Serrano RM, van den Eynde E, Navarro M, Calvet J, Gratacós J, Espasa M, Peña P. Validation of N Protein Antibodies to Diagnose Previous SARS-CoV-2 Infection in a Large Cohort of Healthcare Workers: Use of Roche Elecsys ® Immunoassay in the S Protein Vaccination Era. Viruses 2023; 15:v15040930. [PMID: 37112910 PMCID: PMC10146079 DOI: 10.3390/v15040930] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
The aim of this study was to validate the detection of anti-nucleocapsid protein (N protein) antibodies for the diagnosis of SARS-CoV-2 infection in light of the fact that most COVID-19 vaccines use the spike (S) protein as the antigen. Here, 3550 healthcare workers (HCWs) were enrolled from May 2020 (when no S protein vaccines were available). We defined SARS-CoV-2 infection if HCWs were found to be positive by RT-PCR or found to be positive in at least two different serological immunoassays. Serum samples from Biobanc I3PT-CERCA were analyzed by Roche Elecsys® (N protein) and Vircell IgG (N and S proteins) immunoassays. Discordant samples were reanalyzed with other commercial immunoassays. Roche Elecsys® showed the positivity of 539 (15.2%) HCWs, 664 (18.7%) were found to be positive by Vircell IgG immunoassays, and 164 samples (4.6%) showed discrepant results. According to our SARS-CoV-2 infection criteria, 563 HCWs had SARS-CoV-2 infection. The Roche Elecsys® immunoassay has a sensitivity, specificity, accuracy, and concordance with the presence of infection of 94.7%, 99.8%, 99.3%, and 0.96, respectively. Similar results were observed in a validation cohort of vaccinated HCWs. We conclude that the Roche Elecsys® SARS-CoV-2 N protein immunoassay demonstrated good performance in diagnosing previous SARS-CoV-2 infection in a large cohort of HCWs.
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Affiliation(s)
- Juan Francisco Delgado
- Immunology Laboratory, Clinic Laboratories Service, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Departament de Medicina, Universitat Autònoma de Barcelona, 8207 Sabadell, Spain
| | - Mònica Vidal
- Immunology Laboratory, Clinic Laboratories Service, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Departament de Medicina, Universitat Autònoma de Barcelona, 8207 Sabadell, Spain
| | - Germà Julià
- Immunology Laboratory, Clinic Laboratories Service, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Departament de Medicina, Universitat Autònoma de Barcelona, 8207 Sabadell, Spain
| | - Gema Navarro
- Epidemiology Service, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 8207 Sabadell, Spain
| | - Rosa María Serrano
- Occupational Health Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 8207 Sabadell, Spain
| | - Eva van den Eynde
- Infection Disease Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 8207 Sabadell, Spain
| | - Marta Navarro
- Infection Disease Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 8207 Sabadell, Spain
| | - Joan Calvet
- Rheumatology Service, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Departament de Medicina, Universitat Autònoma de Barcelona, 8207 Sabadell, Spain
| | - Jordi Gratacós
- Rheumatology Service, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Departament de Medicina, Universitat Autònoma de Barcelona, 8207 Sabadell, Spain
| | - Mateu Espasa
- Microbiology Section, Laboratory Service, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 8207 Sabadell, Spain
| | - Pilar Peña
- Occupational Health Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 8207 Sabadell, Spain
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García-García E, Calle-Miguel L, Pérez-Solís D, Urueña IC, Merino ÁG, Gómez HH, Poladura MM, Rodríguez-Pérez M. Household Transmission of SARS-CoV-2 and Long-term Immunity in Children: A Prospective Study in Northern Spain. Pediatr Infect Dis J 2023; 42:226-231. [PMID: 36730092 PMCID: PMC9935233 DOI: 10.1097/inf.0000000000003790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND The role of children in SARS-CoV-2 transmission and their immune response after infection have been profoundly discussed. Hereby, we analyze both aspects in a Spanish pediatric population. METHODS Prospective, multicentre, longitudinal study performed from July 2020 to September 2021 in children up to 14 years old. Venous blood samples were collected every 6 months and serum was analyzed for antibodies against SARS-CoV-2 using a spike (S) and a nucleocapsid (N) protein assays. Household contacts of seropositive children were tested. Household transmission, antibody dynamics, and durability were analyzed. RESULTS Two hundred children were recruited and 28 had SARS-CoV-2 antibodies at the end of the study, resulting in an overall seroprevalence of 16.6% (95% CI: 9.5%-19.6%). Most of children (18/28) were secondary cases. The secondary attack rate (SAR) was lower in households with pediatric index cases than in those with adult index cases ( P = 0.023). The median antibody titers in the first positive serology, for the seropositive patients, were 137 BAU/mL (IQR 83.3-427.4) for the S-assay and 132.5 COI (IQR 14.5-170.5) for the N-assay without significant differences between symptomatic and asymptomatic children. The median time between the RT-PCR and the last serology was 7.5 months (IQR 5.2-8.8), and the duration of SARS-CoV-2 antibodies after infection was proven to be at least 18 months. There were no cases of seroreversion. CONCLUSIONS (1) Children are not the main drivers of SARS-CoV-2 household transmission. (2) They maintain SARS-CoV-2 antibodies for up to 18 months after infection and the titers are similar between symptomatic and asymptomatic children.
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Affiliation(s)
| | - Laura Calle-Miguel
- Pediatrics Department, Hospital Universitario Central de Asturias, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - David Pérez-Solís
- Pediatrics Department, Hospital Universitario San Agustín, Avilés, Spain
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Medrano S, Martínez-Rodríguez M, Vallejo L, Culebras E, Delgado-Iribarren A. [Evaluation of two immunocromatographic tests for the detection of antibodies against SARS-CoV-2]. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2022; 35:538-543. [PMID: 36164855 PMCID: PMC9728603 DOI: 10.37201/req/019.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/24/2022] [Accepted: 07/19/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Serological tests have been a valuable tool during the SARS-CoV-2 pandemic, supporting molecular methods for detection, and monitoring the immune response, caused by vaccination or by natural infection. Within all these techniques, rapid tests are interesting due to their ease of use, rapid response and low cost. METHODS Two different immunological techniques were evaluated: Realy Tech and Mikrogen Diagnostik recomLine SARS-CoV-2 IgG. SARS-CoV-2 IgG II Quant antibody test and SARS-CoV-IgG assay, both from Abbott Diagnostics, were used as reference techniques. RESULTS Mikrogen Diagnostik recomLine SARS-CoV-2 IgG shows the best results (S=0.985; E=0.839). Three techniques offered good positive predictive values, but Realy Tech and Healgen negative predictive values left to be desired. CONCLUSIONS Mikrogen Diagnostik recomLine SARS-CoV-2 IgG showed good results in the detection of antibodies against SARS-CoV-2 and could be used as an alternative to automated techniques.
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Affiliation(s)
- S Medrano
- Sara Medrano Pardo, Microbiology Department. Hospital Clínico San Carlos. C/ Martín Lago s/n. 28040-Madrid. Spain.
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Nah E, Cho S, Park H, Kim S, Noh D, Kwon E, Cho H. Antibody response after two doses of homologous or heterologous SARS-CoV-2 vaccines in healthcare workers at health promotion centers: A prospective observational study. J Med Virol 2022; 94:4719-4726. [PMID: 35655438 PMCID: PMC9347810 DOI: 10.1002/jmv.27911] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/20/2022] [Accepted: 05/31/2022] [Indexed: 11/22/2022]
Abstract
Assaying of anti-spike-protein receptor-binding domain (S-RBD) antibodies are used to aid evaluations of the immune statuses of individuals. The aim of this study was to determine the antibody response after two doses of homologous or heterologous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines and to identify the factors affecting this response among healthcare workers (HCWs) at health promotion centers. In this prospective observational study, 1095 consenting HCWs were recruited from 16 health checkup centers and were tested at T0 (day of first dose), T1-1 (1 month after first dose), T2-0 (day of second dose), T2-1 (1 month after second dose), and T2-3 (3 months after second dose). SARS-CoV-2 antibodies were measured using a chemiluminescence microparticle immunoassay with SARS-CoV-2 IgG II Quant in the ARCHITECT system (Abbott Diagnostics). At T1-1, anti-SARS-CoV-2 S-RBD IgG levels were significantly higher in participants who received messenger RNA (mRNA) vaccines than in those who received viral vector vaccines (p < 0.001). At T2-1, anti-SARS-CoV-2 S-RBD IgG levels were about 10 times higher than at T1-1 in participants who received homologous mRNA vaccines, which decreased to a third of those at T2-3. Anti-SARS-CoV-2 S-RBD IgG levels were highest among those who received homologous mRNA vaccines, followed by heterologous mRNA viral vector vaccines and homologous viral vector vaccines at T2-3 (p < 0.001). In a multivariable linear regression analysis, being female, taking at least one mRNA vaccine, and having a history of recovery from coronavirus disease 2019 (COVID-19) were significantly associated with anti-S-RBD levels. Anti-SARS-CoV-2 S-RBD IgG levels were decreased at 3 months after two-dose vaccinations and were associated with sex, vaccine type, and COVID-19 history.
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Affiliation(s)
- Eun‐Hee Nah
- Department of Laboratory Medicine and Health Promotion Research InstituteKorea Association of Health PromotionSeoulKorea
| | - Seon Cho
- Department of Laboratory Medicine and Health Promotion Research InstituteKorea Association of Health PromotionSeoulKorea
| | - Hyeran Park
- Department of Laboratory Medicine and Health Promotion Research InstituteKorea Association of Health PromotionSeoulKorea
| | - Suyoung Kim
- Department of Laboratory Medicine and Health Promotion Research InstituteKorea Association of Health PromotionSeoulKorea
| | - Dongwon Noh
- Department of Laboratory Medicine and Health Promotion Research InstituteKorea Association of Health PromotionSeoulKorea
| | - Eunjoo Kwon
- Department of Laboratory Medicine and Health Promotion Research InstituteKorea Association of Health PromotionSeoulKorea
| | - Han‐Ik Cho
- MEDIcheck LAB, Korea Association of Health PromotionSeoulKorea
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Dibernardo A, Toledo NPL, Robinson A, Osiowy C, Giles E, Day J, Robbin Lindsay L, Drebot MA, Booth TF, Pidduck T, Baily A, Charlton CL, Tipples G, Kanji JN, Brochu G, Lang A, Therrien C, Bélanger-Collard M, Beaulac SN, Gilfix BM, Boivin G, Hamelin MÈ, Carbonneau J, Lévesque S, Martin P, Finzi A, Gendron-Lepage G, Goyette G, Benlarbi M, Gasser R, Fortin C, Martel-Lafferrière V, Lavoie M, Guérin R, Haraoui LP, Renaud C, Jenkins C, O'Brien SF, Drews SJ, Conrod V, Tran V, Awrey B, Scheuermann R, DuPuis A, Payne A, Warszycki C, Girardin R, Lee W, Zahariadis G, Jiao L, Needle R, Cordenbach J, Zaharatos J, Taylor K, Teltscher M, Miller M, Elsherif M, Robertson P, Robinson JL. Evaluation of the performance of multiple immunoassay diagnostic platforms on the National Microbiology Laboratory SARS-CoV-2 National Serology Panel. JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA = JOURNAL OFFICIEL DE L'ASSOCIATION POUR LA MICROBIOLOGIE MEDICALE ET L'INFECTIOLOGIE CANADA 2022; 7:186-195. [PMID: 36337598 PMCID: PMC9629736 DOI: 10.3138/jammi-2021-0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/05/2021] [Accepted: 03/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Serological assays designed to detect SARS-CoV-2 antibodies are being used in serological surveys and other specialized applications. As a result, and to ensure that the outcomes of serological testing meet high quality standards, evaluations are required to assess the performance of these assays and the proficiency of laboratories performing them. METHODS A panel of 60 plasma/serum samples from blood donors who had reverse transcriptase-polymerase chain reaction (RT-PCR) confirmed SARS-CoV-2 infections and 21 SARS-CoV-2 negative samples were secured and distributed to interested laboratories within Canada (n = 30) and the United States (n = 1). Participating laboratories were asked to provide details on the diagnostic assays used, the platforms the assays were performed on, and the results obtained for each panel sample. Laboratories were blinded with respect to the expected outcomes. RESULTS The performance of the different assays evaluated was excellent, with the high-throughput platforms of Roche, Ortho, and Siemens demonstrating 100% sensitivity. Most other high-throughput platforms had sensitivities of >93%, with the exception of the IgG assay using the Abbott ARCHITECT which had an average sensitivity of only 87%. The majority of the high-throughput platforms also demonstrated very good specificities (>97%). CONCLUSION This proficiency study demonstrates that most of the SARS-CoV-2 serological assays utilized by provincial public health or hospital laboratories in Canada have acceptable sensitivity and excellent specificity.
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Affiliation(s)
- Antonia Dibernardo
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Nikki PL Toledo
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Alyssia Robinson
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Carla Osiowy
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Elizabeth Giles
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Jacqueline Day
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - L Robbin Lindsay
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Michael A Drebot
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Timothy F Booth
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Tamara Pidduck
- BCCDC Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Ashley Baily
- Public Health Laboratory, Alberta Precision Laboratories, University of Alberta Hospital, Edmonton, Alberta, Canada
| | - Carmen L Charlton
- Department of Laboratory Medicine and Pathology, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
| | - Graham Tipples
- Department of Medical Microbiology & Immunology, University of Alberta, Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
- Li Ka Shing Institute for Virology, Edmonton, Alberta, Canada
| | - Jamil N Kanji
- Department of Laboratory Medicine and Pathology, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
- Division of Infectious Diseases, Department of Medicine, University of Alberta, Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gino Brochu
- CIUSSS Mauricie—Centre du Québec, Trois-Rivières, Québec, Canada
| | - Amanda Lang
- Roy Romanow Provincial Laboratory, Saskatchewan Health Authority, Regina, Saskatchewan, Canada
| | - Christian Therrien
- Laboratoire de santé publique du Québec, Institut de santé publique du Québec, Saint-Anne-de-Bellevue, Québec, Canada
| | - Mélina Bélanger-Collard
- Laboratoire de santé publique du Québec, Institut de santé publique du Québec, Saint-Anne-de-Bellevue, Québec, Canada
| | - Sylvie-Nancy Beaulac
- Laboratoire de santé publique du Québec, Institut de santé publique du Québec, Saint-Anne-de-Bellevue, Québec, Canada
| | - Brian M Gilfix
- McGill University Health Centre, Department of Medicine, Montreal, Québec, Canada
| | - Guy Boivin
- Université Laval and CHU de Québec, Québec City, Québec, Canada
| | | | | | - Simon Lévesque
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- CIUSSSE de l'Estrie—CHUS, Sherbrooke, Québec, Canada
- Département de microbiologie et infectiologie, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Philippe Martin
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- CIUSSSE de l'Estrie—CHUS, Sherbrooke, Québec, Canada
- Département de microbiologie et infectiologie, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Andrés Finzi
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada
- Canada Department of Microbiology and Immunology, McGill University, Montreal, Québec, Canada
| | | | | | | | - Romain Gasser
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada
| | - Claude Fortin
- CHUM: Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | | | - Myriam Lavoie
- CIUSSS du Saguenay Lac-St-Jean, Hôpital de Chicoutimi, Chicoutimi, Québec, Canada
| | - Renée Guérin
- Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Louis-Patrick Haraoui
- Department of Microbiology and Infectious Diseases, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Christian Renaud
- Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
| | | | | | | | | | - Vanessa Tran
- BCCDC Public Health Laboratory, Vancouver, British Columbia, Canada
- Public Health Ontario, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Bill Awrey
- Alpha Laboratories Inc., Toronto, Ontario, Canada
| | | | - Alan DuPuis
- Wadsworth Center, New York State Department of Health (NYSDOH), Albany, New York, United States
| | - Anne Payne
- Wadsworth Center, New York State Department of Health (NYSDOH), Albany, New York, United States
| | - Casey Warszycki
- Wadsworth Center, New York State Department of Health (NYSDOH), Albany, New York, United States
| | - Roxie Girardin
- Wadsworth Center, New York State Department of Health (NYSDOH), Albany, New York, United States
| | - William Lee
- BCCDC Public Health Laboratory, Vancouver, British Columbia, Canada
- Wadsworth Center, New York State Department of Health (NYSDOH), Albany, New York, United States
- Department of Biomedical Sciences, School of Public Health, University at Albany, Albany, New York, United States
| | - George Zahariadis
- Newfoundland and Labrador Public Health Microbiology Laboratory, St. Johns, Newfoundland, Canada
| | - Lei Jiao
- Newfoundland and Labrador Public Health Microbiology Laboratory, St. Johns, Newfoundland, Canada
| | - Robert Needle
- Newfoundland and Labrador Public Health Microbiology Laboratory, St. Johns, Newfoundland, Canada
| | | | | | | | | | - Matthew Miller
- Canadian Centre for Vaccinology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - May Elsherif
- Canadian Centre for Vaccinology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Peter Robertson
- Canadian Centre for Vaccinology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jason L Robinson
- Division of Clinical Chemistry, Provincial Laboratory Services, Health PEI, Charlottetown, Prince Edward Island, Canada
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9
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Edelstein M, Wiegler Beiruti K, Ben-Amram H, Bar-Zeev N, Sussan C, Asulin H, Strauss D, Bathish Y, Zarka S, Abu Jabal K. Antibody-Mediated Immunogenicity Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Following Priming, Boosting, and Hybrid Immunity: Insights From 11 Months of Follow-up of a Healthcare Worker Cohort in Israel, December 2020-October 2021. Clin Infect Dis 2022; 75:e572-e578. [PMID: 35279028 PMCID: PMC8992305 DOI: 10.1093/cid/ciac212] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND We determined circulating anti-S severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) antibody titers in a vaccinated healthcare workers (HCWs) cohort from Northern Israel in the 11 months following primary vaccination according to age, ethnicity, and previous infection status. METHODS All consenting HCWs were invited to have their IgG levels measured before vaccination and at 6 subsequent timepoints using a quantitative S1/S2 IgG assay. All HCWs with suspected coronavirus disease 2019 (COVID-19) were polymerase chain reaction (PCR) tested. We described trends in circulating IgG geometric mean concentration (GMC) by age, ethnicity, timing of boosting, and previous infection status and compared strata using Kruskall-Wallis tests. RESULTS Among 985 vaccinated HCWs, IgG titers between 1 month post 2nd dose to pre-boosting gradually decreased in all age groups. Younger or previously infected individuals had higher initial post-vaccination IgG levels (P < .001 in both cases); differences substantially decreased or disappeared at 7-9 months, before boosting. The proportion of individuals infected prior to initiating vaccination and re-infected after dose 1 was comparable to the proportion of breakthrough infection post-dose 2 in those not previously infected (4.2 vs 4.7%). Pre-infection IgG levels in the 40 participants with breakthrough infection after dose 2 were similar to levels measured at the same timepoint in vaccinated HCWs who remained uninfected (P > .3). Post-dose3 IgG levels were more than 10-fold those 1 month post-dose 2. CONCLUSIONS Immunity waned in all age groups and previously infected individuals, reversed by boosting. IgG titers decrease and reinfections in individuals with hybrid immunity (infection + vaccination) suggests they may also require further doses. Our study also highlights the difficulty in determining protective IgG levels.
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Affiliation(s)
- Michael Edelstein
- Ziv Medical Centre, Safed, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | | | | | - Naor Bar-Zeev
- International Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | | | | | - David Strauss
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Younes Bathish
- Ziv Medical Centre, Safed, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Salman Zarka
- Ziv Medical Centre, Safed, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Kamal Abu Jabal
- Ziv Medical Centre, Safed, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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10
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Inés RM, Gabriela HTM, Paula CM, Magdalena TM, Jimena A, Salome KB, Javier AJ, Sebastián B, Lorena S, Adrián DL, Elisa R, Mauricio B, Tersita BM, Verónica GS, Beatriz IM. Performance of Elecsys Anti-SARS CoV-2 (Roche) and VIDAS Anti-SARS CoV-2 (Biomérieux) for SARS-CoV-2 Nucleocapsid and Spike Protein Antibody Detection. EJIFCC 2022; 33:159-165. [PMID: 36313907 PMCID: PMC9562483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Introduction Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the novel viral pathogen that causes coronavirus disease 2019 (COVID-19) in humans, has spread worldwide since its identification in late 2019. The pandemic produced an accelerated development of new serological techniques for diagnosis. Methods We evaluated two commercial assays for serological diagnosis of SARS-CoV-2 infection, approved by the Administración Nacional de Medicamentos, Alimentos y Tecnología Médica (ANMAT) in Argentina: Elecsys Anti-SARS-CoV-2; Roche for nucleocapsid total antibody detection, and VIDAS Anti-SARS-CoV-2 bioMérieux for spike protein IgG antibody detection. Sensitivity was assessed using a panel of 92 plasma samples from recovered COVID-19 patients who were positive for RT-PCR and positive for neutralizing antibodies by plaque reduction neutralization test (PRNT) and/or positive for IgG antibodies by indirect immunofluorescence assay (IFA). Specificity was determined studying 71 plasma samples collected during year 2018 prior to the COVID-19 pandemic. Assays were evaluated as stand-alone tests. Results Sensitivity was 97.8% and 98.9% for the Roche and bioMérieux assays, respectively, specificity: 98.5% (Roche) and 97.1% (bioMérieux), positive predictive value (PPV): 98.9% (Roche) and 97.8% (bioMérieux), and negative predictive value: (NPV) 97.2% (Roche) and 98.5% (bioMérieux). Additionally, Cohen's kappa coefficient demonstrated high concordance (k=0.950) between Roche and bioMérieux. Discussion In conclusion, our results evidenced a very good performance for the nucleocapsid antibody assay (Roche) and the spike protein antibody assay (bioMérieux), thus both platforms are equally adequate for indirect diagnosis of SARS-CoV-2 infection through total antibodies and IgG antibody detection, respectively.
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Affiliation(s)
- Riberi María Inés
- Universidad Católica de Córdoba, Clínica Universitaria Reina Fabiola, Servicio de Microbiología, Laboratorio de Virología, Córdoba, Argentina. Oncativo 1248, 5000, Córdoba, Argentina,Corresponding authors: Universidad Católica de Córdoba Clínica Universitaria Reina Fabiola Servicio de Microbiología Laboratorio de Virología Oncativo 1248, 5000, Córdoba Argentina E-mail:
| | - Hernandez Toledo Marina Gabriela
- Universidad Católica de Córdoba, Clínica Universitaria Reina Fabiola, Servicio de Microbiología, Laboratorio de Virología, Córdoba, Argentina. Oncativo 1248, 5000, Córdoba, Argentina
| | - Cid Mariana Paula
- Universidad Nacional de Córdoba, Facultad de Ciencias Exactas, Departamento de Química, Córdoba, Argentina,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Tenaglia María Magdalena
- Universidad Católica de Córdoba, Clínica Universitaria Reina Fabiola, Servicio de Microbiología, Laboratorio de Virología, Córdoba, Argentina. Oncativo 1248, 5000, Córdoba, Argentina
| | - Alfaro Jimena
- Universidad Católica de Córdoba, Clínica Universitaria Reina Fabiola, Servicio de Microbiología, Laboratorio de Virología, Córdoba, Argentina. Oncativo 1248, 5000, Córdoba, Argentina
| | - Konigheim Brenda Salome
- Universidad Nacional de Córdoba, Facultad de Ciencias Médicas, Instituto de Virología “Dr. J. M. Vanella”, Córdoba, Argentina,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Aguilar Juan Javier
- Universidad Nacional de Córdoba, Facultad de Ciencias Médicas, Instituto de Virología “Dr. J. M. Vanella”, Córdoba, Argentina
| | - Blanco Sebastián
- Universidad Nacional de Córdoba, Facultad de Ciencias Médicas, Instituto de Virología “Dr. J. M. Vanella”, Córdoba, Argentina
| | - Spinsanti Lorena
- Universidad Nacional de Córdoba, Facultad de Ciencias Médicas, Instituto de Virología “Dr. J. M. Vanella”, Córdoba, Argentina
| | - Díaz Luis Adrián
- Universidad Nacional de Córdoba, Facultad de Ciencias Médicas, Instituto de Virología “Dr. J. M. Vanella”, Córdoba, Argentina,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Rivarola Elisa
- Universidad Nacional de Córdoba, Facultad de Ciencias Médicas, Instituto de Virología “Dr. J. M. Vanella”, Córdoba, Argentina
| | - Beranek Mauricio
- Universidad Nacional de Córdoba, Facultad de Ciencias Médicas, Instituto de Virología “Dr. J. M. Vanella”, Córdoba, Argentina,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Bottiglieri Marina Tersita
- Universidad Católica de Córdoba, Clínica Universitaria Reina Fabiola, Servicio de Microbiología, Laboratorio de Virología, Córdoba, Argentina. Oncativo 1248, 5000, Córdoba, Argentina
| | - Gallego Sandra Verónica
- Universidad Nacional de Córdoba, Facultad de Ciencias Médicas, Instituto de Virología “Dr. J. M. Vanella”, Córdoba, Argentina,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Isa María Beatriz
- Universidad Católica de Córdoba, Clínica Universitaria Reina Fabiola, Servicio de Microbiología, Laboratorio de Virología, Córdoba, Argentina. Oncativo 1248, 5000, Córdoba, Argentina,Universidad Nacional de Córdoba, Facultad de Ciencias Médicas, Instituto de Virología “Dr. J. M. Vanella”, Córdoba, Argentina
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11
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Firket L, Bouquegneau A, Seidel L, Bonvoisin C, Grosch S, Hayette MP, Jouret F, Weekers L. The prospective screening for SARS-CoV-2 S1/S2 antibodies delineates the factual incidence of COVID-19 and shows a sustained serological response post COVID-19 in kidney transplant recipients. Acta Clin Belg 2022; 78:200-205. [PMID: 35938938 DOI: 10.1080/17843286.2022.2108978] [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: 10/15/2022]
Abstract
BACKGROUND The impact of immunosuppression on the occurrence of Coronavirus Disease 2019 (COVID-19) remains unclear. METHODS We conducted a prospective screening of anti-S1/S2 IgGs against SARS-CoV-2 Spike protein from March, 1 2020 to May, 15 2021 (prior to the vaccination campaign) in a cohort of 713 kidney transplant recipients (KTRs). In a first phase, the factual incidence and seroprevalence of COVID-19 was established in this cohort: cases diagnosed by serology were added to RT-PCR-based diagnoses to obtain the overall incidence of COVID-19 in both symptomatic and asymptomatic KTRs. In the second phase, the kinetics of the post-COVID-19 humoral response were studied, taking into account the severity of the disease defined by the need for oxygen therapy (group S, "severe") or not (group nS, "not severe"). RESULTS The combined diagnostic approaches identified 138 COVID-19 cases (19.2%), with 37 diagnoses by serology (26.8%). The rate of asymptomatic KTRs reached 20.3% (28/138). Thirteen patients (9.4%) died from COVID-19. The seroconversion rate was 91.7% (99/108). The peak anti-S1/S2 IgG level was 85 [30-150] AU/ml and was similar between the S and nS groups (117 [38; 186] AU/ml versus 73 [23; 140] AU/ml). A high probability of persistence of anti-S1/S2 IgG post-COVID-19 was observed, with only 10.1% (7/69) of the patients having negated their serology during the 9-month follow-up. CONCLUSION Our pragmatic serological screening combined with RT-PCR tests provides a better estimation of the real incidence of COVID-19 in KTRs. A significant proportion of KTRs develop humoral immunity post COVID-19, which most often persists beyond 9 months.
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Affiliation(s)
- Louis Firket
- Division of Nephrology, University of Liege Hospital (ULiege CHU), Liege, Belgium
| | - Antoine Bouquegneau
- Division of Nephrology, University of Liege Hospital (ULiege CHU), Liege, Belgium
| | - Laurence Seidel
- Division of Biostatistics, University of Liege Hospital (ULiege CHU), Liege, Belgium
| | - Catherine Bonvoisin
- Division of Nephrology, University of Liege Hospital (ULiege CHU), Liege, Belgium
| | - Stéphanie Grosch
- Division of Nephrology, University of Liege Hospital (ULiege CHU), Liege, Belgium
| | - Marie-Pierre Hayette
- Division of Microbiology, University of Liege Hospital (ULiege CHU), Liege, Belgium
| | - François Jouret
- Division of Nephrology, University of Liege Hospital (ULiege CHU), Liege, Belgium.,Laboratory of Translational Research in Nephrology, University of Liege GIGA Research Center, ULiege, Belgium
| | - Laurent Weekers
- Division of Nephrology, University of Liege Hospital (ULiege CHU), Liege, Belgium
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12
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McHenry A, Iyer K, Wang J, Liu C, Harigopal M. Detection of SARS-CoV-2 in tissue: the comparative roles of RT-qPCR, in situ RNA hybridization, and immunohistochemistry. Expert Rev Mol Diagn 2022; 22:559-574. [PMID: 35658709 DOI: 10.1080/14737159.2022.2085508] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The emergence of SARS-CoV-2, the causative agent the COVID-19 pandemic, has led to a rapidly expanding arsenal of molecular diagnostic assays for the detection of viral material in tissue specimens. AREAS COVERED We review the value and shortcomings of available tissue-based assays for SARS-CoV-2 detection in formalin-fixed paraffin-embedded (FFPE) tissue, including immunohistochemistry, in situ hybridization, and quantitative reverse transcription PCR (RT-qPCR). The validation, accuracy, and comparative utility of each method is discussed. Subsequently, we identify commercially available antibodies which render the greatest specificity and reproducibility of staining in FFPE specimens. EXPERT OPINION We offer expert opinion on the efficacy of such techniques and guidance for future implementation, both clinical and experimental.
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Affiliation(s)
- Austin McHenry
- Yale University School of Medicine, Department of Pathology, New Haven, CT, 06520, United States
| | - Krishna Iyer
- Yale University School of Medicine, Department of Pathology, New Haven, CT, 06520, United States
| | - Jianhi Wang
- Yale University School of Medicine, Department of Pathology, New Haven, CT, 06520, United States
| | - Chen Liu
- Yale University School of Medicine, Department of Pathology, New Haven, CT, 06520, United States
| | - Malini Harigopal
- Yale University School of Medicine, Department of Pathology, New Haven, CT, 06520, United States
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13
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Şener B, Kirbaş E, Sancak B, Gözalan A, Evren E, Karahan ZC, Zeytinoğlu A, Dinç B, Alp A, Dizman GT, Metan G, Birengel S, Gülten E, Taşbakan M, Ayhan M. PERFORMANCE EVALUATION OF SIX DIFFERENT SARS-CoV-2 ANTIBODY IMMUNOASSAYS: DISEASE SEVERITY AND SERUM SAMPLING TIME AFFECT THE SENSITIVITY. Jpn J Infect Dis 2022; 75:388-394. [PMID: 35354702 DOI: 10.7883/yoken.jjid.2021.636] [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: 11/17/2022]
Abstract
Comparative validation data and clinical performance data are essential for the reliable interpretation of SARS-CoV-2 antibody test results. This study aimed to assess the performance of six SARS-CoV-2 IgG immunoassays in different disease severity settings. Four automated chemiluminescence immunoassays Access (Beckman Coulter), Architect (Abbott), Atellica-IM (Siemens) and Elecsys (Roche) and two ELISA assays (SARS-CoV-2 IgG-S1-based and NCP IgG, Euroimmun) were evaluated in 143 patients and 50 pre-pandemic control sera. Accuracy and precision tests were performed for validation. Overall sensitivity differed between 73.38-88.65%, being higher in spike protein-based assays. Specificity was ≥ 98% in all immunoassays. IgG response was lower for the samples taken <20 days post-symptom onset (87.30%) than for the samples taken ≥20 days post-symptom onset (94.80%). Higher rate of antibody was detected in the clinically moderate disease group. In the asymptomatic and mild group more antibody positivity was detected with spike protein-based assays. Clinical performance of the immunoassays differs according to disease severity and antigen targeted; moderate disease leading to highest rate of IgG response. All the assays tested were eligible for the detection of SARS-CoV-2 IgG however, spike-based assays revealed relatively higher sensitivity than the nucleoprotein-based assays particularly in the asymptomatic and mild disease severity.
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Affiliation(s)
- Burçin Şener
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Turkey
| | - Ekin Kirbaş
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Turkey
| | - Banu Sancak
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Turkey
| | - Ayşegül Gözalan
- Department of Medical Microbiology, Faculty of Medicine, Alaaddin Keykubat University, Turkey
| | - Ebru Evren
- Department of Medical Microbiology, Faculty of Medicine, Ankara University, Turkey
| | - Zeynep Ceren Karahan
- Department of Medical Microbiology, Faculty of Medicine, Ankara University, Turkey
| | - Ayşın Zeytinoğlu
- Department of Medical Microbiology, Faculty of Medicine, Ege University, Turkey
| | - Bedia Dinç
- Medical Microbiology Laboratory, Ankara Bilkent City Hospital, Turkey
| | - Alpaslan Alp
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Turkey
| | - Gülçin Telli Dizman
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Hacettepe University, Turkey
| | - Gökhan Metan
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Hacettepe University, Turkey
| | - Serhat Birengel
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Ankara University, Turkey
| | - Ezgi Gülten
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Ankara University, Turkey
| | - Meltem Taşbakan
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Ege University, Turkey
| | - Müge Ayhan
- Department of Clinical Microbiology and Infectious Diseases, Ankara Bilkent City Hospital, Turkey
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14
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Theel ES. Performance Characteristics of High-Throughput Serologic Assays for Severe Acute Respiratory Syndrome Coronavirus 2 with Food and Drug Administration Emergency Use Authorization: A Review. Clin Lab Med 2022; 42:15-29. [PMID: 35153046 PMCID: PMC8563341 DOI: 10.1016/j.cll.2021.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This review provides a broad summary of the performance characteristics of high-throughput severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serologic assays with Food and Drug Administration Emergency Use Authorization, which are commonly found in central clinical laboratories. In addition, this review discusses the current roles of serologic testing for SARS-CoV-2 and provides a perspective for the future.
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15
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A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE ACCURACY OF SARS-COV-2 IGM AND IGG TESTS IN INDIVIDUALS WITH COVID-19. J Clin Virol 2022; 148:105121. [PMID: 35245882 PMCID: PMC8863416 DOI: 10.1016/j.jcv.2022.105121] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 01/22/2022] [Accepted: 02/21/2022] [Indexed: 01/21/2023]
Abstract
Introduction Objective Methods Results Conclusion
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16
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Kolesov DE, Sinegubova MV, Safenkova IV, Vorobiev II, Orlova NA. Antigenic properties of the SARS-CoV-2 nucleoprotein are altered by the RNA admixture. PeerJ 2022; 10:e12751. [PMID: 35036106 PMCID: PMC8744485 DOI: 10.7717/peerj.12751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/15/2021] [Indexed: 01/07/2023] Open
Abstract
Determining the presence of antibodies to the SARS-CoV-2 antigens is the best way to identify infected people, regardless of the development of symptoms of COVID-19. The nucleoprotein (NP) of the SARS-CoV-2 is an immunodominant antigen of the virus; anti-NP antibodies are detected in persons previously infected with the virus with the highest titers. Many test systems for detecting antibodies to SARS-CoV-2 contain NP or its fragments as antigen. The sensitivity and specificity of such test systems differ significantly, which can be explained by variations in the antigenic properties of NP caused by differences in the methods of its cultivation, isolation and purification. We investigated this effect for the Escherichia coli-derived SARS-CoV-2 NP, obtained from the cytoplasm in the soluble form. We hypothesized that co-purified nucleic acids that form a strong complex with NP might negatively affect NP's antigenic properties. Therefore, we have established the NP purification method, which completely eliminates the RNA in the NP preparation. Two stages of RNA removal were used: treatment of the crude lysate of E. coli with RNase A and subsequent selective RNA elution with 2 M NaCl solution. The resulting NP without RNA has a significantly better signal-to-noise ratio when used as an ELISA antigen and tested with a control panel of serum samples with antibodies to SARS-CoV-2; therefore, it is preferable for in vitro diagnostic use. The same increase of the signal-to-noise ratio was detected for the free N-terminal domain of the NP. Complete removal of RNA complexed with NP during purification will significantly improve its antigenic properties, and the absence of RNA in NP preparations should be controlled during the production of this antigen.
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Affiliation(s)
- Denis E. Kolesov
- Laboratory of Mammalian Cell Bioengineering, Institute of Bioengineering, Research Center of Biotechnology of the Russian Academy of Sciences, Moscow, Russia
| | - Maria V. Sinegubova
- Laboratory of Mammalian Cell Bioengineering, Institute of Bioengineering, Research Center of Biotechnology of the Russian Academy of Sciences, Moscow, Russia
| | - Irina V. Safenkova
- Laboratory of Immunobiochemistry, Institute of Biochemistry, Research Center of Biotechnology of the Russian Academy of Sciences, Moscow, Russia, Moscow, Russia
| | - Ivan I. Vorobiev
- Laboratory of Mammalian Cell Bioengineering, Institute of Bioengineering, Research Center of Biotechnology of the Russian Academy of Sciences, Moscow, Russia
| | - Nadezhda A. Orlova
- Laboratory of Mammalian Cell Bioengineering, Institute of Bioengineering, Research Center of Biotechnology of the Russian Academy of Sciences, Moscow, Russia
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17
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Alshami A, Al Attas R, Anan H, Al Maghrabi A, Ghandorah S, Mohammed A, Alhalimi A, Al-Jishi J, Alqahtani H. Durability of Antibody Responses to SARS-CoV-2 Infection and Its Relationship to Disease Severity Assessed Using a Commercially Available Assay. Front Microbiol 2021; 12:770727. [PMID: 34925278 PMCID: PMC8678500 DOI: 10.3389/fmicb.2021.770727] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 11/08/2021] [Indexed: 01/09/2023] Open
Abstract
Background: Assessing the humoral immune response to SARS-CoV-2 is crucial for inferring protective immunity from reinfection and for assessing vaccine efficacy. Data regarding the durability and sustainability of SARS-CoV-2 antibodies are conflicting. In this study, we aimed to determine the seroconversion rate of SARS-CoV-2 infection in a cohort of reverse-transcriptase polymerase chain reaction (RT–PCR)-confirmed SARS-CoV-2 infections and the antibody dynamics, durability, and the correlation of antibody titers with disease severity using the commercially available SARS-CoV-2 anti-spike (S1/S2) protein. Methods: A total of 342 subjects with PCR-confirmed COVID-19 were enrolled. A total of 395 samples were collected at different time points (0–204) after the onset of symptoms or from the day of positive PCR in asymptomatic patients. Demographics, clinical presentation and the date of PCR were collected. All samples were tested using the automated commercial chemiluminescent system (DiaSorin SARS-CoV-2 S1/S2 IgG) on the LIAISONXL® platform (LIAISON). Results: The seroconversion rate for samples collected 14 days after the onset of infection was much higher than that for samples collected before 14 days (79.4% vs. 39.4%). The rate of seroconversion in symptomatic participants (62.1%) was similar to that of asymptomatic participants (56.1%) (p = 0.496). The IgG titer distribution was also similar across both groups (p = 0.142), with a median IgG level of 27.86 AU/ml (3.8–85.5) and 15 AU/ml (3.8–58.85) in symptomatic and asymptomatic participants, respectively. However, IgG titers were significantly higher in ICU patients, with a median of 104 AU/ml (3.8–179) compared to 34 AU/ml (3.8–70) in the non-ICU participants (p < 0.0001). Furthermore, the median time to seroconversion occurred significantly faster in ICU patients than in non-ICU participants (19 versus 47 days) (P < 0.0001). IgG titers were also higher in subjects ≥50 years compared to those <50 years (p < 0.009), male compared to female (p < 0.054) and non-Saudi compared to Saudi (p < 0.003). Approximately 74% of all samples tested beyond 120 days were positive. Conclusion: Antibodies can persist in circulation for longer than 4 months after COVID-19 infection. The majority of patients with COVID-19 mounted humoral immune responses to SARS-CoV-2 infection that strongly correlated with disease severity, older age and male gender. However, the population of individuals who tested negative should be further evaluated.
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Affiliation(s)
- Alanoud Alshami
- Department of Epidemiology and Biostatistics, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
- *Correspondence: Alanoud Alshami,
| | - Rabab Al Attas
- Division of Immunology, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| | - Hadeel Anan
- Department of Epidemiology and Biostatistics, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| | | | - Salim Ghandorah
- Division of Immunology, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| | - Amani Mohammed
- Division of Immunology, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| | | | - Jumana Al-Jishi
- Division of Infectious Disease, Department of Internal Medicine, Qatif Central Hospital, Qatif, Saudi Arabia
| | - Hadi Alqahtani
- Division of Infectious Disease, Department of Pediatrics, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
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18
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Makoah NA, Tipih T, Litabe MM, Brink M, Sempa JB, Goedhals D, Burt FJ. A systematic review and meta-analysis of the sensitivity of antibody tests for the laboratory confirmation of COVID-19. Future Virol 2021; 17:10.2217/fvl-2021-0211. [PMID: 34950219 PMCID: PMC8686841 DOI: 10.2217/fvl-2021-0211] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 11/19/2021] [Indexed: 12/14/2022]
Abstract
Aim: The aim of this study was to investigate the utility of serological tests for the diagnosis of COVID-19 during the first week of symptom onset in patients confirmed with the real-time RT-PCR. Materials & methods: A systematic review and meta-analysis of 58 publications were performed using data obtained from Academic Search Ultimate, Africa-wide, Scopus, Web of Science and MEDLINE. Results: We found that the highest pooled sensitivities were obtained with ELISA IgM-IgG and chemiluminescence immunoassay IgM tests. Conclusion: Serological tests have low sensitivity within the first week of symptom onset and cannot replace nucleic acid amplification tests. However, serological assays can be used to support nucleic acid amplification tests.
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Affiliation(s)
- Nigel A Makoah
- Division of Virology, Faculty of Health Sciences, University of The Free State, Bloemfontein, 9301, South Africa
| | - Thomas Tipih
- Division of Virology, Faculty of Health Sciences, University of The Free State, Bloemfontein, 9301, South Africa
| | - Matefo M Litabe
- Division of Virology, Faculty of Health Sciences, University of The Free State, Bloemfontein, 9301, South Africa
| | - Mareza Brink
- Free State Department of Health, Bloemfontein, 9301, South Africa
| | - Joseph B Sempa
- Department of Biostatistics, Faculty of Health Sciences, University of The Free State, Bloemfontein, 9301, South Africa
- DST-NRF Centre of Excellence in Epidemiological Modelling & Analysis (SACEMA), Stellenbosch University, Stellenbosch, 7600, South Africa
| | - Dominique Goedhals
- Division of Virology, Faculty of Health Sciences, University of The Free State, Bloemfontein, 9301, South Africa
- Division of Virology, National Health Laboratory Service, Bloemfontein, 9301, South Africa
| | - Felicity J Burt
- Division of Virology, Faculty of Health Sciences, University of The Free State, Bloemfontein, 9301, South Africa
- Division of Virology, National Health Laboratory Service, Bloemfontein, 9301, South Africa
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19
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Saki EF, Setiawan SA, Wicaksono DHB. Portable Tools for COVID-19 Point-of-Care Detection: A Review. IEEE SENSORS JOURNAL 2021; 21:23737-23750. [PMID: 35582343 PMCID: PMC8864949 DOI: 10.1109/jsen.2021.3110857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/22/2021] [Accepted: 08/26/2021] [Indexed: 06/12/2023]
Abstract
Recently, several methods for SARS-CoV-2 detection have been developed to obtain rapid, portable, cheap, and easy-to-use diagnostic tools. This review paper summarizes and discusses studies on the development of point-of-care devices for SARS-CoV-2 diagnosis with comparisons between them from several aspects. Various detection methods of the recently developed portable COVID-19 biosensor will be presented in this review. The discussion is divided into four major classifications based on the target biomarkers of SARS-CoV-2, such as antibodies, nucleic acids, antigens, and metabolic products. An overview of the potential development for future study is also provided. Moreover, basic knowledge of biosensors is also explained for tutoring the implementation of theory into the research of COVID-19 biosensors. This review paper is aimed to provide a tutorial by collecting the information on the development of a point-of-care device for SARS-CoV-2 detection to provide information for further research and propose the new COVID-19 portable diagnostic tool.
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Affiliation(s)
- Elga F. Saki
- Department of Biomedical EngineeringFaculty of Life Sciences and TechnologySwiss German University (SGU)Tangerang15143Indonesia
| | | | - Dedy H. B. Wicaksono
- Department of Biomedical EngineeringFaculty of Life Sciences and TechnologySwiss German University (SGU)Tangerang15143Indonesia
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20
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Mutantu PN, Ngwe Tun MM, Nabeshima T, Yu F, Mukadi PK, Tanaka T, Tashiro M, Fujita A, Kanie N, Oshiro R, Takazono T, Imamura Y, Hirayama T, Moi ML, Inoue S, Izumikawa K, Yasuda J, Morita K. Development and Evaluation of Quantitative Immunoglobulin G Enzyme-Linked Immunosorbent Assay for the Diagnosis of Coronavirus Disease 2019 Using Truncated Recombinant Nucleocapsid Protein as Assay Antigen. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9630. [PMID: 34574555 PMCID: PMC8469721 DOI: 10.3390/ijerph18189630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/04/2021] [Accepted: 09/09/2021] [Indexed: 11/24/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19). Real-time RT-PCR is the most commonly used method for COVID-19 diagnosis. However, serological assays are urgently needed as complementary tools to RT-PCR. Hachim et al. 2020 and Burbelo et al. 2020 demonstrated that anti-nucleocapsid(N) SARS-CoV-2 antibodies are higher and appear earlier than the spike antibodies. Additionally, cross-reactive antibodies against N protein are more prevalent than those against spike protein. We developed a less cross-reactive immunoglobulin G (IgG) indirect ELISA by using a truncated recombinant SARS-CoV-2 N protein as assay antigen. A highly conserved region of coronaviruses N protein was deleted and the protein was prepared using an E. coli protein expression system. A total of 177 samples collected from COVID-19 suspected cases and 155 negative control sera collected during the pre-COVID-19 period were applied to evaluate the assay's performance, with the plaque reduction neutralization test and the commercial SARS-CoV-2 spike protein IgG ELISA as gold standards. The SARS-CoV-2 N truncated protein-based ELISA showed similar sensitivity (91.1% vs. 91.9%) and specificity (93.8% vs. 93.8%) between the PRNT and spike IgG ELISA, as well as also higher specificity compared to the full-length N protein (93.8% vs. 89.9%). Our ELISA can be used for the diagnosis and surveillance of COVID-19.
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Affiliation(s)
- Pierre Nsele Mutantu
- Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan; (P.N.M.); (P.K.M.)
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan; (M.M.N.T.); (T.N.); (M.L.M.); (K.M.)
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Mya Myat Ngwe Tun
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan; (M.M.N.T.); (T.N.); (M.L.M.); (K.M.)
| | - Takeshi Nabeshima
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan; (M.M.N.T.); (T.N.); (M.L.M.); (K.M.)
| | - Fuxun Yu
- Guizhou Provincial People’s Hospital, Guiyang 550002, China;
| | - Patrick Kakoni Mukadi
- Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan; (P.N.M.); (P.K.M.)
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Takeshi Tanaka
- Infection Control and Education Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (T.T.); (M.T.); (A.F.); (K.I.)
| | - Masato Tashiro
- Infection Control and Education Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (T.T.); (M.T.); (A.F.); (K.I.)
| | - Ayumi Fujita
- Infection Control and Education Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (T.T.); (M.T.); (A.F.); (K.I.)
| | - Nobuhiro Kanie
- Department of Infectious Diseases, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (N.K.); (R.O.)
| | - Ryosaku Oshiro
- Department of Infectious Diseases, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (N.K.); (R.O.)
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (T.T.); (Y.I.); (T.H.)
| | - Yoshifumi Imamura
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (T.T.); (Y.I.); (T.H.)
- Medical Education Development Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Tatsuro Hirayama
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (T.T.); (Y.I.); (T.H.)
| | - Meng Ling Moi
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan; (M.M.N.T.); (T.N.); (M.L.M.); (K.M.)
| | - Shingo Inoue
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan; (M.M.N.T.); (T.N.); (M.L.M.); (K.M.)
| | - Koichi Izumikawa
- Infection Control and Education Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (T.T.); (M.T.); (A.F.); (K.I.)
| | - Jiro Yasuda
- Department of Emerging Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan;
| | - Kouichi Morita
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan; (M.M.N.T.); (T.N.); (M.L.M.); (K.M.)
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21
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SARS-CoV-2 Immunogenicity in individuals infected before and after COVID-19 vaccination: Israel, January-March 2021. Epidemiol Infect 2021; 149:e239. [PMID: 34399868 PMCID: PMC8632408 DOI: 10.1017/s0950268821001928] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Between December 2020 and March 2021, we measured anti-SARS-CoV-2 IgG titres among 725 Israeli hospital workers vaccinated against COVID-19. Infection post-dose 1 vaccination did not increase IgG titres, and individuals infected post-dose 1 had IgG levels comparable to never-infected individuals who received a single dose, lower than fully vaccinated, never-infected individuals. This suggests dose 2, currently not offered to those infected post-dose 1, may be required in these individuals. Larger studies should confirm whether individuals infected post-dose 1 need the second.
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22
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Gabaldó-Barrios X, Iftimie S, Hernández-Aguilera A, Pujol I, Ballester F, Fernández L, Cladellas S, Castro A, Joven J, Camps J, Simó JM. Clinical performance of the Elecsys® anti-SARS-CoV-2 combined in an algorithm with two specific anti-IgG immunoassays for the evaluation of the serological response of patients with COVID-19 in a population with a high prevalence of infection. Ann Clin Biochem 2021; 58:614-621. [PMID: 34325536 DOI: 10.1177/00045632211038038] [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: 11/15/2022]
Abstract
BACKGROUND Anti-SARS-CoV-2 antibodies have been used in the study of the immune response in infected patients. However, differences in sensitivity and specificity have been reported, depending on the method of analysis. The aim of the present study was to evaluate the diagnostic accuracy of an algorithm in which a high-throughput automated assay for total antibodies was used for screening and two semi-automated IgG-specific methods were used to confirm the results, and also to correlate the analytical results with the clinical data and the time elapsed since infection. METHODS We studied 306 patients, some hospitalized and some outpatients, belonging to a population with a high prevalence of COVID-19. One-hundred and ten patients were classified as SARS-CoV-2 negative and 196 as positive by polymerase chain reaction. RESULTS The algorithm and automated assay alone had a specificity and a positive predictive value of 100%, although the sensitivity and negative predictive value of the algorithm was higher. Both methods showed a good sensitivity from day 11 of the onset of symptoms in asymptomatic and symptomatic patients. The absorbance of the total antibodies was significantly higher in severely symptomatic than in asymptomatic or mildly symptomatic patients, which suggests the antibody level was higher. We found 15 patients who did not present seroconversion at 12 days from the onset of symptoms or the first polymerase chain reaction test. CONCLUSION This study highlights the proper functioning of algorithms in the diagnosis of the immune response to COVID-19, which can help to define testing strategies against this disease.
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Affiliation(s)
- Xavier Gabaldó-Barrios
- Laboratori de Referència Camp de Tarragona i Terres de l'Ebre, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain.,Laboratori de Referència de Catalunya SA, El Prat de Llobregat, Barcelona, Spain
| | - Simona Iftimie
- Department of Internal Medicine, 16777Universitat Rovira i Virgili, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain
| | - Anna Hernández-Aguilera
- Unitat de Recerca Biomèdica, 16777Universitat Rovira i Virgili, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain.,Department of Pathology, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain
| | - Isabel Pujol
- Laboratori de Referència Camp de Tarragona i Terres de l'Ebre, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain
| | - Frederic Ballester
- Laboratori de Referència Camp de Tarragona i Terres de l'Ebre, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain
| | - Luis Fernández
- Laboratori de Referència Camp de Tarragona i Terres de l'Ebre, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain.,Laboratori de Referència de Catalunya SA, El Prat de Llobregat, Barcelona, Spain
| | - Sara Cladellas
- Laboratori de Referència Camp de Tarragona i Terres de l'Ebre, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain
| | - Antoni Castro
- Department of Internal Medicine, 16777Universitat Rovira i Virgili, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain
| | - Jorge Joven
- Unitat de Recerca Biomèdica, 16777Universitat Rovira i Virgili, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain
| | - Jordi Camps
- Unitat de Recerca Biomèdica, 16777Universitat Rovira i Virgili, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain
| | - Josep M Simó
- Laboratori de Referència Camp de Tarragona i Terres de l'Ebre, Hospital Universitari de Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain.,Laboratori de Referència de Catalunya SA, El Prat de Llobregat, Barcelona, Spain
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23
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Buonfrate D, Piubelli C, Gobbi F, Martini D, Bertoli G, Ursini T, Moro L, Ronzoni N, Angheben A, Rodari P, Cardellino C, Tamarozzi F, Tais S, Rizzi E, Degani M, Deiana M, Prato M, Silva R, Bisoffi Z. Antibody response induced by the BNT162b2 mRNA COVID-19 vaccine in a cohort of health-care workers, with or without prior SARS-CoV-2 infection: a prospective study. Clin Microbiol Infect 2021; 27:1845-1850. [PMID: 34329793 PMCID: PMC8316640 DOI: 10.1016/j.cmi.2021.07.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/05/2021] [Accepted: 07/18/2021] [Indexed: 11/19/2022]
Abstract
Objectives To assess the antibody response to BNT162b2 mRNA COVID-19 vaccine in a cohort of health-care workers (HCW), comparing individuals with previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and SARS-CoV-2-naive individuals. Methods HCW were tested at T0 (day of first dose), T1 (day of second dose) and T2 (2–3 weeks after second dose) for IgG anti-nucleocapsid protein, IgM anti-spike protein and IgG anti-receptor binding domain (IgG-RBD-S). The antibody response was compared between four main groups: group A, individuals with previous infection and positive antibodies at baseline; group B, individuals with the same history but negative antibodies; group C, individuals with no infection history but positive antibodies; group D, naive individuals. Repeated measures analysis was used to compare results over time-points. Results A total of 1935 HCW were included. Median IgG-RBD-S titre was significantly higher for group A (232 individuals) than for group B (56 individuals) both at T1 (A: 22 763 AU/mL, interquartile range (IQR) 14 222–37 204 AU/mL; B: 1373 AU/mL, IQR 783–3078 AU/mL, p 0.0003) and T2 (A: 30 765 AU/mL, IQR 19 841–42 813 AU/mL; B: 13 171 AU/mL, IQR 2324–22 688 AU/mL, p 0.0038) and for group D (1563 individuals; 796 AU/mL, IQR 379–1510 AU/mL at T1; 15 494 AU/mL, IQR 9122–23 916 AU/mL at T2, p < 0.0001 for both time-points). T1 values of group A were also significantly higher than T2 values of group D (p < 0.0001). Presence of symptoms, younger age and being female were associated with stronger antibody response. HCW infected in March showed a significantly stronger response (T1: 35 324 AU/mL, IQR 22 003–44 531 AU/mL; T2: 37 648 AU/mL, IQR 27 088–50 451 AU/mL) than those infected in November (T1: 18 499 AU/mL, IQR 11 492–27 283 AU/mL; T2: 23 210 AU/mL, IQR 18 074–36 086 AU/mL, p < 0.0001 for both time-points. Conclusions Individuals with past SARS-CoV-2 infection had a strong antibody response after one single vaccine shot. A single dose might be sufficient for this group, regardless of the time elapsed since infection; however, the clinical correlation with antibody response needs to be studied.
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Affiliation(s)
- Dora Buonfrate
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy.
| | - Chiara Piubelli
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Federico Gobbi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Davide Martini
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Giulia Bertoli
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Tamara Ursini
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Lucia Moro
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Niccolò Ronzoni
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Andrea Angheben
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Paola Rodari
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Chiara Cardellino
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Francesca Tamarozzi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Stefano Tais
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Eleonora Rizzi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Monica Degani
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Michela Deiana
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Marco Prato
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Ronaldo Silva
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Zeno Bisoffi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy; Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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24
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Manolea C, Capitanescu A, Borș R, Rugescu I, Bechir M, Mehedintu C, Varlas V. The prevalence of SARS-CoV-2 antibodies in triage-negative patients and staff of a fertility setting from lockdown release throughout 2020. Hum Reprod Open 2021; 2021:hoab028. [PMID: 34322605 PMCID: PMC8313405 DOI: 10.1093/hropen/hoab028] [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: 03/13/2021] [Revised: 06/10/2021] [Indexed: 12/13/2022] Open
Abstract
STUDY QUESTION What is the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in triage-negative patients undergoing ART and fertility care providers after lockdown release and throughout 2020? SUMMARY ANSWER Out of the triage-negative patients whose blood samples were assessed for SARS-CoV-2 antibodies over 6 months, 5.2% yielded positive results with a significantly higher rate in health care workers (HCWs) and a significant month-by-month increase in those with evidence of antibodies. WHAT IS KNOWN ALREADY Patients of reproductive age are more prone to asymptomatic or minimal forms of coronavirus disease 2019 (COVID-19) as compared to older age groups, and the identification of those with active infection and those already exposed (and probably immunized) is important for safety and cost-effective use of testing resources in the fertility setting. Data on the prevalence of SARS-CoV-2 in ART patients are limited and encompass short time frames; current rates are unknown. There is also no consensus on the optimal way of screening triage-negative ART patients in moderate/high-risk areas. STUDY DESIGN SIZE DURATION A prospective longitudinal unicentric study on triage negative ART patients (n = 516) and clinical staff (n = 30) was carried out. We analyzed 705 serological tests for SARS-CoV-2 sampled between 17 May 2020 (the first working day after lockdown release) up to 1 December 2020, to assess the positivity rates for SARS-CoV-2 antibodies. PARTICIPANTS/MATERIALS SETTING METHODS We collected data on the serological status for IgM and IgG antibodies against SARS-CoV-2 in 516 triage-negative men (n = 123) and women (n = 393) undergoing ART at a private fertility center and 30 HCWs that were at work during the study period. Antibodies were detected with a capture chemiluminescence assay (CLIA) targeting the highly Immunogenic S1 and S2 domains on the virus spike protein. We also analyzed the molecular test results of the cases exhibiting a positive serology. MAIN RESULTS AND THE ROLE OF CHANCE The data showed that 5.2% of the triage-negative ART patients had a positive serological result for SARS-CoV-2, with an overall conversion rate of 2.1% for IgG and 4.6% for IgM. There was no significant difference in seroprevalence between sexes. The small cohort (n = 30) of HCWs had a markedly increased seroprevalence (12.9% for Ig M and 22.6% for IgG). The highest seropositivity in our cohort was recorded in November (16.2%). The IgM positivity rates revealed significant monthly increments, paralleling official prevalence rates based on nasopharyngeal swabs. No positive molecular tests were identified in cases exhibiting a solitary positive IgG result. We show that despite a 6-fold increase in the number of ART patients with a positive serology between May and December 2020, most of our patients remain unexposed to the virus. The study was undertaken in a high-risk area for COVID-19, with a 20-times increase in the active cases across the study period. LIMITATIONS REASONS FOR CAUTION The geographical restriction, alongside the lack of running a second, differently-targeted immunoassay (orthogonal testing), could limit the generalizability and translation of our results to other fertility settings or other immunoassays. WIDER IMPLICATIONS OF THE FINDINGS The low positivity rates for IgG against the SARS-CoV-2 spike protein seen at the end of 2020 imply that most of the fertility patients are still at risk for SARS-CoV-2 infection. Until mass vaccination and other measures effectively diminish the pandemic, risk mitigation strategies must be maintained in the fertility units in the foreseeable future. Patients with a solitary IgG+ status are most likely 'non-infectious' and can elude further testing without giving up the strict use of universal protective measures. With increasing seroprevalences owing to infection or vaccination, and with the consecutive increase in test performance, it is possible that serological screening of ART patients might be more cost-effective than PCR testing, especially for the many patients with repeat treatments/procedures in a time-frame of months. STUDY FUNDING/COMPETING INTERESTS This research received no external funding. All authors declare having no conflict of interest with regard to this trial.
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Affiliation(s)
- Corina Manolea
- Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania
- Department of Assisted Reproduction, Columna Medical Center, Bucharest, Romania
| | - Andrei Capitanescu
- Hemodialysis Unit, ‘Marie Curie’ Pediatric Clinical Emergency Hospital, Bucharest, Romania
| | - Roxana Borș
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, Bucharest, Romania
| | - Ioana Rugescu
- Department of Cells, National Transplant Agency, Bucharest, Romania
| | - Melihan Bechir
- Department of Assisted Reproduction, Columna Medical Center, Bucharest, Romania
- Dept of Obstetrics and Gynecology, Infertility Center, Regina Maria Medical Network, Bucharest, Romania
| | - Claudia Mehedintu
- Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania
- Department of Obstetrics and Gynecology, Nicolae Malaxa Clinical Hospital, Bucharest, Romania
| | - Valentin Varlas
- Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, Bucharest, Romania
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Husain M, Rachline A, Cousien A, Rolland S, Rouzaud C, Ferre VM, Gomez MV, Le Teurnier M, Wicky-Thisse M, Descamps D, Yazdanpanah Y, Charpentier C, Pasquet-Cadre A. Impact of the COVID-19 pandemic on the homeless: results from a retrospective closed cohort in France (March-May 2020). Clin Microbiol Infect 2021; 27:1520.e1-1520.e5. [PMID: 34111590 PMCID: PMC8182982 DOI: 10.1016/j.cmi.2021.05.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 05/17/2021] [Accepted: 05/25/2021] [Indexed: 11/30/2022]
Abstract
Objectives To evaluate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, hospitalization and fatality rates in residents of homeless shelters run by Samusocial of Paris. Methods We conducted a retrospective serological study between July and August 2020 on all residents and staff members of three homeless shelters run by Samusocial of Paris: two centres providing healthcare accommodation (HCA) and one a women's dormitory. We included all adults present in the shelters or who died of a proven SARS-CoV-2 infection during the first wave (March–May). SARS-CoV-2 antibodies were detected in serum samples using the SARS-CoV-2 IgG Architect (Abbott) test. Any participant with a positive PCR or serology was defined as a confirmed SARS-CoV-2 case. Results We included 100 residents and 83 staff members. The confirmed SARS-CoV-2 rate by PCR or serology was 72/100 (72.0%) for residents and 17/83 (20.5%) for staff members. Women accommodated in the dormitory had the highest infection rate (90.6%). The hospitalization rate in residents was 17/72 (23.6%) and the death rate 4/72 (5.6%). All hospitalizations and deaths occurred among HCA residents. Among the residents of HCA shelters, 34/68 (50%) presented at least two comorbidity factors associated with being at high risk for severe SARS-CoV-2 infection. Conclusion The SARS-CoV-2 infection rate was high in residents of these homeless shelters (10.6% seroprevalence in the Île-de-France region during the first wave). Severe SARS-CoV-2 infection was highly associated with the prevalence of comorbidities. This population should be considered as a priority in vaccination campaigns and in access to individual housing units when at risk.
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Affiliation(s)
- Maya Husain
- Department of Infectious and Tropical Diseases, AP-HP, Hôpital Bichat-Claude Bernard, F-75018, Paris, France.
| | - Anne Rachline
- Department of Infectious and Tropical Diseases, AP-HP, Hôpital Bichat-Claude Bernard, F-75018, Paris, France
| | | | - Simon Rolland
- INSERM CIC 1417 Cochin Pasteur, AP-HP, Hôpital Cochin, 75014, Paris, France; Department of Infectious and Tropical Diseases, Cavale Blanche University Hospital, 29200, Brest, France
| | - Claire Rouzaud
- Department of Infectious and Tropical Diseases, AP-HP, Hôpital Necker enfants malades, F-75015, Paris, France; Samusocial de Paris, 35 avenue Courteline, 75012, Paris, France
| | - Valentine Marie Ferre
- Department of Virology, AP-HP, Hôpital Bichat-Claude Bernard, F-75018, Paris, France; Université de Paris, IAME, INSERM UMR1137, Paris, France
| | | | - Maï Le Teurnier
- Samusocial de Paris, 35 avenue Courteline, 75012, Paris, France
| | | | - Diane Descamps
- Department of Virology, AP-HP, Hôpital Bichat-Claude Bernard, F-75018, Paris, France; Université de Paris, IAME, INSERM UMR1137, Paris, France
| | - Yazdan Yazdanpanah
- Department of Infectious and Tropical Diseases, AP-HP, Hôpital Bichat-Claude Bernard, F-75018, Paris, France; Department of Virology, AP-HP, Hôpital Bichat-Claude Bernard, F-75018, Paris, France
| | - Charlotte Charpentier
- Department of Virology, AP-HP, Hôpital Bichat-Claude Bernard, F-75018, Paris, France; Université de Paris, IAME, INSERM UMR1137, Paris, France
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Brinc D, Biondi MJ, Li D, Sun H, Capraru C, Smookler D, Zahoor MA, Casey J, Kulasingam V, Feld JJ. Evaluation of Dried Blood Spot Testing for SARS-CoV-2 Serology Using a Quantitative Commercial Assay. Viruses 2021; 13:962. [PMID: 34067361 PMCID: PMC8224688 DOI: 10.3390/v13060962] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/10/2021] [Accepted: 05/19/2021] [Indexed: 12/22/2022] Open
Abstract
Dried blood spots (DBS) are commonly used for serologic testing for viruses and provide an alternative collection method when phlebotomy and/or conventional laboratory testing are not readily available. DBS collection could be used to facilitate widespread testing for SARS-CoV-2 antibodies to document past infection, vaccination, and potentially immunity. We investigated the characteristics of Roche's Anti-SARS-CoV-2 (S) assay, a quantitative commercial assay for antibodies against the spike glycoprotein. Antibody levels were reduced relative to plasma following elution from DBS. Quantitative results from DBS samples were highly correlated with values from plasma (r2 = 0.98), allowing for extrapolation using DBS results to accurately estimate plasma antibody levels. High concordance between plasma and fingerpick DBS was observed in PCR-confirmed COVID-19 patients tested 90 days or more after the diagnosis (45/46 matched; 1/46 mismatched plasma vs. DBS). The assessment of antibody responses to SARS-CoV-2 using DBS may be feasible using a quantitative anti-S assay, although false negatives may rarely occur in those with very low antibody levels.
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Affiliation(s)
- Davor Brinc
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (D.B.); (V.K.)
- Department of Clinical Biochemistry, University Health Network, Toronto, ON M5G 2C4, Canada;
| | - Mia J. Biondi
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - Daniel Li
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada;
| | - Heng Sun
- Department of Clinical Biochemistry, University Health Network, Toronto, ON M5G 2C4, Canada;
| | - Camelia Capraru
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - David Smookler
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - Muhammad Atif Zahoor
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - Julia Casey
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - Vathany Kulasingam
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (D.B.); (V.K.)
- Department of Clinical Biochemistry, University Health Network, Toronto, ON M5G 2C4, Canada;
| | - Jordan J. Feld
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada;
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Geisler D, Freeman MC, Rapsinski GJ, Wheeler SE. Unexpected False-Positive Rates in Pediatric SARS-CoV-2 Serology Using the EUROIMMUN Anti-SARS-CoV-2 ELISA IgG Assay. Am J Clin Pathol 2021; 155:773-775. [PMID: 33899091 PMCID: PMC8130881 DOI: 10.1093/ajcp/aqab033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Serologic assay performance studies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in pediatric populations are lacking, and few seroprevalence studies have routinely incorporated orthogonal testing to improve accuracy. METHODS Remnant serum samples for routine bloodwork from 2,338 pediatric patients at UPMC Children's Hospital of Pittsburgh were assessed using the EUROIMMUN Anti-SARS-CoV-2 ELISA IgG (EuroIGG) assay. Reactive cases with sufficient volume were also tested using 3 additional commercial assays. RESULTS Eighty-five specimens were reactive according to the EuroIGG, yielding 3.64% (95% confidence interval [CI], 2.91%-4.48%) seropositivity, of which 73 specimens had sufficient remaining volume for confirmation by orthogonal testing. Overall, 19.18% (95% CI, 10.18%-28.18%) of samples were positive on a second and/or third orthogonal assay. This 80.82% false positivity rate is disproportionate to the expected false positivity rate of 50% given our pediatric population prevalence and assay performance. CONCLUSIONS In pediatric populations, false-positive SARS-CoV-2 serology may be more common than assay and prevalence parameters would predict, and further studies are needed to establish the performance of SARS-CoV-2 serology in children.
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Affiliation(s)
- Daniel Geisler
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Megan Culler Freeman
- Department of Pediatrics, Division of Infectious Diseases, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Glenn J Rapsinski
- Department of Pediatrics, Division of Infectious Diseases, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Sarah E Wheeler
- Department of Pathology, Division of Clinical Immunopathology and Clinical Chemistry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Abstract
The landscape of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnostic testing is rapidly evolving. While serology testing has limited diagnostic capacity for acute infection, its role in providing population-based information on positivity rates and informing evidence-based decision making for public health recommendations is increasing. With the global availability of vaccines, there is increasing pressure on clinical laboratories to provide antibody screening and result interpretation for vaccinated and non-vaccinated individuals. Here we present the most up-to-date data on SARS-CoV-2 antibody timelines, including the longevity of antibodies, and the production and detection of neutralizing antibodies. Additionally, we provide practical guidance for clinical microbiology laboratories to both verify commercial serology assays and choose appropriate testing algorithms for their local populations.
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Klausberger M, Duerkop M, Haslacher H, Wozniak-Knopp G, Cserjan-Puschmann M, Perkmann T, Lingg N, Aguilar PP, Laurent E, De Vos J, Hofner M, Holzer B, Stadler M, Manhart G, Vierlinger K, Egger M, Milchram L, Gludovacz E, Marx N, Köppl C, Tauer C, Beck J, Maresch D, Grünwald-Gruber C, Strobl F, Satzer P, Stadlmayr G, Vavra U, Huber J, Wahrmann M, Eskandary F, Breyer MK, Sieghart D, Quehenberger P, Leitner G, Strassl R, Egger AE, Irsara C, Griesmacher A, Hoermann G, Weiss G, Bellmann-Weiler R, Loeffler-Ragg J, Borth N, Strasser R, Jungbauer A, Hahn R, Mairhofer J, Hartmann B, Binder NB, Striedner G, Mach L, Weinhäusel A, Dieplinger B, Grebien F, Gerner W, Binder CJ, Grabherr R. A comprehensive antigen production and characterisation study for easy-to-implement, specific and quantitative SARS-CoV-2 serotests. EBioMedicine 2021; 67:103348. [PMID: 33906067 PMCID: PMC8099623 DOI: 10.1016/j.ebiom.2021.103348] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/15/2021] [Accepted: 04/02/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Antibody tests are essential tools to investigate humoral immunity following SARS-CoV-2 infection or vaccination. While first-generation antibody tests have primarily provided qualitative results, accurate seroprevalence studies and tracking of antibody levels over time require highly specific, sensitive and quantitative test setups. METHODS We have developed two quantitative, easy-to-implement SARS-CoV-2 antibody tests, based on the spike receptor binding domain and the nucleocapsid protein. Comprehensive evaluation of antigens from several biotechnological platforms enabled the identification of superior antigen designs for reliable serodiagnostic. Cut-off modelling based on unprecedented large and heterogeneous multicentric validation cohorts allowed us to define optimal thresholds for the tests' broad applications in different aspects of clinical use, such as seroprevalence studies and convalescent plasma donor qualification. FINDINGS Both developed serotests individually performed similarly-well as fully-automated CE-marked test systems. Our described sensitivity-improved orthogonal test approach assures highest specificity (99.8%); thereby enabling robust serodiagnosis in low-prevalence settings with simple test formats. The inclusion of a calibrator permits accurate quantitative monitoring of antibody concentrations in samples collected at different time points during the acute and convalescent phase of COVID-19 and disclosed antibody level thresholds that correlate well with robust neutralization of authentic SARS-CoV-2 virus. INTERPRETATION We demonstrate that antigen source and purity strongly impact serotest performance. Comprehensive biotechnology-assisted selection of antigens and in-depth characterisation of the assays allowed us to overcome limitations of simple ELISA-based antibody test formats based on chromometric reporters, to yield comparable assay performance as fully-automated platforms. FUNDING WWTF, Project No. COV20-016; BOKU, LBI/LBG.
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Affiliation(s)
- Miriam Klausberger
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria
| | - Mark Duerkop
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; Novasign GmbH Vienna, Austria
| | - Helmuth Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Gordana Wozniak-Knopp
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; CD Laboratory for innovative Immunotherapeutics, Vienna, Austria
| | - Monika Cserjan-Puschmann
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; ACIB-Austrian Centre of Industrial Biotechnology, Graz, Austria
| | - Thomas Perkmann
- Department of Laboratory Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Nico Lingg
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; ACIB-Austrian Centre of Industrial Biotechnology, Graz, Austria
| | - Patricia Pereira Aguilar
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; ACIB-Austrian Centre of Industrial Biotechnology, Graz, Austria
| | - Elisabeth Laurent
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; BOKU Core Facility Biomolecular & Cellular Analysis, University of Natural Resources and Life Sciences (BOKU),Vienna, Austria
| | - Jelle De Vos
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; Department of Chemical Engineering, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Manuela Hofner
- Competence Unit Molecular Diagnostics, Center for Health and Bioresources, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - Barbara Holzer
- Austrian Agency for Health and Food Safety (AGES), Department for Animal Health, Moedling, Austria
| | - Maria Stadler
- Institute of Immunology, University of Veterinary Medicine, Vienna, Austria
| | - Gabriele Manhart
- Institute for Medical Biochemistry, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria
| | - Klemens Vierlinger
- Competence Unit Molecular Diagnostics, Center for Health and Bioresources, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - Margot Egger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz and Ordensklinikum Linz Barmherzige Schwestern, Linz, Austria
| | - Lisa Milchram
- Competence Unit Molecular Diagnostics, Center for Health and Bioresources, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - Elisabeth Gludovacz
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria
| | - Nicolas Marx
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria
| | - Christoph Köppl
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; ACIB-Austrian Centre of Industrial Biotechnology, Graz, Austria
| | - Christopher Tauer
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria
| | - Jürgen Beck
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria
| | - Daniel Maresch
- BOKU Core Facility Mass Spectrometry, University of Natural Resources and Life Sciences (BOKU), Vienna, Austria
| | - Clemens Grünwald-Gruber
- BOKU Core Facility Mass Spectrometry, University of Natural Resources and Life Sciences (BOKU), Vienna, Austria; Department of Chemistry, University of Natural Resources and Life Sciences (BOKU) Vienna, Austria
| | | | - Peter Satzer
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; ACIB-Austrian Centre of Industrial Biotechnology, Graz, Austria
| | - Gerhard Stadlmayr
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; CD Laboratory for innovative Immunotherapeutics, Vienna, Austria
| | - Ulrike Vavra
- Department of Applied Genetics and Cell Biology, University of Natural Resources and Life Sciences (BOKU) Vienna, Austria
| | - Jasmin Huber
- Competence Unit Molecular Diagnostics, Center for Health and Bioresources, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - Markus Wahrmann
- Department of Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, Austria
| | - Farsad Eskandary
- Department of Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, Austria
| | - Marie-Kathrin Breyer
- Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for Lung Health, Otto Wagner Hospital, Vienna, Austria
| | - Daniela Sieghart
- Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Austria
| | - Peter Quehenberger
- Department of Laboratory Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Gerda Leitner
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Austria
| | - Robert Strassl
- Department of Laboratory Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Alexander E Egger
- Central Institute for Medical and Chemical Laboratory Diagnosis, Innsbruck University Hospital, Innsbruck, Austria
| | - Christian Irsara
- Central Institute for Medical and Chemical Laboratory Diagnosis, Innsbruck University Hospital, Innsbruck, Austria
| | - Andrea Griesmacher
- Central Institute for Medical and Chemical Laboratory Diagnosis, Innsbruck University Hospital, Innsbruck, Austria
| | - Gregor Hoermann
- Central Institute for Medical and Chemical Laboratory Diagnosis, Innsbruck University Hospital, Innsbruck, Austria; MLL Munich Leukemia Laboratory, Munich, Germany
| | - Günter Weiss
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria
| | - Rosa Bellmann-Weiler
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria
| | - Judith Loeffler-Ragg
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria
| | - Nicole Borth
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria
| | - Richard Strasser
- Department of Applied Genetics and Cell Biology, University of Natural Resources and Life Sciences (BOKU) Vienna, Austria
| | - Alois Jungbauer
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; ACIB-Austrian Centre of Industrial Biotechnology, Graz, Austria
| | - Rainer Hahn
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; ACIB-Austrian Centre of Industrial Biotechnology, Graz, Austria
| | | | - Boris Hartmann
- Austrian Agency for Health and Food Safety (AGES), Department for Animal Health, Moedling, Austria
| | - Nikolaus B Binder
- Technoclone Herstellung von Diagnostika und Arzneimitteln GmbH, Vienna, Austria
| | - Gerald Striedner
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria; Novasign GmbH Vienna, Austria; ACIB-Austrian Centre of Industrial Biotechnology, Graz, Austria; enGenes Biotech GmbH, Vienna, Austria
| | - Lukas Mach
- Department of Applied Genetics and Cell Biology, University of Natural Resources and Life Sciences (BOKU) Vienna, Austria
| | - Andreas Weinhäusel
- Competence Unit Molecular Diagnostics, Center for Health and Bioresources, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - Benjamin Dieplinger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz and Ordensklinikum Linz Barmherzige Schwestern, Linz, Austria
| | - Florian Grebien
- Institute for Medical Biochemistry, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria.
| | - Wilhelm Gerner
- Institute of Immunology, University of Veterinary Medicine, Vienna, Austria; Christian Doppler Laboratory for an Optimized Prediction of Vaccination Success in Pigs, University of Veterinary Medicine, Vienna, Austria; Present address: The Pirbright Institute, Pirbright, United Kingdom
| | - Christoph J Binder
- Department of Laboratory Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Reingard Grabherr
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Muthgasse 18, 1190 Vienna, Austria.
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Jabal KA, Wiegler KB, Edelstein M. Convalescent plasma from people vaccinated after COVID-19 infection. THE LANCET. MICROBE 2021; 2:e171-e172. [PMID: 33778791 PMCID: PMC7987300 DOI: 10.1016/s2666-5247(21)00060-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Kamal Abu Jabal
- Ziv Medical Centre, Safed, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | | | - Michael Edelstein
- Ziv Medical Centre, Safed, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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Assessment of S1-, S2-, and NCP-Specific IgM, IgA, and IgG Antibody Kinetics in Acute SARS-CoV-2 Infection by a Microarray and Twelve Other Immunoassays. J Clin Microbiol 2021; 59:JCM.02890-20. [PMID: 33602698 PMCID: PMC8091850 DOI: 10.1128/jcm.02890-20] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/17/2021] [Indexed: 12/21/2022] Open
Abstract
In this study, we comprehensively analyzed multispecific antibody kinetics of different immunoglobulins in hospitalized patients with acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Three hundred fifty-four blood samples longitudinally obtained from 81 IgG-seroconverting progressed coronavirus disease 2019 (CoVID-19) patients were quantified for spike 1 (S1), S2, and nucleocapsid protein (NCP)-specific IgM, IgA, IgG, and total Ig antibodies using a microarray, 11 different enzyme-linked immunosorbent assays (ELISAs)/chemiluminescence immunoassays (CLIAs), and 1 rapid test by seven manufacturers. In this study, we comprehensively analyzed multispecific antibody kinetics of different immunoglobulins in hospitalized patients with acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Three hundred fifty-four blood samples longitudinally obtained from 81 IgG-seroconverting progressed coronavirus disease 2019 (CoVID-19) patients were quantified for spike 1 (S1), S2, and nucleocapsid protein (NCP)-specific IgM, IgA, IgG, and total Ig antibodies using a microarray, 11 different enzyme-linked immunosorbent assays (ELISAs)/chemiluminescence immunoassays (CLIAs), and 1 rapid test by seven manufacturers. The assays’ specificity was assessed in 130 non-CoVID-19 pneumonia patients. Using the microarray, NCP-specific IgA and IgG antibodies continuously displayed higher detection rates during acute CoVID-19 than S1- and S2-specific ones. S1-specific IgG antibodies, however, reached higher peak values. Until the 26th day post-symptom onset, all patients developed IgG responses against S1, S2, and NCP. Although detection rates by ELISAs/CLIAs generally resembled those of the microarray, corresponding to the target antigen, sensitivities and specificities varied among all tests. Notably, patients with more severe CoVID-19 displayed higher IgG and IgA levels, but this difference was mainly observed with S1-specific immunoassays. In patients with high SARS-CoV-2 levels in the lower respiratory tract, we observed high detection rates of IgG and total Ig immunoassays with a particular rise of S1-specific IgG antibodies when viral concentrations in the tracheal aspirate subsequently declined over time. In summary, our study demonstrates that differences in sensitivity among commercial immunoassays during acute SARS-CoV-2 infection are only partly related to the target antigen. Importantly, our data indicate that NCP-specific IgA and IgG antibodies are detected earlier, while higher S1-specific IgA antibody levels occur in severely ill patients.
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Zonneveld R, Jurriaans S, van Gool T, Hofstra JJ, Hekker TAM, Defoer P, Broekhuizen-van Haaften PE, Wentink-Bonnema EM, Boonkamp L, Teunissen CE, Heijboer AC, Martens F, de Bree G, van Vugt M, van Houdt R. Head-to-head validation of six immunoassays for SARS-CoV-2 in hospitalized patients. J Clin Virol 2021; 139:104821. [PMID: 33882373 PMCID: PMC8053367 DOI: 10.1016/j.jcv.2021.104821] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/29/2021] [Accepted: 04/06/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Detecting SARS-CoV-2 antibodies may help to diagnose COVID-19. Head-to-head validation of different types of immunoassays in well-characterized cohorts of hospitalized patients remains needed. METHODS We validated three chemiluminescence immunoassays (CLIAs) (Liaison, Elecsys, and Abbott) and one single molecule array assay (SIMOA) (Quanterix) for automated analyzers, one rapid immunoassay RIA (AllTest), and one ELISA (Wantai) in parallel in first samples from 126 PCR confirmed COVID-19 hospitalized patients and 158 pre-COVID-19 patients. Specificity of the AllTest was also tested in 106 patients with confirmed parasitic and dengue virus infections. Specificity of the Wantai assay was not tested due to limitations in sample volumes. RESULTS Overall sensitivity in first samples was 70.6 % for the Liaison, 71.4 % for the Elecsys, 75.4 % for the Abbott, 70.6 % for the Quanterix, 77.8 % for the AllTest, and 88.9 % for the Wantai assay, respectively. Sensitivity was between 77.4 % (Liaison) and 94.0 % (Wantai) after 10 dpso. No false positive results were observed for the Elecsys and Abbott assays. Specificity was 91.1 % for the Quanterix, 96.2 % for the Liaison, and 98.1 % for the AllTest assay, respectively. CONCLUSION We conclude that low sensitivity of all immunoassays limits their use early after onset of illness in diagnosing COVID-19 in hospitalized patients. After 10 dpso, the Wantai ELISA has a relatively high sensitivity, followed by the point-of-care AllTest RIA that compares favorably with automated analyzer immunoassays.
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Affiliation(s)
- Rens Zonneveld
- Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, University of Amsterdam and VU University Amsterdam, the Netherlands.
| | - Suzanne Jurriaans
- Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, University of Amsterdam and VU University Amsterdam, the Netherlands
| | - Tom van Gool
- Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, University of Amsterdam and VU University Amsterdam, the Netherlands
| | - Jorrit J Hofstra
- Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, University of Amsterdam and VU University Amsterdam, the Netherlands
| | - Thecla A M Hekker
- Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, University of Amsterdam and VU University Amsterdam, the Netherlands
| | - Pien Defoer
- Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, University of Amsterdam and VU University Amsterdam, the Netherlands
| | - Patricia E Broekhuizen-van Haaften
- Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, University of Amsterdam and VU University Amsterdam, the Netherlands
| | - Ellen M Wentink-Bonnema
- Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, University of Amsterdam and VU University Amsterdam, the Netherlands
| | - Lynn Boonkamp
- Neurochemical Laboratory, Amsterdam University Medical Center, University of Amsterdam and VU University Amsterdam, the Netherlands
| | - Charlotte E Teunissen
- Neurochemical Laboratory, Amsterdam University Medical Center, University of Amsterdam and VU University Amsterdam, the Netherlands
| | - Annemieke C Heijboer
- Endocrine Laboratory, Amsterdam University Medical Center, University of Amsterdam and VU University Amsterdam, the Netherlands
| | - Frans Martens
- Endocrine Laboratory, Amsterdam University Medical Center, University of Amsterdam and VU University Amsterdam, the Netherlands
| | - Godelieve de Bree
- Department of Internal Medicine & Infectious Diseases, Amsterdam University Medical Center, University of Amsterdam and VU University Amsterdam, the Netherlands
| | - Michele van Vugt
- Department of Internal Medicine & Infectious Diseases, Amsterdam University Medical Center, University of Amsterdam and VU University Amsterdam, the Netherlands
| | - Robin van Houdt
- Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, University of Amsterdam and VU University Amsterdam, the Netherlands
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Resman Rus K, Korva M, Knap N, Avšič Županc T, Poljak M. Performance of the rapid high-throughput automated electrochemiluminescence immunoassay targeting total antibodies to the SARS-CoV-2 spike protein receptor binding domain in comparison to the neutralization assay. J Clin Virol 2021; 139:104820. [PMID: 33865031 PMCID: PMC8035809 DOI: 10.1016/j.jcv.2021.104820] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 12/29/2022]
Abstract
Background Neutralization tests (NT) are the gold standard for detecting and quantifying anti-SARS-CoV-2 neutralizing antibodies (NAb), but their complexity restricts them to research settings or reference laboratories. Antibodies against S protein receptor binding domain (RBD) have been shown to confer a neutralizing activity against SARS-CoV-2. Assays quantitatively measuring anti-S1-RBD-SARS-CoV-2 antibodies could be of great value for NAb screening of potential donors for convalescent-phase plasma therapy, assessing natural or vaccine-induced immunity, stratifying individuals for vaccine receipt, and documenting vaccine response. Methods Elecsys Anti-SARS-CoV-2 S (Elecsys-S), a high-throughput automated electrochemiluminescence double-antigen sandwich immunoassay for quantitative measurement of pan-anti-S1-RBD-SARS-CoV-2 antibodies, was evaluated against NT on 357 patients with PCR-confirmed SARS-CoV-2 infection. NT was performed in a BSL-3 laboratory using a Slovenian SARS-CoV-2 isolate; the NT titer ≥1:20 was considered positive. Results Elecsys-S detected pan-anti-S1-RBD-SARS-CoV-2 antibodies in 352/357 (98.6 %) samples. NAb were identified by NT in 257/357 (72 %) samples. The Elecsys-S/NT agreement was moderate (Cohen’s kappa 0.56). High NT titer antibodies (≥1:160) were detected in 106/357 (30 %) samples. Elecsys-S’s pan-anti-S1-RBD-SARS-CoV-2 antibody concentrations correlated with individual NT titer categories (the lowest concentrations were identified in NT-negative samples and the highest in samples with NT titer 1:1,280), and the Elecsys-S cutoff value for reasonable prediction of NAb generated after natural infection was established (133 BAU/mL). Conclusion Although NT should remain the gold standard for assessing candidates for convalescent-phase plasma donors, selected commercial anti-SARS-CoV-2 assays with optimized cutoff, like Elecsys-S, could be used for rapid, automated, and large-scale screening of individuals with clinically relevant NAb levels as suitable donors.
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Affiliation(s)
- Katarina Resman Rus
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Miša Korva
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Nataša Knap
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Tatjana Avšič Županc
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Mario Poljak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia.
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Poljak M, Oštrbenk Valenčak A, Štrumbelj E, Maver Vodičar P, Vehovar V, Resman Rus K, Korva M, Knap N, Seme K, Petrovec M, Zupan B, Demšar J, Kurdija S, Avšič Županc T. Seroprevalence of severe acute respiratory syndrome coronavirus 2 in Slovenia: results of two rounds of a nationwide population study on a probability-based sample, challenges and lessons learned. Clin Microbiol Infect 2021; 27:1039.e1-1039.e7. [PMID: 33838303 PMCID: PMC8064903 DOI: 10.1016/j.cmi.2021.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/16/2021] [Accepted: 03/22/2021] [Indexed: 12/23/2022]
Abstract
Objectives Seroprevalence surveys provide crucial information on cumulative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure. This Slovenian nationwide population study is the first longitudinal 6-month serosurvey using probability-based samples across all age categories. Methods Each participant supplied two blood samples: 1316 samples in April 2020 (first round) and 1211 in October/November 2020 (second round). The first-round sera were tested using Euroimmun Anti-SARS-CoV-2 ELISA IgG (ELISA) and, because of uncertain estimates, were retested using Elecsys Anti-SARS-CoV-2 (Elecsys-N) and Elecsys Anti-SARS-CoV-2 S (Elecsys-S). The second-round sera were concomitantly tested using Elecsys-N/Elecsys-S. Results The populations of both rounds matched the overall population (n = 3000), with minor settlement type and age differences. The first-round seroprevalence corrected for the ELISA manufacturer's specificity was 2.78% (95% highest density interval [HDI] 1.81%–3.80%), corrected using pooled ELISA specificity calculated from published data 0.93% (95% CI 0.00%–2.65%), and based on Elecsys-N/Elecsys-S results 0.87% (95% HDI 0.40%–1.38%). The second-round unadjusted lower limit of seroprevalence on 11 November 2020 was 4.06% (95% HDI 2.97%–5.16%) and on 3 October 2020, unadjusted upper limit was 4.29% (95% HDI 3.18%–5.47%). Conclusions SARS-CoV-2 seroprevalence in Slovenia increased four-fold from late April to October/November 2020, mainly due to a devastating second wave. Significant logistic/methodological challenges accompanied both rounds. The main lessons learned were a need for caution when relying on manufacturer-generated assay evaluation data, the importance of multiple manufacturer-independent assay performance assessments, the need for concomitant use of highly-specific serological assays targeting different SARS-CoV-2 proteins in serosurveys conducted in low-prevalence settings or during epidemic exponential growth and the usefulness of a Bayesian approach for overcoming complex methodological challenges.
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Affiliation(s)
- Mario Poljak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
| | - Anja Oštrbenk Valenčak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Erik Štrumbelj
- Faculty of Computer and Information Science, University of Ljubljana, Ljubljana, Slovenia
| | - Polona Maver Vodičar
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Vasja Vehovar
- Faculty of Social Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Katarina Resman Rus
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Miša Korva
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Nataša Knap
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Katja Seme
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Miroslav Petrovec
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Blaž Zupan
- Faculty of Computer and Information Science, University of Ljubljana, Ljubljana, Slovenia
| | - Janez Demšar
- Faculty of Computer and Information Science, University of Ljubljana, Ljubljana, Slovenia
| | - Slavko Kurdija
- Faculty of Social Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Tatjana Avšič Županc
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Garcia-Beltran WF, Miller TE, Kirkpatrick G, Nixon A, Astudillo MG, Yang D, Mahanta LM, Murali M, Dighe AS, Lennerz J, Thierauf J, Naranbhai V, Iafrate AJ. Remote Fingerstick Blood Collection for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibody Testing. Arch Pathol Lab Med 2021; 145:415-418. [PMID: 33264390 DOI: 10.5858/arpa.2020-0713-sa] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2020] [Indexed: 11/06/2022]
Abstract
The rapid worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has propelled the rapid development of serologic tests that can detect anti-SARS-CoV-2 antibodies. These have been used for studying the prevalence and spread of infection in different populations, and helping establish a recent diagnosis of coronavirus disease 2019 (COVID-19), and will likely be used to confirm humoral immunity after infection or vaccination. However, nearly all lab-based high-throughput SARS-CoV-2 serologic assays require a serum sample from venous blood draw, limiting their applications and scalability. Here, we present a method that enables large-scale SARS-CoV-2 serologic studies by combining self or office collection of fingerprick blood with a volumetric absorptive microsampling device (Mitra, Neoteryx LLC) with a high-throughput electrochemiluminescence-based SARS-CoV-2 total antibody assay (Roche Elecsys, Roche Diagnostics Inc) that is emergency use authorization approved for use on serum samples and widely used by clinical laboratories around the world. We found that the Roche Elecsys assay has a high dynamic range that allows for accurate detection of SARS-CoV-2 antibodies in serum samples diluted 1:20 as well as contrived dried blood extracts. Extracts of dried blood from Mitra devices acquired in a community seroprevalence study showed near identical sensitivity and specificity in detection of SARS-CoV-2 antibodies compared with neat sera using predefined thresholds for each specimen type. Overall, this study affirms the use of Mitra dried blood collection device with the Roche Elecsys SARS-CoV-2 total antibody assay for remote or at-home testing as well as large-scale community seroprevalence studies.
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Affiliation(s)
- Wilfredo F Garcia-Beltran
- From the Departments of Pathology (Garcia-Beltran, Miller, Kirkpatrick, Nixon, Astudillo, Yang, Murali, Dighe, Lennerz, Thierauf, Iafrate), Massachusetts General Hospital, Boston.,Garcia-Beltran and Miller contributed equally to this work
| | - Tyler E Miller
- From the Departments of Pathology (Garcia-Beltran, Miller, Kirkpatrick, Nixon, Astudillo, Yang, Murali, Dighe, Lennerz, Thierauf, Iafrate), Massachusetts General Hospital, Boston.,Garcia-Beltran and Miller contributed equally to this work
| | - Grace Kirkpatrick
- From the Departments of Pathology (Garcia-Beltran, Miller, Kirkpatrick, Nixon, Astudillo, Yang, Murali, Dighe, Lennerz, Thierauf, Iafrate), Massachusetts General Hospital, Boston
| | - Andrea Nixon
- From the Departments of Pathology (Garcia-Beltran, Miller, Kirkpatrick, Nixon, Astudillo, Yang, Murali, Dighe, Lennerz, Thierauf, Iafrate), Massachusetts General Hospital, Boston
| | - Michael G Astudillo
- From the Departments of Pathology (Garcia-Beltran, Miller, Kirkpatrick, Nixon, Astudillo, Yang, Murali, Dighe, Lennerz, Thierauf, Iafrate), Massachusetts General Hospital, Boston
| | - Diane Yang
- From the Departments of Pathology (Garcia-Beltran, Miller, Kirkpatrick, Nixon, Astudillo, Yang, Murali, Dighe, Lennerz, Thierauf, Iafrate), Massachusetts General Hospital, Boston
| | - Lisa M Mahanta
- Mass General Brigham Biobank, Boston, Massachusetts (Mahanta)
| | - Mandakolathur Murali
- From the Departments of Pathology (Garcia-Beltran, Miller, Kirkpatrick, Nixon, Astudillo, Yang, Murali, Dighe, Lennerz, Thierauf, Iafrate), Massachusetts General Hospital, Boston.,Medicine (Murali, Naranbhai), Massachusetts General Hospital, Boston
| | - Anand S Dighe
- From the Departments of Pathology (Garcia-Beltran, Miller, Kirkpatrick, Nixon, Astudillo, Yang, Murali, Dighe, Lennerz, Thierauf, Iafrate), Massachusetts General Hospital, Boston
| | - Jochen Lennerz
- From the Departments of Pathology (Garcia-Beltran, Miller, Kirkpatrick, Nixon, Astudillo, Yang, Murali, Dighe, Lennerz, Thierauf, Iafrate), Massachusetts General Hospital, Boston
| | - Julia Thierauf
- From the Departments of Pathology (Garcia-Beltran, Miller, Kirkpatrick, Nixon, Astudillo, Yang, Murali, Dighe, Lennerz, Thierauf, Iafrate), Massachusetts General Hospital, Boston
| | - Vivek Naranbhai
- Medicine (Murali, Naranbhai), Massachusetts General Hospital, Boston
| | - A John Iafrate
- From the Departments of Pathology (Garcia-Beltran, Miller, Kirkpatrick, Nixon, Astudillo, Yang, Murali, Dighe, Lennerz, Thierauf, Iafrate), Massachusetts General Hospital, Boston
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Wehrhahn MC, Brown SJ, Newcombe JP, Chong S, Evans J, Figtree M, Hainke L, Hueston L, Khan S, Marland E, O'Sullivan MVN, Powell H, Roy J, Waring L, Yu M, Robson J. An evaluation of 4 commercial assays for the detection of SARS-CoV-2 antibodies in a predominantly mildly symptomatic low prevalence Australian population. J Clin Virol 2021; 138:104797. [PMID: 33770657 PMCID: PMC7968170 DOI: 10.1016/j.jcv.2021.104797] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/28/2021] [Accepted: 03/14/2021] [Indexed: 02/08/2023]
Abstract
A total of 1080 individual patient samples (158 positive serology samples from confirmed, predominantly mildly symptomatic COVID-19 patients and 922 serology negative including 496 collected pre-COVID) from four states in Australia were analysed on four commercial SARS-CoV-2 serological assays targeting antibodies to different antigens (Roche Elecsys and Abbott Architect: nucleocapsid; Diasorin Liaison and Euroimmun: spike). A subset was compared to immunofluorescent antibody (IFA) and micro-neutralisation. Sensitivity and specificity of the Roche (n = 1033), Abbott (n = 806), Diasorin (n = 1034) and Euroimmun (n = 175) were 93.7 %/99.5 %, 90.2 %/99.4 %, 88.6 %/98.6 % and 91.3 %/98.8 %, respectively. ROC analysis with specificity held at 99 % increased the sensitivity for the Roche and Abbott assays from 93.7% to 98.7% (cut-off 0.21) and 90.2 % to 94.0 % (cut-off 0.91), respectively. Overall seropositivity of samples increased from a maximum of 23 % for samples 0−7 days-post-onset of symptoms (dpos), to 61 % from samples 8−14dpos and 93 % from those >14dpos. IFA and microneutralisation values correlated best with assays targeting antibodies to spike protein with values >80 AU/mL on the Diasorin assay associated with neutralising antibody. Detectable antibody was present in 22/23 (96 %), 20/23 (87 %), 15/23 (65 %) and 9/22 (41 %) patients with samples >180dpos on the Roche, Diasorin, Abbott and microneutralisation assays respectively. Given the low prevalence in this community, two-step algorithms on initial positive results saw an increase in the positive predictive value (PPV) of positive samples (39 %–65 % to ≥98 %) for all combinations. Similarly accuracy increased from a range of 98.5 %–99.4 % to ≥99.8 % assuming a 1 % seroprevalence. Negative predictive value (NPV) was high (≥99.8 %) regardless of which assay was used initially.
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Affiliation(s)
- Michael C Wehrhahn
- Department of Microbiology, Douglass Hanly Moir Pathology, New South Wales, Australia.
| | - Suzanne J Brown
- Department of Endocrinology, Sir Charles Gairdner Hospital, Western Australia, Australia
| | - James P Newcombe
- Department of Microbiology, Douglass Hanly Moir Pathology, New South Wales, Australia; NSW Health Pathology, Department of Microbiology, Royal North Shore Hospital, New South Wales, Australia
| | - Smathi Chong
- Department of Microbiology, Clinipath Pathology, Western Australia, Australia
| | - Jenny Evans
- Department of Microbiology, Sullivan Nicolaides Pathology, Queensland, Australia
| | - Melanie Figtree
- NSW Health Pathology, Department of Microbiology, Royal North Shore Hospital, New South Wales, Australia
| | - Laurence Hainke
- Department of Microbiology, Clinipath Pathology, Western Australia, Australia
| | - Linda Hueston
- NSW Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead, New South Wales, Australia
| | - Sadid Khan
- Department of Microbiology, Melbourne Pathology, Victoria, Australia
| | - Elizabeth Marland
- Department of Microbiology, Douglass Hanly Moir Pathology, New South Wales, Australia
| | - Matthew V N O'Sullivan
- NSW Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead, New South Wales, Australia; Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - Helen Powell
- Department of Microbiology, Sullivan Nicolaides Pathology, Queensland, Australia
| | - Jhumur Roy
- Department of Microbiology, Clinpath Pathology, South Australia, Australia
| | - Lynette Waring
- Department of Microbiology, Melbourne Pathology, Victoria, Australia
| | - Megan Yu
- Department of Microbiology, Douglass Hanly Moir Pathology, New South Wales, Australia
| | - Jennifer Robson
- Department of Microbiology, Sullivan Nicolaides Pathology, Queensland, Australia
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Poljak M, Oštrbenk Valenčak A, Štamol T, Seme K. Head-to-head comparison of two rapid high-throughput automated electrochemiluminescence immunoassays targeting total antibodies to the SARS-CoV-2 nucleoprotein and spike protein receptor binding domain. J Clin Virol 2021; 137:104784. [PMID: 33711693 PMCID: PMC7934695 DOI: 10.1016/j.jcv.2021.104784] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/23/2021] [Accepted: 03/01/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Accurate anti-SARS-CoV-2 assays are needed to inform diagnostic, therapeutic, and public health decisions. The first manufacturer-independent head-to-head comparison of two rapid high-throughput automated electrochemiluminescence double-antigen sandwich immunoassays targeting total anti-SARS-CoV-2 antibodies against two different viral proteins, Elecsys Anti-SARS-CoV-2 (Elecsys-N) and Elecsys Anti-SARS-CoV-2 S (Elecsys-S) (Roche Diagnostics), was performed in a routine setting during the exponential growth phase of the epidemic's second wave. METHODS The diagnostic specificity of Elecsys-N and Elecsys-S was initially evaluated on a panel of 572 pre-COVID-19 samples, showing 100 % specificity of both assays. Elecsys-N/Elecsys-S head-to-head comparison used 3,416 consecutive blood samples from individuals that were tested for the presence of anti-SARS-CoV-2 within commercial out-of-pocket serologic testing. RESULTS Elecsys-N/Elecsys-S head-to-head comparison showed overall agreement of 98.68 % (3,371/3,416; 95 % CI, 98.23-99.03 %), positive agreement of 95.16 % (884/929; 95 % CI, 93.52-96.41 %), and a high kappa value of 0.996 (95 % CI, 0.956-0.976). Previous SARS-CoV-2 PCR positivity was identified in 14/24 (58.3 %) Elecsys-N negative/Elecsys-S positive individuals and in 4/21 (19.0 %) Elecsys-N positive/Elecsys-S negative individuals. CONCLUSION The first Elecsys-N/Elecsys-S head-to-head comparison showed excellent agreement of two highly specific and rapid high-throughput automated anti-SARS-CoV-2 assays. An important question is whether laboratories offering two different antibody assays could benefit from combining the assays; if so, should use be concomitant or sequential-and, in the latter case, in which order? Based on our results, we favor concomitant over sequential Elecsys-N/Elecsys-S use when testing individuals for anti-SARS-CoV-2 antibodies in high-incidence settings; for example, during the exponential or stationary growth phase of the COVID-19 epidemic.
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Affiliation(s)
- Mario Poljak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000, Ljubljana, Slovenia.
| | - Anja Oštrbenk Valenčak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000, Ljubljana, Slovenia
| | - Tina Štamol
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000, Ljubljana, Slovenia
| | - Katja Seme
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000, Ljubljana, Slovenia
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Abu Jabal K, Ben-Amram H, Beiruti K, Batheesh Y, Sussan C, Zarka S, Edelstein M. Impact of age, ethnicity, sex and prior infection status on immunogenicity following a single dose of the BNT162b2 mRNA COVID-19 vaccine: real-world evidence from healthcare workers, Israel, December 2020 to January 2021. Euro Surveill 2021; 26:2100096. [PMID: 33573712 PMCID: PMC7879501 DOI: 10.2807/1560-7917.es.2021.26.6.2100096] [Citation(s) in RCA: 184] [Impact Index Per Article: 61.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/10/2021] [Indexed: 01/10/2023] Open
Abstract
The BNT162b2 mRNA COVID-19 vaccine showed high efficacy in clinical trials but observational data from populations not included in trials are needed. We describe immunogenicity 21 days post-dose 1 among 514 Israeli healthcare workers by age, ethnicity, sex and prior COVID-19 infection. Immunogenicity was similar by ethnicity and sex but decreased with age. Those with prior infection had antibody titres one magnitude order higher than naïve individuals regardless of the presence of detectable IgG antibodies pre-vaccination.
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Affiliation(s)
- Kamal Abu Jabal
- Ziv Medical Centre, Safed, Israel
- These authors contributed equally to this article and share first authorship
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Hila Ben-Amram
- Ziv Medical Centre, Safed, Israel
- These authors contributed equally to this article and share first authorship
| | | | | | | | - Salman Zarka
- Ziv Medical Centre, Safed, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Michael Edelstein
- Ziv Medical Centre, Safed, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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39
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Dobaño C, Vidal M, Santano R, Jiménez A, Chi J, Barrios D, Ruiz-Olalla G, Rodrigo Melero N, Carolis C, Parras D, Serra P, Martínez de Aguirre P, Carmona-Torre F, Reina G, Santamaria P, Mayor A, García-Basteiro AL, Izquierdo L, Aguilar R, Moncunill G. Highly Sensitive and Specific Multiplex Antibody Assays To Quantify Immunoglobulins M, A, and G against SARS-CoV-2 Antigens. J Clin Microbiol 2021; 59:e01731-20. [PMID: 33127841 PMCID: PMC8111153 DOI: 10.1128/jcm.01731-20] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 10/29/2020] [Indexed: 12/13/2022] Open
Abstract
Reliable serological tests are required to determine the prevalence of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and to characterize immunity to the disease in order to address key knowledge gaps in the coronavirus disease 2019 (COVID-19) pandemic. Quantitative suspension array technology (qSAT) assays based on the xMAP Luminex platform overcome the limitations of rapid diagnostic tests and enzyme-linked immunosorbent assays (ELISAs) with their higher precision, dynamic range, throughput, miniaturization, cost-efficiency, and multiplexing capacity. We developed three qSAT assays for IgM, IgA, and IgG against a panel of eight SARS-CoV-2 antigens, including spike protein (S), nucleocapsid protein (N), and membrane protein (M) constructs. The assays were optimized to minimize the processing time and maximize the signal-to-noise ratio. We evaluated their performances using 128 prepandemic plasma samples (negative controls) and 104 plasma samples from individuals with SARS-CoV-2 diagnosis (positive controls), of whom 5 were asymptomatic, 51 had mild symptoms, and 48 were hospitalized. Preexisting IgG antibodies recognizing N, M, and S proteins were detected in negative controls, which is suggestive of cross-reactivity to common-cold coronaviruses. The best-performing antibody/antigen signatures had specificities of 100% and sensitivities of 95.78% at ≥14 days and 95.65% at ≥21 days since the onset of symptoms, with areas under the curve (AUCs) of 0.977 and 0.999, respectively. Combining multiple markers as assessed by qSAT assays has the highest efficiency, breadth, and versatility to accurately detect low-level antibody responses for obtaining reliable data on the prevalence of exposure to novel pathogens in a population. Our assays will allow gaining insights into antibody correlates of immunity and their kinetics, required for vaccine development to combat the COVID-19 pandemic.
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Affiliation(s)
- Carlota Dobaño
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Rebeca Santano
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Alfons Jiménez
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Jordi Chi
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Diana Barrios
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Gemma Ruiz-Olalla
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Natalia Rodrigo Melero
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Carlo Carolis
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Daniel Parras
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Pau Serra
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | | | - Francisco Carmona-Torre
- Infectious Diseases Division, Clínica Universidad de Navarra, Pamplona, Spain
- Clinical Microbiology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Gabriel Reina
- Clínica Universidad de Navarra, Navarra Institute for Health Research, Pamplona, Spain
| | - Pere Santamaria
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Julia McFarlane Diabetes Research Centre, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Diseases, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Alfredo Mayor
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Alberto L García-Basteiro
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
- International Health Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Luis Izquierdo
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
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40
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Dobaño C, Vidal M, Santano R, Jiménez A, Chi J, Barrios D, Ruiz-Olalla G, Rodrigo Melero N, Carolis C, Parras D, Serra P, Martínez de Aguirre P, Carmona-Torre F, Reina G, Santamaria P, Mayor A, García-Basteiro AL, Izquierdo L, Aguilar R, Moncunill G. Highly Sensitive and Specific Multiplex Antibody Assays To Quantify Immunoglobulins M, A, and G against SARS-CoV-2 Antigens. J Clin Microbiol 2021. [PMID: 33127841 DOI: 10.1101/2020.06.11.147363] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
Reliable serological tests are required to determine the prevalence of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and to characterize immunity to the disease in order to address key knowledge gaps in the coronavirus disease 2019 (COVID-19) pandemic. Quantitative suspension array technology (qSAT) assays based on the xMAP Luminex platform overcome the limitations of rapid diagnostic tests and enzyme-linked immunosorbent assays (ELISAs) with their higher precision, dynamic range, throughput, miniaturization, cost-efficiency, and multiplexing capacity. We developed three qSAT assays for IgM, IgA, and IgG against a panel of eight SARS-CoV-2 antigens, including spike protein (S), nucleocapsid protein (N), and membrane protein (M) constructs. The assays were optimized to minimize the processing time and maximize the signal-to-noise ratio. We evaluated their performances using 128 prepandemic plasma samples (negative controls) and 104 plasma samples from individuals with SARS-CoV-2 diagnosis (positive controls), of whom 5 were asymptomatic, 51 had mild symptoms, and 48 were hospitalized. Preexisting IgG antibodies recognizing N, M, and S proteins were detected in negative controls, which is suggestive of cross-reactivity to common-cold coronaviruses. The best-performing antibody/antigen signatures had specificities of 100% and sensitivities of 95.78% at ≥14 days and 95.65% at ≥21 days since the onset of symptoms, with areas under the curve (AUCs) of 0.977 and 0.999, respectively. Combining multiple markers as assessed by qSAT assays has the highest efficiency, breadth, and versatility to accurately detect low-level antibody responses for obtaining reliable data on the prevalence of exposure to novel pathogens in a population. Our assays will allow gaining insights into antibody correlates of immunity and their kinetics, required for vaccine development to combat the COVID-19 pandemic.
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Affiliation(s)
- Carlota Dobaño
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Rebeca Santano
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Alfons Jiménez
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Jordi Chi
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Diana Barrios
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Gemma Ruiz-Olalla
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Natalia Rodrigo Melero
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Carlo Carolis
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Daniel Parras
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Pau Serra
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | | | - Francisco Carmona-Torre
- Infectious Diseases Division, Clínica Universidad de Navarra, Pamplona, Spain
- Clinical Microbiology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Gabriel Reina
- Clínica Universidad de Navarra, Navarra Institute for Health Research, Pamplona, Spain
| | - Pere Santamaria
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Julia McFarlane Diabetes Research Centre, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Diseases, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Alfredo Mayor
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Alberto L García-Basteiro
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
- International Health Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Luis Izquierdo
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
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Silvano J, Ferreira F, Bustorff M, Nunes AT, Tavares I, Sobrinho Simões J, Ramos A, Cardoso MJ, Sampaio S, Pestana M. Viral Clearance and Serological Response to SARS-CoV-2 in Kidney Transplant Recipients. Transplant Proc 2020; 53:1180-1186. [PMID: 33419577 PMCID: PMC7834639 DOI: 10.1016/j.transproceed.2020.11.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/15/2020] [Accepted: 11/20/2020] [Indexed: 01/01/2023]
Abstract
Objectives Knowledge about the impact of coronavirus disease 2019 (COVID-19) on kidney transplant recipients (KTRs) concerning viral shedding and humoral immune response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is limited. The aim of this study is to analyze viral dynamics and the antibody response to SARS-CoV-2 in KTRs with COVID-19 and study their association with clinical data. Materials and methods Consecutive KTRs diagnosed with COVID-19 at our center were evaluated for clinical presentation and outcome; duration of viral shedding and viral burden by reverse transcription-polymerase chain reaction assay cycle threshold; and magnitude of seroconversion to SARS-CoV-2. Results Six KTRs identified with COVID-19 were hospitalized. Presenting symptoms were similar to those in the general population. Four patients had severe disease and, of these, 2 required mechanical ventilation, 4 had acute kidney injury, and 3 had secondary bacterial infections. Immunosuppression was reduced in all patients. Five patients were treated with hydroxychloroquine. No patient required dialysis or died. Patients with severe disease had a longer duration of viral shedding, which lasted more than 40 days, and had IgG antibodies against SARS-CoV-2, which were detected from 3 weeks to as long as 10 weeks after symptom onset. In patients with less severe disease no IgG antibodies where detected between 9 and 14 weeks after symptom onset. Conclusions In our series, KTRs with severe COVID-19 had prolonged viral shedding and a stronger humoral immune response to SARS-CoV-2. These preliminary data need to be confirmed with further studies and over a longer period of time.
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Affiliation(s)
- José Silvano
- Nephrology Department, Centro Hospitalar Universitário de São João, Porto, Portugal.
| | - Filipa Ferreira
- Nephrology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Manuela Bustorff
- Nephrology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Ana Teresa Nunes
- Nephrology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Isabel Tavares
- Nephrology Department, Centro Hospitalar Universitário de São João, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Institute of Biomedical Engineering (INEB-I3S), Nephrology and Infectious Diseases Research and Development Group, University of Porto, Porto, Portugal
| | - Joana Sobrinho Simões
- Serviço de Patologia Clínica, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Angélica Ramos
- Serviço de Patologia Clínica, Centro Hospitalar Universitário de São João, Porto, Portugal; EPI-Unit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Maria João Cardoso
- Serviço de Patologia Clínica, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Susana Sampaio
- Nephrology Department, Centro Hospitalar Universitário de São João, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Institute of Biomedical Engineering (INEB-I3S), Nephrology and Infectious Diseases Research and Development Group, University of Porto, Porto, Portugal
| | - Manuel Pestana
- Nephrology Department, Centro Hospitalar Universitário de São João, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Institute of Biomedical Engineering (INEB-I3S), Nephrology and Infectious Diseases Research and Development Group, University of Porto, Porto, Portugal
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