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Ohira M, Osada T, Kimura H, Sano T, Takao M. Post-acute sequelae of SARS-CoV-2 mimic: An important neurological condition. J Neurol Sci 2024; 465:123199. [PMID: 39182422 DOI: 10.1016/j.jns.2024.123199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 07/09/2024] [Accepted: 08/20/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND AND OBJECTIVES In 2024, the sequalae of the acute phase of coronavirus disease-19 (COVID-19) infection, which include neurological symptoms and are commonly referred to as long COVID or post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PASC), continue to be a substantial health concern; however, similar symptoms are observed in individuals with no previous COVID-19 infection. METHODS This was a single-center, retrospective, descriptive case series study. Data were obtained from patients who visited our outpatient clinic specializing in PASC between June 1, 2021, and May 31, 2023. We compared antibody test results between patients with confirmed acute phase infection and those without. We compared differences in demographic and clinical characteristics between patients with positive results during the acute phase of COVID-19 infection and positive anti-SARS-CoV-2 antibody tests (true-PASC), and those with neither (PASC-mimic). RESULTS Of 437 patients diagnosed with PASC according to World Health Organization criteria, 222 underwent COVID-19 antibody tests. Of these, 193 patients (86.9%) had a history of confirmed acute phase infection, whereas 29 (13.1%) did not. Of the former, 186 patients (96.4%) were seropositive for anti-nucleotide SARS-CoV-2 antibodies (true-PASC), whereas 19 of the latter tested seronegative for anti-nucleotide SARS-CoV-2 antibodies (PASC-mimic). There were no significant differences in symptom characteristics between true-PASC and PASC-mimic participants. CONCLUSIONS It was difficult to identify any clinical features to aid in diagnosing PASC without confirmation of acute COVID-19 infection. The findings indicate the existence of a "PASC-mimic" condition that should be acknowledged and excluded in future PASC-related research studies.
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Affiliation(s)
- Masayuki Ohira
- Department of General Internal Medicine and Clinical Laboratory, National Center of Neurology and Psychiatry National Center Hospital, Kodaira, Tokyo, Japan.
| | - Takashi Osada
- Department of General Internal Medicine, National Center of Neurology and Psychiatry National Center Hospital, Kodaira, Tokyo, Japan
| | - Hiroaki Kimura
- Department of General Internal Medicine, National Center of Neurology and Psychiatry National Center Hospital, Kodaira, Tokyo, Japan
| | - Terunori Sano
- Department of General Internal Medicine and Clinical Laboratory, National Center of Neurology and Psychiatry National Center Hospital, Kodaira, Tokyo, Japan
| | - Masaki Takao
- Department of General Internal Medicine and Clinical Laboratory, National Center of Neurology and Psychiatry National Center Hospital, Kodaira, Tokyo, Japan
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Grayo S, Sagno H, Diassy O, Zogbelemou JB, Kondabo SJ, Houndekon M, Dellagi K, Vigan-Womas I, Rourou S, Hamouda WB, Benabdessalem C, Ahmed MB, Tordo N. Snapshot of Anti-SARS-CoV-2 IgG Antibodies in COVID-19 Recovered Patients in Guinea. J Clin Med 2024; 13:2965. [PMID: 38792506 PMCID: PMC11122401 DOI: 10.3390/jcm13102965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/10/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Because the regular vaccine campaign started in Guinea one year after the COVID-19 index case, the profile of naturally acquired immunity following primary SARS-CoV-2 infection needs to be deepened. Methods: Blood samples were collected once from 200 patients (90% of African extraction) who were recovered from COVID-19 for at least ~2.4 months (72 days), and their sera were tested for IgG antibodies to SARS-CoV-2 using an in-house ELISA assay against the Receptor Binding Domain (RBD) of the SARS-CoV-2 spike1 protein (RBD/S1-IH kit). Results: Results revealed that 73% of sera (146/200) were positive for IgG to SARS-CoV-2 with an Optical Density (OD) ranging from 0.13 to 1.19 and a median value of 0.56 (IC95: 0.51-0.61). The median OD value at 3 months (1.040) suddenly decreased thereafter and remained stable around OD 0.5 until 15 months post-infection. The OD median value was slightly higher in males compared to females (0.62 vs. 0.49), but the difference was not statistically significant (p-value: 0.073). In contrast, the OD median value was significantly higher among the 60-100 age group (0.87) compared to other groups, with a noteworthy odds ratio compared to the 0-20 age group (OR: 9.69, p-value: 0.044*). Results from the RBD/S1-IH ELISA kit demonstrated superior concordance with the whole spike1 protein ELISA commercial kit compared to a nucleoprotein ELISA commercial kit. Furthermore, anti-spike1 protein ELISAs (whole spike1 and RBD/S1) revealed higher seropositivity rates. Conclusions: These findings underscore the necessity for additional insights into naturally acquired immunity against COVID-19 and emphasize the relevance of specific ELISA kits for accurate seropositivity rates.
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Affiliation(s)
- Solène Grayo
- Institut Pasteur de Guinée, Conakry BP 4416, Guinea; (H.S.); (N.T.)
| | - Houlou Sagno
- Institut Pasteur de Guinée, Conakry BP 4416, Guinea; (H.S.); (N.T.)
| | - Oumar Diassy
- Agence Nationale de Sécurité Sanitaire, Conakry BP 797, Guinea;
| | | | | | - Marilyn Houndekon
- Centre Médico-Social de L’ambassade de France, Conakry BP 295, Guinea; (J.-B.Z.); (M.H.)
| | - Koussay Dellagi
- Direction Internationale, Institut Pasteur, 75724 Paris, France;
| | | | - Samia Rourou
- Institut Pasteur de Tunis, Tunis BP 74-1002, Tunisia; (S.R.); : (C.B.); (M.B.A.)
| | - Wafa Ben Hamouda
- Institut Pasteur de Tunis, Tunis BP 74-1002, Tunisia; (S.R.); : (C.B.); (M.B.A.)
| | | | - Melika Ben Ahmed
- Institut Pasteur de Tunis, Tunis BP 74-1002, Tunisia; (S.R.); : (C.B.); (M.B.A.)
| | - Noël Tordo
- Institut Pasteur de Guinée, Conakry BP 4416, Guinea; (H.S.); (N.T.)
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Albrecht S, Grässli F, Cusini A, Brucher A, Goppel S, Betschon E, Möller JC, Ortner M, Ruetti M, Stocker R, Vuichard-Gysin D, Besold U, Risch L, Von Kietzell M, Schlegel M, Vernazza P, Kuster SP, Kahlert CR, Kohler P. SARS-CoV-2 immunity and reasons for non-vaccination among healthcare workers from eastern and northern Switzerland: results from a nested multicentre cross-sectional study. Swiss Med Wkly 2024; 154:3734. [PMID: 38689545 DOI: 10.57187/s.3734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
AIMS OF THE STUDY We aimed to assess the extent of SARS-CoV-2 humoral immunity elicited by previous infections and/or vaccination among healthcare workers, and to identify reasons why healthcare workers decided against vaccination. METHODS This nested cross-sectional study included volunteer healthcare workers from 14 healthcare institutions in German-speaking Switzerland. In January 2021, SARS-CoV-2 vaccines were available for healthcare workers. In May and June 2022, participants answered electronic questionnaires regarding baseline characteristics including SARS-CoV-2 vaccination status (with one or more vaccine doses defined as vaccinated) and previous SARS-CoV-2 infections. Unvaccinated participants indicated their reasons for non-vaccination. Participants underwent testing for SARS-CoV-2 anti-spike (anti-S) and anti-nucleocapsid (anti-N) antibodies. Antibody prevalence was described across age groups. In addition, we performed multivariable logistic regression to identify baseline characteristics independently associated with non-vaccination and described reasons for non-vaccination. RESULTS Among 22,438 eligible employees, 3,436 (15%) participated; the median age was 43.7 years (range 16-73), 2,794 (81.3%) were female, and 1,407 (47.7%) identified as nurses; 3,414 (99.4%) underwent serology testing, among whom 3,383 (99.0%) had detectable anti-S (3,357, 98.3%) antibodies, anti-N (2,396, 70.1%) antibodies, or both (2,370, 69.4%). A total of 296 (8.6%) healthcare workers were unvaccinated, whereas 3,140 (91.4%) were vaccinated. In multivariable analysis, age (adjusted OR [aOR] 1.02 per year, 95% CI 1.01-1.03), being a physician (aOR 3.22, 95% CI 1.75-5.92) or administrator (aOR 1.88, 95% CI 1.27-2.80), and having higher education (aOR 2.23, 95% CI 1.09-4.57) were positively associated with vaccine uptake, whereas working in non-acute care (aOR 0.58, 95% CI 0.34-0.97), active smoking (aOR 0.68, 95% CI 0.51-0.91), and taking prophylactic home remedies against SARS-CoV-2 (aOR 0.42, 95% CI 0.31-0.56) were negatively associated. Important reasons for non-vaccination were a belief that the vaccine might not have long-lasting immunity (267/291, 92.1%) and a preference for gaining naturally acquired instead of vaccine-induced immunity (241/289, 83.4%). CONCLUSIONS Almost all healthcare workers in our cohort had specific antibodies against SARS-CoV-2 from natural infection and/or from vaccination. Young healthcare workers and those working in non-acute settings were less likely to be vaccinated, whereas physicians and administrative staff showed higher vaccination uptake. Presumed ineffectiveness of the vaccine is an important reason for non-vaccination.
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Affiliation(s)
- Selina Albrecht
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Fabian Grässli
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Alexia Cusini
- Cantonal Hospital of Grisons, Division of Infectious Diseases, Chur, Switzerland
| | - Angela Brucher
- Psychiatry Services of the Canton of St. Gallen (South), Trübbach, Switzerland
| | - Stephan Goppel
- Psychiatry Services of the Canton of St. Gallen (North), Wil, Switzerland
| | | | - J Carsten Möller
- Center for Neurological Rehabilitation, Zihlschlacht, Switzerland
| | - Manuela Ortner
- Rheintal Werdenberg Sarganserland Hospital Group, Grabs, Switzerland
| | - Markus Ruetti
- Fuerstenland Toggenburg Hospital Group, Wil, Switzerland
| | | | - Danielle Vuichard-Gysin
- Thurgau Hospital Group, Division of Infectious Diseases and Hospital Epidemiology, Muensterlingen, Switzerland
- Swiss National Centre for Infection Prevention (Swissnoso), Berne, Switzerland
| | - Ulrike Besold
- Geriatric Clinic St. Gallen, St. Gallen, Switzerland
| | - Lorenz Risch
- Labormedizinisches Zentrum Dr Risch Ostschweiz AG, Buchs, Switzerland
- Private Universität im Fürstentum Liechtenstein, Institut für Labormedizin, Triesen, Liechtenstein
- Center of Laboratory Medicine, University Institute of Clinical Chemistry, University of Berne, Inselspital, Berne, Switzerland
| | | | - Matthias Schlegel
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Pietro Vernazza
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Stefan P Kuster
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Christian R Kahlert
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
- Children's Hospital of Eastern Switzerland, Department of Infectious Diseases and Hospital Epidemiology, St. Gallen, Switzerland
| | - Philipp Kohler
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
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Stirrup O, Tut G, Krutikov M, Bone D, Lancaster T, Azmi B, Monakhov I, Moss P, Hayward A, Copas A, Shallcross L. Anti-nucleocapsid antibody levels following initial and repeat SARS-CoV-2 infections in a cohort of long-term care facility residents in England (VIVALDI). Wellcome Open Res 2024; 9:45. [PMID: 38818129 PMCID: PMC11137476 DOI: 10.12688/wellcomeopenres.20750.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 06/01/2024] Open
Abstract
Background We have previously demonstrated that older residents of long-term care facilities (LTCF) in the UK show levels of anti-spike antibodies that are comparable to the general population following primary series and booster vaccination for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, data on the humoral response to other SARS-CoV-2 proteins associated with natural infection are scarce in this vulnerable population. Methods We measured quantitative levels of anti-nucleocapsid antibodies in blood samples taken from LTCF residents and staff after initial and repeat SARS-CoV-2 infections, between December 2020 and March 2023. Data on SARS-CoV-2 infection and vaccination were obtained through linkage to national datasets. Linear mixed effects models were used to investigate anti-nucleocapsid antibody levels, using log10 scale, in relation to time from most recent infection. This included evaluation of associations between repeat infection, staff/resident status, age, sex, Omicron infection and vaccination history and peak antibody level and slope of decline with time. Results We analysed 405 antibody observations from 220 residents and 396 observations from 215 staff. Repeat infection was associated with 8.5-fold (95%CI 4.9-14.8-fold) higher initial (peak) median anti-nucleocapsid antibody level, with steeper subsequent slope of decline. There were no significant differences in antibody level associated with resident (vs. staff) status or age, but Omicron infection was associated with 3.6-fold (95%CI 2.4-5.4-fold) higher levels. There was stronger evidence of waning of antibody levels over time in a sensitivity analysis in which observations were censored in cases with suspected undetected repeat infection. Conclusions We found similar levels of anti-nucleocapsid antibody in residents and staff of LTCFs. Repeat infection and infection with an Omicron strain were associated with higher peak values. There was evidence of waning of anti-nucleocapsid antibody levels over time.
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Affiliation(s)
- Oliver Stirrup
- Institute for Global Health, University College London, London, England, UK
| | - Gokhan Tut
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, England, UK
| | - Maria Krutikov
- Institute of Health Informatics, University College London, London, England, UK
| | - David Bone
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, England, UK
| | - Tara Lancaster
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, England, UK
| | - Borscha Azmi
- Institute of Health Informatics, University College London, London, England, UK
| | | | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, England, UK
| | - Andrew Hayward
- Institute of Epidemiology & Health Care, University College London, London, England, UK
- Health Data Research UK, London, England, UK
| | - Andrew Copas
- Institute for Global Health, University College London, London, England, UK
| | - Laura Shallcross
- Institute of Health Informatics, University College London, London, England, UK
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Wagatsuma K, Saito R, Yoshioka S, Yamazaki S, Sato R, Iwaya M, Takahashi Y, Chon I, Naito M, Watanabe H. Anti-SARS-CoV-2 IgG antibody after the second and third mRNA vaccinations in staff and residents in a nursing home with a previous COVID-19 outbreak in Niigata, Japan. J Infect Chemother 2024; 30:164-168. [PMID: 37739181 DOI: 10.1016/j.jiac.2023.09.021] [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: 06/16/2023] [Revised: 09/06/2023] [Accepted: 09/17/2023] [Indexed: 09/24/2023]
Abstract
This study measured IgG antibody titers against spike (S) and nucleocapsid (N) proteins of SARS-CoV-2 before vaccination and after the second and third doses of an mRNA vaccine in staff and residents of a nursing home in Niigata, Japan. The study included 52 staff members, of whom six (11.5%) were previously infected with SARS-CoV-2, and 32 older residents, of whom 22 (68.8%) were previously infected. All participants received the first two doses in April-July 2021 and a third dose in January-March 2022. In staff, the median anti-S antibody titers (interquartile range) in previously infected and SARS-CoV-2-naïve individuals before vaccination were 960 (592-1,926) and 0.5 (0.0-2.1) arbitrary units (AU)/mL. Anti-S antibody titers 5 months after the second and third doses in previously infected staff were 7,391 (5,230-7,747) and 10,195 (5,582-13,886) AU. In residents, the median anti-S antibody titers in previously infected and naïve individuals before vaccination were 734 (425-1,934) and 1.1 (0.0-3.1) AU/mL. Anti-S antibody titers at 5 months after the second and third doses in previously infected residents were 15,872 (9,683-21,557) and 13,813 (6,689-20,839) AU/mL; however, there were no significant differences in titers between the second and third doses in previously infected residents. Anti-N antibody titers were higher in previously infected than naïve individuals, and titers decreased chronologically.
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Affiliation(s)
- Keita Wagatsuma
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan; Japan Society for the Promotion of Science, Tokyo, Japan.
| | - Reiko Saito
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Sayaka Yoshioka
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Satoru Yamazaki
- Niigata City Public Health and Sanitation Center, Niigata, Japan
| | - Ryosuke Sato
- Niigata City Public Health and Sanitation Center, Niigata, Japan
| | - Masako Iwaya
- Niigata City Public Health and Sanitation Center, Niigata, Japan
| | | | - Irina Chon
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | | | - Hisami Watanabe
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Sembera J, Baine C, Ankunda V, Katende JS, Oluka GK, Akoli CH, Kato L, Odoch G, Ejou P, Opio S, Musenero M, Kaleebu P, Serwanga J. Sustained spike-specific IgG antibodies following CoronaVac (Sinovac) vaccination in sub-Saharan Africa, but increased breakthrough infections in baseline spike-naive individuals. Front Immunol 2023; 14:1255676. [PMID: 38098482 PMCID: PMC10720323 DOI: 10.3389/fimmu.2023.1255676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 11/14/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction This study investigated the antibody responses to the inactivated COVID-19 vaccine, CoronaVac (Sinovac Biotech) in the African population to provide valuable insights into long-term immunity and breakthrough infections against SARS-CoV-2 in individuals with varying prior IgG seropositivity. Methods Real-life cohorts were used to longitudinally track antibody levels against the SARS-CoV-2 spike and nucleoprotein in 60 participants over 12 months to examine the levels of multiple antibody isotypes (S-IgG, S-IgM, S-IgA, N-IgG, and N-IgM). Results Throughout the 12 months, we observed consistently high and stable seropositivity rates for spike-IgG antibodies, spike-IgM antibodies showed a decline in frequencies over time, and spike-IgA levels remained moderate and stable. Vaccinated individuals previously positive for spike-IgG antibodies demonstrated strong and persistent seropositivity, while those initially negative experienced a gradual and delayed increase in seropositivity rates. The fold change analysis of S- and N- antibody responses demonstrated a consistently stable and comparable profile over time, indicating that vaccine-induced antibody responses remain constant and lack significant fluctuations beyond the initial boost. The study emphasized that individuals lacking previous IgG positivity showed reduced vaccine-induced spike-IgG antibodies and were more susceptible to breakthrough infections, highlighting their higher vulnerability. All cases of breakthrough infections were asymptomatic, indicating the conferred protection to the vaccinated individuals. Discussion The findings corroborated earlier studies on the effectiveness of the CoronaVac vaccine and emphasized the significance of accounting for pre-existing seropositivity in vaccine assessments. This study effectively demonstrated durable antibody responses against SARS-CoV-2 in the African population following the CoronaVac vaccination, providing crucial insights for informing vaccination strategies and safeguarding vulnerable populations. Continuous surveillance is imperative for tracking breakthrough infections and monitoring waning immunity. The insights gained offer crucial direction for public health strategies and enhance comprehension of vaccine effectiveness in sub-Saharan Africa. Further research should explore functional outcomes, cellular immune responses, and the vaccine's effectiveness against different variants to enhance our understanding and optimize vaccine strategies.
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Affiliation(s)
- Jackson Sembera
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
| | - Claire Baine
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
| | - Violet Ankunda
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
| | - Joseph Ssebwana Katende
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Gerald Kevin Oluka
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Christine Hermilia Akoli
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Laban Kato
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Geoffrey Odoch
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Peter Ejou
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Solomon Opio
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Monica Musenero
- Science, Technology, and Innovation Secretariat, Office of the President, Government of Uganda, Kampala, Uganda
| | - The COVID-19 Immunoprofiling Team
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Pontiano Kaleebu
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Jennifer Serwanga
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
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Springer DN, Reuberger E, Borsodi C, Puchhammer-Stöckl E, Weseslindtner L. Comparison of anti-nucleocapsid antibody assays for the detection of SARS-CoV-2 Omicron vaccine breakthroughs after various intervals since the infection. J Med Virol 2023; 95:e29229. [PMID: 37966995 DOI: 10.1002/jmv.29229] [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: 06/07/2023] [Revised: 10/06/2023] [Accepted: 11/02/2023] [Indexed: 11/17/2023]
Abstract
Antibody assays with the nucleocapsid (NC) protein as the target antigen can identify severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections when polymerase chain reaction (PCR) analyses are unavailable. Regarding the kinetics of NC-specific antibodies, vaccine breakthroughs with Omicron subvariants may differ from infections with the ancestral wild-type virus. Therefore, we evaluated which assays have the highest sensitivity for detecting NC-specific antibodies after various intervals since breakthrough infections with an Omicron subvariant. The study included 279 samples from vaccinated subjects who experienced PCR-confirmed Omicron breakthrough infections between 21 and 266 days before sampling. The samples were comparatively assessed with the Elecsys® Anti-SARS-CoV-2 N (Roche), the Anti-SARS-CoV-2-NCP-ELISA (Euroimmun), the recomLine SARS-CoV-2 IgG (Mikrogen), and the SARS-CoV-2 ViraChip IgG assays (Viramed). In the whole cohort, the Elecsys® Anti-SARS-CoV-2 N assay displayed the highest sensitivity (93%, p < 0.0001), followed by the recomLine SARS-CoV-2 IgG assay (70%), the SARS-CoV-2 ViraChip IgG assay (41%) and the Anti-SARS-CoV-2-NCP-ELISA (35%). Although measured antibody levels and time-dependent sensitivities differed, the extent of the antibody decrease was similar among all assays. As demonstrated by this study, manufacturer-dependent differences in the sensitivities of NC-specific antibody assays should be considered when serology is applied to link previous SARS-CoV-2 infections with potential post-COVID sequelae.
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Han J, Baek HJ, Noh E, Yoon K, Kim JA, Ryu S, Lee KO, Park NY, Jung E, Kim S, Lee H, Hwang YS, Jung J, Lee HJ, Cho SI, Oh S, Kim M, Oh CM, Yu B, Hong YS, Kim K, Jung S, Han MA, Lee MS, Lee JJ, Hwangbo Y, Yim HW, Kim YM, Lee J, Lee WY, Park JH, Oh S, Jo HS, Kim H, Kang G, Nam HS, Lee JH, Oh GJ, Shin MH, Ryu S, Hwang TY, Park SW, Kim SK, Seol R, Park KS, Kim SY, Kwon JW, Kim SS, Kim B, Lee JW, Jang EY, Kim AR, Nam J, Lee SY, Kim DH. Korea Seroprevalence Study of Monitoring of SARS-COV-2 Antibody Retention and Transmission (K-SEROSMART): findings from national representative sample. Epidemiol Health 2023; 45:e2023075. [PMID: 37591786 PMCID: PMC10728614 DOI: 10.4178/epih.e2023075] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/13/2023] [Indexed: 08/19/2023] Open
Abstract
OBJECTIVES We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.
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Affiliation(s)
- Jina Han
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Hye Jin Baek
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Eunbi Noh
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Kyuhyun Yoon
- Institute of Health and Environment, Seoul National University, Seoul, Korea
| | - Jung Ae Kim
- Department of Nursing, Kyungmin University, Uijeongbu, Korea
| | - Sukhyun Ryu
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea
| | | | - No Yai Park
- Graduate School of Public Health, Inje University, Seoul, Korea
| | - Eunok Jung
- Department of Mathematics, Konkuk University, Seoul, Korea
| | - Sangil Kim
- Department of Internal Medicine, College of Medicine, The Catholic University, Seoul, Korea
| | - Hyukmin Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | | | - Jaehun Jung
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Hun Jae Lee
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Korea
| | - Sung-il Cho
- Institute of Health and Environment, Seoul National University, Seoul, Korea
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | | | | | - Chang-Mo Oh
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Byengchul Yu
- Department of Preventive Medicine, Kosin University College of Medicine, Busan, Korea
| | - Young-Seoub Hong
- Department of Preventive Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Keonyeop Kim
- Department of Preventive Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sunjae Jung
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Mi Ah Han
- Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Moo-Sik Lee
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Jung-Jeung Lee
- Department of Preventive Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Young Hwangbo
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University, Seoul, Korea
| | - Yu-Mi Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
- School of Public Health, Hanyang University, Seoul, Korea
| | - Joongyub Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea
| | - Weon-Young Lee
- Department of Preventive Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jae-Hyun Park
- Department of Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Sungsoo Oh
- Department of Occupational & Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Heui Sug Jo
- Department of Health Policy and Management, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Hyeongsu Kim
- Department of Preventive Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Gilwon Kang
- Department of Health Information and Management, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hae-Sung Nam
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Ju-Hyung Lee
- Department of Preventive Medicine, Jeonbuk National University Medical School, Jeonju, Korea
| | - Gyung-Jae Oh
- Department of Preventive Medicine, Wonkwang University School of Medicine, Iksan, Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Soyeon Ryu
- Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Tae-Yoon Hwang
- Department of Preventive Medicine & Public Health, Yeungnam University College of Medicine, Gyeongsan, Korea
| | - Soon-Woo Park
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Gyeongsan, Korea
| | - Sang Kyu Kim
- Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea
| | - Roma Seol
- Department of Preventive Medicine, Inje University College of Medicine, Busan, Korea
| | - Ki-Soo Park
- Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Su Young Kim
- Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Jun-wook Kwon
- National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sung Soon Kim
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Byoungguk Kim
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - June-Woo Lee
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - Eun Young Jang
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - Ah-Ra Kim
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - Jeonghyun Nam
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - The Korea Community Health Survey Group
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
- Institute of Health and Environment, Seoul National University, Seoul, Korea
- Department of Nursing, Kyungmin University, Uijeongbu, Korea
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea
- Gallup Korea, Seoul, Korea
- Graduate School of Public Health, Inje University, Seoul, Korea
- Department of Mathematics, Konkuk University, Seoul, Korea
- Department of Internal Medicine, College of Medicine, The Catholic University, Seoul, Korea
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
- Seegene Medical Foundation, Seoul, Korea
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Korea
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
- MAPO-gu Public Health Center, Seoul, Korea
- GUNPO-si Public Health Center, Gunpo, Korea
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
- Department of Preventive Medicine, Kosin University College of Medicine, Busan, Korea
- Department of Preventive Medicine, Dong-A University College of Medicine, Busan, Korea
- Department of Preventive Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea
- Department of Preventive Medicine, Keimyung University School of Medicine, Daegu, Korea
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
- Department of Preventive Medicine, College of Medicine, The Catholic University, Seoul, Korea
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
- School of Public Health, Hanyang University, Seoul, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea
- Department of Preventive Medicine, Chung-Ang University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
- Department of Occupational & Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Health Policy and Management, Kangwon National University School of Medicine, Chuncheon, Korea
- Department of Preventive Medicine, Konkuk University School of Medicine, Seoul, Korea
- Department of Health Information and Management, Chungbuk National University College of Medicine, Cheongju, Korea
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea
- Department of Preventive Medicine, Jeonbuk National University Medical School, Jeonju, Korea
- Department of Preventive Medicine, Wonkwang University School of Medicine, Iksan, Korea
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
- Department of Preventive Medicine & Public Health, Yeungnam University College of Medicine, Gyeongsan, Korea
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Gyeongsan, Korea
- Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea
- Department of Preventive Medicine, Inje University College of Medicine, Busan, Korea
- Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea
- Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
- National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Korea
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea Disease Control and Prevention Agency, Cheongju, Korea
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Soon Young Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Dong-Hyun Kim
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea
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9
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Kahlert CR, Strahm C, Güsewell S, Cusini A, Brucher A, Goppel S, Möller E, Möller JC, Ortner M, Ruetti M, Stocker R, Vuichard-Gysin D, Besold U, McGeer A, Risch L, Friedl A, Schlegel M, Vernazza P, Kuster SP, Kohler P. Post-Acute Sequelae After Severe Acute Respiratory Syndrome Coronavirus 2 Infection by Viral Variant and Vaccination Status: A Multicenter Cross-Sectional Study. Clin Infect Dis 2023; 77:194-202. [PMID: 36905145 PMCID: PMC10371307 DOI: 10.1093/cid/ciad143] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Disentangling the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants and vaccination on the occurrence of post-acute sequelae of SARS-CoV-2 (PASC) is crucial to estimate and reduce the burden of PASC. METHODS We performed a cross-sectional analysis (May/June 2022) within a prospective multicenter healthcare worker (HCW) cohort in north-eastern Switzerland. HCWs were stratified by viral variant and vaccination status at time of their first positive SARS-CoV-2 nasopharyngeal swab. HCWs without positive swab and with negative serology served as controls. The sum of 18 self-reported PASC symptoms was modeled with univariable and multivariable negative-binomial regression to analyze the association of mean symptom number with viral variant and vaccination status. RESULTS Among 2912 participants (median age: 44 years; 81.3% female), PASC symptoms were significantly more frequent after wild-type infection (estimated mean symptom number: 1.12; P < .001; median time since infection: 18.3 months), after Alpha/Delta infection (0.67 symptoms; P < .001; 6.5 months), and after Omicron BA.1 infections (0.52 symptoms; P = .005; 3.1 months) versus uninfected controls (0.39 symptoms). After Omicron BA.1 infection, the estimated mean symptom number was 0.36 for unvaccinated individuals versus 0.71 with 1-2 vaccinations (P = .028) and 0.49 with ≥3 prior vaccinations (P = .30). Adjusting for confounders, only wild-type (adjusted rate ratio [aRR]: 2.81; 95% confidence interval [CI]: 2.08-3.83) and Alpha/Delta infections (aRR: 1.93; 95% CI: 1.10-3.46) were significantly associated with the outcome. CONCLUSIONS Previous infection with pre-Omicron variants was the strongest risk factor for PASC symptoms among our HCWs. Vaccination before Omicron BA.1 infection was not associated with a clear protective effect against PASC symptoms in this population.
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Affiliation(s)
- Christian R Kahlert
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St. Gallen, Switzerland
- Department of Infectious Diseases and Hospital Epidemiology, Children’s Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Carol Strahm
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St. Gallen, Switzerland
| | - Sabine Güsewell
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St. Gallen, Switzerland
| | - Alexia Cusini
- Division of Infectious Diseases, Cantonal Hospital of Grisons, Chur, Switzerland
| | - Angela Brucher
- Ambulatory Services, Psychiatry Services of the Canton of St. Gallen (South), St. Gallen, Switzerland
| | - Stephan Goppel
- Ambulatory Services, Psychiatry Services of the Canton of St. Gallen (North), St. Gallen, Switzerland
| | - Elisabeth Möller
- Department of Psychiatry, Clienia Littenheid, Littenheid, Switzerland
| | - J Carsten Möller
- Center for Neurological Rehabilitation, Zihlschlacht, Switzerland
| | - Manuela Ortner
- Rheintal Werdenberg Sarganserland Hospital Group, Grabs, Switzerland
| | - Markus Ruetti
- Fuerstenland Toggenburg Hospital Group, Wil, Switzerland
| | | | - Danielle Vuichard-Gysin
- Division of Infectious Diseases and Hospital Epidemiology, Thurgau Hospital Group, Muensterlingen, Switzerland
- Department of Research and Development, Swiss National Centre for Infection Prevention (Swissnoso), Berne, Switzerland
| | - Ulrike Besold
- Geriatric Clinic St. Gallen, St. Gallen, Switzerland
| | | | - Lorenz Risch
- Labormedizinisches Zentrum Dr Risch Ostschweiz AG, Buchs, Switzerland
- Private Universität im Fürstentum Liechtenstein, Triesen, Liechtenstein
- Center of Laboratory Medicine, University Institute of Clinical Chemistry, University of Bern, Inselspital, Bern, Switzerland
| | - Andrée Friedl
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital Baden, Baden, Switzerland
| | - Matthias Schlegel
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St. Gallen, Switzerland
| | - Pietro Vernazza
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St. Gallen, Switzerland
| | - Stefan P Kuster
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St. Gallen, Switzerland
| | - Philipp Kohler
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St. Gallen, Switzerland
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10
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Martin CA, Nazareth J, Jarkhi A, Pan D, Das M, Logan N, Scott S, Bryant L, Abeywickrama N, Adeoye O, Ahmed A, Asif A, Bandi S, George N, Gohar M, Gray LJ, Kaszuba R, Mangwani J, Martin M, Moorthy A, Renals V, Teece L, Vail D, Khunti K, Moss P, Tattersall A, Hallis B, Otter AD, Rowe C, Willett BJ, Haldar P, Cooper A, Pareek M. Ethnic differences in cellular and humoral immune responses to SARS-CoV-2 vaccination in UK healthcare workers: a cross-sectional analysis. EClinicalMedicine 2023; 58:101926. [PMID: 37034357 PMCID: PMC10071048 DOI: 10.1016/j.eclinm.2023.101926] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 04/07/2023] Open
Abstract
Background Few studies have compared SARS-CoV-2 vaccine immunogenicity by ethnic group. We sought to establish whether cellular and humoral immune responses to SARS-CoV-2 vaccination differ according to ethnicity in UK Healthcare workers (HCWs). Methods In this cross-sectional analysis, we used baseline data from two immunological cohort studies conducted in HCWs in Leicester, UK. Blood samples were collected between March 3, and September 16, 2021. We excluded HCW who had not received two doses of SARS-CoV-2 vaccine at the time of sampling and those who had serological evidence of previous SARS-CoV-2 infection. Outcome measures were SARS-CoV-2 spike-specific total antibody titre, neutralising antibody titre and ELISpot count. We compared our outcome measures by ethnic group using univariable (t tests and rank-sum tests depending on distribution) and multivariable (linear regression for antibody titres and negative binomial regression for ELISpot counts) tests. Multivariable analyses were adjusted for age, sex, vaccine type, length of interval between vaccine doses and time between vaccine administration and sample collection and expressed as adjusted geometric mean ratios (aGMRs) or adjusted incidence rate ratios (aIRRs). To assess differences in the early immune response to vaccination we also conducted analyses in a subcohort who provided samples between 14 and 50 days after their second dose of vaccine. Findings The total number of HCWs in each analysis were 401 for anti-spike antibody titres, 345 for neutralising antibody titres and 191 for ELISpot. Overall, 25.4% (19.7% South Asian and 5.7% Black/Mixed/Other) were from ethnic minority groups. In analyses including the whole cohort, neutralising antibody titres were higher in South Asian HCWs than White HCWs (aGMR 1.47, 95% CI [1.06-2.06], P = 0.02) as were T cell responses to SARS-CoV-2 S1 peptides (aIRR 1.75, 95% CI [1.05-2.89], P = 0.03). In a subcohort sampled between 14 and 50 days after second vaccine dose, SARS-CoV-2 spike-specific antibody and neutralising antibody geometric mean titre (GMT) was higher in South Asian HCWs compared to White HCWs (9616 binding antibody units (BAU)/ml, 95% CI [7178-12,852] vs 5888 BAU/ml [5023-6902], P = 0.008 and 2851 95% CI [1811-4487] vs 1199 [984-1462], P < 0.001 respectively), increments which persisted after adjustment (aGMR 1.26, 95% CI [1.01-1.58], P = 0.04 and aGMR 2.01, 95% CI [1.34-3.01], P = 0.001). SARS-CoV-2 ELISpot responses to S1 and whole spike peptides (S1 + S2 response) were higher in HCWs from South Asian ethnic groups than those from White groups (S1: aIRR 2.33, 95% CI [1.09-4.94], P = 0.03; spike: aIRR, 2.04, 95% CI [1.02-4.08]). Interpretation This study provides evidence that, in an infection naïve cohort, humoral and cellular immune responses to SARS-CoV-2 vaccination are stronger in South Asian HCWs than White HCWs. These differences are most clearly seen in the early period following vaccination. Further research is required to understand the underlying mechanisms, whether differences persist with further exposure to vaccine or virus, and the potential impact on vaccine effectiveness. Funding DIRECT and BELIEVE have received funding from UK Research and Innovation (UKRI) through the COVID-19 National Core Studies Immunity (NCSi) programme (MC_PC_20060).
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Affiliation(s)
- Christopher A. Martin
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
- Leicester NIHR Biomedical Research Centre, Leicester, UK
| | - Joshua Nazareth
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
- Leicester NIHR Biomedical Research Centre, Leicester, UK
| | - Amar Jarkhi
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Daniel Pan
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
- Leicester NIHR Biomedical Research Centre, Leicester, UK
- Li Ka Shing Centre for Health Information and Discovery, Oxford Big Data Institute, University of Oxford, UK
| | - Mrinal Das
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Nicola Logan
- University of Glasgow Centre for Virus Research, University of Glasgow, Bearsden Road, Glasgow, UK
| | - Sam Scott
- University of Glasgow Centre for Virus Research, University of Glasgow, Bearsden Road, Glasgow, UK
| | - Luke Bryant
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Leicester NIHR Biomedical Research Centre, Leicester, UK
| | | | - Oluwatobi Adeoye
- Leicester Medical School, University of Leicester, Leicester, UK
| | - Aleem Ahmed
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Aqua Asif
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Srini Bandi
- Department of Paediatrics, Leicester Royal Infirmary, Leicester, UK
| | - Nisha George
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Marjan Gohar
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Laura J. Gray
- Biostatistics Research Group, Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Ross Kaszuba
- Leicester Medical School, University of Leicester, Leicester, UK
| | - Jitendra Mangwani
- Academic Team of Musculoskeletal Surgery, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
| | - Marianne Martin
- Children's Intensive Care Unit, Leicester Children's Hospital, Leicester, UK
| | - Arumugam Moorthy
- Department of Rheumatology, University Hospitals of Leicester NHS Trust, Leicester, UK
- College of Life Sciences, University of Leicester, Leicester, UK
| | - Valerie Renals
- Research Space, University Hospitals of Leicester NHS Trust, UK
| | - Lucy Teece
- Biostatistics Research Group, Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Denny Vail
- Research Space, University Hospitals of Leicester NHS Trust, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | | | - Bassam Hallis
- UK Health Security Agency, Porton Down, Salisbury, UK
| | | | - Cathy Rowe
- UK Health Security Agency, Porton Down, Salisbury, UK
| | - Brian J. Willett
- University of Glasgow Centre for Virus Research, University of Glasgow, Bearsden Road, Glasgow, UK
| | - Pranab Haldar
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK
| | - Andrea Cooper
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Leicester NIHR Biomedical Research Centre, Leicester, UK
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
- Leicester NIHR Biomedical Research Centre, Leicester, UK
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11
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Amati R, Piumatti G, Franscella G, Buttaroni P, Camerini AL, Corna L, Levati S, Fadda M, Fiordelli M, Annoni AM, Bezani K, Amendola A, Fragoso Corti C, Sabatini S, Kaufmann M, Frei A, Puhan MA, Crivelli L, Albanese E. Trajectories of Seroprevalence and Neutralizing Activity of Antibodies against SARS-CoV-2 in Southern Switzerland between July 2020 and July 2021: An Ongoing, Prospective Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3703. [PMID: 36834397 PMCID: PMC9964112 DOI: 10.3390/ijerph20043703] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES The COVID-19 pandemic continues, and evidence on infection- and vaccine-induced immunity is key. We assessed COVID-19 immunity and the neutralizing antibody response to virus variants across age groups in the Swiss population. STUDY DESIGN We conducted a cohort study in representative community-dwelling residents aged five years or older in southern Switzerland (total population 353,343), and we collected blood samples in July 2020 (in adults only, N = 646), November-December 2020 (N = 1457), and June-July 2021 (N = 885). METHODS We used a previously validated Luminex assay to measure antibodies targeting the spike (S) and the nucleocapsid (N) proteins of the virus and a high-throughput cell-free neutralization assay optimized for multiple spike protein variants. We calculated seroprevalence with a Bayesian logistic regression model accounting for the population's sociodemographic structure and the test performance, and we compared the neutralizing activity between vaccinated and convalescent participants across virus variants. RESULTS The overall seroprevalence was 7.8% (95% CI: 5.4-10.4) by July 2020 and 20.2% (16.4-24.4) by December 2020. By July 2021, the overall seroprevalence increased substantially to 72.5% (69.1-76.4), with the highest estimates of 95.6% (92.8-97.8) among older adults, who developed up to 10.3 more antibodies via vaccination than after infection compared to 3.7 times more in adults. The neutralizing activity was significantly higher for vaccine-induced than infection-induced antibodies for all virus variants (all p values < 0.037). CONCLUSIONS Vaccination chiefly contributed to the reduction in immunonaive individuals, particularly those in older age groups. Our findings on the greater neutralizing activity of vaccine-induced antibodies than infection-induced antibodies are greatly informative for future vaccination campaigns.
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Affiliation(s)
- Rebecca Amati
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | | | - Giovanni Franscella
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Peter Buttaroni
- Faculty of Informatics, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Anne-Linda Camerini
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Laurie Corna
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland
| | - Sara Levati
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland
| | - Marta Fadda
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Maddalena Fiordelli
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
- Department of Health Sciences, University of Lucerne, 6002 Lucerne, Switzerland
| | - Anna Maria Annoni
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Kleona Bezani
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Antonio Amendola
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland
| | - Cristina Fragoso Corti
- Institute of Microbiology, University of Applied Sciences and Arts of Southern Switzerland, 6501 Bellinzona, Switzerland
| | - Serena Sabatini
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Marco Kaufmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
| | - Milo Alan Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
| | - Luca Crivelli
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland
| | - Emiliano Albanese
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
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12
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Impact of BNT162b2 Booster Dose on SARS-CoV-2 Anti-Trimeric Spike Antibody Dynamics in a Large Cohort of Italian Health Care Workers. Vaccines (Basel) 2023; 11:vaccines11020463. [PMID: 36851340 PMCID: PMC9959637 DOI: 10.3390/vaccines11020463] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
Accurate studies on the dynamics of Pfizer-Biontech BNT162b2-induced antibodies are crucial to better tailor booster dose administration depending on age, comorbidities, and previous natural infection with SARS-CoV-2. To date, little is known about the durability and kinetics of antibody titers months after receiving a booster dose. In this work, we studied the dynamic of anti-Trimeric Spike (anti-TrimericS) IgG titer in the healthcare worker population of a large academic hospital in Northern Italy, in those who had received two vaccine doses plus a booster dose. Blood samples were collected on the day of dose 1, dose 2, then 1 month, 3 months, and 6 months after dose 2, the day of the administration of the booster dose, then 1 month and 3 months after the booster dose. The vaccination immunogenicity was evaluated by dosing anti-TrimericS IgG titer, which was further studied in relation to SARS-CoV-2 infection status, age, and sex. Our results suggest that after the booster dose, the anti-TrimericS IgG production was higher in the subjects that were infected only after the completion of the vaccination cycle, compared to those that were infected both before and after the vaccination campaign. Moreover, the booster dose administration exerts a leveling effect, mitigating the differences in the immunogenicity dependent on sex and age.
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Niedrist T, Kriegl L, Zurl CJ, Schmidt F, Perkmann-Nagele N, Mucher P, Repl M, Flieder I, Radakovics A, Sieghart D, Radner H, Aletaha D, Binder CJ, Gülly C, Krause R, Herrmann M, Wagner OF, Perkmann T, Haslacher H. Preanalytical stability of SARS-CoV-2 anti-nucleocapsid antibodies. Clin Chem Lab Med 2023; 61:332-338. [PMID: 36323338 DOI: 10.1515/cclm-2022-0875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/26/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Anti-nucleocapsid (NC) antibodies are produced in response to SARS-CoV-2 infection. Therefore, they are well suited for the detection of a previous infection. Especially in the case of seroprevalence studies or during the evaluation of a novel in-vitro diagnostic test, samples have been stored at <-70 °C (short- and long-term) or 2-10 °C (short-term) before analysis. This study aimed to assess the impact of different storage conditions relevant to routine biobanking on anti-NC antibodies. METHODS The preanalytical impact of short-term storage (84 [58-98] days) on <-70 °C and for 14 days at 2-10 °C was evaluated using samples from 111 donors of the MedUni Vienna Biobank. Long-term effects (443 [409-468] days) were assessed using 208 samples from Biobank Graz and 49 samples from Biobank Vienna. Anti-Nucleocapsid antibodies were measured employing electrochemiluminescence assays (Roche Anti-SARS-CoV-2). RESULTS After short-term storage, the observed changes did not exceed the extent that could be explained by analytical variability. In contrast, results after long-term storage were approximately 20% higher and seemed to increase with storage duration. This effect was independent of the biobank from which the samples were obtained. Accordingly, the sensitivity increased from 92.6 to 95.3% (p=0.008). However, comparisons with data from Anti-Spike protein assays, where these deviations were not apparent, suggest that this deviation could also be explained by the analytical variability of the qualitative Anti-NC assay. CONCLUSIONS Results from anti-NC antibodies are stable during short-term storage at <-70 °C and 2-10 °C. After long-term storage, a slight increase in sensitivity could not be ruled out.
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Affiliation(s)
- Tobias Niedrist
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Lisa Kriegl
- Department of Internal Medicine, Division of Infectiology, Medical University Graz, Graz, Austria
| | - Christoph J Zurl
- Department of Paediatrics and Adolescent Medicine, Division of General Paediatrics, Medical University of Graz, Graz, Austria
| | - Felix Schmidt
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Patrick Mucher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Manuela Repl
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Ines Flieder
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Astrid Radakovics
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Daniela Sieghart
- Department of Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Helga Radner
- Department of Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Daniel Aletaha
- Department of Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Christoph J Binder
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Christian Gülly
- Center for Medical Research (ZMF), Medical University of Graz, Graz, Austria
| | - Robert Krause
- Department of Internal Medicine, Division of Infectiology, Medical University Graz, Graz, Austria
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Oswald F Wagner
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Thomas Perkmann
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Helmuth Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
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Rapidly shifting immunologic landscape and severity of SARS-CoV-2 in the Omicron era in South Africa. Nat Commun 2023; 14:246. [PMID: 36646700 PMCID: PMC9842214 DOI: 10.1038/s41467-022-35652-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/16/2022] [Indexed: 01/18/2023] Open
Abstract
South Africa was among the first countries to detect the SARS-CoV-2 Omicron variant. However, the size of its Omicron BA.1 and BA.2 subvariants (BA.1/2) wave remains poorly understood. We analyzed sequential serum samples collected through a prospective cohort study before, during, and after the Omicron BA.1/2 wave to infer infection rates and monitor changes in the immune histories of participants over time. We found that the Omicron BA.1/2 wave infected more than half of the cohort population, with reinfections and vaccine breakthroughs accounting for > 60% of all infections in both rural and urban sites. After the Omicron BA.1/2 wave, we found few (< 6%) remained naïve to SARS-CoV-2 and the population immunologic landscape is fragmented with diverse infection/immunization histories. Prior infection with the ancestral strain, Beta, and Delta variants provided 13%, 34%, and 51% protection against Omicron BA.1/2 infection, respectively. Hybrid immunity and repeated prior infections reduced the risks of Omicron BA.1/2 infection by 60% and 85% respectively. Our study sheds light on a rapidly shifting landscape of population immunity in the Omicron era and provides context for anticipating the long-term circulation of SARS-CoV-2 in populations no longer naïve to the virus.
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Nakagama S, Nakagama Y, Komase Y, Kudo M, Imai T, Tshibangu-Kabamba E, Nitahara Y, Kaku N, Kido Y. Age-adjusted impact of prior COVID-19 on SARS-CoV-2 mRNA vaccine response. Front Immunol 2023; 14:1087473. [PMID: 36742291 PMCID: PMC9892832 DOI: 10.3389/fimmu.2023.1087473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/05/2023] [Indexed: 01/20/2023] Open
Abstract
More people with a history of prior infection are receiving SARS-CoV-2 vaccines. Understanding the level of protection granted by 'hybrid immunity', the combined response of infection- and vaccine-induced immunity, may impact vaccination strategies through tailored dosing. A total of 36 infected ('prior infection') and 33 SARS-CoV-2 'naïve' individuals participated. Participants provided sera six months after completing a round of BNT162b2 vaccination, to be processed for anti-spike antibody measurements and the receptor binding domain-ACE2 binding inhibition assays. The relationships between antibody titer, groups and age were explored. Anti-spike antibody titers at 6 months post-vaccination were significantly higher, reaching 13- to 17-fold, in the 'prior infection' group. Semi-log regression models showed that participants with 'prior infection' demonstrated higher antibody titer compared with the 'naïve' even after adjusting for age. The enhancement in antibody titer attributable to positive infection history increased from 8.9- to 9.4- fold at age 30 to 19- to 32-fold at age 60. Sera from the 'prior infection' group showed higher inhibition capacity against all six analyzed strains, including the Omicron variant. Prior COVID-19 led to establishing enhanced humoral immunity at 6 months after vaccination. Antibody fold-difference attributed to positive COVID-19 history increased with age, possibly because older individuals are prone to symptomatic infection accompanied by potentiated immune responses. While still pending any modifications of dosing recommendations (i.e. reduced doses for individuals with prior infection), our observation adds to the series of real-world data demonstrating the enhanced and more durable immune response evoked by booster vaccinations following prior infection.
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Affiliation(s)
- Sachie Nakagama
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.,Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yu Nakagama
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.,Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University, Yokohama Seibu Hospital, Yokohama, Japan
| | - Masaharu Kudo
- Department of Medical Statistics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Takumi Imai
- Department of Medical Statistics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Evariste Tshibangu-Kabamba
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.,Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yuko Nitahara
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.,Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Natsuko Kaku
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.,Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yasutoshi Kido
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.,Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
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16
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Skowronski DM, Kaweski SE, Irvine MA, Kim S, Chuang ESY, Sabaiduc S, Fraser M, Reyes RC, Henry B, Levett PN, Petric M, Krajden M, Sekirov I. Serial cross-sectional estimation of vaccine-and infection-induced SARS-CoV-2 seroprevalence in British Columbia, Canada. CMAJ 2022; 194:E1599-E1609. [PMID: 36507788 PMCID: PMC9828974 DOI: 10.1503/cmaj.221335] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The evolving proportion of the population considered immunologically naive versus primed for more efficient immune memory response to SARS-CoV-2 has implications for risk assessment. We sought to chronicle vaccine- and infection-induced seroprevalence across the first 7 waves of the COVID-19 pandemic in British Columbia, Canada. METHODS During 8 cross-sectional serosurveys conducted between March 2020 and August 2022, we obtained anonymized residual sera from children and adults who attended an outpatient laboratory network in the Lower Mainland (Greater Vancouver and Fraser Valley). We used at least 3 immunoassays per serosurvey to detect SARS-CoV-2 spike and nucleocapsid antibodies. We assessed any seroprevalence (vaccineor infection-induced, or both), defined by positivity on any 2 assays, and infection-induced seroprevalence, also defined by dual-assay positivity but requiring both antinucleocapsid and antispike detection. We used estimates of infection-induced seroprevalence to explore underascertainment of infections by surveillance case reports. RESULTS By January 2021, we estimated that any seroprevalence remained less than 5%, increasing with vaccine rollout to 56% by May-June 2021, 83% by September-October 2021 and 95% by March 2022. Infection-induced seroprevalence remained less than 15% through September-October 2021, increasing across Omicron waves to 42% by March 2022 and 61% by July-August 2022. By August 2022, 70%-80% of children younger than 20 years and 60%-70% of adults aged 20-59 years had been infected, but fewer than half of adults aged 60 years and older had been infected. Compared with estimates of infection-induced seroprevalence, surveillance case reports underestimated infections 12-fold between September 2021 and March 2022 and 92-fold between March 2022 and August 2022. INTERPRETATION By August 2022, most children and adults younger than 60 years had evidence of both SARS-CoV-2 vaccination and infection. As previous evidence suggests that a history of both exposures may induce stronger, more durable hybrid immunity than either exposure alone, older adults - who have the lowest infection rates but highest risk of severe outcomes - continue to warrant prioritized vaccination.
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Affiliation(s)
- Danuta M Skowronski
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Samantha E Kaweski
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Michael A Irvine
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Shinhye Kim
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Erica S Y Chuang
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Suzana Sabaiduc
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Mieke Fraser
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Romina C Reyes
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Bonnie Henry
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Paul N Levett
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Martin Petric
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Mel Krajden
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Inna Sekirov
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
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Usefulness and Limitations of Anti-S IgG Assay in Detecting Previous SARS-CoV-2 Breakthrough Infection in Fully Vaccinated Healthcare Workers. Diagnostics (Basel) 2022; 12:diagnostics12092152. [PMID: 36140553 PMCID: PMC9497628 DOI: 10.3390/diagnostics12092152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction: The anti-spike (S) IgG assay is the most widely used method to assess the immunological response to COVID-19 vaccination. Several studies showed that subjects with perivaccination infection have higher anti-S IgG titers. However, a cut-off has not yet been identified so far for distinguishing infected subjects after vaccination. This study thus evaluates the performance of the anti-S IgG assay in identifying subjects with breakthrough infections (BIs) and its potential usefulness for screening healthcare workers (HCWs). Methods: Out of 6400 HCWs of the University Hospital of Verona vaccinated with two doses of BNT162b2, 4462 never infected before subjects who had completed primary vaccination were tested for IgG anti-S 6 to 9 months after the second dose. Of these, 59 (1.3%) had a BI. The discriminant power of IgG anti-S in detecting previous breakthrough infection was tested by constructing receiver operating characteristic (ROC) curves. Results: The discriminant power for BI was rather good (area under the curve (AUC), 0.78) and increased with decreasing time elapsed between antibody titer assessment and previous SARS-CoV-2 infection. Accuracy (AUC) sensitivity increased from 0.78 (95% CI 0.70−0.85) for BI in the previous six months to 0.83 (95% CI 0.67−0.99) for those in the previous two months, and from 0.68 to 0.80, respectively. The specificity (0.86) and optimal cut-off (935 BAU/mL) remained unchanged. However, BI were rather rare (1.3%), so the positive predictive value (PPV) was low. Only 40 of the 664 HCWs with antibody titer > 935 BAU/mL had previously confirmed BI, yielding a PPV of only 6.0%. When adopting as cut-off the 90th percentile (1180 BAU/mL), PPV increased to 7.9% (35/441). Conclusions: The anti-S IgG assay displayed good sensitivity and specificity in discriminating subjects with BI, especially in recent periods. However, BIs were rare among HCWs, so that the anti-S IgG assay may have low PPV in this setting, thus limiting the usefulness of this test as a screening tool for HCWs. Further studies are needed to identify more effective markers of a previous infection in vaccinated subjects.
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18
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Sun K, Tempia S, Kleynhans J, von Gottberg A, McMorrow ML, Wolter N, Bhiman JN, Moyes J, Carrim M, Martinson NA, Kahn K, Lebina L, du Toit JD, Mkhencele T, Viboud C, Cohen C. Rapidly shifting immunologic landscape and severity of SARS-CoV-2 in the Omicron era in South Africa. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.08.19.22278993. [PMID: 36032973 PMCID: PMC9413704 DOI: 10.1101/2022.08.19.22278993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
South Africa was among the first countries to detect the SARS-CoV-2 Omicron variant. Propelled by increased transmissibility and immune escape properties, Omicron displaced other globally circulating variants within 3 months of its emergence. Due to limited testing, Omicron's attenuated clinical severity, and an increased risk of reinfection, the size of the Omicron BA.1 and BA.2 subvariants (BA.1/2) wave remains poorly understood in South Africa and in many other countries. Using South African data from urban and rural cohorts closely monitored since the beginning of the pandemic, we analyzed sequential serum samples collected before, during, and after the Omicron BA.1/2 wave to infer infection rates and monitor changes in the immune histories of participants over time. Omicron BA.1/2 infection attack rates reached 65% (95% CI, 60% - 69%) in the rural cohort and 58% (95% CI, 61% - 74%) in the urban cohort, with repeat infections and vaccine breakthroughs accounting for >60% of all infections at both sites. Combined with previously collected data on pre-Omicron variant infections within the same cohorts, we identified 14 distinct categories of SARS-CoV-2 antigen exposure histories in the aftermath of the Omicron BA.1/2 wave, indicating a particularly fragmented immunologic landscape. Few individuals (<6%) remained naïve to SARS-CoV-2 and no exposure history category represented over 25% of the population at either cohort site. Further, cohort participants were more than twice as likely to get infected during the Omicron BA.1/2 wave, compared to the Delta wave. Prior infection with the ancestral strain (with D614G mutation), Beta, and Delta variants provided 13% (95% CI, -21% - 37%), 34% (95% CI, 17% - 48%), and 51% (95% CI, 39% - 60%) protection against Omicron BA.1/2 infection, respectively. Hybrid immunity (prior infection and vaccination) and repeated prior infections (without vaccination) reduced the risks of Omicron BA.1/2 infection by 60% (95% CI, 42% - 72%) and 85% (95% CI, 76% - 92%) respectively. Reinfections and vaccine breakthroughs had 41% (95% CI, 26% - 53%) lower risk of onward transmission than primary infections. Our study sheds light on a rapidly shifting landscape of population immunity, along with the changing characteristics of SARS-CoV-2, and how these factors interact to shape the success of emerging variants. Our findings are especially relevant to populations similar to South Africa with low SARS-CoV-2 vaccine coverage and a dominant contribution of immunity from prior infection. Looking forward, the study provides context for anticipating the long-term circulation of SARS-CoV-2 in populations no longer naïve to the virus.
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Affiliation(s)
- Kaiyuan Sun
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Stefano Tempia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jackie Kleynhans
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Meredith L McMorrow
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jinal N Bhiman
- Centre for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- SAMRC Antibody Immunity Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Jocelyn Moyes
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Maimuna Carrim
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Neil A Martinson
- Perinatal HIV Research Unit, University of the Witwatersrand, South Africa
- Johns Hopkins University Center for TB Research, Baltimore, Maryland, United States of America
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Limakatso Lebina
- Perinatal HIV Research Unit, University of the Witwatersrand, South Africa
| | - Jacques D du Toit
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Thulisa Mkhencele
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Cécile Viboud
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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