1
|
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.
Collapse
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
| |
Collapse
|
2
|
Fang LL, Zhu JH, Cai MJ, Zhang JW, Jiang LC, Dai Z, Lin Y, Liang XM. PCR combined with serologic testing improves the yield and efficiency of SARS-CoV-2 infection hunting: A study in 40,689 consecutive overseas arrivals. Front Public Health 2023; 11:1077075. [PMID: 36860392 PMCID: PMC9969191 DOI: 10.3389/fpubh.2023.1077075] [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: 10/22/2022] [Accepted: 01/17/2023] [Indexed: 02/16/2023] Open
Abstract
Background The global epidemiological situation of COVID-19 remains serious. The rapid hunting of SARS-CoV-2 infection is the key means for preventing transmission. Methods A total of 40,689 consecutive overseas arrivals were screened for SARS-CoV-2 infection based on PCR and serologic testing. The yield and efficiency of different screening algorithms were evaluated. Result Among the 40,689 consecutive overseas arrivals, 56 (0.14%) subjects were confirmed to have SARS-CoV-2 infection. The asymptomatic rate was 76.8%. When the algorithm based on PCR alone was used, the identification yield of a single round of PCR (PCR1) was only 39.3% (95% CI: 26.1-52.5%). It took at least four rounds of PCR to achieve a yield of 92.9% (95% CI: 85.9-99.8%). Fortunately, an algorithm based on a single round of PCR combined with a single round of serologic testing (PCR1+ Ab1) greatly improved the screening yield to 98.2% (95% CI: 94.6-100.0%) and required 42,299 PCR and 40,689 serologic tests that cost 6,052,855 yuan. By achieving a similar yield, the cost of PCR1+ Ab1 was 39.2% of that of four rounds of PCR. For hunting one case in PCR1+ Ab1, 769 PCR and 740 serologic tests were required, costing 110,052 yuan, which was 63.0% of that of the PCR1 algorithm. Conclusion Comparing an algorithm based on PCR alone, PCR combined with a serologic testing algorithm greatly improved the yield and efficiency of the identification of SARS-CoV-2 infection.
Collapse
Affiliation(s)
- Li-Li Fang
- Department of Clinical Laboratory, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.,Xiamen Key Laboratory of Genetic Testing, School of Medicine, Xiamen University, Xiamen, China
| | - Jian-Hui Zhu
- Centre of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.,Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Min-Jing Cai
- Centre of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.,Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Jing-Wen Zhang
- Centre of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.,Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Long-Can Jiang
- Centre of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.,Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Zhang Dai
- Centre of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.,Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Yu Lin
- Centre of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.,Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Xian-Ming Liang
- Centre of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.,Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| |
Collapse
|
3
|
Cumulative seroprevalence among healthcare workers after the first wave of the COVID-19 pandemic in El Salvador, Central America. Clin Microbiol Infect 2022; 28:1508-1510. [PMID: 35777604 PMCID: PMC9239702 DOI: 10.1016/j.cmi.2022.06.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/24/2022]
|
4
|
Detecting Waning Serological Response with Commercial Immunoassays: 18-Month Longitudinal Follow-up of Anti-SARS-CoV-2 Nucleocapsid Antibodies. Microbiol Spectr 2022; 10:e0098622. [PMID: 35867423 PMCID: PMC9430644 DOI: 10.1128/spectrum.00986-22] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Past severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is an important determinant of protection from reinfection and of postvaccine immune responses. Herein, we conducted a follow-up analysis of health care workers previously infected with coronavirus disease 2019 (COVID-19) with the aim of evaluating different immunoassays for their capability in detecting the waning anti-SARS-CoV-2 immune responses and accuracy in documenting past SARS-CoV-2 infections. We evaluated serum antinucleocapsid antibody levels in convalescent individuals following a 1.5-year interval from SARS-CoV-2 infection. Three different commercial immunoassays that qualitatively measure serum antibodies targeting the SARS-CoV-2 nucleocapsid protein, namely, the Abbott Architect SARS-CoV-2 IgG, the Euroimmun anti-SARS-CoV-2 NCP enzyme-linked immunosorbent assay (ELISA) IgG, and the Roche Elecsys anti-SARS-CoV-2, were tested for comparison of detectability. A total of 38 individuals consented to participating in this follow-up analysis. From assay to assay, seropositivity rate at 18 months from infection varied from lowest at 42% to highest at 92%. The Roche Elecsys immunoassay, dependent on the dual-antigen antibody detection method and tuned for the detection of high avidity antibodies, was most capable of accurately documenting past SARS-CoV-2 infections. Different immunoassays showed variable capability of determining previous infection status under waning antibody concentrations. Immunoassays with lower detection limits are to be selected, and adjusted thresholds are to be considered in order to maximize the tests’ performance. IMPORTANCE Past SARS-CoV-2 infection is an important determinant of protection from reinfection and of postvaccine immune responses. Our results show that different immunoassays, by design, harbor variable capability of tracking SARS-CoV-2 infection under waning antibody concentrations. With each recovered patient standing at a unique time point along the decline curve of antibodies, precise estimation of COVID-19 cumulative incidence remains a challenge. Since future surveillance studies will be targeting more than ever heterogenous cohorts, selecting the appropriate immunoassay is crucial in order to assure reliable decisions about an individual’s previous infection status.
Collapse
|
5
|
Jeong S, Hong YR, Hwang H. Performance comparison between Elecsys Anti-SARS-CoV-2 and Anti-SARS-CoV-2 S and Atellica IM SARS-CoV-2 Total and SARS-CoV-2 IgG assays. KOSIN MEDICAL JOURNAL 2022. [DOI: 10.7180/kmj.22.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: Although serological severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests from several manufacturers have been introduced in South Korea and some are commercially available, the performance of these test kits has not yet been sufficiently validated. Therefore, we compared the performance of Elecsys Anti-SARS-CoV-2 (ACOV2) and Anti-SARS-CoV-2 S (ACOV2S) and Atellica IM SARS-CoV-2 Total (COV2T) and SARS-CoV-2 IgG (sCOVG) serological tests in this study.Methods: A total of 186 patient samples were used. For each test, we analyzed the positive rate of serological antibody tests, precision, linearity, and agreement among the four assays.Results: The positive rates of COV2T, sCOVG, and ACOV2S were high (81.7%–89.2%) in total, with those for ACOV2S being the highest, while those of ACOV2 were as low as 44.6%. This may be related to the high completion rate of vaccination in Korea. The repeatability and within-laboratory coefficients of variation were within the claimed allowable imprecision; however, further research is needed to establish an allowable imprecision at low concentrations. COV2T showed a linear fit, whereas sCOVG and ACOV2S were appropriately modeled with a nonlinear fit. Good agreement was found among COV2T, sCOVG, and ACOV2S; however, the agreement between ACOV2 and any one of the other methods was poor.Conclusions: Considering the different antigens used in serological SARS-CoV-2 antibody assays, the performance of the tested assays is thought to show no significant difference for the qualitative detection of antibodies to SARS-CoV-2.
Collapse
|
6
|
Nishimura M, Sugawa S, Ota S, Suematsu E, Shinoda M, Shinkai M. Detection of silent infection of severe acute respiratory syndrome coronavirus 2 by serological tests. PLoS One 2022; 17:e0267566. [PMID: 35594509 PMCID: PMC9122508 DOI: 10.1371/journal.pone.0267566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/11/2022] [Indexed: 12/19/2022] Open
Abstract
Background To control COVID-19 pandemic is of critical importance to the global public health. To capture the prevalence in an accurate and timely manner and to understand the mode of nosocomial infection are essential for its preventive measure. Methods We recruited 685 healthcare workers (HCW’s) at Tokyo Shinagawa Hospital prior to the vaccination with COVID-19 vaccine. Sera of the subjects were tested by assays for the titer of IgG against S protein’s receptor binding domain (IgG (RBD)) or IgG against nucleocapsid protein (IgG (N)) of SARS-CoV-2. Together with PCR data, the positive rates by these methods were evaluated. Results Overall positive rates among HCW’s by PCR, IgG (RBD), IgG (N) with a cut-off of 1.4 S/C (IgG (N)1.4), and IgG (N) with a cut-off of 0.2 S/C (IgG (N)0.2) were 3.5%, 9.5%, 6.1%, and 27.7%, respectively. Positive rates of HCW’s working in COVID-19 ward were significantly higher than those of HCW’s working in non-COVID-19 ward by all the four methods. Concordances of IgG (RBD), IgG (N)1.4, and IgG (N)0.2 against PCR were 97.1%, 71.4%, and 88.6%, respectively. By subtracting the positive rates of PCR from that of IgG (RBD), the rate of overall silent infection and that of HCW’s in COVID-19 ward were estimated to be 6.0% and 21.1%, respectively. Conclusions For the prevention of nosocomial infection of SARS-CoV-2, identification of silent infection is essential. For the detection of ongoing infection, periodical screening with IgG (RBD) in addition to PCR would be an effective measure. For the surveillance of morbidity in the population, on the other hand, IgG (N)0.2 could be the most reliable indicator among the three serological tests.
Collapse
Affiliation(s)
- Masashi Nishimura
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, Shinagawa-Ku, Tokyo, Japan
| | - Satoshi Sugawa
- Core Diagnostics, Abbott Japan LLC, Minato-Ku, Tokyo, Japan
- * E-mail:
| | - Shinichiro Ota
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, Shinagawa-Ku, Tokyo, Japan
- Department of physiology, Showa University School of Medicine, Shinagawa-Ku, Tokyo, Japan
| | - Etsuko Suematsu
- Department of Clinical Laboratory Medicine, Tokyo Shinagawa Hospital, Shinagawa-Ku, Tokyo, Japan
| | - Masahiro Shinoda
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, Shinagawa-Ku, Tokyo, Japan
| | - Masaharu Shinkai
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, Shinagawa-Ku, Tokyo, Japan
| |
Collapse
|
7
|
Bueno-Hernández N, Carrillo-Ruíz JD, Méndez-García LA, Rizo-Téllez SA, Viurcos-Sanabria R, Santoyo-Chávez A, Márquez-Franco R, Aguado-García A, Baltazar-López N, Tomita-Cruz Y, Barrón EV, Sánchez AL, Márquez E, Fossion R, Rivera AL, Ruelas L, Lecona OA, Martínez-Mekler G, Müller M, Arroyo-Valerio AG, Escobedo G. High Incidence Rate of SARS-CoV-2 Infection in Health Care Workers at a Dedicated COVID-19 Hospital: Experiences of the Pandemic from a Large Mexican Hospital. Healthcare (Basel) 2022; 10:896. [PMID: 35628032 PMCID: PMC9141357 DOI: 10.3390/healthcare10050896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 01/25/2023] Open
Abstract
Health care workers (HCW) are at high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The incidence of SARS-CoV-2 infection in HCW has been examined in cross-sectional studies by quantitative polymerase chain reaction (qPCR) tests, which may lead to underestimating exact incidence rates. We thus investigated the incidence of SARS-CoV-2 infection in a group of HCW at a dedicated coronavirus disease 2019 (COVID-19) hospital in a six-month follow-up period. We conducted a prospective cohort study on 109 participants of both sexes working in areas of high, moderate, and low SARS-CoV-2 exposure. qPCR tests in nasopharyngeal swabs and anti-SARS-CoV-2 IgG serum antibodies were assessed at the beginning and six months later. Demographic, clinical, and laboratory parameters were analyzed according to IgG seropositivity by paired Student's T-test or the chi-square test. The incidence rate of SARS-CoV-2 infection was considerably high in our cohort of HCW (58%), among whom 67% were asymptomatic carriers. No baseline risk factors contributed to the infection rate, including the workplace. It is still necessary to increase hospital safety procedures to prevent virus transmissibility from HCW to relatives and non-COVID-19 patients during the upcoming waves of contagion.
Collapse
Affiliation(s)
- Nallely Bueno-Hernández
- Laboratory of Proteomics, Research Division, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (N.B.-H.); (A.S.-C.)
| | - José Damian Carrillo-Ruíz
- Research Directorate, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (J.D.C.-R.); (R.M.-F.); (A.A.-G.); (N.B.-L.); (Y.T.-C.)
- Department of Neurology and Neurosurgery, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico
- Facultad de Ciencias de la Salud, Universidad Anáhuac, Huixquilucan 52786, Mexico
| | - Lucía A. Méndez-García
- Laboratory of Immunometabolism, Research Division, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (L.A.M.-G.); (S.A.R.-T.); (R.V.-S.)
| | - Salma A. Rizo-Téllez
- Laboratory of Immunometabolism, Research Division, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (L.A.M.-G.); (S.A.R.-T.); (R.V.-S.)
| | - Rebeca Viurcos-Sanabria
- Laboratory of Immunometabolism, Research Division, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (L.A.M.-G.); (S.A.R.-T.); (R.V.-S.)
| | - Alisson Santoyo-Chávez
- Laboratory of Proteomics, Research Division, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (N.B.-H.); (A.S.-C.)
| | - René Márquez-Franco
- Research Directorate, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (J.D.C.-R.); (R.M.-F.); (A.A.-G.); (N.B.-L.); (Y.T.-C.)
| | - Alejandro Aguado-García
- Research Directorate, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (J.D.C.-R.); (R.M.-F.); (A.A.-G.); (N.B.-L.); (Y.T.-C.)
| | - Neyla Baltazar-López
- Research Directorate, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (J.D.C.-R.); (R.M.-F.); (A.A.-G.); (N.B.-L.); (Y.T.-C.)
| | - Yoshio Tomita-Cruz
- Research Directorate, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (J.D.C.-R.); (R.M.-F.); (A.A.-G.); (N.B.-L.); (Y.T.-C.)
| | - Eira Valeria Barrón
- Unidad de Medicina Genómica, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (E.V.B.); (A.L.S.); (E.M.)
| | - Ana Laura Sánchez
- Unidad de Medicina Genómica, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (E.V.B.); (A.L.S.); (E.M.)
| | - Edna Márquez
- Unidad de Medicina Genómica, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (E.V.B.); (A.L.S.); (E.M.)
| | - Ruben Fossion
- Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico; (R.F.); (A.L.R.)
- Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México, Mexico City 04510, Mexico; (L.R.); (O.A.L.)
| | - Ana Leonor Rivera
- Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico; (R.F.); (A.L.R.)
- Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México, Mexico City 04510, Mexico; (L.R.); (O.A.L.)
| | - Luis Ruelas
- Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México, Mexico City 04510, Mexico; (L.R.); (O.A.L.)
| | - Octavio A. Lecona
- Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México, Mexico City 04510, Mexico; (L.R.); (O.A.L.)
| | - Gustavo Martínez-Mekler
- Instituto de Ciencias Físicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico;
| | - Markus Müller
- Instituto de Investigación en Ciencias Básicas y Aplicadas, Universidad Autónoma del Estado de Morelos, Cuernavaca 62209, Mexico;
| | - América G. Arroyo-Valerio
- Research Directorate, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (J.D.C.-R.); (R.M.-F.); (A.A.-G.); (N.B.-L.); (Y.T.-C.)
| | - Galileo Escobedo
- Laboratory of Immunometabolism, Research Division, General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico; (L.A.M.-G.); (S.A.R.-T.); (R.V.-S.)
| |
Collapse
|