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Stern D, Meyer TC, Treindl F, Mages HW, Krüger M, Skiba M, Krüger JP, Zobel CM, Schreiner M, Grossegesse M, Rinner T, Peine C, Stoliaroff-Pépin A, Harder T, Hofmann N, Michel J, Nitsche A, Stahlberg S, Kneuer A, Sandoni A, Kubisch U, Schlaud M, Mankertz A, Schwarz T, Corman VM, Müller MA, Drosten C, de la Rosa K, Schaade L, Dorner MB, Dorner BG. A bead-based multiplex assay covering all coronaviruses pathogenic for humans for sensitive and specific surveillance of SARS-CoV-2 humoral immunity. Sci Rep 2023; 13:21846. [PMID: 38071261 PMCID: PMC10710470 DOI: 10.1038/s41598-023-48581-9] [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: 08/29/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
Serological assays measuring antibodies against SARS-CoV-2 are key to describe the epidemiology, pathobiology or induction of immunity after infection or vaccination. Of those, multiplex assays targeting multiple antigens are especially helpful as closely related coronaviruses or other antigens can be analysed simultaneously from small sample volumes, hereby shedding light on patterns in the immune response that would otherwise remain undetected. We established a bead-based 17-plex assay detecting antibodies targeting antigens from all coronaviruses pathogenic for humans: SARS-CoV-2, SARS-CoV, MERS-CoV, HCoV strains 229E, OC43, HKU1, and NL63. The assay was validated against five commercial serological immunoassays, a commercial surrogate virus neutralisation test, and a virus neutralisation assay, all targeting SARS-CoV-2. It was found to be highly versatile as shown by antibody detection from both serum and dried blot spots and as shown in three case studies. First, we followed seroconversion for all four endemic HCoV strains and SARS-CoV-2 in an outbreak study in day-care centres for children. Second, we were able to link a more severe clinical course to a stronger IgG response with this 17-plex-assay, which was IgG1 and IgG3 dominated. Finally, our assay was able to discriminate recent from previous SARS-CoV-2 infections by calculating the IgG/IgM ratio on the N antigen targeting antibodies. In conclusion, due to the comprehensive method comparison, thorough validation, and the proven versatility, our multiplex assay is a valuable tool for studies on coronavirus serology.
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Affiliation(s)
- Daniel Stern
- Biological Toxins (ZBS 3), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany.
| | - Tanja C Meyer
- Biological Toxins (ZBS 3), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Fridolin Treindl
- Biological Toxins (ZBS 3), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Hans Werner Mages
- Biological Toxins (ZBS 3), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Maren Krüger
- Biological Toxins (ZBS 3), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Martin Skiba
- Biological Toxins (ZBS 3), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Jan Philipp Krüger
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Berlin, Berlin, Germany
| | - Christian M Zobel
- Department of Internal Medicine, Bundeswehr Hospital Berlin, Berlin, Germany
| | | | - Marica Grossegesse
- Highly Pathogenic Viruses (ZBS 1), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Thomas Rinner
- Highly Pathogenic Viruses (ZBS 1), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Caroline Peine
- Immunization Unit (FG 33), Department for Infectious Disease Epidemiology, Robert Koch Institute, 13353, Berlin, Germany
| | - Anna Stoliaroff-Pépin
- Immunization Unit (FG 33), Department for Infectious Disease Epidemiology, Robert Koch Institute, 13353, Berlin, Germany
| | - Thomas Harder
- Immunization Unit (FG 33), Department for Infectious Disease Epidemiology, Robert Koch Institute, 13353, Berlin, Germany
| | - Natalie Hofmann
- Highly Pathogenic Viruses (ZBS 1), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Janine Michel
- Highly Pathogenic Viruses (ZBS 1), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Andreas Nitsche
- Highly Pathogenic Viruses (ZBS 1), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Silke Stahlberg
- Central Epidemiological Laboratory (FG 22), Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101, Berlin, Germany
| | - Antje Kneuer
- Central Epidemiological Laboratory (FG 22), Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101, Berlin, Germany
| | - Anna Sandoni
- Central Epidemiological Laboratory (FG 22), Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101, Berlin, Germany
| | - Ulrike Kubisch
- Central Epidemiological Laboratory (FG 22), Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101, Berlin, Germany
| | - Martin Schlaud
- Central Epidemiological Laboratory (FG 22), Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101, Berlin, Germany
| | - Annette Mankertz
- Measles, Mumps, Rubella, and Viruses Affecting Immunocompromised Patients (FG 12), Robert Koch Institute, 13353, Berlin, Germany
| | - Tatjana Schwarz
- Institute of Virology, Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - Victor M Corman
- Institute of Virology, Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
- Corporate Member, Freie Universität Berlin, 10117, Berlin, Germany
- Corporate Member, Humboldt-Universität zu Berlin, 14195, Berlin, Germany
| | - Marcel A Müller
- Institute of Virology, Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - Christian Drosten
- Institute of Virology, Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - Kathrin de la Rosa
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), 13125, Berlin, Germany
- Berlin Institute of Health (BIH), Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - Lars Schaade
- Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Martin B Dorner
- Biological Toxins (ZBS 3), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Brigitte G Dorner
- Biological Toxins (ZBS 3), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany.
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Vaughan A, Duffell E, Freidl GS, Lemos DS, Nardone A, Valenciano M, Subissi L, Bergeri I, K Broberg E, Penttinen P, Pebody R, Keramarou M. Systematic review of seroprevalence of SARS-CoV-2 antibodies and appraisal of evidence, prior to the widespread introduction of vaccine programmes in the WHO European Region, January-December 2020. BMJ Open 2023; 13:e064240. [PMID: 37931969 PMCID: PMC10632881 DOI: 10.1136/bmjopen-2022-064240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 09/04/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVES Systematic review of SARS-CoV-2 seroprevalence studies undertaken in the WHO European Region to measure pre-existing and cumulative seropositivity prior to the roll out of vaccination programmes. DESIGN A systematic review of the literature. DATA SOURCES We searched MEDLINE, EMBASE and the preprint servers MedRxiv and BioRxiv in the WHO 'COVID-19 Global literature on coronavirus disease' database using a predefined search strategy. Articles were supplemented with unpublished WHO-supported Unity-aligned seroprevalence studies and other studies reported directly to WHO Regional Office for Europe and European Centre for Disease Prevention and Control. ELIGIBILITY CRITERIA Studies published before the widespread implementation of COVID-19 vaccination programmes in January 2021 among the general population and blood donors, at national and regional levels. DATA EXTRACTION AND SYNTHESIS At least two independent researchers extracted the eligible studies; a third researcher resolved any disagreements. Study risk of bias was assessed using a quality scoring system based on sample size, sampling and testing methodologies. RESULTS In total, 111 studies from 26 countries published or conducted between 1 January 2020 and 31 December 2020 across the WHO European Region were included. A significant heterogeneity in implementation was noted across the studies, with a paucity of studies from the east of the Region. Sixty-four (58%) studies were assessed to be of medium to high risk of bias. Overall, SARS-CoV-2 seropositivity prior to widespread community circulation was very low. National seroprevalence estimates after circulation started ranged from 0% to 51.3% (median 2.2% (IQR 0.7-5.2%); n=124), while subnational estimates ranged from 0% to 52% (median 5.8% (IQR 2.3%-12%); n=101), with the highest estimates in areas following widespread local transmission. CONCLUSIONS The low levels of SARS-CoV-2 antibody in most populations prior to the start of vaccine programmes underlines the critical importance of targeted vaccination of priority groups at risk of severe disease, while maintaining reduced levels of transmission to minimise population morbidity and mortality.
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Affiliation(s)
- Aisling Vaughan
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Erika Duffell
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Gudrun S Freidl
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Diogo Simão Lemos
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | | | | | | | | | - Eeva K Broberg
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Richard Pebody
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Maria Keramarou
- European Centre for Disease Prevention and Control, Solna, Sweden
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3
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Heidemann C, Sarganas G, Du Y, Gaertner B, Poethko-Müller C, Cohrdes C, Schmidt S, Schlaud M, Scheidt-Nave C. Long-term health consequences among individuals with SARS-CoV-2 infection compared to individuals without infection: results of the population-based cohort study CoMoLo Follow-up. BMC Public Health 2023; 23:1587. [PMID: 37605232 PMCID: PMC10440884 DOI: 10.1186/s12889-023-16524-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/14/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Most of the previous studies on health sequelae of COVID-19 are uncontrolled cohorts and include a relatively short follow-up. This population-based multi-center cohort study examined health consequences among individuals about 1 to 1.5 years after SARS-CoV-2 infection compared with non-infected. METHODS The study population consisted of adults (≥ 18 years) from four municipalities particularly affected by the COVID-19 pandemic in the year 2020 who completed a detailed follow-up questionnaire on health-related topics. Exposure was the SARS-CoV-2 infection status (based on IgG antibodies, PCR test, or physician-diagnosis of COVID-19) at baseline (May to December 2020). Outcomes assessed at follow-up (October 2021 to January 2022; mean: 452 days) included recurrent or persistent health complaints, incident diseases, health-related quality of life (PROMIS-29), subjective health, and subjective memory impairment. Logistic and linear regression models were adjusted for baseline sociodemographic and lifestyle characteristics (age, sex, municipality, education, smoking, body mass index), pre-existing health conditions (chronic disease/health problem, health-related activity limitation, depressive/anxiety disorder), and follow-up time. RESULTS Among 4817 participants, 350 had a SARS-CoV-2 infection at baseline and 4467 had no infection at baseline or during follow-up. Those with an infection statistically significantly more often reported 7 out of 18 recurrent or persistent health complaints at follow-up: smell/taste disorders (12.8% vs. 3.4%, OR 4.11), shortness of breath (23.0% vs. 9.5%, 3.46), pain when breathing (4.7% vs. 1.9%, 2.36), fatigue (36.9% vs. 26.1%, 1.76), weakness in legs (12.8% vs. 7.8%, 1.93), myalgia/joint pain (21.9% vs. 15.1%, 1.53) and cough (30.8% vs. 24.8%, 1.34) and 3 out of 6 groups of incident diseases: liver/kidney (2.7% vs. 0.9%, 3.70), lung (3.2% vs. 1.1%, 3.50) and cardiovascular/metabolic (6.5% vs. 4.0%, 1.68) diseases. Those with an infection were significantly more likely to report poor subjective health (19.3% vs. 13.0%, 1.91), memory impairment (25.7% vs. 14.3%, 2.27), and worse mean scores on fatigue and physical function domains of PROMIS-29 than non-infected. CONCLUSION Even after more than one year, individuals with SARS-CoV-2 infection showed an increased risk of various health complaints, functional limitations, and worse subjective well-being, pointing toward profound health consequences of SARS-CoV-2 infection relevant for public health.
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Affiliation(s)
- Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Giselle Sarganas
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Yong Du
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Beate Gaertner
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | | | - Caroline Cohrdes
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Sein Schmidt
- Clinical Study Center, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Martin Schlaud
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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4
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Owusu-Boaitey N, Russell TW, Meyerowitz-Katz G, Levin AT, Herrera-Esposito D. Dynamics of SARS-CoV-2 seroassay sensitivity: a systematic review and modelling study. Euro Surveill 2023; 28:2200809. [PMID: 37227301 PMCID: PMC10283460 DOI: 10.2807/1560-7917.es.2023.28.21.2200809] [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: 10/10/2022] [Accepted: 03/10/2023] [Indexed: 05/26/2023] Open
Abstract
BackgroundSerological surveys have been the gold standard to estimate numbers of SARS-CoV-2 infections, the dynamics of the epidemic, and disease severity. Serological assays have decaying sensitivity with time that can bias their results, but there is a lack of guidelines to account for this phenomenon for SARS-CoV-2.AimOur goal was to assess the sensitivity decay of seroassays for detecting SARS-CoV-2 infections, the dependence of this decay on assay characteristics, and to provide a simple method to correct for this phenomenon.MethodsWe performed a systematic review and meta-analysis of SARS-CoV-2 serology studies. We included studies testing previously diagnosed, unvaccinated individuals, and excluded studies of cohorts highly unrepresentative of the general population (e.g. hospitalised patients).ResultsOf the 488 screened studies, 76 studies reporting on 50 different seroassays were included in the analysis. Sensitivity decay depended strongly on the antigen and the analytic technique used by the assay, with average sensitivities ranging between 26% and 98% at 6 months after infection, depending on assay characteristics. We found that a third of the included assays departed considerably from manufacturer specifications after 6 months.ConclusionsSeroassay sensitivity decay depends on assay characteristics, and for some types of assays, it can make manufacturer specifications highly unreliable. We provide a tool to correct for this phenomenon and to assess the risk of decay for a given assay. Our analysis can guide the design and interpretation of serosurveys for SARS-CoV-2 and other pathogens and quantify systematic biases in the existing serology literature.
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Affiliation(s)
- Nana Owusu-Boaitey
- Case Western Reserve University School of Medicine, Cleveland, United States
- These authors contributed equally to this work
| | - Timothy W Russell
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Andrew T Levin
- Dartmouth College, Hanover, United States
- National Bureau for Economic Research, Cambridge, United States
- Centre for Economic Policy Research, London, United Kingdom
| | - Daniel Herrera-Esposito
- These authors contributed equally to this work
- Department of Psychology, University of Pennsylvania, Philadelphia, United States
- Laboratorio de Neurociencias, Universidad de la República, Montevideo, Uruguay
- Centro Interdisciplinario en Ciencia de Datos y Aprendizaje Automático, Universidad de la República, Montevideo, Uruguay
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5
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Comparison of a novel antigen detection test with reverse transcription polymerase chain reaction assay for laboratory diagnosis of SARS-CoV-2 infection. Infection 2023; 51:91-96. [PMID: 35513690 PMCID: PMC9070611 DOI: 10.1007/s15010-022-01832-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/07/2022] [Indexed: 01/31/2023]
Abstract
Molecular diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by real-time reverse transcription polymerase chain reaction (RT-PCR) in respiratory specimens is considered the gold standard method. This method is highly sensitive and specific but it has some limitations such as being expensive and requiring special laboratory equipment and skilled personnel. RapidFor™ Antigen Rapid Test Kit is a commercially available Ag-RDT which is produced in Turkey and designed to detect the nucleocapsid antigen of SARS-CoV-2 in nasopharyngeal swab samples. The aim of this study was to evaluate the performance of this novel SARS-CoV-2 antigen detection considering the RT-PCR method as the gold standard. Four hundred forty-four nasopharyngeal swab samples which were collected from the patients who met clinical criteria of COVID-19 from ten centers in Turkey between September 2020 and February 2021 were included in the study. All the nasopharyngeal swab samples were tested for SARS-CoV-2 RNA using commercial RT-PCR kits (Bioeksen and A1 Lifesciences, İstanbul, Turkey) according to the manufacturer's instructions. Viral loads were assessed according to the cycle threshold (Ct) values. RapidFor™ SARS-CoV-2 antigen test (Vitrosens Biotechnology, Istanbul, Turkey) was used to investigate the presence of SARS-CoV-2 antigen in all samples following the manufacturer's instructions. Out of 444 nasopharyngeal swab samples tested, 346 (77.9%) were positive and 98 (22.1%) were negative for SARS-CoV-2 RNA by RTPCR. Overall sensitivity of the RapidFor™. Antigen Rapid Test Kit was 80.3% whereas specificity was found to be 87.8%. Positivity rate of rapid antigen test in samples with Ct values over 25 and below 30 was 82.7%, while it increased to 95.7% in samples 20 ≤ Ct < 25 and reached 100% in samples with Ct values below 20. RapidFor™ SARS-CoV-2 Ag test might be a good choice in the screening of symptomatic and asymptomatic patients and their contacts for taking isolation measures early, with advantages over RT-PCR as being rapid, easy and being applicable in every laboratory and even at point of care.
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6
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Kharroubi G, Cherif I, Ghawar W, Dhaouadi N, Yazidi R, Chaabane S, Snoussi MA, Salem S, Ben Hammouda W, Ben Hammouda S, Gharbi A, Bel Haj Hmida N, Rourou S, Dellagi K, Barbouche MR, Benabdessalem C, Ben Ahmed M, Bettaieb J. Incidence and risk factors of SARS-CoV-2 infection among workers in a public health laboratory in Tunisia. Arch Virol 2023; 168:69. [PMID: 36658402 PMCID: PMC9851900 DOI: 10.1007/s00705-022-05636-y] [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: 06/03/2022] [Accepted: 09/15/2022] [Indexed: 01/21/2023]
Abstract
The aim of this study was to measure the extent of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among workers at the Institut Pasteur de Tunis (IPT), a public health laboratory involved in the management of the COVID-19 pandemic in Tunisia, and to identify risk factors for infection in this occupational setting. A cross-sectional survey was conducted on IPT workers not vaccinated against coronavirus disease 2019 (COVID-19). Participants completed a questionnaire that included a history of reverse transcription-polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 infection. Immunoglobulin G antibodies against the receptor-binding domain of the spike antigen (anti-S-RBD IgG) and the nucleocapsid protein (anti-N IgG) of the SARS-CoV-2 virus were detected by enzyme-linked immunoassay (ELISA). A multivariate analysis was used to identify factors significantly associated with SARS-CoV-2 infection. A total of 428 workers were enrolled in the study. The prevalence of anti-S-RBD and/or anti-N IgG antibodies was 32.9% [28.7-37.4]. The cumulative incidence of SARS-CoV-2 infection (positive serology and/or previous positive RT-PCR test) was 40.0% [35.5-44.9], while the proportion with asymptomatic infection was 32.9%. One-third of the participants with RT-PCR-confirmed infection tested seronegative more than 90 days postinfection. Participants aged over 40 and laborers were more susceptible to infection (adjusted OR [AOR] = 1.65 [1.08-2.51] and AOR = 2.67 [1.45-4.89], respectively), while tobacco smokers had a lower risk of infection (AOR = 0.54 [0.29-0.97]). The SARS-CoV-2 infection rate among IPT workers was not significantly different from that detected concurrently in the general population. Hence, the professional activities conducted in this public health laboratory did not generate additional risk to that incurred outside the institute in day-to-day activities.
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Affiliation(s)
- Ghassen Kharroubi
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Ines Cherif
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Wissem Ghawar
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Nawel Dhaouadi
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia
| | - Rihab Yazidi
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Sana Chaabane
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Mohamed Ali Snoussi
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Sadok Salem
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Wafa Ben Hammouda
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Sonia Ben Hammouda
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Adel Gharbi
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Nabil Bel Haj Hmida
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Samia Rourou
- Laboratory of Molecular Microbiology, Vaccinology and Biotechnology Development, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Koussay Dellagi
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia ,grid.428999.70000 0001 2353 6535Pasteur Network, Institut Pasteur, Paris, France
| | - Mohamed-Ridha Barbouche
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Chaouki Benabdessalem
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Melika Ben Ahmed
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Jihène Bettaieb
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002, Tunis Belvedere, Tunisia. .,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia.
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7
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Neuhauser H, Rosario AS, Butschalowsky H, Haller S, Hoebel J, Michel J, Nitsche A, Poethko-Müller C, Prütz F, Schlaud M, Steinhauer HW, Wilking H, Wieler LH, Schaade L, Liebig S, Gößwald A, Grabka MM, Zinn S, Ziese T. Nationally representative results on SARS-CoV-2 seroprevalence and testing in Germany at the end of 2020. Sci Rep 2022; 12:19492. [PMID: 36376417 PMCID: PMC9662125 DOI: 10.1038/s41598-022-23821-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 11/07/2022] [Indexed: 11/16/2022] Open
Abstract
Pre-vaccine SARS-CoV-2 seroprevalence data from Germany are scarce outside hotspots, and socioeconomic disparities remained largely unexplored. The nationwide representative RKI-SOEP study (15,122 participants, 18-99 years, 54% women) investigated seroprevalence and testing in a supplementary wave of the Socio-Economic-Panel conducted predominantly in October-November 2020. Self-collected oral-nasal swabs were PCR-positive in 0.4% and Euroimmun anti-SARS-CoV-2-S1-IgG ELISA from dry-capillary-blood antibody-positive in 1.3% (95% CI 0.9-1.7%, population-weighted, corrected for sensitivity = 0.811, specificity = 0.997). Seroprevalence was 1.7% (95% CI 1.2-2.3%) when additionally correcting for antibody decay. Overall infection prevalence including self-reports was 2.1%. We estimate 45% (95% CI 21-60%) undetected cases and lower detection in socioeconomically deprived districts. Prior SARS-CoV-2 testing was reported by 18% from the lower educational group vs. 25% and 26% from the medium and high educational group (p < 0.001, global test over three categories). Symptom-triggered test frequency was similar across educational groups. Routine testing was more common in low-educated adults, whereas travel-related testing and testing after contact with infected persons was more common in highly educated groups. This countrywide very low pre-vaccine seroprevalence in Germany at the end of 2020 can serve to evaluate the containment strategy. Our findings on social disparities indicate improvement potential in pandemic planning for people in socially disadvantaged circumstances.
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Affiliation(s)
- Hannelore Neuhauser
- Robert Koch Institute, Berlin, Germany.
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101, Berlin, Germany.
| | | | | | | | | | | | | | | | | | | | - Hans W Steinhauer
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
| | | | | | | | - Stefan Liebig
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
- SOEP & Department of Political and Social Sciences, Free University, Berlin, Germany
| | | | - Markus M Grabka
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
| | - Sabine Zinn
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
- SOEP & Department of Social Sciences, Humboldt University, Berlin, Germany
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8
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Thalheim T, Krüger T, Galle J. Indirect Virus Transmission via Fomites Can Counteract Lock-Down Effectiveness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14011. [PMID: 36360891 PMCID: PMC9658534 DOI: 10.3390/ijerph192114011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/14/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
The spread of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has raised major health policy questions. Direct transmission via respiratory droplets seems to be the dominant route of its transmission. However, indirect transmission via shared contact of contaminated objects may also occur. The contribution of each transmission route to epidemic spread might change during lock-down scenarios. Here, we simulate viral spread of an abstract epidemic considering both routes of transmission by use of a stochastic, agent-based SEIR model. We show that efficient contact tracing (CT) at a high level of incidence can stabilize daily cases independently of the transmission route long before effects of herd immunity become relevant. CT efficacy depends on the fraction of cases that do not show symptoms. Combining CT with lock-down scenarios that reduce agent mobility lowers the incidence for exclusive direct transmission scenarios and can even eradicate the epidemic. However, even for small fractions of indirect transmission, such lockdowns can impede CT efficacy and increase case numbers. These counterproductive effects can be reduced by applying measures that favor distancing over reduced mobility. In summary, we show that the efficacy of lock-downs depends on the transmission route. Our results point to the particular importance of hygiene measures during mobility lock-downs.
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Affiliation(s)
- Torsten Thalheim
- Interdisciplinary Centre for Bioinformatics (IZBI), Leipzig University, Haertelstr. 16-18, 04107 Leipzig, Germany
| | - Tyll Krüger
- Institute of Computer Engineering, Control and Robotics, Wroclaw University of Science and Technology, Janiszewskiego 11-17, 50-372 Wrocław, Poland
| | - Jörg Galle
- Interdisciplinary Centre for Bioinformatics (IZBI), Leipzig University, Haertelstr. 16-18, 04107 Leipzig, Germany
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9
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Pluss O, Campbell H, Pezzi L, Morales I, Roell Y, Quandelacy TM, Arora RK, Boucher E, Lamb MM, Chu M, Bärnighausen T, Jaenisch T. Limitations introduced by a low participation rate of SARS-CoV-2 seroprevalence data. Int J Epidemiol 2022; 52:32-43. [PMID: 36164817 PMCID: PMC9619459 DOI: 10.1093/ije/dyac178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There has been a large influx of COVID-19 seroprevalence studies, but comparability between the seroprevalence estimates has been an issue because of heterogeneities in testing platforms and study methodology. One potential source of heterogeneity is the response or participation rate. METHODS We conducted a review of participation rates (PR) in SARS-CoV-2 seroprevalence studies collected by SeroTracker and examined their effect on the validity of study conclusions. PR was calculated as the count of participants for whom the investigators had collected a valid sample, divided by the number of people invited to participate in the study. A multivariable beta generalized linear model with logit link was fitted to determine if the PR of international household and community-based seroprevalence studies was associated with the factors of interest, from 1 December 2019 to 10 March 2021. RESULTS We identified 90 papers based on screening and were able to calculate the PR for 35 out of 90 papers (39%), with a median PR of 70% and an interquartile range of 40.92; 61% of the studies did not report PR. CONCLUSIONS Many SARS-CoV-2 seroprevalence studies do not report PR. It is unclear what the median PR rate would be had a larger portion not had limitations in reporting. Low participation rates indicate limited representativeness of results. Non-probabilistic sampling frames were associated with higher participation rates but may be less representative. Standardized definitions of participation rate and data reporting necessary for the PR calculations are essential for understanding the representativeness of seroprevalence estimates in the population of interest.
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Affiliation(s)
- Olivia Pluss
- Center for Global Health, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
| | - Harlan Campbell
- Department of Statistics, University of British Columbia, Vancouver, Canada
| | - Laura Pezzi
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille, France
| | - Ivonne Morales
- Division of Infectious Disease and Tropical Medicine, Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany,Heidelberg Institute for Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Yannik Roell
- Center for Global Health, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
| | - Talia M Quandelacy
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
| | - Rahul Krishan Arora
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Emily Boucher
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada,Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Molly M Lamb
- Center for Global Health, Colorado School of Public Health, University of Colorado, Aurora, CO, USA,Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
| | - May Chu
- Center for Global Health, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
| | - Till Bärnighausen
- Heidelberg Institute for Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Jaenisch
- Corresponding author. Department of Epidemiology and Center for Global Health, Colorado School of Public Health, 13199 East Montview Boulevard, Suite 310, Mail Stop A090, Aurora, CO 80045, USA. E-mail:
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10
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Balck A, Föh B, Borsche M, Rahmöller J, Vollstedt EJ, Waldeck F, Käding N, Twesten C, Mischnik A, Gillessen-Kaesbach G, Ehlers M, Sina C, Taube S, Busch H, Rupp J, Katalinic A, Klein C. Protocol of the Luebeck longitudinal investigation of SARS-CoV-2 infection (ELISA) study - a prospective population-based cohort study. BMC Public Health 2022; 22:1305. [PMID: 35799167 PMCID: PMC9261226 DOI: 10.1186/s12889-022-13666-z] [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: 04/05/2022] [Accepted: 06/03/2022] [Indexed: 11/23/2022] Open
Abstract
Background Considering the insufficiently controlled spread of new SARS-CoV-2 variants, partially low vaccination rates, and increased risk of a post-COVID syndrome, well-functioning, targeted intervention measures at local and national levels are urgently needed to contain the SARS-CoV-2 pandemic. Surveillance concepts (cross-sectional, cohorts, clusters) need to be carefully selected to monitor and assess incidence and prevalence at the population level. A critical methodological gap for identifying specific risks/dynamics for SARS-Cov-2 transmission and post-COVID-19-syndrome includes repetitive testing for past or present infection of a defined cohort with simultaneous assessment of symptoms, behavior, risk, and protective factors, as well as quality of life. Methods The ELISA-Study is a longitudinal, prospective surveillance study with a cohort approach launched in Luebeck in April 2020. The first part comprised regular PCR testing, antibody measurements, and a recurrent App-based questionnaire for a population-based cohort of 3000 inhabitants of Luebeck. The follow-up study protocol includes self-testing for antibodies and PCR testing for a subset of the participants, focusing on studying immunity after vaccination and/or infection and post-COVID-19 symptoms. Discussion The ELISA cohort and our follow-up study protocol will enable us to study the effects of a sharp increase of SARS-CoV-2 infections on seroprevalence of Anti-SARS-CoV-2 antibodies, post-COVID-19-symptoms, and possible medical, occupational, and behavioral risk factors. We will be able to monitor the pandemic continuously and discover potential sequelae of an infection long-term. Further examinations can be readily set up on an ad-hoc basis in the future. Our study protocol can be adapted to other regions and settings and is transferable to other infectious diseases. Trial registration DRKS.de, German Clinical Trials Register (DRKS), Identifier: DRKS00023418, Registered on 28 October 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13666-z.
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Affiliation(s)
- Alexander Balck
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany.,Department of Neurology, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Bandik Föh
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany.,Department of Medicine I, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Max Borsche
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany.,Department of Neurology, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Johann Rahmöller
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany.,Department of Anesthesiology and Intensive Care, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Eva-Juliane Vollstedt
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Frederike Waldeck
- Department of Infectious Diseases and Microbiology, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Nadja Käding
- Department of Infectious Diseases and Microbiology, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | | | | | | | - Marc Ehlers
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany
| | - Christian Sina
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany
| | - Stefan Taube
- Institute of Virology and Cell Biology, University of Lübeck, Lübeck, Germany
| | - Hauke Busch
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - Jan Rupp
- Department of Infectious Diseases and Microbiology, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany.
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11
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Jeong H, Lee S, Ko J, Ko M, Seo HW. Identification of conserved regions from 230,163 SARS-CoV-2 genomes and their use in diagnostic PCR primer design. Genes Genomics 2022; 44:899-912. [PMID: 35653026 PMCID: PMC9160177 DOI: 10.1007/s13258-022-01264-7] [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: 03/03/2022] [Accepted: 05/03/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND As the rapidly evolving characteristic of SARS-CoV-2 could result in false negative diagnosis, the use of as much sequence data as possible is key to the identification of conserved viral sequences. However, multiple alignment of massive genome sequences is computationally intensive. OBJECTIVE To extract conserved sequences from SARS-CoV-2 genomes for the design of diagnostic PCR primers using a bioinformatics approach that can handle massive genomic sequences efficiently. METHODS A total of 230,163 full-length viral genomes were retrieved from the NCBI SARS-CoV-2 Resources and GISAID EpiCoV database. This number was reduced to 14.11% following removal of 5'-/3'-untranslated regions and sequence dereplication. Fast, reference-based, multiple sequence alignments identified conserved sequences and specific primer sets were designed against these regions using a conventional tool. Primer sets chosen among the candidates were evaluated by in silico PCR and RT-qPCR. RESULTS Out of 17 conserved sequences (totaling 4.3 kb), two primer sets targeting the nsp2 and ORF3a genes were picked that exhibited > 99.9% in silico amplification coverage against the original dataset (230,163 genomes) when a 5% mismatch between the primers and target was allowed. In addition, the primer sets successfully detected nine SARS-CoV-2 variant RNA samples (Alpha, Beta, Gamma, Delta, Epsilon, Zeta, Eta, Iota, and Kappa) in experimental RT-qPCR validations. CONCLUSION In addition to the RdRp, E, N, and S genes that are targeted commonly, our approach can be used to identify novel primer targets in SARS-CoV-2 and should be a priority strategy in the event of novel SARS-CoV-2 variants or other pandemic outbreaks.
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Affiliation(s)
- Haeyoung Jeong
- Infectious Disease Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon, 34141, Republic of Korea.
| | - Siseok Lee
- NanoHelix Co., Ltd. 43-15, Daejeon, 34014, Republic of Korea
| | - Junsang Ko
- NanoHelix Co., Ltd. 43-15, Daejeon, 34014, Republic of Korea
| | - Minsu Ko
- NanoHelix Co., Ltd. 43-15, Daejeon, 34014, Republic of Korea
| | - Hwi Won Seo
- Infectious Disease Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon, 34141, Republic of Korea.
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12
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Lohse S, Sternjakob-Marthaler A, Lagemann P, Schöpe J, Rissland J, Seiwert N, Pfuhl T, Müllendorff A, Kiefer LS, Vogelgesang M, Vella L, Denk K, Vicari J, Zwick A, Lang I, Weber G, Geisel J, Rech J, Schnabel B, Hauptmann G, Holleczek B, Scheiblauer H, Wagenpfeil S, Smola S. German federal-state-wide seroprevalence study of 1 st SARS-CoV-2 pandemic wave shows importance of long-term antibody test performance. COMMUNICATIONS MEDICINE 2022; 2:52. [PMID: 35603305 PMCID: PMC9117207 DOI: 10.1038/s43856-022-00100-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 03/09/2022] [Indexed: 12/12/2022] Open
Abstract
Background Reliable data on the adult SARS-CoV-2 infection fatality rate in Germany are still scarce. We performed a federal state-wide cross-sectional seroprevalence study named SaarCoPS, that is representative for the adult population including elderly individuals and nursing home residents in the Saarland. Methods Serum was collected from 2940 adults via stationary or mobile teams during the 1st pandemic wave steady state period. We selected an antibody test system with maximal specificity, also excluding seroreversion effects due to a high longitudinal test performance. For the calculations of infection and fatality rates, we accounted for the delays of seroconversion and death after infection. Results Using a highly specific total antibody test detecting anti-SARS-CoV-2 responses over more than 180 days, we estimate an adult infection rate of 1.02% (95% CI: [0.64; 1.44]), an underreporting rate of 2.68-fold (95% CI: [1.68; 3.79]) and infection fatality rates of 2.09% (95% CI: (1.48; 3.32]) or 0.36% (95% CI: [0.25; 0.59]) in all adults including elderly individuals, or adults younger than 70 years, respectively. Conclusion The study highlights the importance of study design and test performance for seroprevalence studies, particularly when seroprevalences are low. Our results provide a valuable baseline for evaluation of future pandemic dynamics and impact of public health measures on virus spread and human health in comparison to neighbouring countries such as Luxembourg or France.
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Affiliation(s)
- Stefan Lohse
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | | | - Paul Lagemann
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Jakob Schöpe
- Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, 66421 Homburg, Germany
| | - Jürgen Rissland
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Nastasja Seiwert
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Thorsten Pfuhl
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Alana Müllendorff
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Laurent S Kiefer
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Markus Vogelgesang
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Luca Vella
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Katharina Denk
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Julia Vicari
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Anabel Zwick
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Isabelle Lang
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Gero Weber
- Physical Geography and Environmental Research, Saarland University, 66125 Saarbrücken, Germany
| | - Jürgen Geisel
- Central Laboratory, Saarland University Hospital, 66421 Homburg, Germany
| | - Jörg Rech
- Ministry of Health, Social Affairs, Women and the Family, 66119 Saarbrücken, Germany
| | - Bernd Schnabel
- Ministry of Health, Social Affairs, Women and the Family, 66119 Saarbrücken, Germany
| | - Gunter Hauptmann
- Kassenärztliche Vereinigung Saarland, 66113 Saarbrücken, Germany
| | - Bernd Holleczek
- Ministry of Health, Social Affairs, Women and the Family, 66119 Saarbrücken, Germany.,Saarland Cancer Registry, 66117 Saarbrücken, Germany
| | | | - Stefan Wagenpfeil
- Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, 66421 Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany.,Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University Campus, 66123 Saarbrücken, Germany
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13
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rVSV-ΔG-SARS-CoV-2-S vaccine: repeated intramuscular (IM) toxicity, local tolerance, immunogenicity and biodistribution study in NZW rabbits. Arch Toxicol 2022; 96:2329-2339. [PMID: 35577986 PMCID: PMC9110212 DOI: 10.1007/s00204-022-03302-5] [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: 03/16/2022] [Accepted: 04/07/2022] [Indexed: 11/06/2022]
Abstract
BriLife®, a vector-based vaccine that utilizes the recombinant vesicular stomatitis virus (VSV) platform to express and present the spike antigen of SARS-CoV-2, is undergoing testing in a phase 2 clinical trial in Israel. A nonclinical repeated-dose (GLP) toxicity study in New Zealand white rabbits was performed to evaluate the potential toxicity, local tolerance, immunogenicity and biodistribution of the vaccine. rVSV-ΔG-SARS-CoV-2-S (or vehicle) was administered intramuscularly to two groups of animals (106, 107 PFU/animal, n = 10/sex/group) on three occasions, at 2-week intervals, followed by a 3-week recovery period. Systemic clinical signs, local reactions, body weight, body temperature, food consumption, ophthalmology, urinalysis, clinical pathology, C-reactive protein, viremia and antibody levels were monitored. Gross pathology was performed, followed by organs/tissues collection for biodistribution and histopathological evaluation. Treatment-related changes were restricted to multifocal minimal myofiber necrosis at the injection sites, and increased lymphocytic cellularity in the iliac and mesenteric lymph nodes and in the spleen. These changes were considered related to the inflammatory reaction elicited, and correlated with a trend for recovery. Detection of rVSV-ΔG-SARS-CoV-2-S vaccine RNA was noted in the regional iliac lymph node in animals assigned to the high-dose group, at both termination time points. A significant increase in binding and neutralizing antibody titers was observed following vaccination at both vaccine doses. In view of the findings, it was concluded that the rVSV-ΔG-SARS-CoV-2-S vaccine is safe. These results supported the initiation of clinical trials.
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14
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Peinado B, Martínez-García L, Martínez F, Nozal L, Sánchez MB. Improved methods for the detection and quantification of SARS-CoV-2 RNA in wastewater. Sci Rep 2022; 12:7201. [PMID: 35504966 PMCID: PMC9063616 DOI: 10.1038/s41598-022-11187-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 04/12/2022] [Indexed: 12/15/2022] Open
Abstract
Since the start of the COVID-19 pandemic, different methods have been used to detect the presence of genetic material of SARS-CoV-2 in wastewater. The use of wastewater for SARS-CoV-2 RNA detection and quantification showed different problems, associated to the complexity of the matrix and the lack of standard methods used to analyze the presence of an enveloped virus, such as coronavirus. Different strategies for the concentration process were selected to carry out the detection and quantification of SARS-CoV-2 RNA in wastewater: (a) aluminum hydroxide adsorption-precipitation, (b) pre-treatment with glycine buffer and precipitation with polyethylene-glycol (PEG) and (c) ultrafiltration (Centricon). Our results showed that the reduction of organic matter, using the pre-treatment with glycine buffer before the concentration with Centricon or aluminum hydroxide adsorption-precipitation, improved the recovery percentage of the control virus, Mengovirus (MgV) (8.37% ± 5.88 n = 43; 6.97% ± 6.51 n = 20, respectively), and the detection of SARS-CoV-2 in comparison with the same methodology without a pre-treatment. For the concentration with Centricon, the use of 100 mL of wastewater, instead of 200 mL, increased the MgV recovery, and allowed a positive detection of SARS-CoV-2 with N1 and N2 targets. The quantity of SARS-CoV-2 RNA detected in wastewater did not show a direct correlation with the number of confirmed cases, but the study of its upwards or downwards trend over time enabled the detection of an increase of epidemiological data produced in September 2020, January 2021 and April 2021.
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Affiliation(s)
- Beatriz Peinado
- IMDEA Water Institute, Science and Technology Campus of the University of Alcalá, Avenida Punto Com 2, 28805, Alcalá de Henares, Spain
| | - Lorena Martínez-García
- IMDEA Water Institute, Science and Technology Campus of the University of Alcalá, Avenida Punto Com 2, 28805, Alcalá de Henares, Spain
| | - Francisco Martínez
- IMDEA Water Institute, Science and Technology Campus of the University of Alcalá, Avenida Punto Com 2, 28805, Alcalá de Henares, Spain
| | - Leonor Nozal
- Center of Applied Chemistry and Biotechnology (CQAB), University of Alcala and General Foundation of Alcala University (FGUA), A-II km 33.600, 28805, Alcalá de Henares, Madrid, Spain
| | - Maria Blanca Sánchez
- IMDEA Water Institute, Science and Technology Campus of the University of Alcalá, Avenida Punto Com 2, 28805, Alcalá de Henares, Spain.
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15
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Domenech de Cellès M, Wong A, Andrea Barrero Guevara L, Rohani P. Immunological heterogeneity informs estimation of the durability of vaccine protection. J R Soc Interface 2022; 19:20220070. [PMID: 35611620 PMCID: PMC9131131 DOI: 10.1098/rsif.2022.0070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/26/2022] [Indexed: 11/30/2022] Open
Abstract
Deciphering the properties of vaccines against an emerging pathogen is essential for optimizing immunization strategies. Early after vaccine roll-out, however, uncertainties about vaccine immunity raise the question of how much time is needed to estimate these properties, particularly the durability of vaccine protection. Here we designed a simulation study, based on a generic transmission model of vaccination, to simulate the impact of a breadth of vaccines with different mean (range: 10 months-2 years) and variability (coefficient of variation range: 50-100%) of the duration of protection. Focusing on the dynamics of SARS-CoV-2 in the year after start of mass immunization in Germany as a case study, we then assessed how confidently the duration of protection could be estimated under a range of epidemiological scenarios. We found that lower mean and higher heterogeneity facilitated estimation of the duration of vaccine protection. Across the vaccines tested, rapid waning and high heterogeneity permitted complete identification of the duration of protection; by contrast, slow waning and low heterogeneity allowed only estimation of the fraction of vaccinees with rapid loss of immunity. These findings suggest that limited epidemiological data can inform the duration of vaccine immunity. More generally, they highlight the need to carefully consider immunological heterogeneity when designing transmission models to evaluate vaccines.
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Affiliation(s)
| | - Anabelle Wong
- Infectious Disease Epidemiology group, Max Planck Institute for Infection Biology, 10117 Berlin, Germany
- Institute of Public Health, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Laura Andrea Barrero Guevara
- Infectious Disease Epidemiology group, Max Planck Institute for Infection Biology, 10117 Berlin, Germany
- Institute of Public Health, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Pejman Rohani
- Odum School of Ecology, University of Georgia, Athens, GA 30602, USA
- Department of Infectious Diseases, University of Georgia, Athens, GA 30602, USA
- Center for Influenza Disease & Emergence Research (CIDER), University of Georgia, Athens, GA 30602, USA
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16
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Heidemann C, Reitzle L, Schmidt C, Fuchs J, Prütz F, Scheidt-Nave C. Non-utilisation of health care services during the COVID-19 pandemic: Results of the CoMoLo study. JOURNAL OF HEALTH MONITORING 2022; 7:2-17. [PMID: 35356069 PMCID: PMC8939005 DOI: 10.25646/9564] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/20/2022] [Indexed: 11/18/2022]
Abstract
Based on data from the CORONA-MONITORING lokal (CoMoLo) study conducted in four municipalities particularly affected by the COVID-19 pandemic, this article investigates the non-utilisation of health care services in the population aged 18 years and older (n=9,002) in relation to the period after the introduction of the containment measures in March 2020. The results show that about one third of the respondents (35.5%) gave up at least one of the surveyed health care services. The most frequent cancellations were dental (15.2%) and specialist check-ups (11.8%), followed by postponement of physiotherapy, ergotherapy or speech therapy (6.1%), cancellation of general practitioner (GP) check-ups (5.8%), postponement of psychotherapy (2.0%), postponement of planned hospital treatment (1.8%) and not going to an emergency room (0.7%). Almost 10% of the respondents reported not visiting a physician despite health complaints. Compared to respondents without such a waiver, these respondents were more often female and younger than 35 years, less often rated their health as very good or good, more often had a diagnosis of depression and more often used telemedical contacts as an alternative to visiting the practice during the pandemic. Further analyses of trends in utilisation behaviour and changes in health status over the course of the COVID-19 pandemic are important.
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Affiliation(s)
- Christin Heidemann
- Corresponding author Dr Christin Heidemann, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62–66, 12101 Berlin, Germany, E-mail:
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SARS-CoV-2 seroprevalence and determinants of infection in young adults: A population-based seroepidemiological study. Public Health 2022; 207:54-61. [PMID: 35490440 PMCID: PMC8940565 DOI: 10.1016/j.puhe.2022.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/18/2022] [Accepted: 03/15/2022] [Indexed: 11/24/2022]
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18
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Diaz Badial P, Bothorel H, Kherad O, Dussoix P, Tallonneau Bory F, Ramlawi M. A new screening tool for SARS-CoV-2 infection based on self-reported patient clinical characteristics: the COV 19-ID score. BMC Infect Dis 2022; 22:187. [PMID: 35209872 PMCID: PMC8867452 DOI: 10.1186/s12879-022-07164-1] [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: 04/21/2021] [Accepted: 02/16/2022] [Indexed: 01/08/2023] Open
Abstract
Background While several studies aimed to identify risk factors for severe COVID-19 cases to better anticipate intensive care unit admissions, very few have been conducted on self-reported patient symptoms and characteristics, predictive of RT-PCR test positivity. We therefore aimed to identify those predictive factors and construct a predictive score for the screening of patients at admission. Methods This was a monocentric retrospective analysis of clinical data from 9081 patients tested for SARS-CoV-2 infection from August 1 to November 30 2020. A multivariable logistic regression using least absolute shrinkage and selection operator (LASSO) was performed on a training dataset (60% of the data) to determine associations between self-reported patient characteristics and COVID-19 diagnosis. Regression coefficients were used to construct the Coronavirus 2019 Identification score (COV19-ID) and the optimal threshold calculated on the validation dataset (20%). Its predictive performance was finally evaluated on a test dataset (20%). Results A total of 2084 (22.9%) patients were tested positive to SARS-CoV-2 infection. Using the LASSO model, COVID-19 was independently associated with loss of smell (Odds Ratio, 6.4), fever (OR, 2.7), history of contact with an infected person (OR, 1.7), loss of taste (OR, 1.5), muscle stiffness (OR, 1.5), cough (OR, 1.5), back pain (OR, 1.4), loss of appetite (OR, 1.3), as well as male sex (OR, 1.05). Conversely, COVID-19 was less likely associated with smoking (OR, 0.5), sore throat (OR, 0.9) and ear pain (OR, 0.9). All aforementioned variables were included in the COV19-ID score, which demonstrated on the test dataset an area under the receiver-operating characteristic curve of 82.9% (95% CI 80.6%–84.9%), and an accuracy of 74.2% (95% CI 74.1%–74.3%) with a high sensitivity (80.4%, 95% CI [80.3%–80.6%]) and specificity (72.2%, 95% CI [72.2%–72.4%]). Conclusions The COV19-ID score could be useful in early triage of patients needing RT-PCR testing thus alleviating the burden on laboratories, emergency rooms, and wards. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07164-1.
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Affiliation(s)
- Pablo Diaz Badial
- Department of Emergency Medicine, La Tour Hospital, 1217, Geneva, Switzerland
| | - Hugo Bothorel
- Research Department, La Tour Hospital, 1217, Geneva, Switzerland.
| | - Omar Kherad
- Department of Internal Medicine, La Tour Hospital and University of Geneva, 1217, Geneva, Switzerland
| | - Philippe Dussoix
- Department of Emergency Medicine, La Tour Hospital, 1217, Geneva, Switzerland
| | | | - Majd Ramlawi
- Department of Emergency Medicine, La Tour Hospital, 1217, Geneva, Switzerland
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19
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Aukema W, Malhotra BR, Goddek S, Kämmerer U, Borger P, McKernan K, Klement RJ. Bayes Lines Tool (BLT): a SQL-script for analyzing diagnostic test results with an application to SARS-CoV-2-testing. F1000Res 2022; 10:369. [PMID: 35284065 PMCID: PMC8891718 DOI: 10.12688/f1000research.51061.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2022] [Indexed: 11/20/2022] Open
Abstract
The performance of diagnostic tests crucially depends on the disease prevalence, test sensitivity, and test specificity. However, these quantities are often not well known when tests are performed outside defined routine lab procedures which make the rating of the test results somewhat problematic. A current example is the mass testing taking place within the context of the world-wide SARS-CoV-2 crisis. Here, for the first time in history, laboratory test results have a dramatic impact on political decisions. Therefore, transparent, comprehensible, and reliable data is mandatory. It is in the nature of wet lab tests that their quality and outcome are influenced by multiple factors reducing their performance by handling procedures, underlying test protocols, and analytical reagents. These limitations in sensitivity and specificity have to be taken into account when calculating the real test results. As a resolution method, we have developed a Bayesian calculator, the Bayes Lines Tool (BLT), for analyzing disease prevalence, test sensitivity, test specificity, and, therefore, true positive, false positive, true negative, and false negative numbers from official test outcome reports. The calculator performs a simple SQL (Structured Query Language) query and can easily be implemented on any system supporting SQL. We provide an example of influenza test results from California, USA, as well as two examples of SARS-CoV-2 test results from official government reports from The Netherlands and Germany-Bavaria, to illustrate the possible parameter space of prevalence, sensitivity, and specificity consistent with the observed data. Finally, we discuss this tool’s multiple applications, including its putative importance for informing policy decisions.
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Affiliation(s)
- Wouter Aukema
- Independent Data and Pattern Scientist, Hoenderloo, 7351BD, The Netherlands
| | - Bobby Rajesh Malhotra
- Department for Digital Arts, University for Applied Arts Vienna, Vienna, 1030, Austria
| | - Simon Goddek
- Independent Scientist, Ede, 6711 VS, The Netherlands
| | - Ulrike Kämmerer
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Würzburg, 97080, Germany
| | - Peter Borger
- The Independent Research Initiative on Information & Origins, Loerrach, 79540, Germany
| | | | - Rainer Johannes Klement
- Department of Radiation Oncology, Leopoldina Hospital Schweinfurt, Schweinfurt, 97422, Germany
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20
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Le TB, Kim HK, Ahn MJ, Zanin M, Lo VT, Ling S, Jiang Z, Kang JA, Bae PK, Kim YS, Kim S, Wong SS, Jeong DG, Yoon SW. Diagnostic performance and clinical feasibility of a novel one-step RT-qPCR assay for simultaneous detection of multiple severe acute respiratory syndrome coronaviruses. Arch Virol 2022; 167:871-879. [PMID: 35137250 PMCID: PMC8885489 DOI: 10.1007/s00705-022-05383-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 12/29/2021] [Indexed: 11/16/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is an acute respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Other coronaviruses (CoVs) can also infect humans, although the majority cause only mild respiratory symptoms. Because early diagnosis of SARS-CoV-2 is critical for preventing further transmission events and improving clinical outcomes, it is important to be able to distinguish SARS-CoV-2 from other SARS-related CoVs in respiratory samples. Therefore, we developed and evaluated a novel reverse transcription quantitative polymerase chain reaction (RT-qPCR) assay targeting the genes encoding the spike (S) and membrane (M) proteins to enable the rapid identification of SARS-CoV-2, including several new circulating variants and other emerging SARS-like CoVs. By analysis of in vitro-transcribed mRNA, we established multiplex RT-qPCR assays capable of detecting 5 × 10° copies/reaction. Using RNA extracted from cell culture supernatants, our multiple simultaneous SARS-CoV-2 assays had a limit of detection of 1 × 10° TCID50/mL and showed no cross-reaction with human CoVs or other respiratory viruses. We also validated our method using human clinical samples from patients with COVID-19 and healthy individuals, including nasal swab and sputum samples. This novel one-step multiplex RT-qPCR assay can be used to improve the laboratory diagnosis of human-pathogenic CoVs, including SARS-CoV-2, and may be useful for the identification of other SARS-like CoVs of zoonotic origin.
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Affiliation(s)
- Tran Bac Le
- Bio-nanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, South Korea.,Bio-Analytical Science Division, University of Science and Technology, Daejeon, South Korea
| | - Hye Kwon Kim
- Chungbuk National University, Cheongju, South Korea
| | - Min-Ju Ahn
- Bio-nanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, South Korea.,Bio-Analytical Science Division, University of Science and Technology, Daejeon, South Korea
| | - Mark Zanin
- State Key Laboratory for Respiratory Diseases, Guangzhou Medical University, Guangzhou, Guangdong Province, China.,School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Van Thi Lo
- Bio-nanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, South Korea.,Bio-Analytical Science Division, University of Science and Technology, Daejeon, South Korea
| | - Shiman Ling
- State Key Laboratory for Respiratory Diseases, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Zhanpeng Jiang
- State Key Laboratory for Respiratory Diseases, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Jung-Ah Kang
- Bio-nanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, South Korea
| | - Pan Kee Bae
- BioNano Health Guard Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, South Korea
| | - Yeon-Sook Kim
- Chungnam National University School of Medicine, Daejeon, South Korea
| | | | - Sook-San Wong
- State Key Laboratory for Respiratory Diseases, Guangzhou Medical University, Guangzhou, Guangdong Province, China. .,School of Public Health, The University of Hong Kong, Hong Kong, China.
| | - Dae Gwin Jeong
- Bio-nanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, South Korea. .,Bio-Analytical Science Division, University of Science and Technology, Daejeon, South Korea.
| | - Sun-Woo Yoon
- Bio-nanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, South Korea. .,Bio-Analytical Science Division, University of Science and Technology, Daejeon, South Korea.
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21
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Sander I, Kespohl S, Zahradnik E, Göcke P, Hosbach I, Herrmann BL, Brüning T, Raulf M. Quantitative measurement of IgG to SARS-CoV-2 antigens using monoclonal antibody-based enzyme-linked immunosorbent assays. Clin Transl Immunology 2022; 11:e1369. [PMID: 35127087 PMCID: PMC8801209 DOI: 10.1002/cti2.1369] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Standardised quantitative analysis of the humoral immune response to SARS-CoV-2 antigens may be useful for estimating the extent and duration of immunity. The aim was to develop enzyme-linked immunosorbent assays (ELISAs) for the quantification of human IgG antibodies against SARS-CoV-2 antigens. METHODS Enzyme-linked immunosorbent assays were developed based on monoclonal antibodies against human IgG and recombinant SARS-CoV-2 antigens (Spike-S1 and Nucleocapsid). The WHO 67/086 immunoglobulin and WHO 20/136 SARS-CoV-2 references were used for standardisation. Sera of a study group of COVID-19-positive subjects (n = 144), pre-pandemic controls (n = 135) and individuals vaccinated with BioNTech-Pfizer BNT162b2 vaccine (n = 48) were analysed. The study group sera were also tested using EuroImmun SARS-CoV-2-ELISAs and a quantitative S1-specific fluorescence enzyme immunoassay (FEIA) from Thermo Fisher. RESULTS The ELISA results were repeatable and traceable to international units because of their parallelism to both WHO references. In the study group, median anti-S1-IgG concentrations were 102 BAU mL-1, compared to 100 and 1457 BAU mL-1 in the vaccination group after first and second vaccination, respectively. The ELISAs achieved an area under the curve (AUC) of 0.965 (S1) and 0.955 (Nucleocapsid) in receiver operating characteristic (ROC) analysis, and a specificity of 1 (S1) and 0.963 (Nucleocapsid) and sensitivity of 0.903 (S1) and 0.833 (Nucleocapsid) at the maximum Youden index. In comparison, the commercial assays (S1-FEIA, S1 and Nucleocapsid ELISA EuroImmun) achieved sensitivities of 0.764, 0.875 and 0.882 in the study group, respectively. CONCLUSIONS The quantitative ELISAs to measure IgG binding to SARS-CoV-2 antigens have good analytical and clinical performance characteristics and units traceable to international standards.
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Affiliation(s)
- Ingrid Sander
- Institute for Prevention and Occupational Medicine of the German Social Accident InsuranceInstitute of the Ruhr University Bochum (IPA)BochumGermany
| | - Sabine Kespohl
- Institute for Prevention and Occupational Medicine of the German Social Accident InsuranceInstitute of the Ruhr University Bochum (IPA)BochumGermany
| | - Eva Zahradnik
- Institute for Prevention and Occupational Medicine of the German Social Accident InsuranceInstitute of the Ruhr University Bochum (IPA)BochumGermany
| | - Philipp Göcke
- Practice for Laboratory Medicine and Microbiology BochumBochumGermany
| | - Ingolf Hosbach
- Institute for Prevention and Occupational Medicine of the German Social Accident InsuranceInstitute of the Ruhr University Bochum (IPA)BochumGermany
- BG University Hospital Bergmannsheil BochumBochumGermany
| | | | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident InsuranceInstitute of the Ruhr University Bochum (IPA)BochumGermany
| | - Monika Raulf
- Institute for Prevention and Occupational Medicine of the German Social Accident InsuranceInstitute of the Ruhr University Bochum (IPA)BochumGermany
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22
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Madar-Balakirski N, Rosner A, Melamed S, Politi B, Steiner M, Tamir H, Yahalom-Ronen Y, Bar-David E, Ben-Shmuel A, Sittner A, Glinert I, Weiss S, Bar-Haim E, Cohen H, Elia U, Achdout H, Erez N, Rotem S, Lazar S, Nyska A, Yitzhaki S, Beth-Din A, Levy H, Paran N, Israely T, Marcus H. Preliminary nonclinical safety and immunogenicity of an rVSV-ΔG-SARS-CoV-2-S vaccine in mice, hamsters, rabbits and pigs. Arch Toxicol 2022; 96:859-875. [PMID: 35032184 PMCID: PMC8760087 DOI: 10.1007/s00204-021-03214-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/21/2021] [Indexed: 12/18/2022]
Abstract
rVSV-ΔG-SARS-CoV-2-S is a clinical stage (Phase 2) replication competent recombinant vaccine against SARS-CoV-2. To evaluate the safety profile of the vaccine, a series of non-clinical safety, immunogenicity and efficacy studies were conducted in four animal species, using multiple doses (up to 108 Plaque Forming Units/animal) and dosing regimens. There were no treatment-related mortalities or any noticeable clinical signs in any of the studies. Compared to unvaccinated controls, hematology and biochemistry parameters were unremarkable and no adverse histopathological findings. There was no detectable viral shedding in urine, nor viral RNA detected in whole blood or serum samples seven days post vaccination. The rVSV-ΔG-SARS-CoV-2-S vaccination gave rise to neutralizing antibodies, cellular immune responses, and increased lymphocytic cellularity in the spleen germinal centers and regional lymph nodes. No evidence for neurovirulence was found in C57BL/6 immune competent mice or in highly sensitive type I interferon knock-out mice. Vaccine virus replication and distribution in K18-human Angiotensin-converting enzyme 2-transgenic mice showed a gradual clearance from the vaccination site with no vaccine virus recovered from the lungs. The nonclinical data suggest that the rVSV-ΔG-SARS-CoV-2-S vaccine is safe and immunogenic. These results supported the initiation of clinical trials, currently in Phase 2.
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Affiliation(s)
- Noa Madar-Balakirski
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Amir Rosner
- Veterinary Center for Preclinical Research, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Sharon Melamed
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Boaz Politi
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | | | - Hadas Tamir
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Yfat Yahalom-Ronen
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Elad Bar-David
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Amir Ben-Shmuel
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Assa Sittner
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Itai Glinert
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Shay Weiss
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Erez Bar-Haim
- Department of Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Hila Cohen
- Department of Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Uri Elia
- Department of Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Hagit Achdout
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Noam Erez
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Shahar Rotem
- Department of Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Shlomi Lazar
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Abraham Nyska
- Sackler School of Medicine, Tel Aviv University, and Consultant in Toxicologic Pathology, Tel Aviv, Israel
| | - Shmuel Yitzhaki
- Israel Institute for Biological Research, Ness Ziona, Israel
| | - Adi Beth-Din
- Department of Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Haim Levy
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Nir Paran
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Tomer Israely
- Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel.
| | - Hadar Marcus
- Department of Biotechnology, Israel Institute for Biological Research, Ness Ziona, Israel.
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23
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Gornyk D, Harries M, Glöckner S, Strengert M, Kerrinnes T, Heise JK, Maaß H, Ortmann J, Kessel B, Kemmling Y, Lange B, Krause G. SARS-CoV-2 Seroprevalence in Germany. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:824-831. [PMID: 35191825 DOI: 10.3238/arztebl.m2021.0364] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/10/2021] [Accepted: 10/08/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Until now, information on the spread of SARS-CoV-2 infections in Germany has been based mainly on data from the public health offices. It may be assumed that these data do not include many cases of asymptomatic and mild infection. METHODS We determined seroprevalence over the course of the pandemic in a sequential, multilocal seroprevalence study (MuSPAD). Study participants were recruited at random in seven administrative districts (Kreise) in Germany from July 2020 onward; each participant was tested at two different times 3-5 months apart. Test findings on blood samples were used to determine the missed-case rate of reported infections, the infection fatality rate (IFR), and the association between seropositivity and demographic, socio-economic, and health-related factors, as well as to evaluate the self-reported results of PCR and antigenic tests. The registration number of this study is DRKS00022335. RESULTS Among non-vaccinated persons, the seroprevalence from July to December 2020 was 1.3-2.8% and rose between February and May 2021 to 4.1-13.1%. In July 2021, 35% of tested persons in Chemnitz were not vaccinated, and the seroprevalence among these persons was 32.4% (07/2021). The surveillance detection ratio (SDR), i.e., the ratio between the true number of infections estimated from seroprevalence and the actual number or reported infections, varied among the districts included in the study from 2.2 to 5.1 up to December 2020 and from 1.3 to 2.9 up to June 2021, and subsequently declined. The IFR was in the range of 0.8% to 2.4% in all regions except Magdeburg, where a value of 0.3% was calculated for November 2020. A lower educational level was associated with a higher seropositivity rate, smoking with a lower seropositivity rate. On average, 1 person was infected for every 8.5 persons in quarantine. CONCLUSION Seroprevalence was low after the first wave of the pandemic but rose markedly during the second and third waves. The missed-case rate trended downward over the course of the pandemic.
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Affiliation(s)
- Daniela Gornyk
- Department of Epidemiology, Helmholtz Center for Infection Research, Braunschweig; RNA Biology of Bacterial Infections, Helmholtz Institute for RNA-Based Infection Research, Würzburg; TI Bioresources, Biodata, and Digital Health (TI BBD), German Center for Infection Research (DZIF), Braunschweig; TWINCORE, Center for Experimental and Clinical Infection Research, Hanover
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24
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Design of a population-based longitudinal cohort study of SARS-CoV-2 incidence and prevalence among adults in the San Francisco Bay Area. Ann Epidemiol 2021; 67:81-100. [PMID: 34800659 PMCID: PMC8596645 DOI: 10.1016/j.annepidem.2021.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/16/2021] [Accepted: 11/02/2021] [Indexed: 12/12/2022]
Abstract
Purpose We describe the design of a longitudinal cohort study to determine SARS-CoV-2 incidence and prevalence among a population-based sample of adults living in six San Francisco Bay Area counties. Methods Using an address-based sample, we stratified households by county and by census-tract risk. Risk strata were determined by using regression models to predict infections by geographic area using census-level sociodemographic and health characteristics. We disproportionately sampled high and medium risk strata, which had smaller population sizes, to improve precision of estimates, and calculated a desired sample size of 3400. Participants were primarily recruited by mail and were followed monthly with PCR testing of nasopharyngeal swabs, testing of venous blood samples for antibodies to SARS-CoV-2 spike and nucleocapsid antigens, and testing of the presence of neutralizing antibodies, with completion of questionnaires about socio-demographics and behavior. Estimates of incidence and prevalence will be weighted by county, risk strata and sociodemographic characteristics of non-responders, and will take into account laboratory test performance. Results We enrolled 3842 adults from August to December 2020, and completed follow-up March 31, 2021. We reached target sample sizes within most strata. Conclusions Our stratified random sampling design will allow us to recruit a robust general population cohort of adults to determine the incidence of SARS-CoV-2 infection. Identifying risk strata was unique to the design and will help ensure precise estimates, and high-performance testing for presence of virus and antibodies will enable accurate ascertainment of infections.
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25
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Inferring the COVID-19 infection fatality rate in the community-dwelling population: a simple Bayesian evidence synthesis of seroprevalence study data and imprecise mortality data. Epidemiol Infect 2021. [PMCID: PMC8632419 DOI: 10.1017/s0950268821002405] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Abstract
Estimating the coronavirus disease-2019 (COVID-19) infection fatality rate (IFR) has proven to be particularly challenging –and rather controversial– due to the fact that both the data on deaths and the data on the number of individuals infected are subject to many different biases. We consider a Bayesian evidence synthesis approach which, while simple enough for researchers to understand and use, accounts for many important sources of uncertainty inherent in both the seroprevalence and mortality data. With the understanding that the results of one's evidence synthesis analysis may be largely driven by which studies are included and which are excluded, we conduct two separate parallel analyses based on two lists of eligible studies obtained from two different research teams. The results from both analyses are rather similar. With the first analysis, we estimate the COVID-19 IFR to be 0.31% [95% credible interval (CrI) of (0.16%, 0.53%)] for a typical community-dwelling population where 9% of the population is aged over 65 years and where the gross-domestic-product at purchasing-power-parity (GDP at PPP) per capita is $17.8k (the approximate worldwide average). With the second analysis, we obtain 0.32% [95% CrI of (0.19%, 0.47%)]. Our results suggest that, as one might expect, lower IFRs are associated with younger populations (and may also be associated with wealthier populations). For a typical community-dwelling population with the age and wealth of the United States we obtain IFR estimates of 0.43% and 0.41%; and with the age and wealth of the European Union, we obtain IFR estimates of 0.67% and 0.51%.
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26
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Radev ST, Graw F, Chen S, Mutters NT, Eichel VM, Bärnighausen T, Köthe U. OutbreakFlow: Model-based Bayesian inference of disease outbreak dynamics with invertible neural networks and its application to the COVID-19 pandemics in Germany. PLoS Comput Biol 2021; 17:e1009472. [PMID: 34695111 PMCID: PMC8584772 DOI: 10.1371/journal.pcbi.1009472] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 11/11/2021] [Accepted: 09/23/2021] [Indexed: 01/08/2023] Open
Abstract
Mathematical models in epidemiology are an indispensable tool to determine the dynamics and important characteristics of infectious diseases. Apart from their scientific merit, these models are often used to inform political decisions and interventional measures during an ongoing outbreak. However, reliably inferring the epidemical dynamics by connecting complex models to real data is still hard and requires either laborious manual parameter fitting or expensive optimization methods which have to be repeated from scratch for every application of a given model. In this work, we address this problem with a novel combination of epidemiological modeling with specialized neural networks. Our approach entails two computational phases: In an initial training phase, a mathematical model describing the epidemic is used as a coach for a neural network, which acquires global knowledge about the full range of possible disease dynamics. In the subsequent inference phase, the trained neural network processes the observed data of an actual outbreak and infers the parameters of the model in order to realistically reproduce the observed dynamics and reliably predict future progression. With its flexible framework, our simulation-based approach is applicable to a variety of epidemiological models. Moreover, since our method is fully Bayesian, it is designed to incorporate all available prior knowledge about plausible parameter values and returns complete joint posterior distributions over these parameters. Application of our method to the early Covid-19 outbreak phase in Germany demonstrates that we are able to obtain reliable probabilistic estimates for important disease characteristics, such as generation time, fraction of undetected infections, likelihood of transmission before symptom onset, and reporting delays using a very moderate amount of real-world observations.
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Affiliation(s)
- Stefan T. Radev
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Frederik Graw
- BioQuant - Center for Quantitative Biology, Heidelberg University, Heidelberg, Germany
| | - Simiao Chen
- Heidelberg Institute of Global Health, Heidelberg, Germany
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Nico T. Mutters
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany
| | - Vanessa M. Eichel
- Center of Infectious Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg, Germany
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Africa Health Research Institute, Durban, South Africa
| | - Ullrich Köthe
- Computer Vision and Learning Lab, Heidelberg University, Heidelberg, Germany
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Vu DL, Martinez-Murillo P, Pigny F, Vono M, Meyer B, Eberhardt CS, Lemeille S, Von Dach E, Blanchard-Rohner G, Eckerle I, Huttner A, Siegrist CA, Kaiser L, Didierlaurent AM. Longitudinal Analysis of Inflammatory Response to SARS-CoV-2 in the Upper Respiratory Tract Reveals an Association with Viral Load, Independent of Symptoms. J Clin Immunol 2021; 41:1723-1732. [PMID: 34581925 PMCID: PMC8476983 DOI: 10.1007/s10875-021-01134-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 09/05/2021] [Indexed: 12/23/2022]
Abstract
Background SARS-CoV-2 infection leads to high viral loads in the upper respiratory tract that may be determinant in virus dissemination. The extent of intranasal antiviral response in relation to symptoms is unknown. Understanding how local innate responses control virus is key in the development of therapeutic approaches. Methods SARS-CoV-2-infected patients were enrolled in an observational study conducted at the Geneva University Hospitals, Switzerland, investigating virological and immunological characteristics. Nasal wash and serum specimens from a subset of patients were collected to measure viral load, IgA specific for the S1 domain of the spike protein, and a cytokine panel at different time points after infection; cytokine levels were analyzed in relation to symptoms. Results Samples from 13 SARS-CoV-2-infected patients and six controls were analyzed. We found an increase in CXCL10 and IL-6, whose levels remained elevated for up to 3 weeks after symptom onset. SARS-CoV-2 infection also induced CCL2 and GM-CSF, suggesting local recruitment and activation of myeloid cells. Local cytokine levels correlated with viral load but not with serum cytokine levels, nor with specific symptoms, including anosmia. Some patients had S1-specific IgA in the nasal cavity while almost none had IgG. Conclusion The nasal epithelium is an active site of cytokine response against SARS-CoV-2 that can last more than 2 weeks; in this mild COVID-19 cohort, anosmia was not associated with increases in any locally produced cytokines. Supplementary Information The online version contains supplementary material available at 10.1007/s10875-021-01134-z.
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Affiliation(s)
- Diem-Lan Vu
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
- Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals, Geneva, Switzerland.
- University of Geneva Medical School, Geneva, Switzerland.
| | - Paola Martinez-Murillo
- Department of Pathology and Immunology, Faculty of Medicine, Center of Vaccinology, University of Geneva, Geneva, Switzerland
| | - Fiona Pigny
- Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals, Geneva, Switzerland
- University of Geneva Medical School, Geneva, Switzerland
| | - Maria Vono
- Department of Pathology and Immunology, Faculty of Medicine, Center of Vaccinology, University of Geneva, Geneva, Switzerland
| | - Benjamin Meyer
- Department of Pathology and Immunology, Faculty of Medicine, Center of Vaccinology, University of Geneva, Geneva, Switzerland
| | - Christiane S Eberhardt
- University of Geneva Medical School, Geneva, Switzerland
- Department of Pathology and Immunology, Faculty of Medicine, Center of Vaccinology, University of Geneva, Geneva, Switzerland
| | - Sylvain Lemeille
- Department of Pathology and Immunology, Faculty of Medicine, Center of Vaccinology, University of Geneva, Geneva, Switzerland
| | - Elodie Von Dach
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
- University of Geneva Medical School, Geneva, Switzerland
| | - Géraldine Blanchard-Rohner
- Department of Pathology and Immunology, Faculty of Medicine, Center of Vaccinology, University of Geneva, Geneva, Switzerland
- Unit of Immunology and Vaccinology, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Isabella Eckerle
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
- Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals, Geneva, Switzerland
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Angela Huttner
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
- University of Geneva Medical School, Geneva, Switzerland
- Department of Pathology and Immunology, Faculty of Medicine, Center of Vaccinology, University of Geneva, Geneva, Switzerland
| | - Claire-Anne Siegrist
- University of Geneva Medical School, Geneva, Switzerland
- Department of Pathology and Immunology, Faculty of Medicine, Center of Vaccinology, University of Geneva, Geneva, Switzerland
| | - Laurent Kaiser
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
- Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals, Geneva, Switzerland
- University of Geneva Medical School, Geneva, Switzerland
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Arnaud M Didierlaurent
- Department of Pathology and Immunology, Faculty of Medicine, Center of Vaccinology, University of Geneva, Geneva, Switzerland.
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland.
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Wachtler B, Müters S, Michalski N, Koschollek C, Albrecht S, Haller S, Hamouda O, Hövener C, Hoebel J. Socioeconomic inequalities in the prevalence and perceived dangerousness of SARS-CoV-2 infections in two early German hotspots: findings from a seroepidemiological study. BMC Res Notes 2021; 14:375. [PMID: 34565448 PMCID: PMC8474907 DOI: 10.1186/s13104-021-05784-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 09/14/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Evidence on socioeconomic inequalities in infections with the novel coronavirus (SARS-CoV-2) is still limited as most of the available studies are ecological in nature and individual-level data is sparse. We therefore analysed individual-level data on socioeconomic differences in the prevalence and perceived dangerousness of SARS-CoV-2 infections in local populations. Data were obtained from a population-based seroepidemiological study of adult individuals in two early German SARS-CoV-2 hotspots (n = 3903). Infection was determined by IgG antibody ELISA, RT-PCR testing and self-reports on prior positive PCR tests. The perceived dangerousness of an infection and socioeconomic position (SEP) were assessed by self-reports. Logistic and linear regression were applied to examine associations of multiple SEP measures with infection status and perceptions of dangerousness. RESULTS We found no evidence of socioeconomic inequalities in SARS-CoV-2 infections by education, occupation, income and subjective social status. Participants with lower education and lower subjective social status perceived an infection as more dangerous than their better-off counterparts. In successfully contained local outbreaks of SARS-CoV-2 in Germany, infections may have been equally distributed across the socioeconomic spectrum. But residents in disadvantaged socioeconomic groups might have experienced a higher level of mental distress due to the higher perceived dangerousness of an infection.
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Affiliation(s)
- Benjamin Wachtler
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Stephan Müters
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Niels Michalski
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Carmen Koschollek
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Stefan Albrecht
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Sebastian Haller
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Seestraße 10, 13353, Berlin, Germany
| | - Osamah Hamouda
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Seestraße 10, 13353, Berlin, Germany
| | - Claudia Hövener
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Jens Hoebel
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany.
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Wurm J, Starker A, Schienkiewitz A, Domanska O, Krug S, Damerow S, Neuhauser H, Butschalowsky H, Koschollek C. Changes in Alcohol and Tobacco Consumption in Kupferzell (Baden-Württemberg) During the Period of COVID-19 Pandemic Restrictions. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:614-615. [PMID: 34857078 DOI: 10.3238/arztebl.m2021.0315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 06/23/2021] [Accepted: 08/11/2021] [Indexed: 11/27/2022]
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Jacob L, Koyanagi A, Smith L, Haro JM, Rohe AM, Kostev K. Prevalence of and factors associated with COVID-19 diagnosis in symptomatic patients followed in general practices in Germany between March 2020 and March 2021. Int J Infect Dis 2021; 111:37-42. [PMID: 34380089 PMCID: PMC8413670 DOI: 10.1016/j.ijid.2021.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 11/18/2022] Open
Abstract
Aims This study aimed to investigate the prevalence of and the factors associated with the diagnosis of coronavirus disease 2019 (COVID-19) in symptomatic patients followed in general practices in Germany between March 2020 and March 2021. Methods Symptomatic patients tested for COVID-19 and followed in one of 962 general practices in Germany from March 2020 to March 2021 were included in this study. Covariates included sex, age, and comorbidities present in at least 3% of the population. The association between these factors and the diagnosis of COVID-19 was analyzed using an adjusted logistic regression model. Results A total of 301,290 patients tested for COVID-19 were included in this study (54.7% women; mean [SD] age 44.6 [18.5] years). The prevalence of COVID-19 was 13.8% in this sample. Male sex and older age were positively and significantly associated with COVID-19. In terms of comorbidities, the strongest positive associations with COVID-19 were observed for cardiac arrhythmias, depression, and obesity. There was also a negative relationship between the odds of being diagnosed with COVID-19 and several conditions such as chronic sinusitis, asthma, and anxiety disorders. Conclusions Approximately 14% of symptomatic patients tested for COVID-19 were diagnosed with COVID-19 in German general practices from March 2020 to March 2021.
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Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux 78180, France
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Pg. Lluis Companys 23, Barcelona 08010, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Anna M Rohe
- Department of Otorhinolaryngology, Head and Neck Surgery, Solingen Municipal Hospital, Solingen, Germany
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Larribère L, Gordejeva J, Kuhnhenn L, Kurscheidt M, Pobiruchin M, Vladimirova D, Martin M, Roser M, Schramm W, Martens UM, Eigenbrod T. Assessment of SARS-CoV-2 Infection among Healthcare Workers of a German COVID-19 Treatment Center. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7057. [PMID: 34281000 PMCID: PMC8297119 DOI: 10.3390/ijerph18137057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 06/28/2021] [Indexed: 12/11/2022]
Abstract
To date, more than 160 million people have been infected with COVID-19 worldwide. In the present study, we investigated the history of SARS-CoV-2 infection among 3067 healthcare workers (HCW) in a German COVID-19 treatment center during the early phase of the pandemic (July 2020) based on the seroprevalence of SARS-CoV-2 antibodies and self-reported previous PCR results. The results demonstrate a low prevalence of SARS-CoV-2 infection (n = 107 [3.5%]) with no increased risk for employees with a high level of patient exposure in general or working in COVID-19-confined areas in particular. This suggests that the local hygiene standards implemented in our hospital during the first wave of COVID-19 pandemic were effective in preventing patient-to-HCW transmission. No evidence for highly mobile staff serving as a vector for SARS-CoV-2 transmission could be found. In addition, impairment of smell and/or taste was strongly associated with SARS-CoV-2 history.
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Affiliation(s)
- Lionel Larribère
- Cancer Center Heilbronn-Franken, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (D.V.); (U.M.M.)
| | - Jelizaveta Gordejeva
- GECKO Institute for Medicine, Informatics and Economics, Hochschule Heilbronn, 74081 Heilbronn, Germany; (J.G.); (M.K.); (M.P.); (W.S.)
| | - Lisa Kuhnhenn
- Institute of Laboratory Medicine, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (L.K.); (M.R.); (T.E.)
| | - Maximilian Kurscheidt
- GECKO Institute for Medicine, Informatics and Economics, Hochschule Heilbronn, 74081 Heilbronn, Germany; (J.G.); (M.K.); (M.P.); (W.S.)
| | - Monika Pobiruchin
- GECKO Institute for Medicine, Informatics and Economics, Hochschule Heilbronn, 74081 Heilbronn, Germany; (J.G.); (M.K.); (M.P.); (W.S.)
| | - Dilyana Vladimirova
- Cancer Center Heilbronn-Franken, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (D.V.); (U.M.M.)
| | - Maria Martin
- Institute for Infection Prevention and Clinical Hygiene, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany;
| | - Markus Roser
- Institute of Laboratory Medicine, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (L.K.); (M.R.); (T.E.)
| | - Wendelin Schramm
- GECKO Institute for Medicine, Informatics and Economics, Hochschule Heilbronn, 74081 Heilbronn, Germany; (J.G.); (M.K.); (M.P.); (W.S.)
| | - Uwe M. Martens
- Cancer Center Heilbronn-Franken, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (D.V.); (U.M.M.)
| | - Tatjana Eigenbrod
- Institute of Laboratory Medicine, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (L.K.); (M.R.); (T.E.)
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32
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Evaluation of a laboratory-based high-throughput SARS-CoV-2 antigen assay for non-COVID-19 patient screening at hospital admission. Med Microbiol Immunol 2021; 210:165-171. [PMID: 33856557 PMCID: PMC8047582 DOI: 10.1007/s00430-021-00706-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/03/2021] [Indexed: 11/09/2022]
Abstract
Several rapid antigen tests (RATs) for the detection of SARS-CoV-2 were evaluated recently. However, reliable performance data for laboratory-based, high-throughput antigen tests are lacking. Therefore and in response to a short-term shortage of PCR reagents, we evaluated DiaSorin's LIAISON SARS-CoV-2 antigen test in comparison to RT-qPCR, and concerning the application of screening non-COVID-19 patients on hospital admission. Applying the manufacturer-recommended cut-off of 200 arbitrary units (AU/mL) the specificity of the LIAISON Test was 100%, the overall analytical sensitivity 40.2%. Lowering the cut-off to 100 AU/mL increased the sensitivity to 49.7% and decreased the specificity to 98.3%. Confining the analysis to samples with an RT-qPCR result < 25 Ct resulted in a sensitivity of 91.2%. The quality of the LIAISON test is very similar to that of good RATs described in the literature with the advantage of high throughput and the disadvantage of relatively long analysis time. It passes the WHO quality criteria for rapid antigen tests and is characterized by particularly high specificity. The LIAISON test can therefore be used for the same applications as recommended for RATs by the WHO. Due to limited sensitivity, the LIAISON test should only be used for screening, if PCR-based assays are not available.
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Data suggest COVID-19 affected numbers greatly exceeded detected numbers, in four European countries, as per a delayed SEIQR model. Sci Rep 2021; 11:8106. [PMID: 33854165 PMCID: PMC8046823 DOI: 10.1038/s41598-021-87630-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 03/26/2021] [Indexed: 12/28/2022] Open
Abstract
People in many countries are now infected with COVID-19. By now, it is clear that the number of people infected is much greater than the number of reported cases. To estimate the infected but undetected/unreported cases using a mathematical model, we can use a parameter called the probability of quarantining an infected individual. This parameter exists in the time-delayed SEIQR model (Scientific Reports, article number: 3505). Here, two limiting cases of a network of such models are used to estimate the undetected population. The first limit corresponds to the network collapsing onto a single node and is referred to as the mean-\documentclass[12pt]{minimal}
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\begin{document}$$\beta$$\end{document}β model. In the second case, the number of nodes in the network is infinite and results in a continuum model wherein the infectivity is statistically distributed. We use a generalized Pareto distribution to model the infectivity. This distribution has a fat tail and models the presence of super-spreaders that contribute to the disease progression. While both models capture the detected numbers well, the predictions of affected numbers from the continuum model are more realistic. Our results suggest that affected people outnumber detected people by one to two orders of magnitude in Spain, the UK, Italy, and Germany. Our results are consistent with corresponding trends obtained from published serological studies in Spain, the UK and Italy. The match with limited studies in Germany is poor, possibly because Germany’s partial lockdown approach requires different modeling.
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Aziz NA, Corman VM, Echterhoff AKC, Müller MA, Richter A, Schmandke A, Schmidt ML, Schmidt TH, de Vries FM, Drosten C, Breteler MMB. Seroprevalence and correlates of SARS-CoV-2 neutralizing antibodies from a population-based study in Bonn, Germany. Nat Commun 2021; 12:2117. [PMID: 33837204 PMCID: PMC8035181 DOI: 10.1038/s41467-021-22351-5] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 03/05/2021] [Indexed: 02/07/2023] Open
Abstract
To estimate the seroprevalence and temporal course of SARS-CoV-2 neutralizing antibodies, we embedded a multi-tiered seroprevalence survey within an ongoing community-based cohort study in Bonn, Germany. We first assessed anti-SARS-CoV-2 immunoglobulin G levels with an immunoassay, followed by confirmatory testing of borderline and positive test results with a recombinant spike-based immunofluorescence assay and a plaque reduction neutralization test (PRNT). Those with a borderline or positive immunoassay result were retested after 4 to 5 months. At baseline, 4771 persons participated (88% response rate). Between April 24th and June 30th, 2020, seroprevalence was 0.97% (95% CI: 0.72-1.30) by immunoassay and 0.36% (95% CI: 0.21-0.61) when considering only those with two additional positive confirmatory tests. Importantly, about 20% of PRNT+ individuals lost their neutralizing antibodies within five months. Here, we show that neutralizing antibodies are detectable in only one third of those with a positive immunoassay result, and wane relatively quickly.
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Affiliation(s)
- N Ahmad Aziz
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurology, Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Victor M Corman
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
- German Center for Infection Research (DZIF), Berlin, Germany
| | - Antje K C Echterhoff
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Marcel A Müller
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
- German Center for Infection Research (DZIF), Berlin, Germany
| | - Anja Richter
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Antonio Schmandke
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Marie Luisa Schmidt
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
- German Center for Infection Research (DZIF), Berlin, Germany
| | - Thomas H Schmidt
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Folgerdiena M de Vries
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Christian Drosten
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
- German Center for Infection Research (DZIF), Berlin, Germany
| | - Monique M B Breteler
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
- Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Bonn, Germany.
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Sonnleitner ST, Dorighi J, Jansen B, Schönegger C, Gietl S, Koblmüller S, Sturmbauer C, Posch W, Walder G. An in vitro model for assessment of SARS-CoV-2 infectivity by defining the correlation between virus isolation and quantitative PCR value: isolation success of SARS-CoV-2 from oropharyngeal swabs correlates negatively with Cq value. Virol J 2021; 18:71. [PMID: 33827618 PMCID: PMC8025900 DOI: 10.1186/s12985-021-01542-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 03/31/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND At the beginning of the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), little was known about its actual rate of infectivity and any COVID-19 patient positive in laboratory testing was supposed to be highly infective and a public health risk factor. METHODS One hundred oropharyngeal samples were obtained during routine work flow of testing symptomatic persons by quantitative polymerase chain reaction (qPCR) and were inoculated onto cell culture of VeroB4 cells to study the degree of infectivity of SARS-CoV-2 in vitro. Quantification by virus titration and an external standard using synthetic RNA gave the breaking point of infectivity in SARS-CoV-2 in vitro. RESULTS A clear negative correlation (r = - 0.76; p < 0.05) could be asserted between the viral load in quantitative polymerase chain reaction (qPCR) and the probability of a successful isolation in serial isolation experiments of specific oropharyngeal samples positive in qPCR. Quantification by virus titration and an external standard using synthetic RNA indicate a Cq between 27 and 30 in E-gene screening PCR as a breaking point in vitro, where infectivity decreases significantly and isolations become less probable. CONCLUSIONS This study showed that only the 21% of samples with the highest viral load were infectious enough to transmit the virus in vitro and determined that the dispersion rate in vitro is surprisingly close to those calculated in large retrospective epidemiological studies for SARS-CoV-2. This raises the question of whether this simple in vitro model is suitable to give first insights in dispersion characters of novel or neglected viral pathogens. The statement that SARS-CoV-2 needs at least 40,000 copies to reliably induce infection in vitro is an indication of its transmissibility in Public Health decisions. Applying quantitative PCR systems in diagnosis of SARS-CoV2 can distinguish between patients providing a high risk of transmission and those, where the risk of transmission is probably limited to close and long-lasting contacts.
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Affiliation(s)
- Sissy Therese Sonnleitner
- Medical Laboratory, Department of Virology, Dr. Gernot Walder GmbH, 9931, Außervillgraten 30, Austria.
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020, Innsbruck, Austria.
| | - Julian Dorighi
- Medical Laboratory, Department of Virology, Dr. Gernot Walder GmbH, 9931, Außervillgraten 30, Austria
| | - Bianca Jansen
- Medical Laboratory, Department of Virology, Dr. Gernot Walder GmbH, 9931, Außervillgraten 30, Austria
| | - Carmen Schönegger
- Medical Laboratory, Department of Virology, Dr. Gernot Walder GmbH, 9931, Außervillgraten 30, Austria
| | - Sarah Gietl
- Medical Laboratory, Department of Virology, Dr. Gernot Walder GmbH, 9931, Außervillgraten 30, Austria
| | - Stephan Koblmüller
- Institute of Biology, University of Graz, Universitaetsplatz 2, 8010, Graz, Austria
| | - Christian Sturmbauer
- Institute of Biology, University of Graz, Universitaetsplatz 2, 8010, Graz, Austria
| | - Wilfried Posch
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020, Innsbruck, Austria
| | - Gernot Walder
- Medical Laboratory, Department of Virology, Dr. Gernot Walder GmbH, 9931, Außervillgraten 30, Austria
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Loffredo M, Lucero H, Chen DY, O'Connell A, Bergqvist S, Munawar A, Bandara A, De Graef S, Weeks SD, Douam F, Saeed M, Munawar AH. The in-vitro effect of famotidine on sars-cov-2 proteases and virus replication. Sci Rep 2021; 11:5433. [PMID: 33686143 PMCID: PMC7940615 DOI: 10.1038/s41598-021-84782-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/01/2021] [Indexed: 01/07/2023] Open
Abstract
The lack of coronavirus-specific antiviral drugs has instigated multiple drug repurposing studies to redirect previously approved medicines for the treatment of SARS-CoV-2, the coronavirus behind the ongoing COVID-19 pandemic. A recent, large-scale, retrospective clinical study showed that famotidine, when administered at a high dose to hospitalized COVID-19 patients, reduced the rates of intubation and mortality. A separate, patient-reported study associated famotidine use with improvements in mild to moderate symptoms such as cough and shortness of breath. While a prospective, multi-center clinical study is ongoing, two parallel in silico studies have proposed one of the two SARS-CoV-2 proteases, 3CLpro or PLpro, as potential molecular targets of famotidine activity; however, this remains to be experimentally validated. In this report, we systematically analyzed the effect of famotidine on viral proteases and virus replication. Leveraging a series of biophysical and enzymatic assays, we show that famotidine neither binds with nor inhibits the functions of 3CLpro and PLpro. Similarly, no direct antiviral activity of famotidine was observed at concentrations of up to 200 µM, when tested against SARS-CoV-2 in two different cell lines, including a human cell line originating from lungs, a primary target of COVID-19. These results rule out famotidine as a direct-acting inhibitor of SARS-CoV-2 replication and warrant further investigation of its molecular mechanism of action in the context of COVID-19.
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Affiliation(s)
- Madeline Loffredo
- Bisect Therapeutics, Inc., 45 Dan Road, Canton, MA, USA
- Orthogon Therapeutics LLC, 960 Turnpike St, Canton, MA, USA
| | - Hector Lucero
- Bisect Therapeutics, Inc., 45 Dan Road, Canton, MA, USA
- Orthogon Therapeutics LLC, 960 Turnpike St, Canton, MA, USA
| | - Da-Yuan Chen
- National Emerging Infectious Diseases Laboratories (NEIDL), 620 Albany Street, Boston, MA, 02118, USA
- Department of Biochemistry, Boston University School of Medicine, Boston, MA, USA
| | - Aoife O'Connell
- National Emerging Infectious Diseases Laboratories (NEIDL), 620 Albany Street, Boston, MA, 02118, USA
- Department of Microbiology, Boston University School of Medicine, Boston, MA, USA
| | | | - Ahmad Munawar
- Bisect Therapeutics, Inc., 45 Dan Road, Canton, MA, USA
- Orthogon Therapeutics LLC, 960 Turnpike St, Canton, MA, USA
| | - Asanga Bandara
- Bisect Therapeutics, Inc., 45 Dan Road, Canton, MA, USA
- Orthogon Therapeutics LLC, 960 Turnpike St, Canton, MA, USA
| | - Steff De Graef
- Bisect Therapeutics, Inc., 45 Dan Road, Canton, MA, USA
- Pledge Therapeutics B.V., Gaston Geenslaan 1, Leuven, 3000, Belgium
| | - Stephen D Weeks
- Bisect Therapeutics, Inc., 45 Dan Road, Canton, MA, USA
- Pledge Therapeutics B.V., Gaston Geenslaan 1, Leuven, 3000, Belgium
| | - Florian Douam
- National Emerging Infectious Diseases Laboratories (NEIDL), 620 Albany Street, Boston, MA, 02118, USA
- Department of Microbiology, Boston University School of Medicine, Boston, MA, USA
| | - Mohsan Saeed
- National Emerging Infectious Diseases Laboratories (NEIDL), 620 Albany Street, Boston, MA, 02118, USA.
- Department of Biochemistry, Boston University School of Medicine, Boston, MA, USA.
| | - Ali H Munawar
- Bisect Therapeutics, Inc., 45 Dan Road, Canton, MA, USA.
- Orthogon Therapeutics LLC, 960 Turnpike St, Canton, MA, USA.
- Pledge Therapeutics B.V., Gaston Geenslaan 1, Leuven, 3000, Belgium.
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Abstract
BACKGROUND Analyses for the presence of SARS-CoV‑2 in the tissues of COVID-19 patients is important in order to improve our understanding of the disease pathophysiology for interpretation of diagnostic histopathological findings in autopsies, biopsies, or surgical specimens and to assess the potential for occupational infectious hazard. MATERIAL AND METHODS In this review we identified 136 published studies in PubMed's curated literature database LitCovid on SARS-CoV‑2 detection methods in tissues and evaluated them regarding sources of error, specificity, and sensitivity of the methods, taking into account our own experience. RESULTS Currently, no sufficiently specific histomorphological alterations or diagnostic features for COVID-19 are known. Therefore, three approaches for SARS-CoV‑2 detection are used: RNA, proteins/antigens, or morphological detection by electron microscopy. In the preanalytical phase, the dominant source of error is tissue quality, especially the different intervals between sample collection and processing or fixation (and its duration) and specifically the interval between death and sample collection in autopsies. However, this information is found in less than half of the studies (e.g., in only 42% of autopsy studies). Our own experience and first studies prove the significantly higher sensitivity and specificity of RNA-based detection methods compared to antigen or protein detection by immunohistochemistry or immunofluorescence. Detection by electron microscopy is time consuming and difficult to interpret. CONCLUSIONS Different methods are available for the detection of SARS-CoV‑2 in tissue. Currently, RNA detection by RT-PCR is the method of choice. However, extensive validation studies and method harmonization are not available and are absolutely necessary.
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Affiliation(s)
- Saskia von Stillfried
- Institut für Pathologie, Universitätsklinik der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - Peter Boor
- Institut für Pathologie, Universitätsklinik der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
- Medizinische Klinik II (Nephrologie und Immunologie), Universitätsklinik der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
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Hoebel J, Busch MA, Grabka MM, Zinn S, Allen J, Göfêwald A, Wernitz J, Goebel J, Steinhauer HW, Siegers R, Schroder C, Kuttig T, Butschalowsky H, Schlaud M, Rosario AS, Brix J, Rysina A, Glemser A, Neuhauser H, Stahlberg S, Kneuer A, Hey I, Schaarschmidt J, Fiebig J, Buttmann-Schweiger N, Wilking H, Michel J, Nitsche A, Wieler LH, Schaade L, Ziese T, Liebig S, Lampert T. Seroepidemiological study on the spread of SARS-CoV-2 in Germany: Study protocol of the CORONA-MONITORING bundesweit' study (RKI-SOEP study). JOURNAL OF HEALTH MONITORING 2021; 6:2-16. [PMID: 35585914 PMCID: PMC8832365 DOI: 10.25646/7853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 01/20/2021] [Indexed: 01/29/2023]
Abstract
The SARS-CoV-2 coronavirus has spread rapidly across Germany. Infections are likely to be under-recorded in the notification data from local health authorities on laboratory-confirmed cases since SARS-CoV-2 infections can proceed with few symptoms and then often remain undetected. Seroepidemiological studies allow the estimation of the proportion in the population that has been infected with SARS-CoV-2 (seroprevalence) as well as the extent of undetected infections. The ‘CORONA-MONITORING bundesweit’ study (RKI-SOEP study) collects biospecimens and interview data in a nationwide population sample drawn from the German Socio-Economic Panel (SOEP). Participants are sent materials to self-collect a dry blood sample of capillary blood from their finger and a swab sample from their mouth and nose, as well as a questionnaire. The samples returned are tested for SARS-CoV-2 IgG antibodies and SARS-CoV-2 RNA to identify past or present infections. The methods applied enable the identification of SARS-CoV-2 infections, including those that previously went undetected. In addition, by linking the data collected with available SOEP data, the study has the potential to investigate social and health-related differences in infection status. Thus, the study contributes to an improved understanding of the extent of the epidemic in Germany, as well as identification of target groups for infection protection.
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Affiliation(s)
- Jens Hoebel
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Markus A Busch
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Markus M Grabka
- German Institute for Economic Research, Berlin, Socio-Economic Panel
| | - Sabine Zinn
- German Institute for Economic Research, Berlin, Socio-Economic Panel.,Humboldt University Berlin Faculty of Humanities and Social Sciences
| | - Jennifer Allen
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Antje Göfêwald
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jörg Wernitz
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jan Goebel
- German Institute for Economic Research, Berlin, Socio-Economic Panel
| | | | - Rainer Siegers
- German Institute for Economic Research, Berlin, Socio-Economic Panel
| | - Carsten Schroder
- German Institute for Economic Research, Berlin, Socio-Economic Panel.,Freie Universität Berlin School of Business and Economics
| | - Tim Kuttig
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Hans Butschalowsky
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Martin Schlaud
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | | | | | | | | | - Hannelore Neuhauser
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Silke Stahlberg
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Antje Kneuer
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Isabell Hey
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jörg Schaarschmidt
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Julia Fiebig
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | | | - Hendrik Wilking
- Robert Koch Institute, Berlin Department of Infectious Disease Epidemiology
| | - Janine Michel
- Robert Koch Institute, Berlin Centre for Biological Threats and Special Pathogens
| | - Andreas Nitsche
- Robert Koch Institute, Berlin Centre for Biological Threats and Special Pathogens
| | - Lothar H Wieler
- Robert Koch Institute, Berlin Institute Leadership.,Robert Koch Institute, Berlin Methodology and Research Infrastructure
| | - Lars Schaade
- Robert Koch Institute, Berlin Centre for Biological Threats and Special Pathogens.,Robert Koch Institute, Berlin Institute Leadership
| | - Thomas Ziese
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Stefan Liebig
- German Institute for Economic Research, Berlin, Socio-Economic Panel
| | - Thomas Lampert
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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39
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Wolff D, Nee S, Hickey NS, Marschollek M. Risk factors for Covid-19 severity and fatality: a structured literature review. Infection 2021; 49:15-28. [PMID: 32860214 PMCID: PMC7453858 DOI: 10.1007/s15010-020-01509-1] [Citation(s) in RCA: 274] [Impact Index Per Article: 91.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/17/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Covid-19 is a global threat that pushes health care to its limits. Since there is neither a vaccine nor a drug for Covid-19, people with an increased risk for severe and fatal courses of disease particularly need protection. Furthermore, factors increasing these risks are of interest in the search of potential treatments. A systematic literature review on the risk factors of severe and fatal Covid-19 courses is presented. METHODS The review is carried out on PubMed and a publicly available preprint dataset. For analysis, risk factors are categorized and information regarding the study such as study size and location are extracted. The results are compared to risk factors listed by four public authorities from different countries. RESULTS The 28 records included, eleven of which are preprints, indicate that conditions and comorbidities connected to a poor state of health such as high age, obesity, diabetes and hypertension are risk factors for severe and fatal disease courses. Furthermore, severe and fatal courses are associated with organ damages mainly affecting the heart, liver and kidneys. Coagulation dysfunctions could play a critical role in the organ damaging. Time to hospital admission, tuberculosis, inflammation disorders and coagulation dysfunctions are identified as risk factors found in the review but not mentioned by the public authorities. CONCLUSION Factors associated with increased risk of severe or fatal disease courses were identified, which include conditions connected with a poor state of health as well as organ damages and coagulation dysfunctions. The results may facilitate upcoming Covid-19 research.
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Affiliation(s)
- Dominik Wolff
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany.
| | - Sarah Nee
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany
| | - Natalie Sandy Hickey
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany
| | - Michael Marschollek
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany
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40
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Schlickeiser S, Schwarz T, Steiner S, Wittke K, Al Besher N, Meyer O, Kalus U, Pruß A, Kurth F, Zoller T, Witzenrath M, Sander LE, Müller MA, Scheibenbogen C, Volk HD, Drosten C, Corman VM, Hanitsch LG. Disease Severity, Fever, Age, and Sex Correlate With SARS-CoV-2 Neutralizing Antibody Responses. Front Immunol 2021; 11:628971. [PMID: 33584731 PMCID: PMC7878374 DOI: 10.3389/fimmu.2020.628971] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 12/29/2020] [Indexed: 12/15/2022] Open
Abstract
Clinical trials on the use of COVID-19 convalescent plasma remain inconclusive. While data on safety is increasingly available, evidence for efficacy is still sparse. Subgroup analyses hint to a dose-response relationship between convalescent plasma neutralizing antibody levels and mortality. In particular, patients with primary and secondary antibody deficiency might benefit from this approach. However, testing of neutralizing antibodies is limited to specialized biosafety level 3 laboratories and is a time- and labor-intense procedure. In this single center study of 206 COVID-19 convalescent patients, clinical data, results of commercially available ELISA testing of SARS-CoV-2 spike-IgG and -IgA, and levels of neutralizing antibodies, determined by plaque reduction neutralization testing (PRNT), were analyzed. At a medium time point of 58 days after symptom onset, only 12.6% of potential plasma donors showed high levels of neutralizing antibodies (PRNT50 ≥ 1:320). Multivariable proportional odds logistic regression analysis revealed need for hospitalization due to COVID-19 (odds ratio 6.87; p-value 0.0004) and fever (odds ratio 3.00; p-value 0.0001) as leading factors affecting levels of SARS-CoV-2 neutralizing antibody titers in convalescent plasma donors. Using penalized estimation, a predictive proportional odds logistic regression model including the most important variables hospitalization, fever, age, sex, and anosmia or dysgeusia was developed. The predictive discrimination for PRNT50 ≥ 1:320 was reasonably good with AUC: 0.86 (with 95% CI: 0.79-0.92). Combining clinical and ELISA-based pre-screening, assessment of neutralizing antibodies could be spared in 75% of potential donors with a maximal loss of 10% of true positives (PRNT50 ≥ 1:320).
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Affiliation(s)
- Stephan Schlickeiser
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tatjana Schwarz
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Institute of Virology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, and German Centre for Infection Research (DZIF), Partner Site Charité, Berlin, Germany
| | - Sophie Steiner
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Kirsten Wittke
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Nabeel Al Besher
- Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Oliver Meyer
- Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrich Kalus
- Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Axel Pruß
- Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Florian Kurth
- Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Thomas Zoller
- Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Martin Witzenrath
- Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Center for Lung Research (DZL), Partner Site Charité, Berlin, Germany
| | - Leif Erik Sander
- Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Center for Lung Research (DZL), Partner Site Charité, Berlin, Germany
| | - Marcel A. Müller
- Institute of Virology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, and German Centre for Infection Research (DZIF), Partner Site Charité, Berlin, Germany
| | - Carmen Scheibenbogen
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Hans-Dieter Volk
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Center for Advanced Therapies (BeCAT), Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Drosten
- Institute of Virology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, and German Centre for Infection Research (DZIF), Partner Site Charité, Berlin, Germany
| | - Victor M. Corman
- Institute of Virology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, and German Centre for Infection Research (DZIF), Partner Site Charité, Berlin, Germany
| | - Leif G. Hanitsch
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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41
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Evaluation of two rapid antigen tests to detect SARS-CoV-2 in a hospital setting. Med Microbiol Immunol 2021; 210:65-72. [PMID: 33452927 PMCID: PMC7811156 DOI: 10.1007/s00430-020-00698-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 12/16/2020] [Indexed: 12/12/2022]
Abstract
Successful containment strategies for the SARS-CoV-2 pandemic will depend on reliable diagnostic assays. Point-of-care antigen tests (POCT) may provide an alternative to time-consuming PCR tests to rapidly screen for acute infections on site. Here, we evaluated two SARS-CoV-2 antigen tests: the STANDARD™ F COVID-19 Ag FIA (FIA) and the SARS-CoV-2 Rapid Antigen Test (RAT). For diagnostic assessment, we used a large set of PCR-positive and PCR-negative respiratory swabs from asymptomatic and symptomatic patients and health care workers in the setting of two University Hospitals in Munich, Germany, i.e. emergency rooms, patient care units or employee test centers. For FIA, overall clinical sensitivity and specificity were 45.4% (n = 381) and 97.8% (n = 360), respectively, and for RAT, 50.3% (n = 445) and 97.7% (n = 386), respectively. For primary diagnosis of asymptomatic and symptomatic individuals, diagnostic sensitivities were 60.9% (FIA) (n = 189) and 64.5% (RAT) (n = 256). This questions these tests' utility for the reliable detection of acute SARS-CoV-2-infected individuals, in particular in high-risk settings. We support the proposal that convincing high-quality outcome data on the impact of false-negative and false-positive antigen test results need to be obtained in a POCT setting. Moreover, the efficacy of alternative testing strategies to complement PCR assays must be evaluated by independent laboratories, prior to widespread implementation in national and international test strategies.
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42
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Rauber C, Tiwari-Heckler S, Pfeiffenberger J, Mehrabi A, Lund F, Gath P, Mieth M, Merle U, Rupp C. SARS-CoV-2 Seroprevalence and Clinical Features of COVID-19 in a German Liver Transplant Recipient Cohort: A Prospective Serosurvey Study. Transplant Proc 2020; 53:1112-1117. [PMID: 33451759 PMCID: PMC7831557 DOI: 10.1016/j.transproceed.2020.11.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 01/08/2023]
Abstract
Background In liver transplant (LT) recipients with severe coronavirus disease 2019 (COVID-19), fatal outcome has been reported in a substantial subset of patients. Whether LT recipients are at increased risk for severe COVID-19 compared with the general population is controversial. Here we report the results of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serosurvey in a large LT recipient cohort. Methods A total of 219 LT recipients were enrolled between May 5, 2020, and August 6, 2020, at the University Hospital Heidelberg. Serum blood samples were collected and tested for anti–SARS-CoV-2 IgG. SARS-CoV-2 RNA was detected in nasopharyngeal swabs using reverse transcription–polymerase chain reaction assays. Results Taking into account known risk factors of arterial hypertension, obesity, diabetes, or leukopenia, LT recipients a priori represented a high-risk cohort for severe COVID-19 with 101 of 219 (46.1%) presenting with more than 2 risk factors for severe COVID-19. Out of 219 LT recipients, 8 (3.7%) either had a positive test result for nasopharyngeal SARS-CoV-2 RNA or anti–SARS-CoV-2 serum IgG. Five of eight (62.5%) did not show any clinical signs of infection, three of eight (37.5%) had self-limited disease, and none required hospitalization for COVID-19. Two of eight (25%) had known exposure to infected health care staff as the probable source of infection. Conclusions In summary, LT recipients showed a SARS-CoV-2 seroconversion rate similar to that of the general population with a substantial percentage of unrecognized infections.
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Affiliation(s)
- Conrad Rauber
- Department for Gastroenterology and Infectious Diseases, University Hospital Heidelberg, Heidelberg, Germany.
| | - Shilpa Tiwari-Heckler
- Department for Gastroenterology and Infectious Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Jan Pfeiffenberger
- Department for Gastroenterology and Infectious Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Arianeb Mehrabi
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Frederike Lund
- Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Philip Gath
- Department for Gastroenterology, Städtisches Klinikum Ludwigshafen, Ludwigshafen, Germany
| | - Markus Mieth
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Uta Merle
- Department for Gastroenterology and Infectious Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Christian Rupp
- Department for Gastroenterology and Infectious Diseases, University Hospital Heidelberg, Heidelberg, Germany
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