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Abril AG, Alejandre J, Mariscal A, Alserawan L, Rabella N, Roman E, Lopez-Contreras J, Navarro F, Serrano E, Nomdedeu JF, Vidal S. Titers of IgG and IgA against SARS-CoV-2 proteins and their association with symptoms in mild COVID-19 infection. Sci Rep 2024; 14:12725. [PMID: 38830902 PMCID: PMC11148197 DOI: 10.1038/s41598-024-59634-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 04/12/2024] [Indexed: 06/05/2024] Open
Abstract
Humoral immunity in COVID-19 includes antibodies (Abs) targeting spike (S) and nucleocapsid (N) SARS-CoV-2 proteins. Antibody levels are known to correlate with disease severity, but titers are poorly reported in mild or asymptomatic cases. Here, we analyzed the titers of IgA and IgG against SARS-CoV-2 proteins in samples from 200 unvaccinated Hospital Workers (HWs) with mild COVID-19 at two time points after infection. We analyzed the relationship between Ab titers and patient characteristics, clinical features, and evolution over time. Significant differences in IgG and IgA titers against N, S1 and S2 proteins were found when samples were segregated according to time T1 after infection, seroprevalence at T1, sex and age of HWs and symptoms at infection. We found that IgM + samples had higher titers of IgG against N antigen and IgA against S1 and S2 antigens than IgM - samples. There were significant correlations between anti-S1 and S2 Abs. Interestingly, IgM + patients with dyspnea had lower titers of IgG and IgA against N, S1 and S2 than those without dyspnea. Comparing T1 and T2, we found that IgA against N, S1 and S2 but only IgG against certain Ag decreased significantly. In conclusion, an association was established between Ab titers and the development of infection symptoms.
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Affiliation(s)
- Andrés G Abril
- Departament Biologia Cel·lular, Facultat de Medicina, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Bellaterra, Spain
- Althaia Xarxa Assistencial Universitària de Manresa, 08243, Manresa, Spain
- Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IRIS-CC), 08500, Vic, Spain
| | - Jose Alejandre
- Grup de Malalties Inflamatòries, IIB-Sant Pau, Institut Recerca Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
| | - Anais Mariscal
- Servei d'Immunologia, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
| | - Leticia Alserawan
- Servei d'Immunologia, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
| | - Nuria Rabella
- Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
| | - Eva Roman
- Servei de Patologia Digestiva, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
| | - Joaquin Lopez-Contreras
- Servei de Malalties Infeccioses, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
| | - Ferran Navarro
- Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
| | | | - Josep F Nomdedeu
- Servei d'Hematologia, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
| | - Silvia Vidal
- Departament Biologia Cel·lular, Facultat de Medicina, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Bellaterra, Spain.
- Grup de Malalties Inflamatòries, IIB-Sant Pau, Institut Recerca Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain.
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Albrecht S, Grässli F, Cusini A, Brucher A, Goppel S, Betschon E, Möller JC, Ortner M, Ruetti M, Stocker R, Vuichard-Gysin D, Besold U, Risch L, Von Kietzell M, Schlegel M, Vernazza P, Kuster SP, Kahlert CR, Kohler P. SARS-CoV-2 immunity and reasons for non-vaccination among healthcare workers from eastern and northern Switzerland: results from a nested multicentre cross-sectional study. Swiss Med Wkly 2024; 154:3734. [PMID: 38689545 DOI: 10.57187/s.3734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
AIMS OF THE STUDY We aimed to assess the extent of SARS-CoV-2 humoral immunity elicited by previous infections and/or vaccination among healthcare workers, and to identify reasons why healthcare workers decided against vaccination. METHODS This nested cross-sectional study included volunteer healthcare workers from 14 healthcare institutions in German-speaking Switzerland. In January 2021, SARS-CoV-2 vaccines were available for healthcare workers. In May and June 2022, participants answered electronic questionnaires regarding baseline characteristics including SARS-CoV-2 vaccination status (with one or more vaccine doses defined as vaccinated) and previous SARS-CoV-2 infections. Unvaccinated participants indicated their reasons for non-vaccination. Participants underwent testing for SARS-CoV-2 anti-spike (anti-S) and anti-nucleocapsid (anti-N) antibodies. Antibody prevalence was described across age groups. In addition, we performed multivariable logistic regression to identify baseline characteristics independently associated with non-vaccination and described reasons for non-vaccination. RESULTS Among 22,438 eligible employees, 3,436 (15%) participated; the median age was 43.7 years (range 16-73), 2,794 (81.3%) were female, and 1,407 (47.7%) identified as nurses; 3,414 (99.4%) underwent serology testing, among whom 3,383 (99.0%) had detectable anti-S (3,357, 98.3%) antibodies, anti-N (2,396, 70.1%) antibodies, or both (2,370, 69.4%). A total of 296 (8.6%) healthcare workers were unvaccinated, whereas 3,140 (91.4%) were vaccinated. In multivariable analysis, age (adjusted OR [aOR] 1.02 per year, 95% CI 1.01-1.03), being a physician (aOR 3.22, 95% CI 1.75-5.92) or administrator (aOR 1.88, 95% CI 1.27-2.80), and having higher education (aOR 2.23, 95% CI 1.09-4.57) were positively associated with vaccine uptake, whereas working in non-acute care (aOR 0.58, 95% CI 0.34-0.97), active smoking (aOR 0.68, 95% CI 0.51-0.91), and taking prophylactic home remedies against SARS-CoV-2 (aOR 0.42, 95% CI 0.31-0.56) were negatively associated. Important reasons for non-vaccination were a belief that the vaccine might not have long-lasting immunity (267/291, 92.1%) and a preference for gaining naturally acquired instead of vaccine-induced immunity (241/289, 83.4%). CONCLUSIONS Almost all healthcare workers in our cohort had specific antibodies against SARS-CoV-2 from natural infection and/or from vaccination. Young healthcare workers and those working in non-acute settings were less likely to be vaccinated, whereas physicians and administrative staff showed higher vaccination uptake. Presumed ineffectiveness of the vaccine is an important reason for non-vaccination.
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Affiliation(s)
- Selina Albrecht
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Fabian Grässli
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Alexia Cusini
- Cantonal Hospital of Grisons, Division of Infectious Diseases, Chur, Switzerland
| | - Angela Brucher
- Psychiatry Services of the Canton of St. Gallen (South), Trübbach, Switzerland
| | - Stephan Goppel
- Psychiatry Services of the Canton of St. Gallen (North), Wil, Switzerland
| | | | - J Carsten Möller
- Center for Neurological Rehabilitation, Zihlschlacht, Switzerland
| | - Manuela Ortner
- Rheintal Werdenberg Sarganserland Hospital Group, Grabs, Switzerland
| | - Markus Ruetti
- Fuerstenland Toggenburg Hospital Group, Wil, Switzerland
| | | | - Danielle Vuichard-Gysin
- Thurgau Hospital Group, Division of Infectious Diseases and Hospital Epidemiology, Muensterlingen, Switzerland
- Swiss National Centre for Infection Prevention (Swissnoso), Berne, Switzerland
| | - Ulrike Besold
- Geriatric Clinic St. Gallen, St. Gallen, Switzerland
| | - Lorenz Risch
- Labormedizinisches Zentrum Dr Risch Ostschweiz AG, Buchs, Switzerland
- Private Universität im Fürstentum Liechtenstein, Institut für Labormedizin, Triesen, Liechtenstein
- Center of Laboratory Medicine, University Institute of Clinical Chemistry, University of Berne, Inselspital, Berne, Switzerland
| | | | - Matthias Schlegel
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Pietro Vernazza
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Stefan P Kuster
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Christian R Kahlert
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
- Children's Hospital of Eastern Switzerland, Department of Infectious Diseases and Hospital Epidemiology, St. Gallen, Switzerland
| | - Philipp Kohler
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
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3
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Grossmann K, Risch M, Markovic A, Aeschbacher S, Weideli OC, Velez L, Kovac M, Pereira F, Wohlwend N, Risch C, Hillmann D, Lung T, Renz H, Twerenbold R, Rothenbühler M, Leibovitz D, Kovacevic V, Klaver P, Brakenhoff TB, Franks B, Mitratza M, Downward GS, Dowling A, Montes S, Veen D, Grobbee DE, Cronin M, Conen D, Goodale BM, Risch L. Sex-specific differences in physiological parameters related to SARS-CoV-2 infections among a national cohort (COVI-GAPP study). PLoS One 2024; 19:e0292203. [PMID: 38446766 PMCID: PMC10917257 DOI: 10.1371/journal.pone.0292203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/04/2024] [Indexed: 03/08/2024] Open
Abstract
Considering sex as a biological variable in modern digital health solutions, we investigated sex-specific differences in the trajectory of four physiological parameters across a COVID-19 infection. A wearable medical device measured breathing rate, heart rate, heart rate variability, and wrist skin temperature in 1163 participants (mean age = 44.1 years, standard deviation [SD] = 5.6; 667 [57%] females). Participants reported daily symptoms and confounders in a complementary app. A machine learning algorithm retrospectively ingested daily biophysical parameters to detect COVID-19 infections. COVID-19 serology samples were collected from all participants at baseline and follow-up. We analysed potential sex-specific differences in physiology and antibody titres using multilevel modelling and t-tests. Over 1.5 million hours of physiological data were recorded. During the symptomatic period of infection, men demonstrated larger increases in skin temperature, breathing rate, and heart rate as well as larger decreases in heart rate variability than women. The COVID-19 infection detection algorithm performed similarly well for men and women. Our study belongs to the first research to provide evidence for differential physiological responses to COVID-19 between females and males, highlighting the potential of wearable technology to inform future precision medicine approaches.
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Affiliation(s)
- Kirsten Grossmann
- Private University in the Principality of Liechtenstein (UFL), Triesen, Principality of Liechtenstein
- Dr Risch Medical Laboratory, Vaduz, Liechtenstein
| | - Martin Risch
- Dr Risch Medical Laboratory, Vaduz, Liechtenstein
- Central Laboratory, Kantonsspital Graubünden, Chur, Switzerland
- Dr Risch Medical Laboratory, Buchs, Switzerland
| | - Andjela Markovic
- Ava AG, Zürich, Switzerland
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Stefanie Aeschbacher
- Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland
| | - Ornella C. Weideli
- Dr Risch Medical Laboratory, Vaduz, Liechtenstein
- Soneva Fushi, Boduthakurufaanu Magu, Male, Maldives
| | - Laura Velez
- Dr Risch Medical Laboratory, Vaduz, Liechtenstein
| | - Marc Kovac
- Dr Risch Medical Laboratory, Buchs, Switzerland
| | - Fiona Pereira
- Department of Metabolism, Digestive Diseases and Reproduction, Imperial College London, South Kensington Campus, London, United Kingdom
| | | | | | | | - Thomas Lung
- Dr Risch Medical Laboratory, Buchs, Switzerland
| | - Harald Renz
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University Marburg, Marburg, Germany
| | - Raphael Twerenbold
- Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Cardiology and University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | | | | | | | | | | | | | - Marianna Mitratza
- UMC Utrecht, Utrecht, The Netherlands
- Julius Global Health, the Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
| | - George S. Downward
- UMC Utrecht, Utrecht, The Netherlands
- Julius Global Health, the Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
| | - Ariel Dowling
- Takeda Pharmaceuticals, Digital Clinical Devices, Cambridge, Massachusetts, United States of America
| | | | - Duco Veen
- Department of Methodology and Statistics, Utrecht University, Utrecht, The Netherlands
- Optentia Research Programme, North-West University, Potchefstroom, South Africa
| | - Diederick E. Grobbee
- UMC Utrecht, Utrecht, The Netherlands
- Julius Global Health, the Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
| | | | - David Conen
- Population Health Research Institute, McMaster University, Hamilton, Canada
| | | | - Lorenz Risch
- Private University in the Principality of Liechtenstein (UFL), Triesen, Principality of Liechtenstein
- Dr Risch Medical Laboratory, Vaduz, Liechtenstein
- Dr Risch Medical Laboratory, Buchs, Switzerland
- Center of Laboratory Medicine, University Institute of Clinical Chemistry, University of Bern, Inselspital, Bern, Switzerland
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Trofor AC, Robu Popa D, Melinte OE, Trofor L, Vicol C, Grosu-Creangă IA, Crișan Dabija RA, Cernomaz AT. Looking at the Data on Smoking and Post-COVID-19 Syndrome-A Literature Review. J Pers Med 2024; 14:97. [PMID: 38248798 PMCID: PMC10821354 DOI: 10.3390/jpm14010097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
Long COVID is a recently described entity that is responsible for significant morbidity and that has consequences ranging from mild to life-threatening. The underlying mechanisms are not completely understood, and treatment options are currently limited, as existing data focus more on risk factors and predictors. Smoking has been reported as a risk factor for poor outcomes of acute SARS-CoV-2 infection and seems to also play a role in mediating post-COVID-19 symptoms. We aimed to review relevant work addressing the interaction between smoking and long COVID in order to characterize smoking's role as a risk factor and possibly identify new research directions. Methods: The PubMed/MEDLINE database was searched using the keywords 'smoking', 'long COVID', and 'post-acute COVID' to identify relevant English-language articles published up to October 2023. Results and conclusions: From the 374 initial hits, a total of 36 papers were deemed relevant to the aim of the review. There was significant variability concerning the ways in which tobacco usage was quantified and reported; still, there is compelling evidence linking smoking to an increased risk of developing manifestations of post-acute-COVID disease. Some clinical conditions, such as dyspnea, cardiovascular symptoms, and cognitive or mental-health impairment, seem to be relatively strongly associated with smoking, while the connection between smoking and upper-airway involvement seems less certain. The available data support recommending smoking cessation as a clinical tool for the prevention of long COVID.
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Affiliation(s)
- Antigona Carmen Trofor
- Discipline of Pneumology, III-rd Medical Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.C.T.); (O.E.M.); (C.V.); (I.A.G.-C.); (R.A.C.D.); (A.T.C.)
- Clinical Hospital of Pulmonary Diseases, 700116 Iasi, Romania
| | - Daniela Robu Popa
- Discipline of Pneumology, III-rd Medical Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.C.T.); (O.E.M.); (C.V.); (I.A.G.-C.); (R.A.C.D.); (A.T.C.)
| | - Oana Elena Melinte
- Discipline of Pneumology, III-rd Medical Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.C.T.); (O.E.M.); (C.V.); (I.A.G.-C.); (R.A.C.D.); (A.T.C.)
- Clinical Hospital of Pulmonary Diseases, 700116 Iasi, Romania
| | | | - Cristina Vicol
- Discipline of Pneumology, III-rd Medical Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.C.T.); (O.E.M.); (C.V.); (I.A.G.-C.); (R.A.C.D.); (A.T.C.)
| | - Ionela Alina Grosu-Creangă
- Discipline of Pneumology, III-rd Medical Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.C.T.); (O.E.M.); (C.V.); (I.A.G.-C.); (R.A.C.D.); (A.T.C.)
- Clinical Hospital of Pulmonary Diseases, 700116 Iasi, Romania
| | - Radu Adrian Crișan Dabija
- Discipline of Pneumology, III-rd Medical Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.C.T.); (O.E.M.); (C.V.); (I.A.G.-C.); (R.A.C.D.); (A.T.C.)
- Clinical Hospital of Pulmonary Diseases, 700116 Iasi, Romania
| | - Andrei Tudor Cernomaz
- Discipline of Pneumology, III-rd Medical Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.C.T.); (O.E.M.); (C.V.); (I.A.G.-C.); (R.A.C.D.); (A.T.C.)
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Ergun T, Hosgoren Tekin S, Apti Sengun O, Akin Cakici O, Seckin D, Adiay C, Enul H, Yilmaz S, Ay P, Haklar G, Sili U. Immunogenicity, efficacy, and safety of CoronaVac and Pfizer/BioNTech mRNA vaccines in patients with psoriasis receiving systemic therapies: A prospective cohort study. Vaccine 2023:S0264-410X(23)00615-1. [PMID: 37277251 DOI: 10.1016/j.vaccine.2023.05.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 05/08/2023] [Accepted: 05/18/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND OBJECTIVES Evidence of immune response to COVID-19 vaccine in psoriasis patients on biological agents is lacking. This study aimed to evaluate SARS-CoV-2 antibody levels following vaccination with CoronaVac or Pfizer/BioNTech mRNA in patients using biological agents or methotrexate, high-titer antibody levels achievement rate, and impact of medications on immunogenicity. METHODS This noninterventional, prospective cohort study included 89 patients and 40 controls vaccinated with two doses of inactivated (CoronaVac) or Pfizer/BioNTech mRNA vaccines. Anti-spike and neutralising antibodies were analysed before and three to six weeks after the second dose. Adverse effects and symptomatic COVID-19 were assessed. RESULTS Median anti-spike and neutralising antibody titers after CoronaVac were significantly lower in patients than controls (57.92 U/mL vs 125.4 U/mL, and 1/6 vs 1/32, respectively, p < 0.05). Patients were less likely to achieve high-titer anti-spike antibody levels (25.6 % vs 50 %). Infliximab was associated with attenuated vaccine response. Pfizer/BioNTech vaccine induced comparable median anti-spike (2,080 U/mL vs 2,976.5 U/mL,) and neutralising antibody levels (1/96 vs 1/160) in patients and controls, respectively (p > 0.05). High-titer anti-spike and neutralising antibodies development rates were comparable among patients and controls (95.2 % vs 100 %, and 30.4 % vs 50.0 %, respectively, p > 0.05). Nine (10.1 %) COVID-19 cases- all mild - were identified. Psoriasis flare was seen in 6.74 %, mostly after Pfizer/BioNTech vaccine. CONCLUSION Psoriasis patients treated with biological agents and methotrexate developed similar response to mRNA vaccine but weaker response to inactivated vaccine. Infliximab reduced response to the inactivated vaccine. Adverse effects were more frequent with mRNA vaccine, but none was severe.
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Affiliation(s)
- Tulin Ergun
- Marmara University, School of Medicine, Department of Dermatology, Istanbul, Turkey.
| | | | - Ozlem Apti Sengun
- Marmara University, School of Medicine, Department of Dermatology, Istanbul, Turkey
| | - Ozlem Akin Cakici
- Marmara University, School of Medicine, Department of Dermatology, Istanbul, Turkey
| | - Dilek Seckin
- Marmara University, School of Medicine, Department of Dermatology, Istanbul, Turkey
| | - Cumhur Adiay
- Pendik Veterinary Control Institute, Istanbul, Turkey
| | - Hakan Enul
- Pendik Veterinary Control Institute, Istanbul, Turkey
| | - Seval Yilmaz
- Marmara University, School of Medicine, Department of Biochemistry, Istanbul, Turkey
| | - Pinar Ay
- Marmara University, School of Medicine, Department of Public Health, Istanbul, Turkey
| | - Goncagul Haklar
- Marmara University, School of Medicine, Department of Biochemistry, Istanbul, Turkey
| | - Uluhan Sili
- Marmara University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
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Sunada N, Honda H, Nakano Y, Yamamoto K, Tokumasu K, Sakurada Y, Matsuda Y, Hasegawa T, Otsuka Y, Obika M, Hanayama Y, Hagiya H, Ueda K, Kataoka H, Otsuka F. Hormonal trends in patients suffering from long COVID symptoms. Endocr J 2022; 69:1173-1181. [PMID: 35491089 DOI: 10.1507/endocrj.ej22-0093] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Symptoms of long COVID are complex and long-lasting, and endocrine dysfunction might be involved in the underlying mechanisms. In this study, to clarify the hormonal characteristics of long COVID patients, laboratory data for patients who visited the outpatient clinic for long COVID were evaluated. A retrospective analysis was performed for patients who visited Okayama University Hospital during the period from Feb 2021 to Dec 2021 with focus on the interrelationships between major symptoms and endocrine data. Information and laboratory data were obtained from medical records for 186 patients. The patients had various symptoms, and the most frequent symptoms were general malaise, dysosmia/dysgeusia, hair loss, headache, dyspnea, and sleeplessness. Patients who were suffering from fatigue and dysosmia/dysgeusia were younger, while hair loss was more frequent in older and female patients. As for the characteristics of patients suffering from general fatigue, the scores of depression and fatigue were positively correlated with serum levels of cortisol and free thyroxin (FT4), respectively. Also, patients suffering from general fatigue had lower levels of serum growth hormone and higher levels of serum FT4, while patients with dysosmia/dysgeusia had a significantly lower level of serum cortisol. Serum thyrotropin (TSH) levels were higher and the ratios of FT4/TSH were lower in the initially severe cases, suggesting occult hypothyroidism. In addition, the ratios of plasma adrenocorticotropin to serum cortisol were decreased in patients with relatively high titers of serum SARS-CoV-2 antibody. Thus, hormonal changes seem to be, at least in part, involved in the persistent symptoms of long COVID.
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Affiliation(s)
- Naruhiko Sunada
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Hiroyuki Honda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Yasuhiro Nakano
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Koichiro Yamamoto
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Kazuki Tokumasu
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Yasue Sakurada
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Yui Matsuda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Toru Hasegawa
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Yuki Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Mikako Obika
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Yoshihisa Hanayama
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Keigo Ueda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Hitomi Kataoka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
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7
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Dobaño C, Ramírez-Morros A, Alonso S, Rubio R, Ruiz-Olalla G, Vidal-Alaball J, Macià D, Catalina QM, Vidal M, Casanovas AF, Prados de la Torre E, Barrios D, Jiménez A, Zanoncello J, Melero NR, Carolis C, Izquierdo L, Aguilar R, Moncunill G, Ruiz-Comellas A. Sustained seropositivity up to 20.5 months after COVID-19. BMC Med 2022; 20:379. [PMID: 36224590 PMCID: PMC9556137 DOI: 10.1186/s12916-022-02570-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/15/2022] [Indexed: 01/09/2023] Open
Abstract
This study evaluated the persistence of IgM, IgA, and IgG to SARS-CoV-2 spike and nucleocapsid antigens up to 616 days since the onset of symptoms in a longitudinal cohort of 247 primary health care workers from Barcelona, Spain, followed up since the start of the pandemic. The study also assesses factors affecting antibody levels, including comorbidities and the responses to variants of concern as well as the frequency of reinfections. Despite a gradual and significant decline in antibody levels with time, seropositivity to five SARS-CoV-2 antigens combined was always higher than 90% over the whole study period. In a subset of 23 participants who had not yet been vaccinated by November 2021, seropositivity remained at 95.65% (47.83% IgM, 95.65% IgA, 95.65% IgG). IgG seropositivity against Alpha and Delta predominant variants was comparable to that against the Wuhan variant, while it was lower for Gamma and Beta (minority) variants and for IgA and IgM. Antibody levels at the time point closest to infection were associated with age, smoking, obesity, hospitalization, fever, anosmia/hypogeusia, chest pain, and hypertension in multivariable regression models. Up to 1 year later, just before the massive roll out of vaccination, antibody levels were associated with age, occupation, hospitalization, duration of symptoms, anosmia/hypogeusia, fever, and headache. In addition, tachycardia and cutaneous symptoms associated with slower antibody decay, and oxygen supply with faster antibody decay. Eight reinfections (3.23%) were detected in low responders, which is consistent with a sustained protective role for anti-spike naturally acquired antibodies. Stable persistence of IgG and IgA responses and cross-recognition of the predominant variants circulating in the 2020-2021 period indicate long-lasting and largely variant-transcending humoral immunity in the initial 20.5 months of the pandemic, in the absence of vaccination.
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Affiliation(s)
- Carlota Dobaño
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Spain.
- CIBER de Enfermedades Infecciosas, Barcelona, Spain.
| | - Anna Ramírez-Morros
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Selena Alonso
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Spain
| | - Rocío Rubio
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Spain
| | - Gemma Ruiz-Olalla
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Spain
| | - Josep Vidal-Alaball
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
- Grup de Promoció de la Salut en l'Àmbit Rural (ProSaARu), Institut Català de la Salut, Sant Fruitós de Bages, Spain
- Facultat de Medicina, Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Spain
| | - Dídac Macià
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Spain
- CIBER de Enfermedades Infecciosas, Barcelona, Spain
| | - Queralt Miró Catalina
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Spain
| | - Aina Fuster Casanovas
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Esther Prados de la Torre
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Spain
| | - Diana Barrios
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Spain
| | - Alfons Jiménez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Spain
| | - Jasmina Zanoncello
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Spain
| | - Natalia Rodrigo Melero
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Carlo Carolis
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Luis Izquierdo
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Spain
- CIBER de Enfermedades Infecciosas, Barcelona, Spain
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Spain
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Spain
- CIBER de Enfermedades Infecciosas, Barcelona, Spain
| | - Anna Ruiz-Comellas
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
- Grup de Promoció de la Salut en l'Àmbit Rural (ProSaARu), Institut Català de la Salut, Sant Fruitós de Bages, Spain
- Facultat de Medicina, Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Spain
- Centre d'Atenció Primària (CAP) Sant Joan de Vilatorrada. Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
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Serology suggests adequate safety measures to protect healthcare workers from COVID-19 in Shiga Prefecture, Japan. PLoS One 2022; 17:e0270334. [PMID: 35749426 PMCID: PMC9231724 DOI: 10.1371/journal.pone.0270334] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 06/08/2022] [Indexed: 01/24/2023] Open
Abstract
Healthcare workers (HCWs), especially frontline workers against coronavirus disease 2019 (COVID-19), are considered to be risky because of occupational exposure to infected patients. This study evaluated the correlation between seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies among HCWs and the implementation of personal protective equipment (PPE) & infection prevention and control (IPC). We recruited 1237 HCWs from nine public COVID-19-designated hospitals in Shiga Prefecture, central Japan, between 15-26 February 2021. All participants answered a self-administered questionnaire and provided blood samples to evaluate SARS-CoV-2 antibodies. A total of 22 cases (1·78%) were seropositive among the 1237 study participants. An unavoidable outbreak of SARS-CoV-2 had occurred at the terminal care unit of one hospital, before identifying and securely isolating this cluster of cases. Excluding with this cluster, 0·68% of HCWs were suspected to have had previous SARS-CoV-2 infections. Binomial logistic regression from individual questionnaires and seropositivity predicted a significant correlation with N95 mask implementation under aerosol conditions (p = 8.63e-06, aOR = 2.47) and work duration in a red zone (p = 2.61e-04, aOR = 1.99). The institutional questionnaire suggested that IPC education was correlated with reduced seropositivity at hospitals. Seroprevalence and questionnaire analyses among HCWs indicated that secure implementation of PPE and re-education of IPC are essential to prevent SARS-CoV-2 infection within healthcare facilities. Occupational infections from SARS-CoV-2 in healthcare settings could be prevented by adhering to adequate measures and appropriate use of PPE. With these measures securely implemented, HCWs should not be considered against as significantly risky or dirty by local communities.
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Chansaenroj J, Yorsaeng R, Puenpa J, Wanlapakorn N, Chirathaworn C, Sudhinaraset N, Sripramote M, Chalongviriyalert P, Jirajariyavej S, Kiatpanabhikul P, Saiyarin J, Soudon C, Thienfaidee O, Ayuthaya TPN, Brukesawan C, Intharasongkroh D, Chaiwanichsiri D, Issarasongkhram M, Kitphati R, Mungaomklang A, Thitithanyanont A, Nagavajara P, Poovorawan Y. Long-term persistence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein-specific and neutralizing antibodies in recovered COVID-19 patients. PLoS One 2022; 17:e0267102. [PMID: 35446889 PMCID: PMC9022880 DOI: 10.1371/journal.pone.0267102] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/01/2022] [Indexed: 12/12/2022] Open
Abstract
Understanding antibody responses after natural severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can guide the coronavirus disease 2019 (COVID-19) vaccine schedule, especially in resource-limited settings. This study aimed to assess the dynamics of SARS-CoV-2 antibodies, including anti-spike protein 1 (S1) immunoglobulin (Ig)G, anti-receptor-binding domain (RBD) total Ig, anti-S1 IgA, and neutralizing antibody against wild-type SARS-CoV-2 over time in a cohort of patients who were previously infected with the wild-type SARS-CoV-2. Between March and May 2020, 531 individuals with virologically confirmed cases of wild-type SARS-CoV-2 infection were enrolled in our immunological study. Blood samples were collected at 3-, 6-, 9-, and 12-months post symptom onset or detection of SARS-CoV-2 by RT-PCR (in asymptomatic individuals). The neutralizing titers against SARS-CoV-2 were detected in 95.2%, 86.7%, 85.0%, and 85.4% of recovered COVID-19 patients at 3, 6, 9, and 12 months after symptom onset, respectively. The seropositivity rate of anti-S1 IgG, anti-RBD total Ig, anti-S1 IgA, and neutralizing titers remained at 68.6%, 89.6%, 77.1%, and 85.4%, respectively, at 12 months after symptom onset. We observed a high level of correlation between neutralizing and SARS-CoV-2 spike protein-specific antibody titers. The half-life of neutralizing titers was estimated at 100.7 days (95% confidence interval = 44.5–327.4 days, R2 = 0.106). These results support that the decline in serum antibody levels over time in both participants with severe disease and mild disease were depended on the symptom severity, and the individuals with high IgG antibody titers experienced a significantly longer persistence of SARS-CoV-2-specific antibody responses than those with lower titers.
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Affiliation(s)
- Jira Chansaenroj
- Faculty of Medicine, Department of Pediatrics, Center of Excellence in Clinical Virology, Chulalongkorn University, Bangkok, Thailand
| | - Ritthideach Yorsaeng
- Faculty of Medicine, Department of Pediatrics, Center of Excellence in Clinical Virology, Chulalongkorn University, Bangkok, Thailand
| | - Jiratchaya Puenpa
- Faculty of Medicine, Department of Pediatrics, Center of Excellence in Clinical Virology, Chulalongkorn University, Bangkok, Thailand
| | - Nasamon Wanlapakorn
- Faculty of Medicine, Department of Pediatrics, Center of Excellence in Clinical Virology, Chulalongkorn University, Bangkok, Thailand
| | - Chintana Chirathaworn
- Faculty of Medicine, Department of Pediatrics, Center of Excellence in Clinical Virology, Chulalongkorn University, Bangkok, Thailand
| | - Natthinee Sudhinaraset
- Faculty of Medicine, Department of Pediatrics, Center of Excellence in Clinical Virology, Chulalongkorn University, Bangkok, Thailand
| | - Manit Sripramote
- Medical Service Department, Bangkok Metropolitan Administration, Bangkok, Thailand
| | | | - Supunee Jirajariyavej
- Taksin Hospital, Medical Service Department, Bangkok Metropolitan Administration, Bangkok, Thailand
| | - Phatharaporn Kiatpanabhikul
- Medical Service Department, Charoenkrung Pracharak Hospital, Bangkok Metropolitan Administration, Bangkok, Thailand
| | - Jatuporn Saiyarin
- Medical Service Department, Klang General Hospital, Bangkok Metropolitan Administration, Bangkok, Thailand
| | - Chulikorn Soudon
- Medical Service Department, Sirindhorn Hospital, Bangkok Metropolitan Administration, Bangkok, Thailand
| | - Orawan Thienfaidee
- Medical Service Department, Ratchaphiphat Hospital, Bangkok Metropolitan Administration, Bangkok, Thailand
| | | | - Chantapat Brukesawan
- Health Department, Public Health Center 26, Bangkok Metropolitan Administration, Bangkok, Thailand
| | | | | | - Mila Issarasongkhram
- Department of Disease Control, Institute for Urban Disease Control and Prevention, Ministry of Public Health, Bangkok, Thailand
| | - Rungrueng Kitphati
- Department of Disease Control, Institute for Urban Disease Control and Prevention, Ministry of Public Health, Bangkok, Thailand
| | - Anek Mungaomklang
- Department of Disease Control, Institute for Urban Disease Control and Prevention, Ministry of Public Health, Bangkok, Thailand
| | | | - Pijaya Nagavajara
- Office of the Permanent Secretary for the Bangkok Metropolitan Administration, Bangkok, Thailand
| | - Yong Poovorawan
- Faculty of Medicine, Department of Pediatrics, Center of Excellence in Clinical Virology, Chulalongkorn University, Bangkok, Thailand
- * E-mail:
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10
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Kitamura M, Takazono T, Yamamoto K, Harada T, Funakoshi S, Mukae H, Nishino T. Low humoral immune response to the BNT162b2 vaccine against COVID-19 in nursing home residents undergoing hemodialysis: a case-control observational study. RENAL REPLACEMENT THERAPY 2022; 8:8. [PMID: 35308296 PMCID: PMC8924726 DOI: 10.1186/s41100-022-00397-5] [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: 09/11/2021] [Accepted: 03/08/2022] [Indexed: 12/30/2022] Open
Abstract
Background Patients on hemodialysis (HD) face a high mortality risk from coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and they are therefore prioritized for vaccination. However, the efficacy of vaccination in this vulnerable population has not been confirmed. Although age is negatively correlated with serum immunoglobulin (Ig) levels, humoral responses to vaccination in elderly patients undergoing HD have not been investigated. To address this issue, we evaluated the anti-SARS-CoV-2 spike protein antibodies in nursing home residents on HD after BNT162b2 vaccine administration. Methods Patients on HD from a nursing home and care workers (controls) receiving two doses of the BNT162b2 vaccine between April and May 2021 were enrolled in this study. Those with a prior history of COVID-19 were excluded. Anti-spike protein antibodies were measured with the Elecsys (Roche) immunoassay system. Results The study included 26 nursing home residents (41% male; median age, 86 years) and 184 care workers (28% male; median age, 45 years). The median HD vintage was 51 months. After two doses of BNT162b2, 73% of the nursing home residents and 99.5% of the control group developed sufficient anti-spike protein antibodies (> 29 U/mL) to neutralize SARS-CoV-2. Three weeks after the second dose, median IgG titers of the residents and care workers were 83 [interquartile range (IQR) 17–511] and 1365 (IQR 847–2245) U/mL, respectively (p < 0.001). Conclusions The humoral response to BNT162b2 among elderly HD patients was relatively low; therefore, the optimal vaccination strategy for this population should be studied further to avoid COVID-19 outbreaks in healthcare facilities. Supplementary Information The online version contains supplementary material available at 10.1186/s41100-022-00397-5.
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Affiliation(s)
- Mineaki Kitamura
- Nagasaki Renal Center, Nagasaki, Japan.,Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Takahiro Takazono
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Kazuko Yamamoto
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | | | | | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.,Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomoya Nishino
- Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
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11
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Serial Changes of Long COVID Symptoms and Clinical Utility of Serum Antibody Titers for Evaluation of Long COVID. J Clin Med 2022; 11:jcm11051309. [PMID: 35268400 PMCID: PMC8911256 DOI: 10.3390/jcm11051309] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 12/13/2022] Open
Abstract
Background: Various symptoms persist even after the acute symptoms in about one third of patients with COVID-19. In February 2021, we established an outpatient clinic in a university hospital for patients with long COVID and started medical treatment for sequelae that persisted one month or more after infection. Methods: To determine the key factors that affect the onset and clinical course of sequelae, a retrospective analysis was performed at Okayama University Hospital (Japan) between February and July 2021. We focused on changes in the numbers of symptoms and the background of the patients during a three-month period from the first outpatient visit. We also examined the relationship with SARS-CoV-2 antibody titers. Results: Information was obtained from medical records for 65 patients. The symptoms of sequelae were diverse, with more than 20 types. The most frequent symptoms were general malaise, dysosmia, dysgeusia, sleeplessness, and headache. These symptoms improved in about 60% of the patients after 3 months. Patients who required hospitalization and had a poor condition in the acute phase and patients who received oxygen/dexamethasone therapy had higher antibody titers at the time of consultation. Patients with antibody titers ≥200 U/mL showed significantly fewer improvements in long COVID symptoms in 1 month, but they showed improvements at 3 months after the first visit. Conclusion: Long COVID symptoms were improved at 3 months after the initial visit in more than half of the patients. Serum antibody titers were higher in patients who experienced a severe acute phase, but the serum antibody titers did not seem to be directly related to the long-term persistence of long COVID symptoms.
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12
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Sumer J, Flury D, Kahlert CR, Mueller NJ, Risch L, Nigg S, Seneghini M, Vernazza P, Schlegel M, Kohler P. Safety Evaluation of a Medical Congress Held During the COVID-19 Pandemic-A Prospective Cohort. Int J Public Health 2022; 67:1604147. [PMID: 35250429 PMCID: PMC8889572 DOI: 10.3389/ijph.2022.1604147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 01/21/2022] [Indexed: 12/29/2022] Open
Abstract
Objectives: During the COVID-19 pandemic, few scientific congresses have been held on-site. We prospectively evaluated the safety concept of the congress of the Swiss Societies of Infectious Diseases and Hospital Hygiene. Methods: The congress was held in Geneva (Switzerland) while local COVID-19 incidence (with SARS-CoV-2 wild type circulating) was 65/100,000 population (September 2020). A rigorous safety concept was implemented. Congress attendees filled out a questionnaire to assess risk perception, exposures, symptoms and diagnoses of SARS-CoV-2 before, during and after the congress. Dried blood spots were taken on-site and 4 weeks later to detect SARS-CoV-2 seroconversions. Results: Of 365 congress attendees, 196 (54%) either answered the questionnaire (N = 150) or provided baseline and follow-up blood samples (N = 168). None of the participants reported a positive PCR in the 2 weeks after the congress. Five of 168 (3%) participants were seropositive at follow-up, all of which had already been positive at baseline. Conclusion: Findings indicate that congresses with a rigorous safety concept may take place, even in areas with moderately-high COVID-19 activity. Whether this holds true in vaccinated populations and with more transmissible viral variants circulating remains unclear.
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Affiliation(s)
- Johannes Sumer
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St Gallen, Switzerland
| | - Domenica Flury
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St Gallen, Switzerland
| | - Christian R. Kahlert
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St Gallen, Switzerland
| | - Nicolas J. Mueller
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zürich, Zürich, Switzerland
| | - Lorenz Risch
- Labormedizinische Zentrum Dr Risch, Bern, Switzerland
| | - Susanne Nigg
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St Gallen, Switzerland
| | - Marco Seneghini
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St Gallen, Switzerland
| | - Pietro Vernazza
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St Gallen, Switzerland
| | - Matthias Schlegel
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St Gallen, Switzerland
| | - Philipp Kohler
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St Gallen, Switzerland
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Karachaliou M, Moncunill G, Espinosa A, Castaño-Vinyals G, Jiménez A, Vidal M, Santano R, Barrios D, Puyol L, Carreras A, Mayer L, Rubio R, Cortés B, Pleguezuelos V, O'Callaghan-Gordo C, Fossati S, Rivas I, Casabonne D, Vrijheid M, Izquierdo L, Aguilar R, Basagaña X, Garcia-Aymerich J, de Cid R, Dobaño C, Kogevinas M. Infection induced SARS-CoV-2 seroprevalence and heterogeneity of antibody responses in a general population cohort study in Catalonia Spain. Sci Rep 2021; 11:21571. [PMID: 34732749 PMCID: PMC8566562 DOI: 10.1038/s41598-021-00807-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/12/2021] [Indexed: 12/23/2022] Open
Abstract
Sparse data exist on the complex natural immunity to SARS-CoV-2 at the population level. We applied a well-validated multiplex serology test in 5000 participants of a general population study in Catalonia in blood samples collected from end June to mid November 2020. Based on responses to fifteen isotype-antigen combinations, we detected a seroprevalence of 18.1% in adults (n = 4740), and modeled extrapolation to the general population of Catalonia indicated a 15.3% seroprevalence. Antibodies persisted up to 9 months after infection. Immune profiling of infected individuals revealed that with increasing severity of infection (asymptomatic, 1-3 symptoms, ≥ 4 symptoms, admitted to hospital/ICU), seroresponses were more robust and rich with a shift towards IgG over IgA and anti-spike over anti-nucleocapsid responses. Among seropositive participants, lower antibody levels were observed for those ≥ 60 years vs < 60 years old and smokers vs non-smokers. Overweight/obese participants vs normal weight had higher antibody levels. Adolescents (13-15 years old) (n = 260) showed a seroprevalence of 11.5%, were less likely to be tested seropositive compared to their parents and had dominant anti-spike rather than anti-nucleocapsid IgG responses. Our study provides an unbiased estimate of SARS-CoV-2 seroprevalence in Catalonia and new evidence on the durability and heterogeneity of post-infection immunity.
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Affiliation(s)
| | - Gemma Moncunill
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Ana Espinosa
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | | | - Alfons Jiménez
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 08036, Madrid, Spain
| | - Marta Vidal
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Rebeca Santano
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Diana Barrios
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Laura Puyol
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Anna Carreras
- Genomes for Life-GCAT Lab, Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Leonie Mayer
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Rocío Rubio
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Beatriz Cortés
- Genomes for Life-GCAT Lab, Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
| | | | - Cristina O'Callaghan-Gordo
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 08036, Madrid, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Serena Fossati
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Ioar Rivas
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Delphine Casabonne
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 08036, Madrid, Spain
- Unit of Molecular and Genetic Epidemiology in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Hospitalet De Llobregat, Spain
| | - Martine Vrijheid
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 08036, Madrid, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Luis Izquierdo
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Ruth Aguilar
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Xavier Basagaña
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Judith Garcia-Aymerich
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 08036, Madrid, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Rafael de Cid
- Genomes for Life-GCAT Lab, Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Carlota Dobaño
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Manolis Kogevinas
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 08036, Madrid, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain
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Maraqa B, Basha W, Khayyat R, Abdul-Hadi AR, Jabareen J, Al-Shakhra K, Al-Kaila M, Nazzal Z. Prevalence of SARS-CoV-2 antibodies in the Palestinian population: A primary health center-based cross-sectional study. PLoS One 2021; 16:e0258255. [PMID: 34624024 PMCID: PMC8500452 DOI: 10.1371/journal.pone.0258255] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/22/2021] [Indexed: 12/22/2022] Open
Abstract
This study aimed to assess the prevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) total antibodies in the north, middle, and south regions of West Bank and the prevalence of SARS-CoV-2 specific antibodies (IgA, IgM, and IgG) in the Palestinian population. This was a cross-sectional study. The serological and epidemiological data of 1269 persons were assessed. Participants were selected randomly among primary health care center attendees in Palestine between November 1, 2020 and December 31, 2020. All serum samples were tested for total antibodies using an enzyme-linked immunosorbent assay (ELISA) test. IgM, IgG, and IgA-specific antibody titers were measured using ELISA. The overall prevalence (with 95% confidence intervals [CIs]) of SARS-CoV-2 total antibodies and specific antibodies were estimated. A multivariate regression model was used to assess the predictive factors for SARS-CoV-2-specific antibodies. The overall seroprevalence of SARS-CoV-2 antibodies was 24·0% (95% CI, 21·7%–26·5%). Seroprevalence was significantly higher among people living in south West Bank (adjusted Odds ratio [aOR], 2·22; 95% CI: 1·58–3·11), people who had COVID-19 symptoms (aOR, 3·92; 95% CI, 2·83–5·43), people with a COVID-19 contact history (aOR, 1·44; 95% CI, 1·03–2·03), patients with hypertension (aOR, 1·57; 95% CI, 1·06–2·33), and non-smokers (aOR, 0·47; 95% CI, 0·31–0·72). A total of 171 blood samples from SARS-CoV-2-positive patients were chosen at random for additional serological testing. Specific IgM, IgG, and IgA antibodies were positive in 14·0% (95% CI, 9·2%–20·2%), 88·3% (82·5%–92·7%), and 42·1% (34·6%–59·9%) of the samples, respectively. SARS-CoV-2 antibodies were common among PHC center attendees and were significantly associated to sex, smoking, and COVID-19 contact history. However, considering that almost three-quarters of this population remains susceptible, maintaining public health measures and encouraging access to immunization is critical in protecting this population.
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Affiliation(s)
- Beesan Maraqa
- Primary Health Directorate, Ministry of Health, Nablus, Palestine
| | - Walid Basha
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Rasha Khayyat
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | | | - Jurouh Jabareen
- Primary Health Directorate, Ministry of Health, Nablus, Palestine
| | - Kamal Al-Shakhra
- Primary Health Directorate, Ministry of Health, Nablus, Palestine
| | | | - Zaher Nazzal
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- * E-mail:
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15
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Carreño JM, Mendu DR, Simon V, Shariff MA, Singh G, Menon V, Krammer F. Longitudinal analysis of severe acute respiratory syndrome coronavirus 2 seroprevalence using multiple serology platforms. iScience 2021; 24:102937. [PMID: 34368647 PMCID: PMC8324485 DOI: 10.1016/j.isci.2021.102937] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/28/2021] [Accepted: 07/29/2021] [Indexed: 11/30/2022] Open
Abstract
Current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological tests are based on the full-length spike (S), the receptor-binding domain (RBD), or the nucleoprotein (NP) as substrates. Here, we used samples from healthcare workers (HCWs) to perform a longitudinal analysis of the antibody responses using a research-grade RBD and spike-based enzyme-linked immunosorbent assay (ELISA), a commercial RBD and spike-based ELISA, and a commercial NP-based chemiluminescent microparticle immunoassay. Seroprevalence ranged around 28% early during the pandemic and a good correlation was observed between RBD and spike-based ELISAs. Modest correlations were observed between NP and both RBD and spike-based assays. The antibody levels in HCWs declined over time; however, the overall seroprevalence measured by RBD and spike-based assays remained unchanged, while the seroprevalence of NP-reactive antibodies significantly declined. Moreover, RBD and spike-based assays effectively detected seroconversion in vaccinees. Overall, our results consolidate the strength of different serological assays to assess the magnitude and duration of antibodies to SARS-CoV-2.
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Affiliation(s)
- Juan Manuel Carreño
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Damodara Rao Mendu
- Clinical Microbiology Laboratory, Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Viviana Simon
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- The Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Masood A. Shariff
- Department of Internal Medicine, NYC Health + Hospitals/Lincoln, The Bronx, NY 10451, USA
| | - Gagandeep Singh
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Vidya Menon
- Department of Internal Medicine, NYC Health + Hospitals/Lincoln, The Bronx, NY 10451, USA
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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16
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Linardou H, Spanakis N, Koliou GA, Christopoulou A, Karageorgopoulou S, Alevra N, Vagionas A, Tsoukalas N, Sgourou S, Fountzilas E, Sgouros J, Razis E, Chatzokou D, Lampaki S, Res E, Saridaki Z, Mountzios G, Saroglou G, Fountzilas G. Responses to SARS-CoV-2 Vaccination in Patients with Cancer (ReCOVer Study): A Prospective Cohort Study of the Hellenic Cooperative Oncology Group. Cancers (Basel) 2021; 13:4621. [PMID: 34572848 PMCID: PMC8466969 DOI: 10.3390/cancers13184621] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/11/2021] [Accepted: 09/13/2021] [Indexed: 01/03/2023] Open
Abstract
Data on the effectiveness and safety of approved SARS-CoV-2 vaccines in cancer patients are limited. This observational, prospective cohort study investigated the humoral immune response to SARS-CoV-2 vaccination in 232 cancer patients from 12 HeCOG-affiliated oncology departments compared to 100 healthcare volunteers without known active cancer. The seropositivity rate was measured 2-4 weeks after two vaccine doses, by evaluating neutralising antibodies against the SARS-CoV-2 spike protein using a commercially available immunoassay. Seropositivity was defined as ≥33.8 Binding-Antibody-Units (BAU)/mL. A total of 189 patients and 99 controls were eligible for this analysis. Among patients, 171 (90.5%) were seropositive after two vaccine doses, compared to 98% of controls (p = 0.015). Most seronegative patients were males (66.7%), >70-years-old (55.5%), with comorbidities (61.1%), and on active treatment (88.9%). The median antibody titers among patients were significantly lower than those of the controls (523 vs. 2050 BAU/mL; p < 0.001). The rate of protective titers was 54.5% in patients vs. 97% in controls (p < 0.001). Seropositivity rates and IgG titers in controls did not differ for any studied factor. In cancer patients, higher antibody titers were observed in never-smokers (p = 0.006), women (p = 0.022), <50-year-olds (p = 0.004), PS 0 (p = 0.029), and in breast or ovarian vs. other cancers. Adverse events were comparable to registration trials. In this cohort study, although the seropositivity rate after two vaccine doses in cancer patients seemed satisfactory, their antibody titers were significantly lower than in controls. Monitoring of responses and further elucidation of the clinical factors that affect immunity could guide adaptations of vaccine strategies for vulnerable subgroups.
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Affiliation(s)
- Helena Linardou
- Fourth Oncology Department and Comprehensive Clinical Trials Centre, Metropolitan Hospital, 18547 Athens, Greece; (N.A.); (S.S.)
| | - Nikolaos Spanakis
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11524 Athens, Greece;
- AlfaLab, Hellenic HealthCare Group, 11524 Athens, Greece;
| | - Georgia-Angeliki Koliou
- Section of Biostatistics, Hellenic Cooperative Oncology Group, Data Office, 11526 Athens, Greece;
| | | | | | - Nephely Alevra
- Fourth Oncology Department and Comprehensive Clinical Trials Centre, Metropolitan Hospital, 18547 Athens, Greece; (N.A.); (S.S.)
| | | | - Nikolaos Tsoukalas
- Department of Oncology, 401 General Military Hospital of Athens, 11525 Athens, Greece;
| | - Stavroula Sgourou
- Fourth Oncology Department and Comprehensive Clinical Trials Centre, Metropolitan Hospital, 18547 Athens, Greece; (N.A.); (S.S.)
| | - Elena Fountzilas
- Second Department of Medical Oncology, Euromedica General Clinic of Thessaloniki, 54645 Thessaloniki, Greece;
- European University Cyprus, Nicosia 2404, Cyprus
| | - Joseph Sgouros
- Third Department of Medical Oncology, Agii Anargiri Cancer Hospital, 14564 Athens, Greece; (J.S.); (E.R.)
| | - Evangelia Razis
- Third Department of Medical Oncology, Hygeia Hospital, 15123 Athens, Greece;
| | | | - Sofia Lampaki
- Pulmonary Department, Lung Cancer Oncology Unit, Aristotle University of Thessaloniki, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece;
| | - Eleni Res
- Third Department of Medical Oncology, Agii Anargiri Cancer Hospital, 14564 Athens, Greece; (J.S.); (E.R.)
| | | | - Giannis Mountzios
- Fourth Department of Medical Oncology and Clinical Trials Unit, Henry Dunant Hospital Center, 11526 Athens, Greece;
| | - George Saroglou
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
- Internal Medicine Department, Metropolitan Hospital, 18547 Athens, Greece
| | - George Fountzilas
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
- Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Department of Medical Oncology, German Oncology Center, Limassol 4108, Cyprus
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17
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Perkmann T, Perkmann-Nagele N, Koller T, Mucher P, Radakovics A, Marculescu R, Wolzt M, Wagner OF, Binder CJ, Haslacher H. Anti-Spike Protein Assays to Determine SARS-CoV-2 Antibody Levels: a Head-to-Head Comparison of Five Quantitative Assays. Microbiol Spectr 2021; 9:e0024721. [PMID: 34190591 PMCID: PMC8552734 DOI: 10.1128/spectrum.00247-21] [Citation(s) in RCA: 134] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 06/02/2021] [Indexed: 02/07/2023] Open
Abstract
Reliable quantification of the antibody response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly relevant, e.g., for identifying possible vaccine failure and estimating the time of protection. Therefore, we evaluated five different anti-SARS-CoV-2 antibody assays regarding the quantification of anti-spike (S) antibodies. Sera from 69 SARS-CoV-2-naive individuals 21 ± 1 days after vaccination with a single dose of BNT162b2 (Pfizer/BioNTech) were tested using the following quantitative assays: Roche S total antibody, DiaSorin trimeric spike IgG, DiaSorin S1/S2 IgG, Abbott II IgG, and Serion/Virion IgG. Results were further compared to the percent inhibition calculated from a surrogate virus neutralization test (sVNT). Individual values were distributed over several orders of magnitude for all assays. Although the assays were in good overall agreement (ρ = 0.80 to 0.94), Passing-Bablok regression revealed systematic constant and proportional differences, which could not be eliminated by converting the results to binding antibody units (BAU) per milliliter, as suggested by the manufacturers. Seven (10%) individuals had negative sVNT results (i.e., <30% inhibition). These samples were identified by most assays and yielded significantly lower binding antibody levels. Although all assays showed good correlation, they were not interchangeable, even when converted to BAU per milliliter using the WHO international standard for SARS-CoV-2 immunoglobulin. This highlights the need for further standardization of SARS-CoV-2 serology. IMPORTANCE Reliable quantification of the antibody response to SARS-CoV-2 is highly relevant, e.g., for identifying possible vaccine failure and estimating the time of protection. We compared the performance of five CE marked tests that quantify antibodies against the viral spike protein. Our findings suggest that, although all assays showed good correlation, their results were not interchangeable, even when converted to BAU per milliliter using the WHO international standard for SARS-CoV-2 immunoglobulin. This highlights the need for further standardization of SARS-CoV-2 serology.
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Affiliation(s)
- Thomas Perkmann
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Thomas Koller
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Patrick Mucher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Astrid Radakovics
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Rodrig Marculescu
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Michael Wolzt
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Oswald F. Wagner
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Christoph J. Binder
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Helmuth Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
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18
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Favresse J, Bayart JL, Mullier F, Elsen M, Eucher C, Van Eeckhoudt S, Roy T, Wieers G, Laurent C, Dogné JM, Closset M, Douxfils J. Antibody titres decline 3-month post-vaccination with BNT162b2. Emerg Microbes Infect 2021; 10:1495-1498. [PMID: 34232116 PMCID: PMC8300930 DOI: 10.1080/22221751.2021.1953403] [Citation(s) in RCA: 125] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Several studies reported on the humoral response in subjects having received the BNT162b2 mRNA COVID-19 vaccine. However, data on the kinetics of antibodies 3 months post-vaccination are currently lacking and are important to drive the future vaccination strategy. The CRO-VAX HCP study is an ongoing multicentre, prospective and interventional study designed to assess the antibody response in a population of healthcare professionals who had received two doses of the BNT162b2 mRNA COVID-19 vaccine. Two hundred individuals underwent a blood drawn within 2 days before the first vaccine dose. One-hundred and forty-two persons (71%) were categorized as seronegative at baseline while 58 (29%) were seropositive. Samples were then collected after 14, 28, 42, 56, and 90 days. Antibodies against the SARS-CoV-2 nucleocapsid and the receptor binding domain of the S1 subunit of the spike protein were measured in all individuals at different time points. Using a one-compartment kinetics model, the time to maximum concentration was estimated at 36 ± 3 days after the first dose and the estimated half-life of antibodies was 55 days (95% CI: 37-107 days) in seronegative participants. In seropositive participants, the time to maximum concentration was estimated at 24 ± 4 days and the estimated half-life was 80 days (95% CI: 46-303 days). The antibody response was higher in seropositive compared to seronegative participants. In both seropositive and seronegative subjects, a significant antibody decline was observed at 3 months compared to the peak response. Nevertheless, the humoral response remained robust in all participants.
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Affiliation(s)
- Julien Favresse
- Department of Laboratory Medicine, Clinique St-Luc Bouge, Namur, Belgium.,Department of Pharmacy, Namur Research Institute for LIfe Sciences, University of Namur, Namur, Belgium
| | - Jean-Louis Bayart
- Department of Laboratory Medicine, Clinique St-Pierre, Ottignies, Belgium
| | - François Mullier
- Department of Laboratory Medicine, Université catholique de Louvain, CHU UCL Namur, Namur, Belgium
| | - Marc Elsen
- Department of Laboratory Medicine, Clinique St-Luc Bouge, Namur, Belgium
| | - Christine Eucher
- Department of Laboratory Medicine, Clinique St-Luc Bouge, Namur, Belgium
| | | | - Tatiana Roy
- Department of Laboratory Medicine, Clinique St-Pierre, Ottignies, Belgium
| | - Gregoire Wieers
- Department of Internal Medicine, Clinique St-Pierre, Ottignies, Belgium
| | - Christine Laurent
- Department of Internal Medicine, Université catholique de Louvain, CHU UCL Namur, Namur, Belgium
| | - Jean-Michel Dogné
- Department of Pharmacy, Namur Research Institute for LIfe Sciences, University of Namur, Namur, Belgium
| | - Mélanie Closset
- Department of Laboratory Medicine, Université catholique de Louvain, CHU UCL Namur, Namur, Belgium
| | - Jonathan Douxfils
- Department of Pharmacy, Namur Research Institute for LIfe Sciences, University of Namur, Namur, Belgium.,Qualiblood sa, Namur, Belgium
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19
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El-Khoury JM, Schulz WL, Durant TJS. Longitudinal Assessment of SARS-CoV-2 Antinucleocapsid and Antispike-1-RBD Antibody Testing Following PCR-Detected SARS-CoV-2 Infection. J Appl Lab Med 2021; 6:1005-1011. [PMID: 33822964 PMCID: PMC8083453 DOI: 10.1093/jalm/jfab030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/22/2021] [Indexed: 02/07/2023]
Abstract
Background SARS-CoV-2 serologic assays are becoming increasingly available and may serve as a diagnostic aid in a multitude of settings relating to past infection status. However, there is limited literature detailing the longitudinal performance of EUA-cleared serologic assays in US populations, particularly in cohorts with a remote history of PCR-confirmed SARS-CoV-2 infection (e.g., > 2 months). Methods We evaluated the diagnostic sensitivities and specificities of the Elecsys® Anti-SARS-CoV-2 (anti-N) and Elecsys® Anti-SARS-CoV-2 S (anti-S1-RBD) assays, using 174 residual clinical samples up to 267 days post-PCR diagnosis of SARS-CoV-2 infection (n = 154) and a subset of samples obtained prior to the COVID-19 pandemic as negative controls (n = 20). Results The calculated diagnostic sensitivities for the anti-N and anti-S1-RBD assays were 89% and 93%, respectively. Of the 154 samples in the SARS-CoV-2-positive cohort, there were 6 discrepant results between the anti-N and anti-S1-RBD assays, 5 of which were specimens collected ≥ 200 days post-PCR positivity and only had detectable levels of anti-S1-RBD antibodies. When only considering specimens collected ≥ 100 days post-PCR positivity (n = 41), the sensitivities for the anti-N and anti-S1-RBD assays were 85% and 98%, respectively. Conclusions The anti-S1-RBD assay demonstrated superior sensitivity at time points more remote to the PCR detection date, with 6 more specimens from the SARS-CoV-2-positive cohort detected, 5 of which were collected more than 200 days post-PCR positivity. While analytical differences and reagent lot-to-lot variability are possible, this may indicate that, in some instances, anti-S1-RBD antibodies may persist longer in vivo and may be a better target for detecting remote SARS-CoV-2 infection.
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Affiliation(s)
- Joe M El-Khoury
- Department of Laboratory Medicine, Yale University, New Haven, CT
| | - Wade L Schulz
- Department of Laboratory Medicine, Yale University, New Haven, CT
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20
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Laterza R, Schirinzi A, Bruno R, Genco R, Contino R, Ostuni A, Di Serio F. SARS-CoV-2 antibodies: Comparison of three high-throughput immunoassays versus the neutralization test. Eur J Clin Invest 2021; 51:e13573. [PMID: 33870493 PMCID: PMC8250358 DOI: 10.1111/eci.13573] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 12/13/2022]
Affiliation(s)
| | | | - Rossella Bruno
- Immunohaematology and Transfusion Medicine Service, University Hospital of Bari, Bari, Italy
| | - Rosa Genco
- Clinic Pathology Unit, University Hospital of Bari, Bari, Italy
| | - Renato Contino
- Clinic Pathology Unit, University Hospital of Bari, Bari, Italy
| | - Angelo Ostuni
- Immunohaematology and Transfusion Medicine Service, University Hospital of Bari, Bari, Italy
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21
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Dobaño C, Ramírez-Morros A, Alonso S, Vidal-Alaball J, Ruiz-Olalla G, Vidal M, Rubio R, Cascant E, Parras D, Rodrigo Melero N, Serra P, Carolis C, Santamaria P, Forcada A, Mendioroz J, Aguilar R, Moncunill G, Ruiz-Comellas A. Persistence and baseline determinants of seropositivity and reinfection rates in health care workers up to 12.5 months after COVID-19. BMC Med 2021; 19:155. [PMID: 34183003 PMCID: PMC8237770 DOI: 10.1186/s12916-021-02032-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 06/11/2021] [Indexed: 12/12/2022] Open
Abstract
We assessed the duration and baseline determinants of antibody responses to SARS-CoV-2 spike antigens and the occurrence of reinfections in a prospective cohort of 173 Spanish primary health care worker patients followed initially for 9 months and subsequently up to 12.5 months after COVID-19 symptoms onset. Seropositivity to SARS-CoV-2 spike and receptor-binding domain antigens up to 149-270 days was 92.49% (90.17% IgG, 76.3% IgA, 60.69% IgM). In a subset of 64 health care workers who had not yet been vaccinated by April 2021, seropositivity was 96.88% (95.31% IgG, 82.81% IgA) up to 322-379 days post symptoms onset. Four suspected reinfections were detected by passive case detection, two among seronegative individuals (5 and 7 months after the first episode), and one low antibody responder. Antibody levels significantly correlated with fever, hospitalization, anosmia/hypogeusia, allergies, smoking, and occupation. Stable sustainment of IgG responses raises hope for long-lasting COVID-19 vaccine immunity.
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Affiliation(s)
- Carlota Dobaño
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Catalonia, Spain.
| | - Anna Ramírez-Morros
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain.
| | - Selena Alonso
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Catalonia, Spain
| | - Josep Vidal-Alaball
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
| | - Gemma Ruiz-Olalla
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Catalonia, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Catalonia, Spain
| | - Rocío Rubio
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Catalonia, Spain
| | - Emma Cascant
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Catalonia, Spain
| | - Daniel Parras
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
| | - Natalia Rodrigo Melero
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Pau Serra
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
| | - Carlo Carolis
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Pere Santamaria
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
- Julia McFarlane Diabetes Research Centre (JMDRC) and Department of Microbiology, Immunology and Infectious Diseases, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Anna Forcada
- Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
| | - Jacobo Mendioroz
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
- COVID-19 Response Unit, Department of Health, Generalitat de Catalunya, Barcelona, Spain
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Catalonia, Spain
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Carrer Roselló 153 (CEK building), E-08036, Barcelona, Catalonia, Spain
| | - Anna Ruiz-Comellas
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
- Centre d'Atenció Primària (CAP) Sant Joan de Vilatorrada, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
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22
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Brinc D, Biondi MJ, Li D, Sun H, Capraru C, Smookler D, Zahoor MA, Casey J, Kulasingam V, Feld JJ. Evaluation of Dried Blood Spot Testing for SARS-CoV-2 Serology Using a Quantitative Commercial Assay. Viruses 2021; 13:962. [PMID: 34067361 PMCID: PMC8224688 DOI: 10.3390/v13060962] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/10/2021] [Accepted: 05/19/2021] [Indexed: 12/22/2022] Open
Abstract
Dried blood spots (DBS) are commonly used for serologic testing for viruses and provide an alternative collection method when phlebotomy and/or conventional laboratory testing are not readily available. DBS collection could be used to facilitate widespread testing for SARS-CoV-2 antibodies to document past infection, vaccination, and potentially immunity. We investigated the characteristics of Roche's Anti-SARS-CoV-2 (S) assay, a quantitative commercial assay for antibodies against the spike glycoprotein. Antibody levels were reduced relative to plasma following elution from DBS. Quantitative results from DBS samples were highly correlated with values from plasma (r2 = 0.98), allowing for extrapolation using DBS results to accurately estimate plasma antibody levels. High concordance between plasma and fingerpick DBS was observed in PCR-confirmed COVID-19 patients tested 90 days or more after the diagnosis (45/46 matched; 1/46 mismatched plasma vs. DBS). The assessment of antibody responses to SARS-CoV-2 using DBS may be feasible using a quantitative anti-S assay, although false negatives may rarely occur in those with very low antibody levels.
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Affiliation(s)
- Davor Brinc
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (D.B.); (V.K.)
- Department of Clinical Biochemistry, University Health Network, Toronto, ON M5G 2C4, Canada;
| | - Mia J. Biondi
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - Daniel Li
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada;
| | - Heng Sun
- Department of Clinical Biochemistry, University Health Network, Toronto, ON M5G 2C4, Canada;
| | - Camelia Capraru
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - David Smookler
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - Muhammad Atif Zahoor
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - Julia Casey
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - Vathany Kulasingam
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (D.B.); (V.K.)
- Department of Clinical Biochemistry, University Health Network, Toronto, ON M5G 2C4, Canada;
| | - Jordan J. Feld
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada;
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23
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Evaluations of SARS-CoV-2 Serological Assay Performance Need Inclusion of Long-Term Samples. J Clin Microbiol 2021; 59:JCM.00487-21. [PMID: 33758035 DOI: 10.1128/jcm.00487-21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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24
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Schallier A, De Baets S, De Bruyne D, Dauwe K, Herpol M, Couck P. Assay dependence of long-term kinetics of SARS-CoV-2 antibodies. Diagn Microbiol Infect Dis 2021; 100:115403. [PMID: 34058541 PMCID: PMC8061083 DOI: 10.1016/j.diagmicrobio.2021.115403] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/07/2021] [Accepted: 04/14/2021] [Indexed: 12/11/2022]
Abstract
Since the worldwide outbreak of the novel coronavirus (SARS-CoV-2), the question raised whether infected patients would elicit long-lasting protective immunity. Several companies developed serological assays for the detection of SARS-CoV-2 antibodies. In this study, we compared 4 different serology assays in convalescents up to 7 months post-infection. Both Abbott assays showed a significative decrease of IgG antibodies over time. Whereas the Elecsys Anti‑SARS‑CoV‑2 N assay (Roche) initially showed a significant increase, antibody titers significantly decreased at the latest timepoint. Although not significant, the Elecsys Anti‑SARS‑CoV‑2 S assay (Roche) showed tendency towards increasing titers overtime. Our data showed that results of SARS-CoV-2 serology should be interpreted with caution.
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Affiliation(s)
| | | | | | - Kenny Dauwe
- Cerba Healthcare Belgium, CRI, Zwijnaarde, Belgium
| | | | - Pedro Couck
- Cerba Healthcare Belgium, CRI, Zwijnaarde, Belgium
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Padoan A, Dall'Olmo L, Rocca FD, Barbaro F, Cosma C, Basso D, Cattelan A, Cianci V, Plebani M. Antibody response to first and second dose of BNT162b2 in a cohort of characterized healthcare workers. Clin Chim Acta 2021; 519:60-63. [PMID: 33857476 PMCID: PMC8056941 DOI: 10.1016/j.cca.2021.04.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Vaccine-induced population immunity is a key global strategy to control coronavirus disease 2019 (COVID-19). The rapid implementation and availability of several COVID-19 vaccines is now a global health-care priority but more information about humoral responses to single- and double-dose vaccine is needed. METHODS 163 health care workers (HCW) of the Padua University Hospitals, who underwent a complete vaccination campaign with BNT162b2 vaccine were asked to collect serum samples at 12 (t12) and 28 (t28) days after the first inoculum to allow the measurement of SARS-CoV-2 Antibodies (Ab) using chemiluminescent assays against the spike (S) protein and the Receptor Binding Domain (RBD) of the virus, respectively. RESULTS Significant differences were found at t12 for infection-naïve and subjects with previous-natural infection who present higher values of specific antibodies, while no significant differences have been found between t12 and t28. No statistically significant difference was found between male and female, while lower Ab levels have been observed in subjects older than 60 years at t12 but not at t28. CONCLUSIONS Our study confirms observed differences in vaccine responses between infection-naïve and subjects with previous natural infection at t12 but not for a longer time. The influence of sex and age deserves further studies, even if the relationship with age seems particularly significant.
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Affiliation(s)
- Andrea Padoan
- Department of Medicine-DIMED, University of Padova, Italy; Department of Laboratory Medicine, University-Hospital of Padova, Italy
| | - Luigi Dall'Olmo
- Department of Surgical Oncological and Gastroenterological Sciences - DISCOG, University of Padova, Italy; Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | | | - Francesco Barbaro
- Infective and Tropical Disease Unit, Padua University Hospital, Padua, Italy
| | - Chiara Cosma
- Department of Laboratory Medicine, University-Hospital of Padova, Italy
| | - Daniela Basso
- Department of Medicine-DIMED, University of Padova, Italy; Department of Laboratory Medicine, University-Hospital of Padova, Italy
| | - Annamaria Cattelan
- Infective and Tropical Disease Unit, Padua University Hospital, Padua, Italy
| | - Vito Cianci
- Emergency Department, Padua University Hospital, Padua, Italy
| | - Mario Plebani
- Department of Medicine-DIMED, University of Padova, Italy; Department of Laboratory Medicine, University-Hospital of Padova, Italy.
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26
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Resman Rus K, Korva M, Knap N, Avšič Županc T, Poljak M. Performance of the rapid high-throughput automated electrochemiluminescence immunoassay targeting total antibodies to the SARS-CoV-2 spike protein receptor binding domain in comparison to the neutralization assay. J Clin Virol 2021; 139:104820. [PMID: 33865031 PMCID: PMC8035809 DOI: 10.1016/j.jcv.2021.104820] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 12/29/2022]
Abstract
Background Neutralization tests (NT) are the gold standard for detecting and quantifying anti-SARS-CoV-2 neutralizing antibodies (NAb), but their complexity restricts them to research settings or reference laboratories. Antibodies against S protein receptor binding domain (RBD) have been shown to confer a neutralizing activity against SARS-CoV-2. Assays quantitatively measuring anti-S1-RBD-SARS-CoV-2 antibodies could be of great value for NAb screening of potential donors for convalescent-phase plasma therapy, assessing natural or vaccine-induced immunity, stratifying individuals for vaccine receipt, and documenting vaccine response. Methods Elecsys Anti-SARS-CoV-2 S (Elecsys-S), a high-throughput automated electrochemiluminescence double-antigen sandwich immunoassay for quantitative measurement of pan-anti-S1-RBD-SARS-CoV-2 antibodies, was evaluated against NT on 357 patients with PCR-confirmed SARS-CoV-2 infection. NT was performed in a BSL-3 laboratory using a Slovenian SARS-CoV-2 isolate; the NT titer ≥1:20 was considered positive. Results Elecsys-S detected pan-anti-S1-RBD-SARS-CoV-2 antibodies in 352/357 (98.6 %) samples. NAb were identified by NT in 257/357 (72 %) samples. The Elecsys-S/NT agreement was moderate (Cohen’s kappa 0.56). High NT titer antibodies (≥1:160) were detected in 106/357 (30 %) samples. Elecsys-S’s pan-anti-S1-RBD-SARS-CoV-2 antibody concentrations correlated with individual NT titer categories (the lowest concentrations were identified in NT-negative samples and the highest in samples with NT titer 1:1,280), and the Elecsys-S cutoff value for reasonable prediction of NAb generated after natural infection was established (133 BAU/mL). Conclusion Although NT should remain the gold standard for assessing candidates for convalescent-phase plasma donors, selected commercial anti-SARS-CoV-2 assays with optimized cutoff, like Elecsys-S, could be used for rapid, automated, and large-scale screening of individuals with clinically relevant NAb levels as suitable donors.
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Affiliation(s)
- Katarina Resman Rus
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Miša Korva
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Nataša Knap
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Tatjana Avšič Županc
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Mario Poljak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia.
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27
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Irsara C, Egger AE, Prokop W, Nairz M, Loacker L, Sahanic S, Pizzini A, Sonnweber T, Holzer B, Mayer W, Schennach H, Loeffler-Ragg J, Bellmann-Weiler R, Hartmann B, Tancevski I, Weiss G, Binder CJ, Anliker M, Griesmacher A, Hoermann G. Clinical validation of the Siemens quantitative SARS-CoV-2 spike IgG assay (sCOVG) reveals improved sensitivity and a good correlation with virus neutralization titers. Clin Chem Lab Med 2021; 59:1453-1462. [PMID: 33837679 DOI: 10.1515/cclm-2021-0214] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 03/24/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections cause coronavirus disease 2019 (COVID-19) and induce a specific antibody response. Serological assays detecting IgG against the receptor binding domain (RBD) of the spike (S) protein are useful to monitor the immune response after infection or vaccination. The objective of our study was to evaluate the clinical performance of the Siemens SARS-CoV-2 IgG (sCOVG) assay. METHODS Sensitivity and specificity of the Siemens sCOVG test were evaluated on 178 patients with SARS-CoV-2-infection and 160 pre-pandemic samples in comparison with its predecessor test COV2G. Furthermore, correlation with virus neutralization titers was investigated on 134 samples of convalescent COVID-19 patients. RESULTS Specificity of the sCOVG test was 99.4% and sensitivity was 90.5% (COV2G assay 78.7%; p<0.0001). S1-RBD antibody levels showed a good correlation with virus neutralization titers (r=0.843; p<0.0001) and an overall qualitative agreement of 98.5%. Finally, median S1-RBD IgG levels increase with age and were significantly higher in hospitalized COVID-19 patients (median levels general ward: 25.7 U/mL; intensive care: 59.5 U/mL) than in outpatients (3.8 U/mL; p<0.0001). CONCLUSIONS Performance characteristics of the sCOVG assay have been improved compared to the predecessor test COV2G. Quantitative SARS-CoV-2 S1-RBD IgG levels could be used as a surrogate for virus neutralization capacity. Further harmonization of antibody quantification might assist to monitor the humoral immune response after COVID-19 disease or vaccination.
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Affiliation(s)
- Christian Irsara
- Central Institute of Clinical and Chemical Laboratory Diagnostics, University Hospital of Innsbruck, Innsbruck, Austria
| | - Alexander E Egger
- Central Institute of Clinical and Chemical Laboratory Diagnostics, University Hospital of Innsbruck, Innsbruck, Austria
| | - Wolfgang Prokop
- Central Institute of Clinical and Chemical Laboratory Diagnostics, University Hospital of Innsbruck, Innsbruck, Austria
| | - Manfred Nairz
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Lorin Loacker
- Central Institute of Clinical and Chemical Laboratory Diagnostics, University Hospital of Innsbruck, Innsbruck, Austria
| | - Sabina Sahanic
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alex Pizzini
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Sonnweber
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Barbara Holzer
- Department for Animal Health, Austrian Agency for Health and Food Safety (AGES), Moedling, Austria
| | - Wolfgang Mayer
- Central Institute for Blood Transfusion and Immunology (ZIB), University Hospital of Innsbruck, Innsbruck, Austria
| | - Harald Schennach
- Central Institute for Blood Transfusion and Immunology (ZIB), University Hospital of Innsbruck, Innsbruck, Austria
| | - Judith Loeffler-Ragg
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Rosa Bellmann-Weiler
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Boris Hartmann
- Department for Animal Health, Austrian Agency for Health and Food Safety (AGES), Moedling, Austria
| | - Ivan Tancevski
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Günter Weiss
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph J Binder
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Markus Anliker
- Central Institute of Clinical and Chemical Laboratory Diagnostics, University Hospital of Innsbruck, Innsbruck, Austria
| | - Andrea Griesmacher
- Central Institute of Clinical and Chemical Laboratory Diagnostics, University Hospital of Innsbruck, Innsbruck, Austria
| | - Gregor Hoermann
- Central Institute of Clinical and Chemical Laboratory Diagnostics, University Hospital of Innsbruck, Innsbruck, Austria.,MLL Munich Leukemia Laboratory, Munich, Germany
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28
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Werner M, Pervan P, Glück V, Zeman F, Koller M, Burkhardt R, Glück T, Wenzel JJ, Schmidt B, Gessner A, Peterhoff D. Evaluation of a Broad Panel of SARS-CoV-2 Serological Tests for Diagnostic Use. J Clin Med 2021; 10:1580. [PMID: 33918081 PMCID: PMC8070215 DOI: 10.3390/jcm10081580] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/31/2021] [Accepted: 04/06/2021] [Indexed: 12/20/2022] Open
Abstract
Serological testing is crucial in detection of previous infection and in monitoring convalescent and vaccine-induced immunity. During the Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) pandemic, numerous assay platforms have been developed and marketed for clinical use. Several studies recently compared clinical performance of a limited number of serological tests, but broad comparative evaluation is currently missing. Within this study, a panel of 161 sera from SARS-CoV-2 infected, seasonal CoV-infected and SARS-CoV-2 naïve subjects was enrolled to evaluate 16 ELISA/ECLIA-based and 16 LFA-based tests. Specificities of all ELISA/ECLIA-based assays were acceptable and generally in agreement with the providers' specifications, but sensitivities were lower as specified. Results of the LFAs were less accurate as compared to the ELISAs, albeit with some exceptions. We found a sporadic unequal immune response for different antigens and thus recommend the use of a nucleocapsid protein (N)- and spike protein (S)-based test combination when maximal sensitivity is necessary. Finally, the quality of the immune response in terms of neutralization should be tested using S-based IgG tests.
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Affiliation(s)
- Maren Werner
- Institute for Medical Microbiology and Hygiene, University of Regensburg, 93053 Regensburg, Germany; (M.W.); (B.S.); (A.G.)
| | - Philip Pervan
- Institute for Clinical Microbiology and Hygiene, University Hospital Regensburg, 93053 Regensburg, Germany; (P.P.); (V.G.); (J.J.W.)
| | - Vivian Glück
- Institute for Clinical Microbiology and Hygiene, University Hospital Regensburg, 93053 Regensburg, Germany; (P.P.); (V.G.); (J.J.W.)
| | - Florian Zeman
- Center for Clinical Studies, University Hospital Regensburg, 93053 Regensburg, Germany; (F.Z.); (M.K.)
| | - Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, 93053 Regensburg, Germany; (F.Z.); (M.K.)
| | - Ralph Burkhardt
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Regensburg, 93053 Regensburg, Germany;
| | - Thomas Glück
- Kliniken Südostbayern, 83278 Traunstein/Trostberg, Germany;
| | - Jürgen J. Wenzel
- Institute for Clinical Microbiology and Hygiene, University Hospital Regensburg, 93053 Regensburg, Germany; (P.P.); (V.G.); (J.J.W.)
| | - Barbara Schmidt
- Institute for Medical Microbiology and Hygiene, University of Regensburg, 93053 Regensburg, Germany; (M.W.); (B.S.); (A.G.)
- Institute for Clinical Microbiology and Hygiene, University Hospital Regensburg, 93053 Regensburg, Germany; (P.P.); (V.G.); (J.J.W.)
| | - André Gessner
- Institute for Medical Microbiology and Hygiene, University of Regensburg, 93053 Regensburg, Germany; (M.W.); (B.S.); (A.G.)
- Institute for Clinical Microbiology and Hygiene, University Hospital Regensburg, 93053 Regensburg, Germany; (P.P.); (V.G.); (J.J.W.)
| | - David Peterhoff
- Institute for Medical Microbiology and Hygiene, University of Regensburg, 93053 Regensburg, Germany; (M.W.); (B.S.); (A.G.)
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29
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Lung T, Sakem B, Risch M, Nydegger U. Convalescent blood plasma (CBP) donated by recovered COVID-19 patients - A comment. Transfus Apher Sci 2021; 60:103108. [PMID: 33678561 PMCID: PMC7923855 DOI: 10.1016/j.transci.2021.103108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/18/2021] [Accepted: 02/25/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Th Lung
- Center for Laboratory Medicine Dr Risch, Vaduz, Principality of Liechtenstein, University of Bern, Switzerland
| | - B Sakem
- Center for Laboratory Medicine Dr Risch, Vaduz, Principality of Liechtenstein, University of Bern, Switzerland
| | - M Risch
- Center for Laboratory Medicine Dr Risch, Vaduz, Principality of Liechtenstein, University of Bern, Switzerland
| | - U Nydegger
- Center for Laboratory Medicine Dr Risch, Vaduz, Principality of Liechtenstein, University of Bern, Switzerland.
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30
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Dörschug A, Frickmann H, Schwanbeck J, Yilmaz E, Mese K, Hahn A, Groß U, Zautner AE. Comparative Assessment of Sera from Individuals after S-Gene RNA-Based SARS-CoV-2 Vaccination with Spike-Protein-Based and Nucleocapsid-Based Serological Assays. Diagnostics (Basel) 2021; 11:diagnostics11030426. [PMID: 33802453 PMCID: PMC7998789 DOI: 10.3390/diagnostics11030426] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 12/12/2022] Open
Abstract
Due to the beginning of vaccination against COVID-19, serological discrimination between vaccine-associated humoral response and serology-based surveillance of natural SARS-CoV-2 infections as well as breakthrough infections becomes an issue of relevance. Here, we assessed the differentiated effects of the application of an RNA vaccine using SARS-CoV-2 spike protein epitopes on the results of both anti-spike protein–based serology (EUROIMMUN) and anti-nucleocapsid-based serology (VIROTECH). A total of 80 serum samples from vaccinees acquired at different time points after vaccination was assessed. While positive or borderline serological response in the anti-spike protein assay was observed for all samples (90% both IgG and IgA, 6.3% IgA only, 3.8% borderline IgG only), only a single case of a falsely positive IgM was observed for the anti-nucleocapsid assay as expected due to this assay’s specificity. Positive anti-spike protein antibodies were already detectable in the second week after the first dose of vaccination, with higher titers after the second dose of the vaccine. In conclusion, the combined application of anti-spike protein–based serology and anti-nucleocapsid-based serology will provide a useful option for the discrimination of vaccination response and natural infection.
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Affiliation(s)
- Anja Dörschug
- Institute for Medical Microbiology, University Medical Center Göttingen, 37075 Göttingen, Germany; (A.D.); (J.S.); (K.M.); (U.G.)
| | - Hagen Frickmann
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany; (H.F.); (A.H.)
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, 20359 Hamburg, Germany
| | - Julian Schwanbeck
- Institute for Medical Microbiology, University Medical Center Göttingen, 37075 Göttingen, Germany; (A.D.); (J.S.); (K.M.); (U.G.)
| | - Elif Yilmaz
- Department of Anesthesiology, University Medical Center Göttingen, 37075 Göttingen, Germany;
| | - Kemal Mese
- Institute for Medical Microbiology, University Medical Center Göttingen, 37075 Göttingen, Germany; (A.D.); (J.S.); (K.M.); (U.G.)
| | - Andreas Hahn
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany; (H.F.); (A.H.)
| | - Uwe Groß
- Institute for Medical Microbiology, University Medical Center Göttingen, 37075 Göttingen, Germany; (A.D.); (J.S.); (K.M.); (U.G.)
| | - Andreas E. Zautner
- Institute for Medical Microbiology, University Medical Center Göttingen, 37075 Göttingen, Germany; (A.D.); (J.S.); (K.M.); (U.G.)
- Correspondence: ; Tel.: +49-551-39-65927
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