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Dong H, Mo J, Yu Y, Xie W, Zheng J, Jia C. A portable system for economical nucleic acid amplification testing. Front Bioeng Biotechnol 2023; 11:1214624. [PMID: 37600301 PMCID: PMC10436208 DOI: 10.3389/fbioe.2023.1214624] [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: 04/30/2023] [Accepted: 07/14/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction: Regular and rapid large-scale screening for pathogens is crucial for controlling pandemics like Coronavirus Disease 2019 (COVID-19). In this study, we present the development of a digital point-of-care testing (POCT) system utilizing microfluidic paper-based analytical devices (μPADs) for the detection of SARS-CoV-2 gene fragments. The system incorporates temperature tuning and fluorescent detection components, along with intelligent and autonomous image acquisition and self-recognition programs. Methods: The developed POCT system is based on the nucleic acid amplification test (NAAT), a well-established molecular biology technique for detecting and amplifying nucleic acids. We successfully detected artificially synthesized SARS-CoV-2 gene fragments, namely ORF1ab gene, N gene, and E gene, with minimal reagent consumption of only 2.2 μL per readout, representing a mere 11% of the requirements of conventional in-tube methods. The power dissipation of the system was low, at 6.4 W. Results: Our testing results demonstrated that the proposed approach achieved a limit of detection of 1000 copies/mL, which is equivalent to detecting 1 copy or a single RNA template per reaction. By employing standard curve analysis, the quantity of the target templates can be accurately determined. Conclusion: The developed digital POCT system shows great promise for rapid and reliable detection of SARS-CoV-2 gene fragments, offering a cost-effective and efficient solution for controlling pandemics. Its compatibility with other diagnostic techniques and low reagent consumption make it a viable option to enhance healthcare in resource-limited areas.
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Affiliation(s)
- Hui Dong
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, China
- Fujian Provincial Collaborative Innovation Center of High-End Equipment Manufacturing, Fuzhou, China
| | - Jin Mo
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, China
- Fujian Provincial Collaborative Innovation Center of High-End Equipment Manufacturing, Fuzhou, China
| | - Yongjian Yu
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, China
- Fujian Provincial Collaborative Innovation Center of High-End Equipment Manufacturing, Fuzhou, China
| | - Wantao Xie
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, China
- Fujian Provincial Collaborative Innovation Center of High-End Equipment Manufacturing, Fuzhou, China
| | | | - Chao Jia
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, China
- Fujian Provincial Collaborative Innovation Center of High-End Equipment Manufacturing, Fuzhou, China
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The prevalence of SARS-CoV-2 antibodies within the community of a private tertiary university in the Philippines: A serial cross sectional study. PLoS One 2022; 17:e0268145. [PMID: 36469505 PMCID: PMC9721473 DOI: 10.1371/journal.pone.0268145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic has caused a public health emergency in all sectors of society, including universities and other academic institutions. This study determined the seroprevalence of SARS-CoV-2 antibodies among administrators, faculty, staff, and students of a private tertiary academic institution in the Philippines over a 7 month period. It employed a serial cross-sectional method using qualitative and quantitative COVID-19 antibody test kits. A total of 1,318 participants were tested, showing 47.80% of the study population yielding IgG antibodies to SARS-CoV-2 virus. A general increase in seroprevalence was observed from June to December 2021, which coincided with the vaccine roll-out of the country. All brands yielded positive antibody formation, with mRNA vaccines having higher levels than other types of vaccines. A decreasing trend in IgG reactivity was found in vaccinated individuals after 1 to 6 months of completion of the 2 doses of the COVID-19 vaccine. Where possible, IgG and T-cell reactivity and/or neutralizing capacity against SAR-CoV-2 need to be monitored regardless of vaccine brand. Together with uptake of COVID-19 vaccines and boosters, other public health interventions such as wearing of masks and regular testing need to be continued for better protection. Effective communication is also needed to inform risks associated with activities across different settings. Investments in long-term measures such as air filtration and ventilation systems, and wastewater surveillance need to be made.
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Serology as a Tool to Assess Infectious Disease Landscapes and Guide Public Health Policy. Pathogens 2022; 11:pathogens11070732. [PMID: 35889978 PMCID: PMC9323579 DOI: 10.3390/pathogens11070732] [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: 05/14/2022] [Revised: 06/10/2022] [Accepted: 06/16/2022] [Indexed: 01/27/2023] Open
Abstract
Understanding the local burden and epidemiology of infectious diseases is crucial to guide public health policy and prioritize interventions. Typically, infectious disease surveillance relies on capturing clinical cases within a healthcare system, classifying cases by etiology and enumerating cases over a period of time. Disease burden is often then extrapolated to the general population. Serology (i.e., examining serum for the presence of pathogen-specific antibodies) has long been used to inform about individuals past exposure and immunity to specific pathogens. However, it has been underutilized as a tool to evaluate the infectious disease burden landscape at the population level and guide public health decisions. In this review, we outline how serology provides a powerful tool to complement case-based surveillance for determining disease burden and epidemiology of infectious diseases, highlighting its benefits and limitations. We describe the current serology-based technologies and illustrate their use with examples from both the pre- and post- COVID-19-pandemic context. In particular, we review the challenges to and opportunities in implementing serological surveillance in low- and middle-income countries (LMICs), which bear the brunt of the global infectious disease burden. Finally, we discuss the relevance of serology data for public health decision-making and describe scenarios in which this data could be used, either independently or in conjunction with case-based surveillance. We conclude that public health systems would greatly benefit from the inclusion of serology to supplement and strengthen existing case-based infectious disease surveillance strategies.
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Garzillo EM, Cioffi A, Carta A, Monaco MGL. Returning to Work after the COVID-19 Pandemic Earthquake: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084538. [PMID: 35457407 PMCID: PMC9024882 DOI: 10.3390/ijerph19084538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/04/2022] [Accepted: 04/06/2022] [Indexed: 01/06/2023]
Abstract
Background: The ongoing SARS-CoV-2 pandemic has disrupted life and work habits and has produced landmark changes worldwide. This systematic review aimed to analyse the management of Return to Work (RTW) by work organisations following the virus spread. Methods: A selection of 2477 papers, using string research on PubMed, Embase, Web of Science and Scopus from January 2020 to October 2021, were analysed. Results: Fifty-one articles were finally included, and the results obtained were discussed from three different points of view. Twenty articles concerning ‘Remodelling of Work Organization’ proposed some model strategies for resumption to work. Twenty-one papers, including ‘Clinical Evaluation of Workers’, mostly explored the psychosocial impact of returned workers. Finally, twelve articles explored the best ‘Testing Strategies related to RTW’. Despite the heterogeneity of included articles, several interesting approaches have emerged in managing RTW. Conclusions: The reported experiences could help to develop an RTW model for COVID-19 and future pandemics.
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Affiliation(s)
| | - Arcangelo Cioffi
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (A.C.); (A.C.)
| | - Angela Carta
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (A.C.); (A.C.)
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy
| | - Maria Grazia Lourdes Monaco
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy
- Correspondence: ; Tel.: +39-045-8123946
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Sil BK, Jamiruddin MR, Haq MA, Khondoker MU, Jahan N, Khandker SS, Ali T, Oishee MJ, Kaitsuka T, Mie M, Tomizawa K, Kobatake E, Haque M, Adnan N. AuNP Coupled Rapid Flow-Through Dot-Blot Immuno-Assay for Enhanced Detection of SARS-CoV-2 Specific Nucleocapsid and Receptor Binding Domain IgG. Int J Nanomedicine 2021; 16:4739-4753. [PMID: 34267520 PMCID: PMC8277418 DOI: 10.2147/ijn.s313140] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/24/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Serological tests detecting severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are widely used in seroprevalence studies and evaluating the efficacy of the vaccination program. Some of the widely used serological testing techniques are enzyme-linked immune-sorbent assay (ELISA), chemiluminescence immunoassay (CLIA), and lateral flow immunoassay (LFIA). However, these tests are plagued with low sensitivity or specificity, time-consuming, labor-intensive, and expensive. We developed a serological test implementing flow-through dot-blot assay (FT-DBA) for SARS-CoV-2 specific IgG detection, which provides enhanced sensitivity and specificity while being quick to perform and easy to use. METHODS SARS-CoV-2 antigens were immobilized on nitrocellulose membrane to capture human IgG, which was then detected with anti-human IgG conjugated gold nanoparticle (hIgG-AuNP). A total of 181 samples were analyzed in-house. Within which 35 were further evaluated in US FDA-approved CLIA Elecsys SARS-CoV-2 assay. The positive panel consisted of RT-qPCR positive samples from patients with both <14 days and >14 days from the onset of clinical symptoms. The negative panel contained samples collected from the pre-pandemic era dengue patients and healthy donors during the pandemic. Moreover, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FT-DBA were evaluated against RT-qPCR positive sera. However, the overall efficacies were assessed with sera that seroconverted against either nucleocapsid (NCP) or receptor-binding domain (RBD). RESULTS In-house ELISA selected a total of 81 true seropositive and 100 seronegative samples. The sensitivity of samples with <14 days using FT-DBA was 94.7%, increasing to 100% for samples >14 days. The overall detection sensitivity and specificity were 98.8% and 98%, respectively, whereas the overall PPV and NPV were 99.6% and 99%. Moreover, comparative analysis between in-house ELISA assays and FT-DBA revealed clinical agreement of Cohen's Kappa value of 0.944. The FT-DBA showed sensitivity and specificity of 100% when compared with commercial CLIA kits. CONCLUSION The assay can confirm past SARS-CoV-2 infection with high accuracy within 2 minutes compared to commercial CLIA or in-house ELISA. It can help track SARS-CoV-2 disease progression, population screening, and vaccination response. The ease of use of the assay without requiring any instruments while being semi-quantitative provides the avenue of its implementation in remote areas around the globe, where conventional serodiagnosis is not feasible.
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Affiliation(s)
- Bijon Kumar Sil
- Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhaka, 1205, Bangladesh
| | | | - Md Ahsanul Haq
- Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhaka, 1205, Bangladesh
| | | | - Nowshin Jahan
- Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhaka, 1205, Bangladesh
| | - Shahad Saif Khandker
- Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhaka, 1205, Bangladesh
| | - Tamanna Ali
- Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhaka, 1205, Bangladesh
| | | | - Taku Kaitsuka
- School of Pharmacy, International University of Health and Welfare, Okawa, Fukuoka, 831-8501, Japan
| | - Masayasu Mie
- School of Life Science and Technology, Tokyo Institute of Technology, Yokohama, Kanagawa, 226-8502, Japan
| | - Kazuhito Tomizawa
- Department of Molecular Physiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, 860-0811, Japan
| | - Eiry Kobatake
- School of Life Science and Technology, Tokyo Institute of Technology, Yokohama, Kanagawa, 226-8502, Japan
| | - Mainul Haque
- The Unit of Pharmacology, Faculty of Medicine and Defence Health Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, 57000, Malaysia
| | - Nihad Adnan
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
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Oishee MJ, Ali T, Jahan N, Khandker SS, Haq MA, Khondoker MU, Sil BK, Lugova H, Krishnapillai A, Abubakar AR, Kumar S, Haque M, Jamiruddin MR, Adnan N. COVID-19 Pandemic: Review of Contemporary and Forthcoming Detection Tools. Infect Drug Resist 2021; 14:1049-1082. [PMID: 33762831 PMCID: PMC7982560 DOI: 10.2147/idr.s289629] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/30/2021] [Indexed: 01/10/2023] Open
Abstract
Recent severe acute respiratory syndrome 2 (SARS-CoV-2) known as COVID-19, presents a deadly challenge to the global healthcare system of developing and developed countries, exposing the limitations of health facilities preparedness for emerging infectious disease pandemic. Opportune detection, confinement, and early treatment of infected cases present the first step in combating COVID-19. In this review, we elaborate on various COVID-19 diagnostic tools that are available or under investigation. Consequently, cell culture, followed by an indirect fluorescent antibody, is one of the most accurate methods for detecting SARS-CoV-2 infection. However, restrictions imposed by the regulatory authorities prevented its general use and implementation. Diagnosis via radiologic imaging and reverse transcriptase PCR assay is frequently employed, considered as standard procedures, whereas isothermal amplification methods are currently on the verge of clinical introduction. Notably, techniques such as CRISPR-Cas and microfluidics have added new dimensions to the SARS-CoV-2 diagnosis. Furthermore, commonly used immunoassays such as enzyme-linked immunosorbent assay (ELISA), lateral flow immunoassay (LFIA), neutralization assay, and the chemiluminescent assay can also be used for early detection and surveillance of SARS-CoV-2 infection. Finally, advancement in the next generation sequencing (NGS) and metagenomic analysis are smoothing the viral detection further in this global challenge.
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Affiliation(s)
| | - Tamanna Ali
- Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhaka, Bangladesh
| | - Nowshin Jahan
- Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhaka, Bangladesh
| | | | - Md Ahsanul Haq
- Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhaka, Bangladesh
| | | | | | - Halyna Lugova
- Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia
| | - Ambigga Krishnapillai
- Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia
| | - Abdullahi Rabiu Abubakar
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Bayero University, Kano, 700233, Kano, Nigeria
| | - Santosh Kumar
- Department of Periodontology and Implantology, Karnavati University, Gandhinagar, 382422, India
| | - Mainul Haque
- The Unit of Pharmacology, Faculty of Medicine and Defence Health Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, Malaysia
| | | | - Nihad Adnan
- Department of Microbiology, Jahangirnagar University, Dhaka, 1342, Bangladesh
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Matthias J, Spencer EC, Michniewicz M, Bendle TM, Wilson C, Scheppke KA, Blackmore C, Otis A, Rivkees SA. SARS-COV-2 ANTIBODY PREVALENCE AMONG HEALTHCARE WORKERS AND FIRST RESPONDERS, FLORIDA, MAY-JUNE 2020. FLORIDA PUBLIC HEALTH REVIEW 2021; 18:1-10. [PMID: 33851146 PMCID: PMC8040388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND The SARS-CoV-2 virus responsible for severe respiratory infection associated with coronavirus disease 2019 (COVID-19) was first confirmed in Florida on March 1, 2020. Responding to the pandemic, multi-agency collaborative partnerships put in place actions integrating point-of-care antibody testing at established large-scale COVID-19 testing sites where the baseline seropositivity of COVID-19 in health care workers and first responders in Florida at the start of the pandemic was established. PURPOSE Determine the seropositivity of healthcare workers and first responders at five drive thru testing sites using a rapid SARS-CoV-2 antibody test in Florida from May 6 through June 3, 2020. METHODS The first drive-thru SARS-CoV-2 antibody test site was opened at Miami Hard Rock Stadium, May 6, 2020. Testing expanded to three additional sites on May 9, 2020: Jacksonville, Orlando, and Palm Beach. The fifth and final site, Miami Beach, began testing on May 21, 2020. Healthcare workers and first responder's self-seeking SARS-CoV-2 testing were designated for antibody testing and completed a laboratory collection form onsite for the point-of-care test. All testing was performed on whole blood specimens (obtained by venipuncture) using the Cellex Inc. qSARS-CoV-2 IgG/IgM Rapid Test. Seropositivity was assessed by univariate analysis and by logistic regression including the covariates age, sex, race/ethnicity, and testing location. RESULTS AND DISCUSSION As of June 3, 2020, of 5,779 healthcare workers and first responders tested, 4.1% were seropositive (range 2.6-8.2%). SARS-COV-2 antibody tests had higher odds of being positive for persons testing at the Miami Hard Rock Stadium (aOR 2.24 [95% C.I. 1.48-3.39]), persons of Haitian/Creole ethnicity (aOR 3.28 [95% C.I. 1.23-8.72]), Hispanic/Latino(a) ethnicity (aOR 2.17 [95% C.I. 1.50-3.13], and Black non-Hispanic persons (aOR 1.63 [95% C.I. 1.08-2.46]). SARS-COV-2 antibody prevalence among first responders and healthcare workers in five sites in Florida varied by race and ethnicity and by testing location.
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Affiliation(s)
| | | | | | | | | | | | | | - Aaron Otis
- Centers for Disease Control and Prevention, Atlanta, GA
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Sil BK, Jahan N, Haq MA, Oishee MJ, Ali T, Khandker SS, Kobatake E, Mie M, Khondoker MU, Jamiruddin MR, Adnan N. Development and performance evaluation of a rapid in-house ELISA for retrospective serosurveillance of SARS-CoV-2. PLoS One 2021; 16:e0246346. [PMID: 33529223 PMCID: PMC7853452 DOI: 10.1371/journal.pone.0246346] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 01/16/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In the ongoing pandemic situation of COVID-19, serological tests can complement the molecular diagnostic methods, and can be one of the important tools of sero-surveillance and vaccine evaluation. AIM To develop and evaluate a rapid SARS-CoV-2 specific ELISA for detection of anti-SARS-CoV2 IgG from patients' biological samples. METHODS In order to develop this ELISA, three panels of samples (n = 184) have been used: panel 1 (n = 19) and panel 2 (n = 60) were collected from RT-PCR positive patients within 14 and after 14 days of onset of clinical symptoms, respectively; whereas panel 3 consisted of negative samples (n = 105) collected either from healthy donors or pre-pandemic dengue patients. As a capturing agent full-length SARS-CoV2 specific recombinant nucleocapsid was immobilized. Commercial SARS-CoV2 IgG kit based on chemiluminescent assay was used for the selection of samples and optimization of the assay. The threshold cut-off point, inter-assay and intra-assay variations were determined. RESULTS The incubation/reaction time was set at a total of 30 minutes with the sensitivity of 84% (95% confidence interval, CI, 60.4%, 96.6%) and 98% (95% CI, 91.1%, 100.0%), for panel 1 and 2, respectively; with overall 94.9% sensitivity (95% CI 87.5%, 98.6%). Moreover, the clinical specificity was 97.1% (95% CI, 91.9%, 99.4%) with no cross reaction with dengue samples. The overall positive and negative predictive values are 96.2% (95% CI 89.2%, 99.2%) and 96.2% (95% CI, 90.6% 99.0%), respectively. In-house ELISA demonstrated 100% positive and negative percent agreement with Elecsys Anti-SARS-CoV-2, with Cohen's kappa value of 1.00 (very strong agreement), while comparing 13 positive and 17 negative confirmed cases. CONCLUSION The assay is rapid and can be applied as one of the early and retrospective sero-monitoring tools in all over the affected areas.
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Affiliation(s)
- Bijon Kumar Sil
- Gonoshasthaya-RNA Molecular Diagnostic & Research Center, Dhanmondi, Dhaka, Bangladesh
- Department of Microbiology, Gono Bishwabidyalay, Savar, Dhaka, Bangladesh
| | - Nowshin Jahan
- Gonoshasthaya-RNA Molecular Diagnostic & Research Center, Dhanmondi, Dhaka, Bangladesh
| | - Md. Ahsanul Haq
- Gonoshasthaya-RNA Molecular Diagnostic & Research Center, Dhanmondi, Dhaka, Bangladesh
| | - Mumtarin Jannat Oishee
- Gonoshasthaya-RNA Molecular Diagnostic & Research Center, Dhanmondi, Dhaka, Bangladesh
- Department of Microbiology, Gono Bishwabidyalay, Savar, Dhaka, Bangladesh
| | - Tamanna Ali
- Gonoshasthaya-RNA Molecular Diagnostic & Research Center, Dhanmondi, Dhaka, Bangladesh
| | - Shahad Saif Khandker
- Gonoshasthaya-RNA Molecular Diagnostic & Research Center, Dhanmondi, Dhaka, Bangladesh
| | - Eiry Kobatake
- Department of Life Science and Technology, Tokyo Institute of Technology, Yokohama, Japan
| | - Masayasu Mie
- Department of Life Science and Technology, Tokyo Institute of Technology, Yokohama, Japan
| | - Mohib Ullah Khondoker
- Gonoshasthaya-RNA Molecular Diagnostic & Research Center, Dhanmondi, Dhaka, Bangladesh
- Gonoshasthaya Samaj Vittik Medical College, Savar, Dhaka, Bangladesh
| | - Mohd. Raeed Jamiruddin
- Gonoshasthaya-RNA Molecular Diagnostic & Research Center, Dhanmondi, Dhaka, Bangladesh
- Department of Pharmacy, BRAC University, Dhaka, Bangladesh
| | - Nihad Adnan
- Gonoshasthaya-RNA Molecular Diagnostic & Research Center, Dhanmondi, Dhaka, Bangladesh
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka, Bangladesh
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Krsak M, Henao-Martínez AF, Franco-Paredes C. COVID-19: Way Forward With Serosurveillance Without Overemphasizing Neutralizing Antibodies. Viral Immunol 2020; 34:130-133. [PMID: 33181055 DOI: 10.1089/vim.2020.0246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Serosurveillance of coronavirus disease 2019 (COVID-19) is lagging due to concerns regarding testing performance and interpretation of what represents protective immunity. The scientific community has pointed out concerns related to suboptimal performance of certain tests, although a selection of tests with sensitivity and specificity of >99% is available. Neutralizing antibodies represent a generally accepted surrogate marker of immunological protection against viral infections. In COVID-19, we argue that focusing only on neutralizing antibodies may not be necessary and that evidence of spontaneous clearance of COVID-19 may be a reliable surrogate marker of individuals' immune competency toward future reinfections (regardless of its mechanism) for a period of time. Furthermore, current polymerase chain reaction testing lacks the ability to determine the duration of transmissibility, thus alternatives for direct testing of replicating virus are needed. Broadly applied viable virus testing together with serosurveillance will help reopen the economy with more precision and speed, and help guide isolation, quarantine, and cohorting protocols in conglomerate settings such as correctional facilities, nursing facilities, schools, and long-distance travel.
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Affiliation(s)
- Martin Krsak
- Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Andrés F Henao-Martínez
- Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Carlos Franco-Paredes
- Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, Colorado, USA.,Instituto Nacional de Salud, Hospital Infantil de México, Federico Gomez, México City, México
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Borremans B, Gamble A, Prager KC, Helman SK, McClain AM, Cox C, Savage V, Lloyd-Smith JO. Quantifying antibody kinetics and RNA detection during early-phase SARS-CoV-2 infection by time since symptom onset. eLife 2020; 9:e60122. [PMID: 32894217 PMCID: PMC7508557 DOI: 10.7554/elife.60122] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/04/2020] [Indexed: 01/03/2023] Open
Abstract
Understanding and mitigating SARS-CoV-2 transmission hinges on antibody and viral RNA data that inform exposure and shedding, but extensive variation in assays, study group demographics and laboratory protocols across published studies confounds inference of true biological patterns. Our meta-analysis leverages 3214 datapoints from 516 individuals in 21 studies to reveal that seroconversion of both IgG and IgM occurs around 12 days post-symptom onset (range 1-40), with extensive individual variation that is not significantly associated with disease severity. IgG and IgM detection probabilities increase from roughly 10% at symptom onset to 98-100% by day 22, after which IgM wanes while IgG remains reliably detectable. RNA detection probability decreases from roughly 90% to zero by day 30, and is highest in feces and lower respiratory tract samples. Our findings provide a coherent evidence base for interpreting clinical diagnostics, and for the mathematical models and serological surveys that underpin public health policies.
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Affiliation(s)
- Benny Borremans
- Ecology and Evolutionary Biology Department, University of California, Los AngelesLos AngelesUnited States
- I-BioStat, Data Science Institute, Hasselt UniversityHasseltBelgium
- Evolutionary Ecology Group, University of AntwerpAntwerpBelgium
| | - Amandine Gamble
- Ecology and Evolutionary Biology Department, University of California, Los AngelesLos AngelesUnited States
| | - KC Prager
- Ecology and Evolutionary Biology Department, University of California, Los AngelesLos AngelesUnited States
| | - Sarah K Helman
- Ecology and Evolutionary Biology Department, University of California, Los AngelesLos AngelesUnited States
| | | | - Caitlin Cox
- Ecology and Evolutionary Biology Department, University of California, Los AngelesLos AngelesUnited States
| | - Van Savage
- Ecology and Evolutionary Biology Department, University of California, Los AngelesLos AngelesUnited States
- Biomathematics Department, University of California, Los AngelesLos AngelesUnited States
| | - James O Lloyd-Smith
- Ecology and Evolutionary Biology Department, University of California, Los AngelesLos AngelesUnited States
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