1
|
Li Q, Chen L, Li F, He A. Long-term evaluation of the seroprevalence of SARS-CoV-2 IgG and IgM antibodies in recovered patients: a meta-analysis. BMC Infect Dis 2023; 23:444. [PMID: 37393304 DOI: 10.1186/s12879-023-08425-3] [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: 10/31/2022] [Accepted: 06/24/2023] [Indexed: 07/03/2023] Open
Abstract
Estimating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) -specific immunoglobulin G (IgG) immunoglobulin M (IgM) antibodies are increasingly important for tracking the spread of infection and defining herd immunity barrier and individual immunization levels in the ongoing coronavirus disease 2019 (COVID-19) pandemic. Therefore, we conducted the present systematic review and meta-analysis to evaluate the seroprevalence of SARS-CoV-2 IgM and IgG antibodies of recovered COVID-19 patients in long-term follow-up studies. A systematic search of the MEDLINE, Embase, COVID-19 Primer, PubMed, CNKI, and the Public Health England library databases was conducted. Twenty-fourth eligible studies were included. Meta-analysis showed that 27% (95%CI: 0.04-0.49) and 66% (95%CI:0.47-0.85) were seropositive for SARS-CoV-2 IgM and IgG, respectively, while in long-term 12 months following up studies, the seroprevalences of IgM antibody (17%) decreased and IgG antibody (75%) was higher than 6 months follow-up patients. However, due to the limited number of relevant studies, the high level of heterogeneity, and the large gap in studies conducted, the findings of our study may not accurately reflect the true seroprevalence status of SARS-CoV-2 infection. Nevertheless, sequential vaccination or booster immunization is considered to be a necessary long-term strategy to sustain the fight against the pandemic.
Collapse
Affiliation(s)
- Qiu Li
- Laboratory Medicine Center, Chenzhou First People's Hospital, Chenzhou, 423000, P.R. China
| | - Lu Chen
- Baoshan Community Hospital, Chenzhou, 424400, P.R. China
| | - Fen Li
- Laboratory Medicine Center, Chenzhou First People's Hospital, Chenzhou, 423000, P.R. China
| | - An He
- Laboratory Medicine Center, Chenzhou First People's Hospital, Chenzhou, 423000, P.R. China.
| |
Collapse
|
2
|
López-Pintor JM, Herráez Carrera Ó, Sánchez-López J, Gaitán Pitera J, Huertas Vaquero M, Tejera-Muñoz A, Arias-Arias Á, Asencio Egea MÁ. [Evolución de marcadores de laboratorio en pacientes con detección persistente de SARS-CoV-2.]. Rev Esp Salud Publica 2023; 97:e202305039. [PMID: 37226982 PMCID: PMC10540886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 04/21/2023] [Indexed: 05/26/2023] Open
Abstract
OBJECTIVE The study of the evolution of certain biomarkers in patients with persistent detection of SARS-CoV-2 could determine the profile of the pathology that these patients may suffer. The objective of this study was to describe the evolution of different laboratory markers in patients with persistent detection of SARS-CoV-2, and determining these parameters were into reference values. METHODS Patients were divided into two groups: the control group (G0) included patients with a positive direct test for SARS-CoV-2 followed by 2 negative, while the problem group (G1) included patients with at least 3 consecutive positive tests. The time between consecutive samples was five to twenty days, and only patients with negative serology were included. Demographic data, comorbidities, symptoms, radiology and hospitalization were collected, as well as data from analytic and blood gases. The comparison between the study groups was realized using the t-student and U Mann-Whitney test for quantitative variables, and the χ2 test for qualitative variables. Results with p<0.05 were taken as significant. RESULTS Ninety patients were included, thirty-eight in G0 and fifty-two in G1. D-dimer decreased 10.20 times more in G0 patients, and normal levels of this parameter at t1 were 1.46 times more frequent in these patients. The percentage of lymphocytes increased sixteen times more in G0, and the normal values in t1 were 10.40 times more common in these patients. C-reactive protein decreased significantly in both groups, and lactate increased more in G1 patients. CONCLUSIONS The results of the study suggest that some biomarkers evolve differently in patients with persistent detection of SARS-CoV-2, which may have significant clinical impact. This information could help to determine the main organs or systems affected, allowing to anticipate socio-sanitary measures to prevent or compensate these alterations.
Collapse
Affiliation(s)
- José María López-Pintor
- Servicio de Microbiología, Hospital General La Mancha Centro.Hospital General La Mancha CentroAlcázar de San Juan (Ciudad Real)Spain
| | - Óscar Herráez Carrera
- Servicio de Análisis Clínicos, Hospital General La Mancha Centro.Hospital General La Mancha CentroAlcázar de San Juan (Ciudad Real)Spain
| | - Javier Sánchez-López
- Servicio de Microbiología, Hospital General La Mancha Centro.Hospital General La Mancha CentroAlcázar de San Juan (Ciudad Real)Spain
| | - Jorge Gaitán Pitera
- Servicio de Microbiología, Hospital General La Mancha Centro.Hospital General La Mancha CentroAlcázar de San Juan (Ciudad Real)Spain
| | - María Huertas Vaquero
- Servicio de Microbiología, Hospital General La Mancha Centro.Hospital General La Mancha CentroAlcázar de San Juan (Ciudad Real)Spain
| | - Antonio Tejera-Muñoz
- Unidad de Investigación, Formación y Desarrollo (IDF), Hospital General La Mancha Centro.Hospital General La Mancha CentroAlcázar de San Juan (Ciudad Real)Spain
| | - Ángel Arias-Arias
- Unidad de Investigación, Formación y Desarrollo (IDF), Hospital General La Mancha Centro.Hospital General La Mancha CentroAlcázar de San Juan (Ciudad Real)Spain
| | - María Ángeles Asencio Egea
- Servicio de Microbiología, Hospital General La Mancha Centro.Hospital General La Mancha CentroAlcázar de San Juan (Ciudad Real)Spain
| |
Collapse
|
3
|
Filiatreau LM, Zivich PN, Edwards JK, Mulholland GE, Max R, Westreich D. Optimizing SARS-CoV-2 Pooled Testing Strategies Through Differentiated Pooling for Distinct Groups. Am J Epidemiol 2023; 192:246-256. [PMID: 36222677 PMCID: PMC9620733 DOI: 10.1093/aje/kwac178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/02/2022] [Accepted: 10/06/2022] [Indexed: 02/07/2023] Open
Abstract
Pooled testing has been successfully used to expand SARS-CoV-2 testing, especially in settings requiring high volumes of screening of lower-risk individuals, but efficiency of pooling declines as prevalence rises. We propose a differentiated pooling strategy that independently optimizes pool sizes for distinct groups with different probabilities of infection to further improve the efficiency of pooled testing. We compared the efficiency (results obtained per test kit used) of the differentiated strategy with a traditional pooling strategy in which all samples are processed using uniform pool sizes under a range of scenarios. For most scenarios, differentiated pooling is more efficient than traditional pooling. In scenarios examined here, an improvement in efficiency of up to 3.94 results per test kit could be obtained through differentiated versus traditional pooling, with more likely scenarios resulting in 0.12 to 0.61 additional results per kit. Under circumstances similar to those observed in a university setting, implementation of our strategy could result in an improvement in efficiency between 0.03 to 3.21 results per test kit. Our results can help identify settings, such as universities and workplaces, where differentiated pooling can conserve critical testing resources.
Collapse
Affiliation(s)
- Lindsey M Filiatreau
- Correspondence Address: Department of Psychiatry, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, E-mail:
| | - Paul N Zivich
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Jessie K Edwards
- Gillings Center for Coronavirus Testing, Screening, and Surveillance, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Grace E Mulholland
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Ryan Max
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Daniel Westreich
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Gillings Center for Coronavirus Testing, Screening, and Surveillance, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| |
Collapse
|
4
|
A Highly Sensitive Immunoassay for Determination of Immune Response to SARS-CoV-2 in Capillary Blood Samples. Biomedicines 2022; 10:biomedicines10112897. [PMID: 36428468 PMCID: PMC9687217 DOI: 10.3390/biomedicines10112897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/21/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
Throughout the pandemic, serological assays have been revealed as crucial for detecting previous exposures to the virus and determining the timing of antibody maintenance after vaccination or natural infection. This study aimed to develop an optimized enzyme-linked immunosorbent assay (ELISA)-based serology, which could be used in case of reagent shortages, such as that occurred in the beginning of this health emergency. As a result, we present a high-sensitive immunoassay for the determination of IgG levels in venous serum samples, using 2 μg/mL antigen (receptor-binding domain of the spike protein S1) for coating the plate and utilizing human samples at a dilution 1:1000. This method showed non-inferiority features versus a commercial kit, is less expensive, and has a higher spectrophotometric range that allows for a better quantification of the antibody titers. The optical density values before and after heating venous serum samples at 56 °C during 30 min was quite similar, showing that heat inactivation can be used to reduce the biohazardous risks while handling samples. Furthermore, we show that finger-stick capillary blood samples can also serve as a suitable source for IgG detection, bypassing the need for serum isolation and being suitable for point-of-care application (Pearson's coefficient correlation with capillary serum was 0.95, being statistically significant).
Collapse
|
5
|
Yuan H, Chen P, Wan C, Li Y, Liu BF. Merging microfluidics with luminescence immunoassays for urgent point-of-care diagnostics of COVID-19. Trends Analyt Chem 2022; 157:116814. [PMCID: PMC9637550 DOI: 10.1016/j.trac.2022.116814] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/29/2022] [Accepted: 10/30/2022] [Indexed: 11/09/2022]
|
6
|
Comparison of Positivity in Two Epidemic Waves of COVID-19 in Colombia with FDA. STATS 2022. [DOI: 10.3390/stats5040059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We use the functional data methodology to examine whether there are significant differences between two waves of contagion by COVID-19 in Colombia between 7 July 2020 and 20 July 2021. A pointwise functional t-test is initially used, then an alternative statistical test proposal for paired samples is presented, which has a theoretical distribution and performs well in small samples. Our statistical test generates a scalar p-value, which provides a global idea about the significance of the positivity curves, complementing the existing punctual tests, as an advantage.
Collapse
|
7
|
Campbell C, Roblin D, Padmanabhan N, Romero D, Joe J, Fathi L, Whiting T, Williamson J, Goodwin P, Mckie C, Deneal A, Greenberg L, Sigal G. Saliva-based SARS-CoV-2 serology using at-home collection kits returned via mail. Sci Rep 2022; 12:14061. [PMID: 35982133 PMCID: PMC9387411 DOI: 10.1038/s41598-022-17057-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 07/20/2022] [Indexed: 12/16/2022] Open
Abstract
Serology provides tools for epidemiologic studies, and may have a role in vaccine prioritization and selection. Automated serologic testing of saliva, especially specimens that are self-collected at home and sent to a laboratory via the mail without refrigeration, could be a highly-scalable strategy for population-wide testing. In this prospective study, non-vaccinated patients were recruited after PCR testing to self-collect saliva and return their specimens via mail. Longitudinal specimens were analyzed in order to monitor seroconversion in the weeks after a diagnostic PCR test for SARS-CoV-2. Diverse users self-collected saliva and returned specimens via mail in compliance with shipping regulations. At our pre-established threshold (0.963 AU/mL), salivary IgG reactivity to full-length spike protein achieved 95.8% sensitivity and 92.4% specificity at 2–4 weeks after diagnostic testing, which is comparable to the typical sensitivity and specificity achieved for serum testing. Reactivity to N antigen also was detected with 92.6% sensitivity and 90.7% specificity at 4–8 weeks after diagnostic testing. Moreover, serologic testing for endemic coronaviruses performed in multiplex with SARS-CoV-2 antigens has the potential to identify samples that may require retesting due to effects of pre-analytical factors. The easy-to-use saliva collection kit, coupled with thresholds for positivity and methods of flagging samples for retest, provides a framework for large-scale serosurveillance of SARS-CoV-2.
Collapse
Affiliation(s)
- Christopher Campbell
- Meso Scale Diagnostics, LLC., Rockville, MD, USA. .,Meso Scale Diagnostics, LLC, 16020 Industrial Drive, Gaithersburg, MD, 20877, USA.
| | - Douglas Roblin
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente, Rockville, MD, USA
| | | | | | - Jessica Joe
- Meso Scale Diagnostics, LLC., Rockville, MD, USA
| | - Lily Fathi
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente, Rockville, MD, USA
| | - Thomas Whiting
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente, Rockville, MD, USA
| | - Jared Williamson
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente, Rockville, MD, USA
| | - Paul Goodwin
- Meso Scale Diagnostics, LLC., Rockville, MD, USA
| | - Charmaine Mckie
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente, Rockville, MD, USA
| | - Adrienne Deneal
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente, Rockville, MD, USA
| | - Leslie Greenberg
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente, Rockville, MD, USA
| | - George Sigal
- Meso Scale Diagnostics, LLC., Rockville, MD, USA
| |
Collapse
|
8
|
Jacot D, von Rotz U, Blondet F, Aebischer O, Matthieu P, De Rham M, Pantaleo G, Marchetti O, Greub G. SARS-CoV-2 seroprevalence in hospital healthcare workers in Western Switzerland at the end of the second pandemic wave. J Med Microbiol 2022; 71. [PMID: 35921229 DOI: 10.1099/jmm.0.001558] [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: 11/18/2022] Open
Abstract
Introduction. In early January 2020, the pandemic of COVID-19 (coronavirus disease 2019) rapidly spread from China and caused a worldwide pandemic.Hypothesis. Healthcare workers represent a high-risk group for acquiring COVID-19 and for nosocomial transmission of severe acute respiratory coronavirus 2 (SARS-CoV-2).Aim. We aimed to investigate over a 1 year period, across two pandemic waves, the SARS-CoV-2 seroprevalence in employees at a Western Switzerland public hospital.Methodology. A prospective observational SARS-CoV-2 seroprevalence study was proposed to all hospital employees who enrolled on a voluntary basis.Results. Out of 594 participants recruited on a voluntary basis, 269 volunteers (45.3 %) had anti-SARS-CoV-2 antibodies: this seroprevalence was twice higher than that reported in the local community. Healthcare workers with prolonged exposure to patients with COVID-19 showed a significantly higher odds ratio (OR) of having a positive SARS-CoV-2 serology [OR 3.19, 95 % confidence interval (CI) 2.16-4.74]. Symptoms showing the highest association with a positive serology were anosmia (OR 11.9, 95 % CI 5.58-30.9) and ageusia (OR 10.3, 95 % CI 4.8-26.3). A total of 17.1 % (95 % CI 12.2-21.1 %) of SARS-CoV-2 seropositive volunteers did not report a suspicion of COVID-19 in their personal history.Conclusion. Overall, we observed that the impact of the second SARS-CoV-2 pandemic wave was considerable and significantly affected healthcare workers with prolonged exposure to patients with COVID-19.
Collapse
Affiliation(s)
- Damien Jacot
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, 21 Rue du Bugnon, Lausanne CH-1011, Switzerland
| | - Urs von Rotz
- Healthcare Workers Medical Service, Ensemble Hospitalier de la Côte, Morges, Switzerland
| | - Fanny Blondet
- Department of Medicine, Ensemble Hospitalier de la Côte, 2 Chemin du Crêt, Morges CH-1110, Switzerland
| | - Oriane Aebischer
- Department of Medicine, Ensemble Hospitalier de la Côte, 2 Chemin du Crêt, Morges CH-1110, Switzerland
| | - Perreau Matthieu
- Institute of Immunology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mikael De Rham
- Patients' Safety Program, General Direction, Ensemble Hospitalier de la Côte, Morges, Switzerland
| | - Giuseppe Pantaleo
- Institute of Immunology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Oscar Marchetti
- Department of Medicine, Ensemble Hospitalier de la Côte, 2 Chemin du Crêt, Morges CH-1110, Switzerland
| | - Gilbert Greub
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, 21 Rue du Bugnon, Lausanne CH-1011, Switzerland.,Infectious Diseases Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
9
|
Choudhary H, Sinha LN, Belodu R, Solanki S, Kumar HRS, Bishnoi R. Patterns of RT-PCR Test Conversion and Implications on Time of Discharge in a District Hospital and a COVID-19 Care Centre in Pali, Rajasthan, India. Cureus 2022; 14:e27325. [PMID: 36043024 PMCID: PMC9411711 DOI: 10.7759/cureus.27325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Although coronavirus disease 2019 (COVID-19) first appeared in 2019, the symptoms are similar to common viral illnesses, and if undiagnosed or there is a delay in treatment, it may prove fatal because of the virus's propensity to attack the respiratory and cardiovascular system. The antigenic conversion status of reverse transcription-polymerase chain reaction (RT-PCR) was an important criterion for discharge among the COVID-19 patients of the two hospitals in the study. Aim The aim of the study was to assess the time taken to antigenic conversion from positive to negative in RT-PCR test for COVID-19 done on patients admitted to the two hospitals where the study took place. Materials and methods A prospective cross-sectional study with repeated sampling for antigenic conversion by RT-PCR was done on 117 patients of different age groups admitted to Bangur Hospital and Agarsen Bhavan in Pali, Rajasthan, India, from April 27 to June 30, 2020. Pharyngeal and nasal swabs were analyzed by real-time RT-PCR for COVID-19 infection. The patients' first positive sample was taken as “zero sample”. If the repeat sample taken on the fifth day was positive, sampling was repeated after 48 hours on consecutive days 7, 9, 11, 13, and 15 of admission till the RT-PCR test returned negative. Results Among the 117 patients, 92 (78.63%) were treated as mild, 10 (8.54%) were moderately severe, and 15 (12.82%) were very severe requiring ICU care. The median rate of conversion of RT-PCR test (positive to negative) from the day of admission was quite variable as five patients converted to negative by RT-PCR test on day seven of admission, one on day eight of admission, 26 on day nine, 30 on day 10, five on day 11, 13 on day 12, 10 on day 13, 11 on day 14, five on day 15, six on day 16, three on day 17, and one on day 18 of admission. Conclusion The study proved that follow-up of patients, prompt and comprehensive treatment, and repeated sampling ensures fast recovery with implications on time to discharge of such patients in a pandemic. The study justified and heralds the message that the inherent immunity of an individual corresponds to the time taken to conversion from positive to negative in the RT-PCR test.
Collapse
|
10
|
Haslbauer JD, Bratic-Hench I, Cima K, Luger AK, Schmitz K, Augustin F, Krapf C, Hoefer D, Tancevski I, Tzankov A, Löffler-Ragg J. Interstitial Pulmonary Fibrosis and Extensive Dendriform Ossification with Persistent Viral Load: A Rare Presentation of Post-COVID-19 Condition in Need of Lung Transplantation. Pathobiology 2022; 90:138-146. [PMID: 35835004 PMCID: PMC10129030 DOI: 10.1159/000525457] [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: 03/29/2022] [Accepted: 06/04/2022] [Indexed: 11/19/2022] Open
Abstract
The incidence, presentation, and predisposing factors of post-acute sequelae of COVID-19 (PASC) are currently poorly understood. Lung explants may provide a rare insight into terminal SARS-CoV-2-associated lung damage and its pathophysiology. A 62-year-old man presented with progressively worsening respiratory symptoms after recovering from mild COVID-19 3 months earlier. No underlying pulmonary comorbidities were reported. A chest CT revealed bilateral extensive ground-glass and reticular opacities, suspicious of pulmonary fibrosis. Despite initial high-dose glucocorticoid therapy, the interstitial lung disease progressed, and after exhausting all viable therapeutic options, bilateral lung transplantation was successfully conducted. Histological analysis revealed extensive end-stage interstitial fibrosis with diffuse dendriform ossification and bronchiolar and transitional cell metaplasia. Signs of interstitial remodeling such as an increased interstitial collagen deposition, a pathological accumulation of CD163+/CD206+ M2-polarized macrophages with an increased expression of phosphorylated ERK, and an increased density of CD105+ newly formed capillaries were observed. qRT-PCR and immunohistochemistry for SARS-CoV-2 N-protein in the endothelium of medium-sized vessels confirmed a persistence of SARS-CoV-2. Our findings highlight a highly unusual presentation of SARS-CoV-2-associated lung fibrosis, implying that incomplete viral clearance in the vascular compartment may play a vital pathophysiological role in the development of PASC.
Collapse
Affiliation(s)
- Jasmin Dionne Haslbauer
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland,
| | - Ivana Bratic-Hench
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Katharina Cima
- Department of Internal Medicine II (Infectiology, Rheumatology, Pneumology), Medical University of Innsbruck, Innsbruck, Austria
| | | | - Katja Schmitz
- Institute of Pathology, Innpath, Tyrolean State Clinics, Innsbruck, Austria
| | - Florian Augustin
- Department of Visceral, Transplantation and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Krapf
- Department of Thoracic and Cardiovascular Surgery, University Hospital Innsbruck, Innsbruck, Austria
| | - Daniel Hoefer
- Department of Thoracic and Cardiovascular Surgery, University Hospital Innsbruck, Innsbruck, Austria
| | - Ivan Tancevski
- Department of Internal Medicine II (Infectiology, Rheumatology, Pneumology), Medical University of Innsbruck, Innsbruck, Austria
| | - Alexandar Tzankov
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Judith Löffler-Ragg
- Department of Internal Medicine II (Infectiology, Rheumatology, Pneumology), Medical University of Innsbruck, Innsbruck, Austria
| |
Collapse
|
11
|
Hutto SK, Venna N. Response to Letter to the Editor: Spinomedullary Weston Hurst Syndrome After COVID-19 and Influenza Co-Infection. Neurohospitalist 2022; 12:711-712. [PMID: 36147769 PMCID: PMC9204127 DOI: 10.1177/19418744221109218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Spencer K. Hutto
- Division of Hospital Neurology, Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Nagagopal Venna
- Division of Neuroimmunology and Neuroinfectious Diseases, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| |
Collapse
|
12
|
Ravera F, Borea R, Cirmena G, Dameri M, Ferrando L, Gallo M, Casini C, Fallani N, Stabile M, Barbero V, Murialdo R, Tixi L, Cappuccio M, Cuboni A, Sivieri I, Fornarini G, De Maria A, Ballestrero A, Zoppoli G. Incidence and immunomic features of apyretic COVID-19 in patients affected by solid tumors: a prospective cohort study. J Transl Med 2022; 20:230. [PMID: 35568887 PMCID: PMC9107211 DOI: 10.1186/s12967-022-03429-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND RATIONALE Little is known about SARS-CoV-2 seroconversion in asymptomatic patients affected by solid cancer, and whether it is associated with specific transcriptomics changes in peripheral blood mononuclear cells (PBMC). METHODS Patients affected by solid cancer treated in a top comprehensive cancer center in Italy during the first COVID-19 pandemic wave, and negative for COVID-19-symptoms since the first detection of COVID-19 in Italy, were prospectively evaluated by SARS-CoV-2 serology in the period between April 14th and June 23rd 2020. Follow-up serologies were performed, every 21-28 days, until August 23rd 2020. All SARS-CoV-2 IgM + patients underwent confirmatory nasopharyngeal swab (NPS). PBMCs from a subset of SARS-CoV-2 IgM + patients were collected at baseline, at 2 months, and at 7 months for transcriptome sequencing. RESULTS SARS-CoV-2 serology was performed on 446 of the 466 recruited patients. A total of 14 patients (3.14%) tested positive for at least one SARS-CoV-2 immunoglobulin in the period between April 14th and August 23rd 2020. Incidence of SARS-CoV-2 IgM decreased from 1.48% in the first month of the accrual to 0% in the last month. Viral RNA could not be detected in any of the NPS. PBMC serial transcriptomic analysis showed progressive downregulation of interleukin 6 upregulated signatures, chemokine-mediated signaling and chemokine-chemokine receptor KEGG pathways. B- and T-cell receptor pathways (p-values = 0.0002 and 0.017 respectively) were progressively upregulated. CONCLUSIONS SARS-CoV-2 seroconversion rate in asymptomatic patients affected by solid cancer is consistent with that of asymptomatic COVID-19 assessed in the general population through NPS at the peak of the first wave. Transcriptomic features over time in IgM + asymptomatic cases are suggestive of previous viral exposure.
Collapse
Affiliation(s)
- Francesco Ravera
- Department of Internal Medicine (DiMI), Università Degli Studi Di Genova, Genoa, Italy
| | - Roberto Borea
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Martina Dameri
- Department of Internal Medicine (DiMI), Università Degli Studi Di Genova, Genoa, Italy
| | | | - Maurizio Gallo
- Department of Internal Medicine (DiMI), Università Degli Studi Di Genova, Genoa, Italy
| | - Cecilia Casini
- Department of Internal Medicine (DiMI), Università Degli Studi Di Genova, Genoa, Italy
| | - Neri Fallani
- Department of Internal Medicine (DiMI), Università Degli Studi Di Genova, Genoa, Italy
| | - Mario Stabile
- Department of Internal Medicine (DiMI), Università Degli Studi Di Genova, Genoa, Italy
| | | | | | - Lucia Tixi
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Andrea Cuboni
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Irene Sivieri
- Department of Internal Medicine (DiMI), Università Degli Studi Di Genova, Genoa, Italy
| | | | - Andrea De Maria
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Health Sciences (DISSAL), Università Degli Studi Di Genova, Genoa, Italy
| | - Alberto Ballestrero
- Department of Internal Medicine (DiMI), Università Degli Studi Di Genova, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gabriele Zoppoli
- Department of Internal Medicine (DiMI), Università Degli Studi Di Genova, Genoa, Italy.
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| |
Collapse
|
13
|
SARS-CoV-2 RNA and antibody dynamics in a Dutch household study with dense sampling frame. Sci Rep 2022; 12:7937. [PMID: 35562380 PMCID: PMC9099349 DOI: 10.1038/s41598-022-11480-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 04/19/2022] [Indexed: 12/14/2022] Open
Abstract
This study investigated the dynamics of SARS-CoV-2 infection and diagnostics in 242 household members of different ages and with different symptom severity after SARS-CoV-2 exposure early in the pandemic (March–April 2020). Households with a SARS-CoV-2 confirmed positive case and at least one child in the Netherlands were followed for 6 weeks. Naso (NP)- and oropharyngeal (OP) swabs, oral fluid and feces specimens were analyzed for SARS-CoV-2 RNA and serum for SARS-CoV-2-specific antibodies. The dynamics of the presence of viral RNA and the serological response was modeled to determine the sampling time-frame and sample type with the highest sensitivity to confirm or reject a SARS-CoV-2 diagnosis. In children higher viral loads compared to adults were detected at symptom onset. Early in infection, higher viral loads were detected in NP and OP specimens, while RNA in especially feces were longer detectable. SARS-CoV-2-specific antibodies have 90% probability of detection from 7 days (total Ig) and 18 days (IgG) since symptom onset. For highest probability of detection in SARS-CoV-2 diagnostics early in infection, RT-PCR on NP and OP specimens are more sensitive than on oral fluid and feces. For SARS-CoV-2 diagnostics late after infection, RT-PCR on feces specimens and serology are more valuable.
Collapse
|
14
|
Jiménez D, Torres Arias M. Immunouniverse of SARS-CoV-2. Immunol Med 2022; 45:186-224. [PMID: 35502127 DOI: 10.1080/25785826.2022.2066251] [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: 10/18/2022] Open
Abstract
SARS-CoV-2 virus has become a global health problem that has caused millions of deaths worldwide. The infection can present with multiple clinical features ranging from asymptomatic or mildly symptomatic patients to patients with severe or critical illness that can even lead to death. Although the immune system plays an important role in pathogen control, SARS-CoV-2 can drive dysregulation of this response and trigger severe immunopathology. Exploring the mechanisms of the immune response involved in host defense against SARS-CoV-2 allows us to understand its immunopathogenesis and possibly detect features that can be used as potential therapies to eliminate the virus. The main objective of this review on SARS-CoV-2 is to highlight the interaction between the virus and the immune response. We explore the function and action of the immune system, the expression of molecules at the site of infection that cause hyperinflammation and hypercoagulation disorders, the factors leading to the development of pneumonia and subsequent severe acute respiratory distress syndrome which is the leading cause of death in patients with COVID-19.
Collapse
Affiliation(s)
- Dennis Jiménez
- Departamento de Ciencias de la Vida y Agricultura, Carrera de Ingeniería en Biotecnología, Universidad de las Fuerzas Armadas ESPE, Sangolquí, Pichincha, Ecuador
| | - Marbel Torres Arias
- Departamento de Ciencias de la Vida y Agricultura, Carrera de Ingeniería en Biotecnología, Universidad de las Fuerzas Armadas ESPE, Sangolquí, Pichincha, Ecuador.,Laboratorio de Inmunología y Virología, CENCINAT, GISAH, Universidad de las Fuerzas Armadas, Sangolquí, Pichincha, Ecuador
| |
Collapse
|
15
|
Fernández-Rojas MA, Luna-Ruiz Esparza MA, Campos-Romero A, Calva-Espinosa DY, Moreno-Camacho JL, Mendlovic F, Plett-Torres T, Alcántar-Fernández J. Seroconversion dynamic and SARS-CoV-2 seropositivity in unvaccinated population during the first and second outbreaks in Mexico. Sci Rep 2022; 12:5241. [PMID: 35347208 PMCID: PMC8960100 DOI: 10.1038/s41598-022-09395-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 03/22/2022] [Indexed: 12/23/2022] Open
Abstract
Serosurveillance helps establish reopening guidelines and determine the immunity levels in different populations to reach herd immunity. Then, there is an urgent need to estimate seroprevalence population wide. In Mexico, information about COVID-19 cases and related deaths is scarce. Also, there is no official serosurveillance, limiting our knowledge of the impact of the SARS-CoV-2 pandemic. Here, we report the prevalence of anti-SARS-CoV-2 antibodies in 522,690 unvaccinated people from July 5th to December 31st, 2020. The overall seroprevalence was 32.8% and highest in adults aged 30–39 years (38.5%) than people under 20 years (33.0%) or older (28.9%). Moreover, in a cohort of 1655 individuals confirmed COVID-19 by PCR, we found that symptomatic people (HR = 2.56) increased seroconversion than presymptomatic. Also, we identified that the most discriminative symptoms for COVID-19 that could predict seroconversion were anosmia and ageusia (HR = 1.70), fever, myalgia/arthralgia, and cough (HR = 1.75). Finally, we found that obese people had lower seroconversion (HR = 0.53) than healthy people, but the opposite happens in diabetic people (HR = 1.39). These findings reveal that around one-third of Mexican outpatients had anti-SARS-CoV-2 antibodies before vaccination. Also, some symptoms improve empirically COVID-19 diagnosis and seroconversion. This information could help fine-tune vaccination schemes and the reopening and back-to-work algorithms.
Collapse
Affiliation(s)
- Miguel A Fernández-Rojas
- Innovation and Research Department, Salud Digna A.C., Francisco Villa 113 sur, 80000, Culiacán, Sinaloa, Mexico
| | - Marco A Luna-Ruiz Esparza
- Innovation and Research Department, Salud Digna A.C., Francisco Villa 113 sur, 80000, Culiacán, Sinaloa, Mexico
| | - Abraham Campos-Romero
- Innovation and Research Department, Salud Digna A.C., Francisco Villa 113 sur, 80000, Culiacán, Sinaloa, Mexico
| | | | - José L Moreno-Camacho
- Clinical Laboratory Department, Salud Digna, 80000, Culiacán, Sinaloa, Mexico.,National Reference Center "Culiacan", Salud Digna, 80300, Culiacán, Sinaloa, Mexico
| | - Fela Mendlovic
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.,Facultad de Ciencias de la Salud, Universidad Anáhuac México Norte, Huixquilucan, Estado de Mexico, Mexico
| | - Tanya Plett-Torres
- Plan de Estudios Combinados en Medicina, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Jonathan Alcántar-Fernández
- Innovation and Research Department, Salud Digna A.C., Francisco Villa 113 sur, 80000, Culiacán, Sinaloa, Mexico.
| |
Collapse
|
16
|
Kurano M, Ohmiya H, Kishi Y, Okada J, Nakano Y, Yokoyama R, Qian C, Xia F, He F, Zheng L, Yu Y, Jubishi D, Okamoto K, Moriya K, Kodama T, Yatomi Y. Measurement of SARS-CoV-2 Antibody Titers Improves the Prediction Accuracy of COVID-19 Maximum Severity by Machine Learning in Non-Vaccinated Patients. Front Immunol 2022; 13:811952. [PMID: 35126396 PMCID: PMC8814445 DOI: 10.3389/fimmu.2022.811952] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/03/2022] [Indexed: 12/23/2022] Open
Abstract
Numerous studies have suggested that the titers of antibodies against SARS-CoV-2 are associated with the COVID-19 severity, however, the types of antibodies associated with the disease maximum severity and the timing at which the associations are best observed, especially within one week after symptom onset, remain controversial. We attempted to elucidate the antibody responses against SARS-CoV-2 that are associated with the maximum severity of COVID-19 in the early phase of the disease, and to investigate whether antibody testing might contribute to prediction of the disease maximum severity in COVID-19 patients. We classified the patients into four groups according to the disease maximum severity (severity group 1 (did not require oxygen supplementation), severity group 2a (required oxygen supplementation at low flow rates), severity group 2b (required oxygen supplementation at relatively high flow rates), and severity group 3 (required mechanical ventilatory support)), and serially measured the titers of IgM, IgG, and IgA against the nucleocapsid protein, spike protein, and receptor-binding domain of SARS-CoV-2 until day 12 after symptom onset. The titers of all the measured antibody responses were higher in severity group 2b and 3, especially severity group 2b, as early as at one week after symptom onset. Addition of data obtained from antibody testing improved the ability of analysis models constructed using a machine learning technique to distinguish severity group 2b and 3 from severity group 1 and 2a. These models constructed with non-vaccinated COVID-19 patients could not be applied to the cases of breakthrough infections. These results suggest that antibody testing might help physicians identify non-vaccinated COVID-19 patients who are likely to require admission to an intensive care unit.
Collapse
Affiliation(s)
- Makoto Kurano
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
- Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- *Correspondence: Makoto Kurano,
| | - Hiroko Ohmiya
- Business Planning Department, Sales & Marketing Division, Medical & Biological Laboratories Co., Ltd, Tokyo, Japan
| | - Yoshiro Kishi
- Business Planning Department, Sales & Marketing Division, Medical & Biological Laboratories Co., Ltd, Tokyo, Japan
| | - Jun Okada
- Business Planning Department, Sales & Marketing Division, Medical & Biological Laboratories Co., Ltd, Tokyo, Japan
| | - Yuki Nakano
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Rin Yokoyama
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Chungen Qian
- The Key Laboratory for Biomedical Photonics of Ministry of Education at Wuhan National Laboratory for Optoelectronics - Hubei Bioinformatics & Molecular Imaging Key Laboratory, Systems Biology Theme, Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Fuzhen Xia
- Reagent R&D Center, Shenzhen YHLO Biotech Co., Ltd, Shenzhen, China
| | - Fan He
- Reagent R&D Center, Shenzhen YHLO Biotech Co., Ltd, Shenzhen, China
| | - Liang Zheng
- Reagent R&D Center, Shenzhen YHLO Biotech Co., Ltd, Shenzhen, China
| | - Yi Yu
- Reagent R&D Center, Shenzhen YHLO Biotech Co., Ltd, Shenzhen, China
| | - Daisuke Jubishi
- Department of Infection Control and Prevention, The University of Tokyo, Tokyo, Japan
| | - Koh Okamoto
- Department of Infection Control and Prevention, The University of Tokyo, Tokyo, Japan
| | - Kyoji Moriya
- Department of Infection Control and Prevention, The University of Tokyo, Tokyo, Japan
| | - Tatsuhiko Kodama
- Laboratory for Systems Biology and Medicine, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
- Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
17
|
Zhang Y, Cai X, Ge W, Wang D, Zhu G, Qian L, Xiang N, Yue L, Liang S, Zhang F, Wang J, Zhou K, Zheng Y, Lin M, Sun T, Lu R, Zhang C, Xu L, Sun Y, Zhou X, Yu J, Lyu M, Shen B, Zhu H, Xu J, Zhu Y, Guo T. Potential Use of Serum Proteomics for Monitoring COVID-19 Progression to Complement RT-PCR Detection. J Proteome Res 2022; 21:90-100. [PMID: 34783559 PMCID: PMC8610005 DOI: 10.1021/acs.jproteome.1c00525] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Indexed: 12/18/2022]
Abstract
RT-PCR is the primary method to diagnose COVID-19 and is also used to monitor the disease course. This approach, however, suffers from false negatives due to RNA instability and poses a high risk to medical practitioners. Here, we investigated the potential of using serum proteomics to predict viral nucleic acid positivity during COVID-19. We analyzed the proteome of 275 inactivated serum samples from 54 out of 144 COVID-19 patients and shortlisted 42 regulated proteins in the severe group and 12 in the non-severe group. Using these regulated proteins and several key clinical indexes, including days after symptoms onset, platelet counts, and magnesium, we developed two machine learning models to predict nucleic acid positivity, with an AUC of 0.94 in severe cases and 0.89 in non-severe cases, respectively. Our data suggest the potential of using a serum protein-based machine learning model to monitor COVID-19 progression, thus complementing swab RT-PCR tests. More efforts are required to promote this approach into clinical practice since mass spectrometry-based protein measurement is not currently widely accessible in clinic.
Collapse
Affiliation(s)
- Ying Zhang
- Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000,
China
| | - Xue Cai
- Key Laboratory of Structural Biology of Zhejiang
Province, School of Life Sciences, Westlake University, Xihu
District, Hangzhou, Zhejiang 310000, China
- Center for Infectious Disease Research,
Westlake Laboratory of Life Sciences and Biomedicine, Xihu
District, Hangzhou, Zhejiang 310000, China
- Institute of Basic Medical Sciences,
Westlake Institute for Advanced Study, Xihu District,
Hangzhou, Zhejiang 310000, China
| | - Weigang Ge
- Key Laboratory of Structural Biology of Zhejiang
Province, School of Life Sciences, Westlake University, Xihu
District, Hangzhou, Zhejiang 310000, China
- Center for Infectious Disease Research,
Westlake Laboratory of Life Sciences and Biomedicine, Xihu
District, Hangzhou, Zhejiang 310000, China
- Institute of Basic Medical Sciences,
Westlake Institute for Advanced Study, Xihu District,
Hangzhou, Zhejiang 310000, China
- Westlake Omics (Hangzhou) Biotechnology
Co., Ltd., No.1, Yunmeng Road, Cloud Town, Xihu District, Hangzhou,
Zhejiang 310000, China
| | - Donglian Wang
- Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000,
China
| | - Guangjun Zhu
- Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000,
China
| | - Liujia Qian
- Key Laboratory of Structural Biology of Zhejiang
Province, School of Life Sciences, Westlake University, Xihu
District, Hangzhou, Zhejiang 310000, China
- Center for Infectious Disease Research,
Westlake Laboratory of Life Sciences and Biomedicine, Xihu
District, Hangzhou, Zhejiang 310000, China
- Institute of Basic Medical Sciences,
Westlake Institute for Advanced Study, Xihu District,
Hangzhou, Zhejiang 310000, China
| | - Nan Xiang
- Key Laboratory of Structural Biology of Zhejiang
Province, School of Life Sciences, Westlake University, Xihu
District, Hangzhou, Zhejiang 310000, China
- Center for Infectious Disease Research,
Westlake Laboratory of Life Sciences and Biomedicine, Xihu
District, Hangzhou, Zhejiang 310000, China
- Institute of Basic Medical Sciences,
Westlake Institute for Advanced Study, Xihu District,
Hangzhou, Zhejiang 310000, China
- Westlake Omics (Hangzhou) Biotechnology
Co., Ltd., No.1, Yunmeng Road, Cloud Town, Xihu District, Hangzhou,
Zhejiang 310000, China
| | - Liang Yue
- Key Laboratory of Structural Biology of Zhejiang
Province, School of Life Sciences, Westlake University, Xihu
District, Hangzhou, Zhejiang 310000, China
- Center for Infectious Disease Research,
Westlake Laboratory of Life Sciences and Biomedicine, Xihu
District, Hangzhou, Zhejiang 310000, China
- Institute of Basic Medical Sciences,
Westlake Institute for Advanced Study, Xihu District,
Hangzhou, Zhejiang 310000, China
| | - Shuang Liang
- Key Laboratory of Structural Biology of Zhejiang
Province, School of Life Sciences, Westlake University, Xihu
District, Hangzhou, Zhejiang 310000, China
- Center for Infectious Disease Research,
Westlake Laboratory of Life Sciences and Biomedicine, Xihu
District, Hangzhou, Zhejiang 310000, China
- Institute of Basic Medical Sciences,
Westlake Institute for Advanced Study, Xihu District,
Hangzhou, Zhejiang 310000, China
| | - Fangfei Zhang
- Key Laboratory of Structural Biology of Zhejiang
Province, School of Life Sciences, Westlake University, Xihu
District, Hangzhou, Zhejiang 310000, China
- Center for Infectious Disease Research,
Westlake Laboratory of Life Sciences and Biomedicine, Xihu
District, Hangzhou, Zhejiang 310000, China
- Institute of Basic Medical Sciences,
Westlake Institute for Advanced Study, Xihu District,
Hangzhou, Zhejiang 310000, China
| | - Jing Wang
- Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000,
China
| | - Kai Zhou
- Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000,
China
| | - Yufen Zheng
- Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000,
China
| | - Minjie Lin
- Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000,
China
| | - Tong Sun
- Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000,
China
| | - Ruyue Lu
- Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000,
China
| | - Chao Zhang
- Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000,
China
| | - Luang Xu
- Key Laboratory of Structural Biology of Zhejiang
Province, School of Life Sciences, Westlake University, Xihu
District, Hangzhou, Zhejiang 310000, China
- Center for Infectious Disease Research,
Westlake Laboratory of Life Sciences and Biomedicine, Xihu
District, Hangzhou, Zhejiang 310000, China
- Institute of Basic Medical Sciences,
Westlake Institute for Advanced Study, Xihu District,
Hangzhou, Zhejiang 310000, China
| | - Yaoting Sun
- Key Laboratory of Structural Biology of Zhejiang
Province, School of Life Sciences, Westlake University, Xihu
District, Hangzhou, Zhejiang 310000, China
- Center for Infectious Disease Research,
Westlake Laboratory of Life Sciences and Biomedicine, Xihu
District, Hangzhou, Zhejiang 310000, China
- Institute of Basic Medical Sciences,
Westlake Institute for Advanced Study, Xihu District,
Hangzhou, Zhejiang 310000, China
| | - Xiaoxu Zhou
- Key Laboratory of Structural Biology of Zhejiang
Province, School of Life Sciences, Westlake University, Xihu
District, Hangzhou, Zhejiang 310000, China
- Institute of Basic Medical Sciences,
Westlake Institute for Advanced Study, Xihu District,
Hangzhou, Zhejiang 310000, China
| | - Jing Yu
- Key Laboratory of Structural Biology of Zhejiang
Province, School of Life Sciences, Westlake University, Xihu
District, Hangzhou, Zhejiang 310000, China
- Center for Infectious Disease Research,
Westlake Laboratory of Life Sciences and Biomedicine, Xihu
District, Hangzhou, Zhejiang 310000, China
- Institute of Basic Medical Sciences,
Westlake Institute for Advanced Study, Xihu District,
Hangzhou, Zhejiang 310000, China
| | - Mengge Lyu
- Key Laboratory of Structural Biology of Zhejiang
Province, School of Life Sciences, Westlake University, Xihu
District, Hangzhou, Zhejiang 310000, China
- Center for Infectious Disease Research,
Westlake Laboratory of Life Sciences and Biomedicine, Xihu
District, Hangzhou, Zhejiang 310000, China
- Institute of Basic Medical Sciences,
Westlake Institute for Advanced Study, Xihu District,
Hangzhou, Zhejiang 310000, China
| | - Bo Shen
- Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000,
China
| | - Hongguo Zhu
- Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000,
China
| | - Jiaqin Xu
- Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000,
China
| | - Yi Zhu
- Key Laboratory of Structural Biology of Zhejiang
Province, School of Life Sciences, Westlake University, Xihu
District, Hangzhou, Zhejiang 310000, China
- Center for Infectious Disease Research,
Westlake Laboratory of Life Sciences and Biomedicine, Xihu
District, Hangzhou, Zhejiang 310000, China
- Institute of Basic Medical Sciences,
Westlake Institute for Advanced Study, Xihu District,
Hangzhou, Zhejiang 310000, China
| | - Tiannan Guo
- Key Laboratory of Structural Biology of Zhejiang
Province, School of Life Sciences, Westlake University, Xihu
District, Hangzhou, Zhejiang 310000, China
- Center for Infectious Disease Research,
Westlake Laboratory of Life Sciences and Biomedicine, Xihu
District, Hangzhou, Zhejiang 310000, China
- Institute of Basic Medical Sciences,
Westlake Institute for Advanced Study, Xihu District,
Hangzhou, Zhejiang 310000, China
| |
Collapse
|
18
|
Aloglu M, Gulgosteren S, Atikcan S. Do the symptoms affect SARS-CoV-2 RT-PCR results? THE JOURNAL OF ASSOCIATION OF CHEST PHYSICIANS 2022. [DOI: 10.4103/jacp.jacp_37_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
|
19
|
Toori KU, Chaudhry A, Qureshi MA. Time to negative PCR in various disease categories of COVID-19 infection in Pakistani population. Pak J Med Sci 2022; 38:243-247. [PMID: 35035433 PMCID: PMC8713225 DOI: 10.12669/pjms.38.1.4476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 08/20/2021] [Indexed: 01/08/2023] Open
Abstract
Objectives: To identify association of epidemiological characteristics, presence of underlying pre-morbidities and disease severity with time to first negative PCR in Corona virus disease 2019. Methods: Total 842 Corona Virus Real Time Polymerase-Chain-Reaction positive patients were included in this cross-sectional study. Patients were admitted to Department of Medicine at KRL Hospital Islamabad from April to August 2020. Age, gender, symptoms, pre-morbidities and disease severity were recorded. Outcome (recovered versus died) was documented. World Health Organization categories to classify disease severity (asymptomatic, mild, moderate and severe) were used. Time to negative PCR was documented as time between first positive PCR to first negative PCR. Results: The mean age of patients was 39.04 ± 11.32 years with 99.8 % being males. Majority of patients (78.4%) were asymptomatic. Amongst symptoms, fever was the most common symptom. Diabetes mellitus and hypertension were the most commonly recorded co-morbidity. Mean time to negative PCR was 8.8 ± 3.1 days. A large proportion of patients recovered (99.9%). Significant positive correlation (p value < 0.05) was found between age, gender, presence of underlying pre-morbidities and disease severity categories with time to first negative PCR. Conclusion: The underlying epidemiological factors, pre-morbidities and disease severity are associated with time to negative PCR and hence affect frequency of recovery samples.
Collapse
Affiliation(s)
- Kaleem Ullah Toori
- Dr. Kaleem Ullah Toori, FRCP (Glasgow) Department of Medicine, KRL Hospital, Islamabad, Pakistan
| | - Asma Chaudhry
- Dr. Asma Chaudhry, MRCP (UK), FCPS General Medicine, (Pakistan) Department of Medicine and Endocrinology, Southend University Hospital, Southend-on-Sea, United Kingdom
| | | |
Collapse
|
20
|
Verma A, Shukla S, Verma AK, Puri B, Jain A. Seropositivity of Anti-SARS CoV2 IgG antibodies in health care workers of an Indian tertiary care hospital during COVID-19. Indian J Med Microbiol 2022; 40:228-230. [PMID: 35277299 PMCID: PMC8903802 DOI: 10.1016/j.ijmmb.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/17/2022] [Accepted: 02/20/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE Health care workers [HCW] are at a higher risk of infection SARS CoV2 infection due to frequent and close contact to patients with COVID-19. METHODS Serum samples from 500 HCW's were tested for SARS CoV2 IgG antibodies in October 2020. A questionnaire was used to collect demographic and clinical data. All these HCWs were tested for COVID-19, in 2nd week of September 2020, as a hospital policy. RESULTS Anti SARS CoV2 antibodies were detected in 128/ 500 [25.6%] HCWs. A total of 195/ 500 [39%] enrolled cases had already tested positive for Covid-19 at least once in last six months by RT-PCR. Sixty eight percent of HCWs with previous COVID-19 positivity by RT- PCR tested positive for Anti SARS CoV2 antibodies, whereas only 2.76% of asymptomatic HCWs tested positive. Of 121 anti SARS-CoV-2 IgG positive persons, 70 [57.85%] had CT value < 25. Low CT value and asymptomatic cases had a strong reverse statistically significant association with SARS CoV2 IgG antibody positivity. CONCLUSIONS We report that sero-conversion rate in HCWs is similar to that in general population suggesting that preventive practices used in hospitals are satisfactory. Cases with low viral counts in respiratory sample and asymptomatic cases have lower rate of seroconversion.
Collapse
Affiliation(s)
- Anuragani Verma
- Department of Microbiology, King George's Medical University, Lucknow, UP, India
| | - Suruchi Shukla
- Department of Microbiology, King George's Medical University, Lucknow, UP, India
| | - Anil K. Verma
- Department of Microbiology, King George's Medical University, Lucknow, UP, India
| | - Bipin Puri
- King George's Medical University, Lucknow, UP, India
| | - Amita Jain
- Department of Microbiology, King George's Medical University, Lucknow, UP, India,Corresponding author
| |
Collapse
|
21
|
Yokoyama R, Kurano M, Nakano Y, Morita Y, Ohmiya H, Kishi Y, Okada J, Qian C, Xia F, He F, Zheng L, Yu Y, Mizoguchi M, Higurashi Y, Harada S, Jubishi D, Okamoto K, Moriya K, Kodama T, Yatomi Y. Association of the Serum Levels of the Nucleocapsid Antigen of SARS-CoV-2 With the Diagnosis, Disease Severity, and Antibody Titers in Patients With COVID-19: A Retrospective Cross-Sectional Study. Front Microbiol 2021; 12:791489. [PMID: 34956158 PMCID: PMC8696188 DOI: 10.3389/fmicb.2021.791489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/22/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Several types of laboratory tests for COVID-19 have been established to date; however, the clinical significance of the serum SARS-CoV-2 nucleocapsid (N) antigen levels remains to be fully elucidated. In the present study, we attempted to elucidate the usefulness and clinical significance of the serum N antigen levels. Methods: We measured the serum N antigen levels in 391 serum samples collected from symptomatic patients with a confirmed diagnosis of COVID-19 and 96 serum samples collected from patients with non-COVID-19, using a fully automated chemiluminescence immunoassay analyzer. Results: Receiver operating characteristic analysis identified the optimal cutoff value of the serum N antigen level (cutoff index, based on Youden’s index) as 0.255, which yielded a sensitivity and specificity for the diagnosis of COVID-19 of 91.0 and 81.3%, respectively. The serum N antigen levels were significantly higher in the patient groups with moderate and severe COVID-19 than with mild disease. Moreover, a significant negative correlation was observed between the serum N antigen levels and the SARS-CoV-2 IgG antibody titers, especially in patients with severe COVID-19. Conclusion: Serum N antigen testing might be useful both for the diagnosis of COVID-19 and for obtaining a better understanding of the clinical features of the disease.
Collapse
Affiliation(s)
- Rin Yokoyama
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Makoto Kurano
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan.,Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuki Nakano
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Yoshifumi Morita
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Hiroko Ohmiya
- Sales and Marketing Division, Business Planning Department, Medical and Biological Laboratories Co., Ltd., Tokyo, Japan
| | - Yoshiro Kishi
- Sales and Marketing Division, Business Planning Department, Medical and Biological Laboratories Co., Ltd., Tokyo, Japan
| | - Jun Okada
- Sales and Marketing Division, Business Planning Department, Medical and Biological Laboratories Co., Ltd., Tokyo, Japan
| | - Chungen Qian
- The Key Laboratory for Biomedical Photonics of MOE at Wuhan National Laboratory for Optoelectronics-Hubei Bioinformatics and Molecular Imaging Key Laboratory, Systems Biology Theme, Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Fuzhen Xia
- Reagent R and D Center, Shenzhen YHLO Biotech Co., Ltd., Guangdong, China
| | - Fan He
- Reagent R and D Center, Shenzhen YHLO Biotech Co., Ltd., Guangdong, China
| | - Liang Zheng
- Reagent R and D Center, Shenzhen YHLO Biotech Co., Ltd., Guangdong, China
| | - Yi Yu
- Reagent R and D Center, Shenzhen YHLO Biotech Co., Ltd., Guangdong, China
| | - Miyuki Mizoguchi
- Department of Infection Control and Prevention, The University of Tokyo, Tokyo, Japan
| | - Yoshimi Higurashi
- Department of Infection Control and Prevention, The University of Tokyo, Tokyo, Japan
| | - Sohei Harada
- Department of Infection Control and Prevention, The University of Tokyo, Tokyo, Japan
| | - Daisuke Jubishi
- Department of Infection Control and Prevention, The University of Tokyo, Tokyo, Japan
| | - Koh Okamoto
- Department of Infection Control and Prevention, The University of Tokyo, Tokyo, Japan
| | - Kyoji Moriya
- Department of Infection Control and Prevention, The University of Tokyo, Tokyo, Japan
| | - Tatsuhiko Kodama
- Laboratory for Systems Biology and Medicine, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan.,Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
22
|
Response kinetics of different classes of antibodies to SARS-CoV2 infection in the Japanese population: The IgA and IgG titers increased earlier than the IgM titers. Int Immunopharmacol 2021; 103:108491. [PMID: 34954559 PMCID: PMC8687758 DOI: 10.1016/j.intimp.2021.108491] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 12/13/2022]
Abstract
To better understand the immune responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in individuals with COVID-19, it is important to investigate the kinetics of the antibody responses and their associations with the clinical course in different populations, since there seem to be considerable differences between Western and Asian populations in the clinical features and spread of COVID-19. In this study, we serially measured the serum titers of IgM, IgG and IgA antibodies generated against the nucleocapsid protein (NCP), S1 subunit of the spike protein (S1), and receptor-binding domain in the S1 subunit (RBD) of SARS-CoV-2 in Japanese individuals with COVID-19. Among the IgM, IgG, and IgA antibodies, IgA antibodies against all of the aforementioned viral proteins were the first to appear after the infection, and IgG and/or IgA seroconversion often preceded IgM seroconversion. In regard to the timeline of the antibody responses to the different viral proteins (NCP, S1 and RBD), IgA against NCP appeared than IgA against S1 or RBD, while IgM and IgG against S1 appeared earlier than IgM/IgG against NCP or RBD. The IgG responses to all three viral proteins and responses of all three antibody classes to S1 and RBD were sustained for longer durations than the IgA/IgM responses to all three viral proteins and responses of all three antibody classes to NCP, respectively. The seroconversion of IgA against NCP occurred later and less frequently in patients with mild COVID-19. These results suggest possible differences in the antibody responses to SARS-CoV-2 antigens between the Japanese and Western populations.
Collapse
|
23
|
Heinrich F, Nentwich MF, Bibiza-Freiwald E, Nörz D, Roedl K, Christner M, Hoffmann A, Olearo F, Kluge S, Aepfelbacher M, Wichmann D, Lütgehetmann M, Pfefferle S. SARS-CoV-2 Blood RNA Load Predicts Outcome in Critically Ill COVID-19 Patients. Open Forum Infect Dis 2021; 8:ofab509. [PMID: 34796247 PMCID: PMC8522363 DOI: 10.1093/ofid/ofab509] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/04/2021] [Indexed: 01/19/2023] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA loads in patient specimens may act as a clinical outcome predictor in critically ill patients with coronavirus disease 2019 (COVID-19). Methods We evaluated the predictive value of viral RNA loads and courses in the blood compared with the upper and lower respiratory tract loads of critically ill COVID-19 patients. Daily specimen collection and viral RNA quantification by reverse transcription quantitative polymerase chain reaction were performed in all consecutive 170 COVID-19 patients between March 2020 and February 2021 during the entire intensive care unit (ICU) stay (4145 samples analyzed). Patients were grouped according to their 90-day outcome as survivors (n=100) or nonsurvivors (n=70). Results In nonsurvivors, blood SARS-CoV-2 RNA loads were significantly higher at the time of admission to the ICU (P=.0009). Failure of blood RNA clearance was observed in 33/50 (66%) of the nonsurvivors compared with 12/64 (19%) survivors (P<.0001). As determined by multivariate analysis, taking sociodemographic and clinical parameters into account, blood SARS-CoV-2 RNA load represents a valid and independent predictor of outcome in critically ill COVID-19 patients (odds ratio [OR; log10], 0.23; 95% CI, 0.12–0.42; P<.0001), with a significantly higher effect for survival compared with respiratory tract SARS-CoV-2 RNA loads (OR [log10], 0.75; 95% CI, 0.66–0.85; P<.0001). Blood RNA loads exceeding 2.51×103 SARS-CoV-2 RNA copies/mL were found to indicate a 50% probability of death. Consistently, 29/33 (88%) nonsurvivors with failure of virus clearance exceeded this cutoff value constantly. Conclusions Blood SARS-CoV-2 load is an important independent outcome predictor and should be further evaluated for treatment allocation and patient monitoring.
Collapse
Affiliation(s)
- Fabian Heinrich
- Center for Diagnostics, Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael F Nentwich
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eric Bibiza-Freiwald
- Center for Diagnostics, Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dominik Nörz
- Center for Diagnostics, Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kevin Roedl
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Christner
- Center for Diagnostics, Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Armin Hoffmann
- Center for Diagnostics, Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Flaminia Olearo
- Center for Diagnostics, Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Kluge
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Aepfelbacher
- Center for Diagnostics, Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dominic Wichmann
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marc Lütgehetmann
- Center for Diagnostics, Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Pfefferle
- Center for Diagnostics, Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
24
|
Changes in COVID-19 IgM and IgG antibodies in emergency medical technicians (EMTs). Am J Emerg Med 2021; 52:59-63. [PMID: 34864629 PMCID: PMC8594169 DOI: 10.1016/j.ajem.2021.11.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/08/2021] [Accepted: 11/11/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction Serologic testing can provide a safe and fast approach for assessing SARS-CoV-2 antibodies. These tests can be utilized as a complementary method in diagnosis and patients' follow-up, and can also be helpful in epidemiological studies. This study aimed to describe temporal changes in the incidence of COVID-19 IgM and IgG antibodies in emergency medical technicians (EMTs) within a specified time period. Methods All EMTs working for Tehran Emergency Medical Service (EMS) center during May to September 2020 were eligible for this study. Those EMTs who were suspected/probable/confirmed cases of COVID-19, based on WHO defined criteria and were willing to participate, entered the study. The EMTs underwent serology testing four weeks after the occurrence of exposure (in suspected cases) or onset of their symptoms (in probable/confirmed cases). Cases were further confirmed by RT-PCR and/or lung CT, and antibody testing was performed for the second and third time with 12-week intervals. Finger-stick blood sampling was utilized for the specimen collection in three different phases. Samples were then analyzed by a commercial immunochromatography-based kit for qualitative measurement of serum IgM and IgG antibodies against the COVID-19 S-protein antigen. Results Two hundred eighty-four participants met the inclusion criteria; their mean age was 35.9 (SD = 7.6) years and consisted of 244 (85.9%) males. COVID-19 was confirmed in 169 out of 284 participants. Subsequently, 142 and 122 participants were included in phases 2 and 3 of the study, respectively. The number of seronegative patients exceeded seropositive ones in all three phases. At baseline, 162 (57%) patients were seronegative, 27 (9.5%) were only positive for IgG, 3 (1.1%) were only positive for IgM, and 92 (32.4%) were positive for both antibodies; Seventy-eight (54.9%) were seronegative, and 31 (21.8%) were positive for both antibodies in the second phase; These values were 85 (69.6%) and 8 (6.6%) for the third phase, respectively. Among the people who were positive IgG in the first phase (80 people), 56.3% were still positive in the second phase and 27.5% in both subsequent phases. Conclusion The results of our study show that there is a significant reduction in COVID-19 antibody seropositivity over time.
Collapse
|
25
|
Kinetics of SARS-CoV-2 Specific and Neutralizing Antibodies over Seven Months after Symptom Onset in COVID-19 Patients. Microbiol Spectr 2021; 9:e0059021. [PMID: 34550000 PMCID: PMC8557935 DOI: 10.1128/spectrum.00590-21] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
To assess the persistence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies produced by natural infection and describe the serological characteristics over 7 months after symptom onset among coronavirus disease 2019 (COVID-19) patients by age and severity group, we followed up COVID-19 convalescent patients confirmed from 1 January to 20 March 2020 in Jiangsu, China and collected serum samples for testing IgM/IgG and neutralizing antibodies against SARS-CoV-2 between 26 August and 28 October 2020. In total, 284 recovered participants with COVID-19 were enrolled in our study. Patients had a mean age of 46.72 years (standard deviation [SD], 17.09), and 138 (48.59%) were male. The median follow-up time after symptom onset was 225.5 (interquartile range [IQR], 219 to 232) days. During the follow-up period (162 to 282 days after symptom onset), the seropositive rate of IgM fluctuated around 25.70% (95% confidence interval [CI], 20.72% to 31.20%) and that of IgG fluctuated around 79.93% (95% CI, 74.79% to 84.43%). Of the 284 patients, 64 participants were tested when discharged from hospital. Compared with that at the acute phase, the IgM/IgG antibody levels and IgM seropositivity have decreased; however, the seropositivity of IgG was not significantly lower at this follow-up (78.13% versus 82.81%). Fifty percent inhibitory dilution (ID50) titers of neutralizing antibody for samples when discharged from hospital (geometric mean titer [GMT], 82; 95% CI, 56 to 121) were significantly higher than those at 6 to 7 months after discharge (GMT, 47; 95% CI, 35 to 63) (P < 0.001). After 7 months from symptom onset, the convalescent COVID-19 patients continued to have high IgG seropositive; however, many plasma samples decreased neutralizing activity. IMPORTANCE The long-term characteristics of anti-SARS-CoV-2 antibodies among COVID-19 patients remain largely unclear. Tracking the longevity of these antibodies can provide a forward-looking reference for monitoring COVID-19. We conducted a comprehensive assessment combining the kinetics of specific and neutralizing antibodies over 7 months with age and disease severity and revealed influencing factors of the protection period of convalescent patients. By observing the long-term antibody levels against SARS-CoV-2 and comparing antibody levels at two time points after symptom onset, we found that the convalescent COVID-19 patients continued to have a high IgG seropositive rate; however, their plasma samples decreased neutralizing activity. These findings provide evidence supporting that the neutralizing activity of SARS-CoV-2-infected persons should be monitored and the administration of vaccine may be needed.
Collapse
|
26
|
Gaspar-Rodríguez A, Padilla-González A, Rivera-Toledo E. Coronavirus persistence in human respiratory tract and cell culture: An overview. Braz J Infect Dis 2021; 25:101632. [PMID: 34627782 PMCID: PMC8486621 DOI: 10.1016/j.bjid.2021.101632] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/13/2021] [Accepted: 09/13/2021] [Indexed: 01/12/2023] Open
Abstract
Emerging human coronaviruses, including the recently identified SARS-CoV-2, are relevant respiratory pathogens due to their potential to cause epidemics with high case fatality rates, although endemic coronaviruses are also important for immunocompromised patients. Long-term coronavirus infections had been described mainly in experimental models, but it is currently evident that SARS-CoV-2 genomic-RNA can persist for many weeks in the respiratory tract of some individuals clinically recovered from coronavirus infectious disease-19 (COVID-19), despite a lack of isolation of infectious virus. It is still not clear whether persistence of such viral RNA may be pathogenic for the host and related to long-term sequelae. In this review, we summarize evidence of SARS-CoV-2 RNA persistence in respiratory samples besides results obtained from cell culture and histopathology describing long-term coronavirus infection. We also comment on potential mechanisms of coronavirus persistence and relevance for pathogenesis.
Collapse
Affiliation(s)
- Adriana Gaspar-Rodríguez
- Universidad Nacional Autonoma de Mexico, Facultad de Medicina, Departamento de Microbiología y Parasitología, Coyoacan, Mexico
| | - Ana Padilla-González
- Universidad Nacional Autonoma de Mexico, Facultad de Medicina, Departamento de Microbiología y Parasitología, Coyoacan, Mexico.
| | - Evelyn Rivera-Toledo
- Universidad Nacional Autonoma de Mexico, Facultad de Medicina, Departamento de Microbiología y Parasitología, Coyoacan, Mexico.
| |
Collapse
|
27
|
Cui D, Tang Y, Jiang Q, Jiang D, Zhang Y, Lv Y, Xu D, Wu J, Xie J, Wen C, Lu L. Follicular Helper T Cells in the Immunopathogenesis of SARS-CoV-2 Infection. Front Immunol 2021; 12:731100. [PMID: 34603308 PMCID: PMC8481693 DOI: 10.3389/fimmu.2021.731100] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 09/01/2021] [Indexed: 12/21/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a serious infectious disease that has led to a global pandemic with high morbidity and mortality. High-affinity neutralizing antibody is important for controlling infection, which is closely regulated by follicular helper T (Tfh) cells. Tfh cells play a central role in promoting germinal center reactions and driving cognate B cell differentiation for antibody secretion. Available studies indicate a close relationship between virus-specific Tfh cell-mediated immunity and SARS-CoV-2 infection progression. Although several lines of evidence have suggested that Tfh cells contribute to the control of SARS-CoV-2 infection by eliciting neutralizing antibody productions, further studies are needed to elucidate Tfh-mediated effector mechanisms in anti-SARS-CoV-2 immunity. Here, we summarize the functional features and roles of virus-specific Tfh cells in the immunopathogenesis of SARS-CoV-2 infection and in COVID-19 vaccines, and highlight the potential of targeting Tfh cells as therapeutic strategy against SARS-CoV-2 infection.
Collapse
Affiliation(s)
- Dawei Cui
- Department of Blood Transfusion, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuan Tang
- Department of Pathology and Shenzhen Institute of Research and Innovation, The University of Hong Kong, Hong Kong, Hong Kong, SAR China.,Chongqing International Institute for Immunology, Chongqing, China
| | - Qi Jiang
- Department of Blood Transfusion, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
| | - Daixi Jiang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yun Zhang
- School of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yan Lv
- Department of Blood Transfusion, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dandan Xu
- Department of Blood Transfusion, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jian Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jue Xie
- Department of Blood Transfusion, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chengping Wen
- School of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Liwei Lu
- Department of Pathology and Shenzhen Institute of Research and Innovation, The University of Hong Kong, Hong Kong, Hong Kong, SAR China.,Chongqing International Institute for Immunology, Chongqing, China
| |
Collapse
|
28
|
Pang NYL, Pang ASR, Chow VT, Wang DY. Understanding neutralising antibodies against SARS-CoV-2 and their implications in clinical practice. Mil Med Res 2021; 8:47. [PMID: 34465396 PMCID: PMC8405719 DOI: 10.1186/s40779-021-00342-3] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 08/25/2021] [Indexed: 12/23/2022] Open
Abstract
SARS-CoV-2 is a newly identified member of the coronavirus family that has caused the Coronavirus disease 2019 (COVID-19) pandemic. This rapidly evolving and unrelenting SARS-CoV-2 has disrupted the lives and livelihoods of millions worldwide. As of 23 August 2021, a total of 211,373,303 COVID-19 cases have been confirmed globally with a death toll of 4,424,341. A strong understanding of the infection pathway of SARS-CoV-2, and how our immune system responds to the virus is highly pertinent for guiding the development and improvement of effective treatments. In this review, we discuss the current understanding of neutralising antibodies (NAbs) and their implications in clinical practice. The aspects include the pathophysiology of the immune response, particularly humoral adaptive immunity and the roles of NAbs from B cells in infection clearance. We summarise the onset and persistence of IgA, IgM and IgG antibodies, and we explore their roles in neutralising SARS-CoV-2, their persistence in convalescent individuals, and in reinfection. Furthermore, we also review the applications of neutralising antibodies in the clinical setting-from predictors of disease severity to serological testing to vaccinations, and finally in therapeutics such as convalescent plasma infusion.
Collapse
Affiliation(s)
- Natalie Yan-Lin Pang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | | | - Vincent T Chow
- Department of Microbiology and Immunology, National University of Singapore, Science Drive 2, Singapore, 117545, Singapore. .,Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore.
| | - De-Yun Wang
- Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore. .,Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore, 119228, Singapore.
| |
Collapse
|
29
|
Chen PZ, Bobrovitz N, Premji ZA, Koopmans M, Fisman DN, Gu FX. SARS-CoV-2 shedding dynamics across the respiratory tract, sex, and disease severity for adult and pediatric COVID-19. eLife 2021; 10:e70458. [PMID: 34414888 PMCID: PMC8504968 DOI: 10.7554/elife.70458] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/17/2021] [Indexed: 12/11/2022] Open
Abstract
Background Previously, we conducted a systematic review and analyzed the respiratory kinetics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Chen et al., 2021). How age, sex, and coronavirus disease 2019 (COVID-19) severity interplay to influence the shedding dynamics of SARS-CoV-2, however, remains poorly understood. Methods We updated our systematic dataset, collected individual case characteristics, and conducted stratified analyses of SARS-CoV-2 shedding dynamics in the upper (URT) and lower respiratory tract (LRT) across COVID-19 severity, sex, and age groups (aged 0-17 years, 18-59 years, and 60 years or older). Results The systematic dataset included 1266 adults and 136 children with COVID-19. Our analyses indicated that high, persistent LRT shedding of SARS-CoV-2 characterized severe COVID-19 in adults. Severe cases tended to show slightly higher URT shedding post-symptom onset, but similar rates of viral clearance, when compared to nonsevere infections. After stratifying for disease severity, sex and age (including child vs. adult) were not predictive of respiratory shedding. The estimated accuracy for using LRT shedding as a prognostic indicator for COVID-19 severity was up to 81%, whereas it was up to 65% for URT shedding. Conclusions Virological factors, especially in the LRT, facilitate the pathogenesis of severe COVID-19. Disease severity, rather than sex or age, predicts SARS-CoV-2 kinetics. LRT viral load may prognosticate COVID-19 severity in patients before the timing of deterioration and should do so more accurately than URT viral load. Funding Natural Sciences and Engineering Research Council of Canada (NSERC) Discovery Grant, NSERC Senior Industrial Research Chair, and the Toronto COVID-19 Action Fund.
Collapse
Affiliation(s)
- Paul Z Chen
- Department of Chemical Engineering & Applied Chemistry, University of TorontoTorontoCanada
| | - Niklas Bobrovitz
- Temerty Faculty of Medicine, University of TorontoTorontoCanada
- Department of Critical Care Medicine, Cumming School of Medicine, University of CalgaryCalgaryCanada
- O'Brien Institute of Public Health, University of CalgaryCalgaryCanada
| | | | - Marion Koopmans
- Department of Viroscience, Erasmus University Medical CenterRotterdamNetherlands
| | - David N Fisman
- Division of Epidemiology, Dalla Lana School of Public Health, University of TorontoTorontoCanada
| | - Frank X Gu
- Department of Chemical Engineering & Applied Chemistry, University of TorontoTorontoCanada
- Institute of Biomedical Engineering, University of TorontoTorontoCanada
| |
Collapse
|
30
|
Speer C, Morath C, Töllner M, Buylaert M, Göth D, Nusshag C, Kälble F, Schaier M, Grenz J, Kreysing M, Reichel P, Hidmark A, Ponath G, Schnitzler P, Zeier M, Süsal C, Klein K, Benning L. Humoral Responses to Single-Dose BNT162b2 mRNA Vaccination in Dialysis Patients Previously Infected With SARS-CoV-2. Front Med (Lausanne) 2021; 8:721286. [PMID: 34485347 PMCID: PMC8415834 DOI: 10.3389/fmed.2021.721286] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 07/26/2021] [Indexed: 01/18/2023] Open
Abstract
Seroconversion rates following infection and vaccination are lower in dialysis patients compared to healthy controls. There is an urgent need for the characterization of humoral responses and success of a single-dose SARS-CoV-2 vaccination in previously infected dialysis patients. We performed a dual-center cohort study comparing three different groups: 25 unvaccinated hemodialysis patients after PCR-confirmed COVID-19 (Group 1), 43 hemodialysis patients after two-time BNT162b2 vaccination without prior SARS-CoV-2 infection (Group 2), and 13 single-dose vaccinated hemodialysis patients with prior SARS-CoV-2 infection (Group 3). Group 3 consists of seven patients from Group 1 and 6 additional patients with sera only available after single-dose vaccination. Anti-S1 IgG, neutralizing antibodies, and antibodies against various SARS-CoV-2 protein epitopes were measured 3 weeks after the first and 3 weeks after the second vaccination in patients without prior SARS-CoV-2 infection, 6 weeks after the onset of COVID-19 in unvaccinated patients, and 3 weeks after single-dose vaccination in patients with prior SARS-CoV-2 infection, respectively. Unvaccinated patients after COVID-19 showed a significantly higher neutralizing antibody capacity than two-time vaccinated patients without prior COVID-19 [median (IQR) percent inhibition 88.0 (71.5-95.5) vs. 50.7 (26.4-81.0); P = 0.018]. After one single vaccine dose, previously infected individuals generated 15- to 34-fold higher levels of anti-S1 IgG than age- and dialysis vintage-matched unvaccinated patients after infection or two-time vaccinated patients without prior SARS-CoV-2 infection with a median (IQR) index of 274 (151-791) compared to 18 (8-41) and 8 (1-21) (for both P < 0.001). With a median (IQR) percent inhibition of 97.6 (97.2-98.9), the neutralizing capacity of SARS-CoV-2 antibodies was significantly higher in single-dose vaccinated patients with prior SARS-CoV-2 infection compared to other groups (for both P < 0.01). Bead-based analysis showed high antibody reactivity against various SARS-CoV-2 spike protein epitopes after single-dose vaccination in previously infected patients. In conclusion, single-dose vaccination in previously infected dialysis patients induced a strong and broad antibody reactivity against various SARS-CoV-2 spike protein epitopes with high neutralizing capacity.
Collapse
Affiliation(s)
- Claudius Speer
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
- Molecular Medicine Partnership Unit Heidelberg, European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - Christian Morath
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | | | - Mirabel Buylaert
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Daniel Göth
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Christian Nusshag
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Florian Kälble
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Matthias Schaier
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Julia Grenz
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Martin Kreysing
- Department of Gastroenterology and Hepatology, University of Heidelberg, Heidelberg, Germany
| | - Paula Reichel
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Asa Hidmark
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Gerald Ponath
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Paul Schnitzler
- Virology, Department of Infectious Diseases, University of Heidelberg, Heidelberg, Germany
| | - Martin Zeier
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Caner Süsal
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
| | - Katrin Klein
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Louise Benning
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
31
|
Hall JA, Harris RJ, Emmett HE, Lowe B, Singanayagam A, Twohig KA, Zaidi A, Kall M, Zambon M, Dabrera G. On the Sensitivity and Specificity of Postmortem Upper Respiratory Tract Testing for SARS-CoV-2. J Infect Dis 2021; 224:389-394. [PMID: 33999152 PMCID: PMC8194530 DOI: 10.1093/infdis/jiab270] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/13/2021] [Indexed: 01/18/2023] Open
Abstract
Background Post-mortem testing can improve our understanding of the impact of SARS-CoV-2 if it is sufficiently sensitive and specific. Methods We investigated the post-mortem sensitivity and specificity of reverse transcriptase PCR testing on upper respiratory swabs using a dataset of everyone who had been tested for SARS-CoV-2 before and after death in England between 1 st March-29 th October 2020. We analysed sensitivity in those who had a positive test before death by time to post-mortem test. We developed a multivariate model and conducted time-to-negativity survival analysis. For specificity we analysed those with a negative test in the week before death. Results Post-mortem testing within a week after death had a sensitivity of 96.8% if the person had tested positive within a week before death. There was no effect of age, sex, or specimen type on sensitivity, but individuals with COVID-19-related codes on their death certificate were 5.65 times more likely to test positive after death (95%CI 2.31,13.9). Specificity was 94.2%, increasing to 97.5% in individuals without COVID-19 on the death certificate. Conclusion Post-mortem testing has high sensitivity (96.8%) and specificity (94.2%) if performed within a week after death and could be a useful diagnostic tool.
Collapse
Affiliation(s)
- Jennifer A Hall
- National COVID-19 Epidemiology Cell, Public Health England, London, United Kingdom.,University College London Elizabeth Garrett Anderson (UCL EGA), Institute for Women's Health, London, United Kingdom
| | - Ross J Harris
- Statistics Modelling and Economics Department, Public Health England, London, United Kingdom
| | - Hannah E Emmett
- National COVID-19 Epidemiology Cell, Public Health England, London, United Kingdom
| | - Belinda Lowe
- National COVID-19 Epidemiology Cell, Public Health England, London, United Kingdom
| | - Anika Singanayagam
- National COVID-19 Virology Cell, Public Health England, London, United Kingdom
| | - Katherine A Twohig
- National COVID-19 Epidemiology Cell, Public Health England, London, United Kingdom
| | - Asad Zaidi
- National COVID-19 Epidemiology Cell, Public Health England, London, United Kingdom
| | - Meaghan Kall
- National COVID-19 Epidemiology Cell, Public Health England, London, United Kingdom
| | - Maria Zambon
- National COVID-19 Virology Cell, Public Health England, London, United Kingdom
| | - Gavin Dabrera
- National COVID-19 Epidemiology Cell, Public Health England, London, United Kingdom
| |
Collapse
|
32
|
Abdul Bari AB, Samuel PJ. Road toward universal COVID-19 testing method - A review. J Immunoassay Immunochem 2021; 42:335-346. [PMID: 33689569 DOI: 10.1080/15321819.2021.1895214] [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: 01/11/2023]
Abstract
Patients infected with novel coronavirus exhibit a wide range of symptoms from common cold to pneumonia. Furthermore, several cases have been reported as asymptomatic across the globe. Since there are no conclusive clinical manifestations, clinicians have to rely more on laboratory diagnostic methods for confirmation of coronavirus disease. Hematological and biochemical tests are found to be of more prognostic value. Genetic assays by means of rRT-PCR technique is time-consuming but seems to be a more sensitive and specific test among the available testing methods for diagnosis of the coronavirus disease. Radiological imaging of the CT chest of the confirmed positive patients taken during the initial few days doesn't show any significant changes. However, from the second week onward a ground glass lesion pattern is observed. The immunological tests which are being used as a rapid testing method are found to be more false test negative. Hence, based on the effectiveness of various testing methods, it can be concluded that either rRT-PCR or mass antibody testing has to be done, and it has to be compared with CT chest in order to avoid false negatives across the globe which may help in the prevention of community spread of the disease.
Collapse
|
33
|
Yang B, Fan J, Huang J, Guo E, Fu Y, Liu S, Xiao R, Liu C, Lu F, Qin T, He C, Wang Z, Qin X, Hu D, You L, Li X, Wang T, Wu P, Chen G, Zhou J, Li K, Sun C. Clinical and molecular characteristics of COVID-19 patients with persistent SARS-CoV-2 infection. Nat Commun 2021; 12:3501. [PMID: 34108465 PMCID: PMC8190301 DOI: 10.1038/s41467-021-23621-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 05/08/2021] [Indexed: 02/06/2023] Open
Abstract
The characteristics of COVID-19 patients with persistent SARS-CoV-2 infection are not yet well described. Here, we compare the clinical and molecular features of patients with long duration of viral shedding (LDs) with those from patients with short duration patients (SDs), and healthy donors (HDs). We find that several cytokines and chemokines, such as interleukin (IL)-2, tumor necrosis factor (TNF) and lymphotoxin α (LT-α) are present at lower levels in LDs than SDs. Single-cell RNA sequencing shows that natural killer (NK) cells and CD14+ monocytes are reduced, while regulatory T cells are increased in LDs; moreover, T and NK cells in LDs are less activated than in SDs. Importantly, most cells in LDs show reduced expression of ribosomal protein (RP) genes and related pathways, with this inversed correlation between RP levels and infection duration further validated in 103 independent patients. Our results thus indicate that immunosuppression and low RP expression may be related to the persistence of the viral infection in COVID-19 patients.
Collapse
Affiliation(s)
- Bin Yang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junpeng Fan
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jia Huang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ensong Guo
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Fu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Si Liu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rourou Xiao
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chen Liu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Funian Lu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tianyu Qin
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chao He
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zizhuo Wang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xu Qin
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dianxing Hu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lixin You
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xi Li
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tian Wang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Peng Wu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Chen
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianfeng Zhou
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kezhen Li
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Chaoyang Sun
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
- Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| |
Collapse
|
34
|
Falzone L, Gattuso G, Tsatsakis A, Spandidos DA, Libra M. Current and innovative methods for the diagnosis of COVID‑19 infection (Review). Int J Mol Med 2021; 47:100. [PMID: 33846767 PMCID: PMC8043662 DOI: 10.3892/ijmm.2021.4933] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/07/2021] [Indexed: 12/11/2022] Open
Abstract
The Coronavirus Disease 2019 (COVID‑19) pandemic has forced the scientific community to rapidly develop highly reliable diagnostic methods in order to effectively and accurately diagnose this pathology, thus limiting the spread of infection. Although the structural and molecular characteristics of the severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) were initially unknown, various diagnostic strategies useful for making a correct diagnosis of COVID‑19 have been rapidly developed by private research laboratories and biomedical companies. At present, rapid antigen or antibody tests, immunoenzymatic serological tests and molecular tests based on RT‑PCR are the most widely used and validated techniques worldwide. Apart from these conventional methods, other techniques, including isothermal nucleic acid amplification techniques, clusters of regularly interspaced short palindromic repeats/Cas (CRISPR/Cas)‑based approaches or digital PCR methods are currently used in research contexts or are awaiting approval for diagnostic use by competent authorities. In order to provide guidance for the correct use of COVID‑19 diagnostic tests, the present review describes the diagnostic strategies available which may be used for the diagnosis of COVID‑19 infection in both clinical and research settings. In particular, the technical and instrumental characteristics of the diagnostic methods used are described herein. In addition, updated and detailed information about the type of sample, the modality and the timing of use of specific tests are also discussed.
Collapse
Affiliation(s)
- Luca Falzone
- Epidemiology and Biostatistics Unit, National Cancer Institute-IRCCS 'Fondazione G. Pascale', I-80131 Naples, Italy
| | - Giuseppe Gattuso
- Department of Biomedical and Biotechnological Sciences, University of Catania, I-95123 Catania, Italy
| | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, 71003 Heraklion, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, I-95123 Catania, Italy
- Research Center for the Prevention, Diagnosis and Treatment of Tumors, University of Catania, I-95123 Catania, Italy
| |
Collapse
|
35
|
Falzone L, Gattuso G, Tsatsakis A, Spandidos DA, Libra M. Current and innovative methods for the diagnosis of COVID‑19 infection (Review). Int J Mol Med 2021. [PMID: 33846767 DOI: 10.3892/ijmm.2021.4933/html] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
The Coronavirus Disease 2019 (COVID‑19) pandemic has forced the scientific community to rapidly develop highly reliable diagnostic methods in order to effectively and accurately diagnose this pathology, thus limiting the spread of infection. Although the structural and molecular characteristics of the severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) were initially unknown, various diagnostic strategies useful for making a correct diagnosis of COVID‑19 have been rapidly developed by private research laboratories and biomedical companies. At present, rapid antigen or antibody tests, immunoenzymatic serological tests and molecular tests based on RT‑PCR are the most widely used and validated techniques worldwide. Apart from these conventional methods, other techniques, including isothermal nucleic acid amplification techniques, clusters of regularly interspaced short palindromic repeats/Cas (CRISPR/Cas)‑based approaches or digital PCR methods are currently used in research contexts or are awaiting approval for diagnostic use by competent authorities. In order to provide guidance for the correct use of COVID‑19 diagnostic tests, the present review describes the diagnostic strategies available which may be used for the diagnosis of COVID‑19 infection in both clinical and research settings. In particular, the technical and instrumental characteristics of the diagnostic methods used are described herein. In addition, updated and detailed information about the type of sample, the modality and the timing of use of specific tests are also discussed.
Collapse
Affiliation(s)
- Luca Falzone
- Epidemiology and Biostatistics Unit, National Cancer Institute‑IRCCS 'Fondazione G. Pascale', I‑80131 Naples, Italy
| | - Giuseppe Gattuso
- Department of Biomedical and Biotechnological Sciences, University of Catania, I‑95123 Catania, Italy
| | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, I‑95123 Catania, Italy
| |
Collapse
|
36
|
Kortela E, Kirjavainen V, Ahava MJ, Jokiranta ST, But A, Lindahl A, Jääskeläinen AE, Jääskeläinen AJ, Järvinen A, Jokela P, Kallio-Kokko H, Loginov R, Mannonen L, Ruotsalainen E, Sironen T, Vapalahti O, Lappalainen M, Kreivi HR, Jarva H, Kurkela S, Kekäläinen E. Real-life clinical sensitivity of SARS-CoV-2 RT-PCR test in symptomatic patients. PLoS One 2021; 16:e0251661. [PMID: 34019562 PMCID: PMC8139477 DOI: 10.1371/journal.pone.0251661] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 04/29/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Understanding the false negative rates of SARS-CoV-2 RT-PCR testing is pivotal for the management of the COVID-19 pandemic and it has implications for patient management. Our aim was to determine the real-life clinical sensitivity of SARS-CoV-2 RT-PCR. METHODS This population-based retrospective study was conducted in March-April 2020 in the Helsinki Capital Region, Finland. Adults who were clinically suspected of SARS-CoV-2 infection and underwent SARS-CoV-2 RT-PCR testing, with sufficient data in their medical records for grading of clinical suspicion were eligible. In addition to examining the first RT-PCR test of repeat-tested individuals, we also used high clinical suspicion for COVID-19 as the reference standard for calculating the sensitivity of SARS-CoV-2 RT-PCR. RESULTS All 1,194 inpatients (mean [SD] age, 63.2 [18.3] years; 45.2% women) admitted to COVID-19 cohort wards during the study period were included. The outpatient cohort of 1,814 individuals (mean [SD] age, 45.4 [17.2] years; 69.1% women) was sampled from epidemiological line lists by systematic quasi-random sampling. The sensitivity (95% CI) for laboratory confirmed cases (repeat-tested patients) was 85.7% (81.5-89.1%) inpatients; 95.5% (92.2-97.5%) outpatients, 89.9% (88.2-92.1%) all. When also patients that were graded as high suspicion but never tested positive were included in the denominator, the sensitivity (95% CI) was: 67.5% (62.9-71.9%) inpatients; 34.9% (31.4-38.5%) outpatients; 47.3% (44.4-50.3%) all. CONCLUSIONS The clinical sensitivity of SARS-CoV-2 RT-PCR testing was only moderate at best. The relatively high false negative rates of SARS-CoV-2 RT-PCR testing need to be accounted for in clinical decision making, epidemiological interpretations, and when using RT-PCR as a reference for other tests.
Collapse
Affiliation(s)
- Elisa Kortela
- Division of Infectious Diseases, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Vesa Kirjavainen
- HUSLAB Clinical Microbiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Maarit J. Ahava
- HUSLAB Clinical Microbiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Suvi T. Jokiranta
- Translational Immunology Research Program and Department of Bacteriology and Immunology, University of Helsinki, Helsinki, Finland
| | - Anna But
- Biostatistics Consulting, Department of Public Health, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anna Lindahl
- Department of Respiratory Medicine, Heart and Lung Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Anu E. Jääskeläinen
- HUSLAB Clinical Microbiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Annemarjut J. Jääskeläinen
- HUSLAB Clinical Microbiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Asko Järvinen
- Division of Infectious Diseases, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Pia Jokela
- HUSLAB Clinical Microbiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hannimari Kallio-Kokko
- HUSLAB Clinical Microbiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Raisa Loginov
- HUSLAB Clinical Microbiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Laura Mannonen
- HUSLAB Clinical Microbiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Eeva Ruotsalainen
- Division of Infectious Diseases, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tarja Sironen
- Department of Virology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Olli Vapalahti
- HUSLAB Clinical Microbiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Virology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Maija Lappalainen
- HUSLAB Clinical Microbiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna-Riikka Kreivi
- Department of Respiratory Medicine, Heart and Lung Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Hanna Jarva
- HUSLAB Clinical Microbiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Translational Immunology Research Program and Department of Bacteriology and Immunology, University of Helsinki, Helsinki, Finland
| | - Satu Kurkela
- HUSLAB Clinical Microbiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Eliisa Kekäläinen
- HUSLAB Clinical Microbiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Translational Immunology Research Program and Department of Bacteriology and Immunology, University of Helsinki, Helsinki, Finland
| |
Collapse
|
37
|
Salciccia S, Eisenberg ML, Maggi M, Lai S, Mastroianni CM, Pasculli P, Ciardi MR, Canale V, Ferro M, Busetto GM, De Berardinis E, Ricciuti GP, Sciarra A, Del Giudice F. Modeling the Contribution of Male Testosterone Levels to the Duration of Positive COVID Testing among Hospitalized Male COVID-19 Patients. Diagnostics (Basel) 2021; 11:581. [PMID: 33804969 PMCID: PMC8063957 DOI: 10.3390/diagnostics11040581] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/13/2021] [Accepted: 03/18/2021] [Indexed: 12/23/2022] Open
Abstract
Background: A growing body of evidence is emerging suggesting testosterone can affect all cells involved in the immune response to both bacterial and viral infections, and the testosterone effect on the immune response could explain the greater susceptibility of men to infections including COVID-19. We aimed to explore the predictive role of male serum total testosterone (TT) levels on the time till viral negativity testing among hospitalized COVID-19 patients. Methods: The univariate effect of risk factors for the duration of COVID-19 viral positivity was evaluated using the log-rank test and Kaplan-Meier estimates. A multivariable Cox regression model was developed to test the role of TT levels and the subsequent odds for shorter viral positivity intervals. Results: Increasing serum TT levels and the need for an oxygen administration strategy were independently predictive for respectively reduced and increased days to negativization (Hazard Ratio [HR]: 1.39, 95% CI: 0.95-2.03 and HR: 0.19, 95% CI: 0.03-1.18). Conclusion: Baseline higher TT levels for male COVID-19 patients at hospital admission are associated with shorter durations of positive COVID-19 testing and thus viral clearance. Our preliminary findings might play a relevant to help pandemic control strategies if these will be verified in future larger multicentric and possibly randomized trials.
Collapse
Affiliation(s)
- Stefano Salciccia
- Department of Maternal-Infant and Urological Sciences, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (S.S.); (M.M.); (V.C.); (E.D.B.); (G.P.R.); (A.S.); (F.D.G.)
| | - Michael L. Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - Martina Maggi
- Department of Maternal-Infant and Urological Sciences, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (S.S.); (M.M.); (V.C.); (E.D.B.); (G.P.R.); (A.S.); (F.D.G.)
| | - Silvia Lai
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy;
| | - Claudio Maria Mastroianni
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (C.M.M.); (P.P.); (M.R.C.)
| | - Patrizia Pasculli
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (C.M.M.); (P.P.); (M.R.C.)
| | - Maria Rosa Ciardi
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (C.M.M.); (P.P.); (M.R.C.)
| | - Vittorio Canale
- Department of Maternal-Infant and Urological Sciences, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (S.S.); (M.M.); (V.C.); (E.D.B.); (G.P.R.); (A.S.); (F.D.G.)
| | - Matteo Ferro
- Department of Urology, European Institute of Oncology (IEO), IRCCS, 20141 Milan, Italy
| | - Gian Maria Busetto
- Department of Urology and Organ Transplantation, University of Foggia, 71122 Foggia, Italy;
| | - Ettore De Berardinis
- Department of Maternal-Infant and Urological Sciences, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (S.S.); (M.M.); (V.C.); (E.D.B.); (G.P.R.); (A.S.); (F.D.G.)
| | - Gian Piero Ricciuti
- Department of Maternal-Infant and Urological Sciences, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (S.S.); (M.M.); (V.C.); (E.D.B.); (G.P.R.); (A.S.); (F.D.G.)
| | - Alessandro Sciarra
- Department of Maternal-Infant and Urological Sciences, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (S.S.); (M.M.); (V.C.); (E.D.B.); (G.P.R.); (A.S.); (F.D.G.)
| | - Francesco Del Giudice
- Department of Maternal-Infant and Urological Sciences, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy; (S.S.); (M.M.); (V.C.); (E.D.B.); (G.P.R.); (A.S.); (F.D.G.)
- Department of Urology, Stanford University School of Medicine, Stanford, CA 94305, USA;
| |
Collapse
|
38
|
Risk Factors and Mortality of COVID-19 in Patients With Lymphoma: A Multicenter Study. Hemasphere 2021; 5:e538. [PMID: 33604516 PMCID: PMC7886434 DOI: 10.1097/hs9.0000000000000538] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 01/08/2021] [Indexed: 02/06/2023] Open
Abstract
Patients with cancer are poorly represented in coronavirus disease 2019 (COVID-19) series, and heterogeneous series concerning hematology patients have been published. This study aimed to analyze the impact of COVID-19 in patients with lymphoma. We present a multicenter retrospective study from 19 centers in Madrid, Spain, evaluating risk factors for mortality in adult patients with COVID-19 and lymphoma. About 177 patients (55.9% male) were included with a median follow-up of 27 days and a median age of 70 years. At the time of COVID-19 diagnosis, 49.7% of patients were on active treatment. The overall mortality rate was 34.5%. Age >70 years, confusion, urea concentration, respiratory rate, blood pressure, and age >65 score ≥2, heart disease, and chronic kidney disease were associated with higher mortality risk (P < 0.05). Active disease significantly increased the risk of death (hazard ratio, 2.43; 95% confidence interval, 1.23-4.77; P = 0.01). However, active treatment did not modify mortality risk and no differences were found between the different therapeutic regimens. The persistence of severe acute respiratory syndrome coronavirus 2-positive polymerase chain reaction after week 6 was significantly associated with mortality (54.5% versus 1.4%; P < 0.001). We confirm an increased mortality compared with the general population. In view of our results, any interruption or delay in the start of treatment should be questioned given that active treatment has not been demonstrated to increase mortality risk and that achieving disease remission could lead to better outcomes.
Collapse
|