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Duell J, Abrisqueta P, Andre M, Gaidano G, Gonzales-Barca E, Jurczak W, Kalakonda N, Liberati AM, Maddocks KJ, Menne T, Nagy Z, Tournilhac O, Kuffer C, Bakuli A, Amin A, Gurbanov K, Salles G. Tafasitamab for patients with relapsed or refractory diffuse large B-cell lymphoma: final 5-year efficacy and safety findings in the phase II L-MIND study. Haematologica 2024; 109:553-566. [PMID: 37646664 PMCID: PMC10828760 DOI: 10.3324/haematol.2023.283480] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/23/2023] [Indexed: 09/01/2023] Open
Abstract
Tafasitamab, an anti-CD19 immunotherapy, is used with lenalidomide for patients with autologous stem cell transplant-ineligible relapsed/refractory diffuse large B-cell lymphoma based on the results of the phase II L-MIND study (NCT02399085). We report the final 5-year analysis of this study. Eighty patients ≥18 years who had received one to three prior systemic therapies, and had Eastern Cooperative Oncology Group performance status 0-2 received up to 12 cycles of co-administered tafasitamab and lenalidomide, followed by tafasitamab monotherapy until disease progression or unacceptable toxicity. The primary endpoint was the best objective response rate. Secondary endpoints included duration of response, progression-free survival, overall survival, and safety. Exploratory analyses evaluated efficacy endpoints by prior lines of therapy. At data cutoff on November 14, 2022, the objective response rate was 57.5%, with a complete response rate of 41.3% (n=33), which was consistent with prior analyses. With a median follow-up of 44.0 months, the median duration of response was not reached. The median progression-free survival was 11.6 months (95% confidence interval [95% CI]: 5.7-45.7) with a median follow-up of 45.6 months. The median overall survival was 33.5 months (95% CI: 18.3-not reached) with a median follow-up of 65.6 months. Patients who had received one prior line of therapy (n=40) showed a higher objective response rate (67.5%; 52.5% complete responses) compared to patients who had received two or more prior lines of therapy (n=40; 47.5%; 30% complete responses), but the median duration of response was not reached in either subgroup. Other exploratory analyses revealed consistent long-term efficacy results across subgroups. Adverse events were consistent with those described in previous reports, were manageable, and their frequency decreased during tafasitamab monotherapy, with no new safety concerns. This final 5-year analysis of L-MIND demonstrates that the immunotherapy combination of tafasitamab and lenalidomide is well tolerated and has long-term clinical benefit with durable responses.
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Affiliation(s)
- Johannes Duell
- Medizinische Klinik und Poliklinik II, Universitätsklinik Würzburg, Würzburg.
| | - Pau Abrisqueta
- Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital, Barcelona
| | - Marc Andre
- Centre Hospitalier Universitaire CHU UCL Namur, Belgium
| | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine University of Eastern Piedmont and Ospedale Maggiore della Carità, Novara
| | - Eva Gonzales-Barca
- Department of Hematology, Institut Català d'Oncologia, Hospitalet de Llobregat, IDIBELL, Univeristat de Barcelona, Barcelona
| | - Wojciech Jurczak
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Kraków
| | - Nagesh Kalakonda
- Department of Molecular and Clinical Cancer University of Liverpool, Liverpool, United Kingdom
| | - Anna Marina Liberati
- Università degli Studi di Perugia, Azienda Ospedaliera Santa Maria di Terni, Terni
| | - Kami J Maddocks
- Department of Internal Medicine, Arthur G James Comprehensive Cancer Center, Ohio State University Wexner Medical Center, Columbus, OH
| | - Tobias Menne
- Freeman Hospital, The Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
| | - Zsolt Nagy
- Semmelweis University, Budapest, Hungary
| | | | | | | | | | | | - Gilles Salles
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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2
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Kroidl I, Winter S, Rubio-Acero R, Bakuli A, Geldmacher C, Eser TM, Déak F, Horn S, Zielke A, Ahmed MIM, Diepers P, Guggenbühl J, Frese J, Bruger J, Puchinger K, Reich J, Falk P, Markgraf A, Fensterseifer H, Paunovic I, Thomschke A, Pritsch M, Riess F, Saathoff E, Hoelscher M, Olbrich L, Castelletti N, Wieser A. Studying temporal titre evolution of commercial SARS-CoV-2 assays reveals significant shortcomings of using BAU standardization for comparison. Virol J 2023; 20:200. [PMID: 37658454 PMCID: PMC10474769 DOI: 10.1186/s12985-023-02167-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 08/24/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Measuring specific anti-SARS-CoV-2 antibodies has become one of the main epidemiological tools to survey the ongoing SARS-CoV-2 pandemic, but also vaccination response. The WHO made available a set of well-characterized samples derived from recovered individuals to allow normalization between different quantitative anti-Spike assays to defined Binding Antibody Units (BAU). METHODS To assess sero-responses longitudinally, a cohort of ninety-nine SARS-CoV-2 RT-PCR positive subjects was followed up together with forty-five vaccinees without previous infection but with two vaccinations. Sero-responses were evaluated using a total of six different assays: four measuring anti-Spike proteins (converted to BAU), one measuring anti-Nucleocapsid proteins and one SARS-CoV-2 surrogate virus neutralization. Both cohorts were evaluated using the Euroimmun Anti-SARS-CoV-2-ELISA anti-S1 IgG and the Roche Elecsys Anti-SARS-CoV-2 anti-S1 assay. RESULTS In SARS-CoV-2-convalesce subjects, the BAU-sero-responses of Euroimmun Anti-SARS-CoV-2-ELISA anti-S1 IgG and Roche Elecsys Anti-SARS-CoV-2 anti-S1 peaked both at 47 (43-51) days, the first assay followed by a slow decay thereafter (> 208 days), while the second assay not presenting any decay within one year. Both assay values in BAUs are only equivalent a few months after infection, elsewhere correction factors up to 10 are necessary. In contrast, in infection-naive vaccinees the assays perform similarly. CONCLUSION The results of our study suggest that the establishment of a protective correlate or vaccination booster recommendation based on different assays, although BAU-standardised, is still challenging. At the moment the characteristics of the available assays used are not related, and the BAU-standardisation is unable to correct for that.
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Affiliation(s)
- Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Simon Winter
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Raquel Rubio-Acero
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- Max-von-Pettenkofer Institute, LMU Munich, Munich, Germany
| | - Abhishek Bakuli
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Christof Geldmacher
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Tabea M Eser
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Flora Déak
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Sacha Horn
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Anna Zielke
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Mohamed I M Ahmed
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Paulina Diepers
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Jessica Guggenbühl
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Jonathan Frese
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Jan Bruger
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Kerstin Puchinger
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Jakob Reich
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Philine Falk
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Alisa Markgraf
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Heike Fensterseifer
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Ivana Paunovic
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- Max-von-Pettenkofer Institute, LMU Munich, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Türkenstraße 87, 80799, Munich, Germany
| | - Angelika Thomschke
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Michael Pritsch
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Friedrich Riess
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Elmar Saathoff
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Türkenstraße 87, 80799, Munich, Germany
- Center for International Health (CIH), University Hospital, LMU Munich, 80336, Munich, Germany
| | - Laura Olbrich
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Noemi Castelletti
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Türkenstraße 87, 80799, Munich, Germany
- Institute of Radiation Medicine, Helmholtz Zentrum München, 85764, Neuherberg, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany.
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany.
- Max-von-Pettenkofer Institute, LMU Munich, Munich, Germany.
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Türkenstraße 87, 80799, Munich, Germany.
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Rachow A, Ivanova O, Bakuli A, Khosa C, Nhassengo P, Owolabi O, Jayasooriya S, Ntinginya NE, Sabi I, Rassool M, Bennet J, Niemann S, Mekota AM, Allwood BW, Wallis RS, Charalambous S, Hoelscher M, Churchyard G. Performance of spirometry assessment at TB diagnosis. Int J Tuberc Lung Dis 2023; 27:850-857. [PMID: 37880896 PMCID: PMC10599411 DOI: 10.5588/ijtld.23.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/08/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND: Spirometry is considered relevant for the diagnosis and monitoring of post-TB lung disease. However, spirometry is rarely done in newly diagnosed TB patients.METHODS: Newly diagnosed, microbiologically confirmed TB patients were recruited for the study. Spirometry was performed within 21 days of TB treatment initiation according to American Thoracic Society/European Respiratory Society guidelines. Spirometry analysis was done using Global Lung Initiative equations for standardisation.RESULTS: Of 1,430 eligible study participants, 24.7% (353/1,430) had no spirometry performed mainly due to contraindications and 23.0% (329/1,430) had invalid results; 52.3% (748/1,430) of participants had a valid result, 82.8% (619/748) of whom had abnormal spirometry. Of participants with abnormal spirometry, 70% (436/619) had low forced vital capacity (FVC), 6.1% (38/619) had a low ratio of forced expiratory volume in 1 sec (FEV1) to FVC, and 19.1% (118/619) had low FVC, as well as low FEV1/FVC ratio. Among those with abnormal spirometry, 26.3% (163/619) had severe lung impairment.CONCLUSIONS: In this population, a high proportion of not performed and invalid spirometry assessments was observed; this was addressed by removing tachycardia as a (relative) contraindication from the study guidance and retraining. The high proportion of patients with severe pulmonary impairment at the time of TB diagnosis suggests a huge morbidity burden and calls for further longitudinal studies on the relevance of spirometry in predicting chronic lung impairment after TB.
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Affiliation(s)
- A Rachow
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich, German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - O Ivanova
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich
| | - A Bakuli
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich
| | - C Khosa
- Instituto Nacional de Saúde, Marracuene, Mozambique
| | - P Nhassengo
- Instituto Nacional de Saúde, Marracuene, Mozambique
| | - O Owolabi
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - S Jayasooriya
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - N E Ntinginya
- Mbeya Medical Research Centre, National Institute for Medical Research, Mbeya, Tanzania
| | - I Sabi
- Mbeya Medical Research Centre, National Institute for Medical Research, Mbeya, Tanzania
| | - M Rassool
- Clinical HIV Research Unit, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - J Bennet
- Clinical HIV Research Unit, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - S Niemann
- Leibniz Lung Center, Research Center Borstel, Borstel, Germany
| | - A-M Mekota
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich
| | - B W Allwood
- Division of Pulmonology, Department of Medicine Stellenbosch University and Tygerberg Hospital, Cape Town
| | | | - S Charalambous
- The Aurum Institute, Johannesburg, Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - M Hoelscher
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich, German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - G Churchyard
- The Aurum Institute, Johannesburg, Department of Medicine, Vanderbilt University, Nashville, TN, USA
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4
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Le Gleut R, Plank M, Pütz P, Radon K, Bakuli A, Rubio-Acero R, Paunovic I, Rieß F, Winter S, Reinkemeyer C, Schälte Y, Olbrich L, Hannes M, Kroidl I, Noreña I, Janke C, Wieser A, Hoelscher M, Fuchs C, Castelletti N. The representative COVID-19 cohort Munich (KoCo19): from the beginning of the pandemic to the Delta virus variant. BMC Infect Dis 2023; 23:466. [PMID: 37442952 DOI: 10.1186/s12879-023-08435-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Population-based serological studies allow to estimate prevalence of SARS-CoV-2 infections despite a substantial number of mild or asymptomatic disease courses. This became even more relevant for decision making after vaccination started. The KoCo19 cohort tracks the pandemic progress in the Munich general population for over two years, setting it apart in Europe. METHODS Recruitment occurred during the initial pandemic wave, including 5313 participants above 13 years from private households in Munich. Four follow-ups were held at crucial times of the pandemic, with response rates of at least 70%. Participants filled questionnaires on socio-demographics and potential risk factors of infection. From Follow-up 2, information on SARS-CoV-2 vaccination was added. SARS-CoV-2 antibody status was measured using the Roche Elecsys® Anti-SARS-CoV-2 anti-N assay (indicating previous infection) and the Roche Elecsys® Anti-SARS-CoV-2 anti-S assay (indicating previous infection and/or vaccination). This allowed us to distinguish between sources of acquired antibodies. RESULTS The SARS-CoV-2 estimated cumulative sero-prevalence increased from 1.6% (1.1-2.1%) in May 2020 to 14.5% (12.7-16.2%) in November 2021. Underreporting with respect to official numbers fluctuated with testing policies and capacities, becoming a factor of more than two during the second half of 2021. Simultaneously, the vaccination campaign against the SARS-CoV-2 virus increased the percentage of the Munich population having antibodies, with 86.8% (85.5-87.9%) having developed anti-S and/or anti-N in November 2021. Incidence rates for infections after (BTI) and without previous vaccination (INS) differed (ratio INS/BTI of 2.1, 0.7-3.6). However, the prevalence of infections was higher in the non-vaccinated population than in the vaccinated one. Considering the whole follow-up time, being born outside Germany, working in a high-risk job and living area per inhabitant were identified as risk factors for infection, while other socio-demographic and health-related variables were not. Although we obtained significant within-household clustering of SARS-CoV-2 cases, no further geospatial clustering was found. CONCLUSIONS Vaccination increased the coverage of the Munich population presenting SARS-CoV-2 antibodies, but breakthrough infections contribute to community spread. As underreporting stays relevant over time, infections can go undetected, so non-pharmaceutical measures are crucial, particularly for highly contagious strains like Omicron.
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Affiliation(s)
- Ronan Le Gleut
- Institute of Computational Biology, Helmholtz Munich, German Research Centre for Environmental Health, 85764, Neuherberg, Germany
- Core Facility Statistical Consulting, Helmholtz Munich, German Research Centre for Environmental Health, 85764, Neuherberg, Germany
| | - Michael Plank
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Peter Pütz
- Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Katja Radon
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336, Munich, Germany
- Centre for International Health (CIH), University Hospital, LMU Munich, 80336, Munich, Germany
- Comprehensive Pneumology Centre (CPC) Munich, German Centre for Lung Research (DZL), 89337, Munich, Germany
| | - Abhishek Bakuli
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Raquel Rubio-Acero
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Ivana Paunovic
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Friedrich Rieß
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Simon Winter
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Christina Reinkemeyer
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Yannik Schälte
- Institute of Computational Biology, Helmholtz Munich, German Research Centre for Environmental Health, 85764, Neuherberg, Germany
- Centre for Mathematics, Technische Universität München, 85748, Garching, Germany
- Life and Medical Sciences Institute, University of Bonn, 53115, Bonn, Germany
| | - Laura Olbrich
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Marlene Hannes
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Ivan Noreña
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Christian Janke
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, 80799, Munich, Germany
- Max Von Pettenkofer Institute, Faculty of Medicine, LMU Munich, 80336, Munich, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
- Centre for International Health (CIH), University Hospital, LMU Munich, 80336, Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, 80799, Munich, Germany
| | - Christiane Fuchs
- Institute of Computational Biology, Helmholtz Munich, German Research Centre for Environmental Health, 85764, Neuherberg, Germany
- Core Facility Statistical Consulting, Helmholtz Munich, German Research Centre for Environmental Health, 85764, Neuherberg, Germany
- Centre for Mathematics, Technische Universität München, 85748, Garching, Germany
- Faculty of Business Administration and Economics, Bielefeld University, 33615, Bielefeld, Germany
| | - Noemi Castelletti
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany.
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, 80799, Munich, Germany.
- Institute of Radiation Medicine, Helmholtz Munich, German Research Centre for Environmental Health, 85764, Neuherberg, Germany.
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5
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Korri R, Bakuli A, Owolabi OA, Lalashowi J, Azize C, Rassool M, Sathar F, Rachow A, Ivanova O. Tuberculosis and Sexual and Reproductive Health of Women in Four African Countries. Int J Environ Res Public Health 2022; 19:15103. [PMID: 36429820 PMCID: PMC9690042 DOI: 10.3390/ijerph192215103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 06/16/2023]
Abstract
Tuberculosis (TB) is a major reason of maternal mortality in low-income countries, and it increases the probability of adverse sexual and reproductive health (SRH) outcomes, including ectopic pregnancy and perinatal mortality. The data presented here is from the TB Sequel observational cohort conducted in four African countries. For this sub-study, we selected only female participants, who were diagnosed with drug susceptible TB and followed-up until the end of anti-TB treatment. The data collection included questionnaires, clinical examination and laboratory tests at TB diagnosis, day 14, month 2, 4 and 6. A total of 486 women, with 88.3% being 18-49 years old, were included in the analysis. Around 54.7% were HIV positive. Most of the participants (416/486; 85.6%) in our cohort were considered cured at month 6. Only 40.4% of non-pregnant women of reproductive age used contraception at TB diagnosis. A total of 31 out of 486 women experienced pregnancy during TB treatment. Pregnancy outcomes varied between live birth (16/31; 51.6%), induced abortion (6/31; 19.4%), miscarriage (4/31; 12.9%) and stillbirth (3/31; 9.6%). Integration and linking of SRH services with TB programmes are vital to increase contraception use and protect women from obstetric risks associated with pregnancy during TB treatment.
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Affiliation(s)
- Rayan Korri
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), 80802 Munich, Germany
| | - Abhishek Bakuli
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), 80802 Munich, Germany
| | - Olumuyiwa A. Owolabi
- Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Banjul P.O. Box 273, The Gambia
| | - Julieth Lalashowi
- National Institute for Medical Research (NIMR), Mbeya Medical Research Centre, Mbeya P.O. Box 2410, Tanzania
| | - Cândido Azize
- Instituto Nacional de Saúde (INS), Marracuene 3943, Mozambique
| | - Mohammed Rassool
- Clinical HIV Research Unit, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg 2092, South Africa
| | | | - Andrea Rachow
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), 80802 Munich, Germany
- German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany
| | - Olena Ivanova
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), 80802 Munich, Germany
- German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany
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6
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Sitoe N, Ahmed MIM, Enosse M, Bakuli A, Chissumba RM, Held K, Hoelscher M, Nhassengo P, Khosa C, Rachow A, Geldmacher C. Tuberculosis Treatment Response Monitoring by the Phenotypic Characterization of MTB-Specific CD4+ T-Cells in Relation to HIV Infection Status. Pathogens 2022; 11:pathogens11091034. [PMID: 36145465 PMCID: PMC9506022 DOI: 10.3390/pathogens11091034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/03/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
HIV infection causes systemic immune activation, impacts TB disease progression and hence may influence the diagnostic usability of Mycobacterium tuberculosis-specific T cell profiling. We investigated changes of activation and maturation markers on MTB-specific CD4+ T-cells after anti-tuberculosis treatment initiation in relation to HIV status and the severity of lung impairment. Thawed peripheral blood mononuclear cells from TB patients with (n = 27) and without HIV (n = 17) were analyzed using an intracellular IFN-γ assay and flow cytometry 2 and 6 months post-TB treatment initiation. H37Rv antigen was superior to the profile MTB-specific CD4+ T-cells phenotype when compared to PPD and ESAT6/CFP10. Regardless of HIV status and the severity of lung impairment, activation markers (CD38, HLA-DR and Ki67) on MTB-specific CD4+ T-cells declined after TB treatment initiation (p < 0.01), but the expression of the maturation marker CD27 did not change over the course of TB treatment. The MTB-specific T cell phenotype before, during and after treatment completion was similar between people living with and without HIV, as well as between subjects with severe and mild lung impairment. These data suggest that the assessment of activation and maturation markers on MTB-specific CD4+ T-cells can be useful for TB treatment monitoring, regardless of HIV status and the severity of lung disease.
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Affiliation(s)
- Nádia Sitoe
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique
- CIH LMU Center for International Health, Ludwig-Maximilians University, 80802 Munich, Germany
- Correspondence: ; Tel.: +258-840784833
| | - Mohamed I. M. Ahmed
- Division of Infectious Diseases and Tropical Medicine, Klinikum of the University of Munich (LMU), 80802 Munich, Germany
- German Center for Infection Research, Partner Site Munich, 80802 Munich, Germany
| | - Maria Enosse
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique
| | - Abhishek Bakuli
- Division of Infectious Diseases and Tropical Medicine, Klinikum of the University of Munich (LMU), 80802 Munich, Germany
- German Center for Infection Research, Partner Site Munich, 80802 Munich, Germany
| | | | - Kathrin Held
- Division of Infectious Diseases and Tropical Medicine, Klinikum of the University of Munich (LMU), 80802 Munich, Germany
- German Center for Infection Research, Partner Site Munich, 80802 Munich, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, Klinikum of the University of Munich (LMU), 80802 Munich, Germany
- German Center for Infection Research, Partner Site Munich, 80802 Munich, Germany
| | | | - Celso Khosa
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique
| | - Andrea Rachow
- Division of Infectious Diseases and Tropical Medicine, Klinikum of the University of Munich (LMU), 80802 Munich, Germany
- German Center for Infection Research, Partner Site Munich, 80802 Munich, Germany
| | - Christof Geldmacher
- Division of Infectious Diseases and Tropical Medicine, Klinikum of the University of Munich (LMU), 80802 Munich, Germany
- German Center for Infection Research, Partner Site Munich, 80802 Munich, Germany
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7
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Ntinginya NE, Bakuli A, Mapamba D, Sabiiti W, Kibiki G, Minja LT, Kuchaka D, Reither K, Phillips PPJ, Boeree MJ, Gillespie SH, Hoelscher M, Heinrich N. Tuberculosis Molecular Bacterial Load Assay Reveals Early Delayed Bacterial Killing in Patients With Relapse. Clin Infect Dis 2022; 76:e990-e994. [PMID: 35717643 PMCID: PMC9907486 DOI: 10.1093/cid/ciac445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 05/25/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
Bacterial killing in patients with tuberculosis (TB) relapse was compared to that in patients achieving cure, measured by TB molecular bacterial load assay (TB-MBLA) or mycobacteria growth indicator tube (MGIT) time to positivity (TTP). TB-MBLA in 4 relapsed patients was significantly different compared to 132 cured patients after 2 weeks of treatment; MGIT TTP showed a significant difference from week 8.
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Affiliation(s)
| | | | - Daniel Mapamba
- National Institute for Medical Research–Mbeya Medical Research Centre, Mbeya, United Republic of Tanzania
| | - Wilber Sabiiti
- Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Gibson Kibiki
- East African Health Research Commission, Bujumbura, Burundi
| | | | - Davis Kuchaka
- Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
| | - Klaus Reither
- Ifakara Health Institute,Dar Es Salaam, United Republic of Tanzania,Swiss Tropical and Public Health Institute, Basel, Switzerland,University of Basel, Basel, Switzerland
| | | | - Martin Johan Boeree
- Radboud Institute of Health Science, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Stephen H Gillespie
- Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany,German Center for Infection Research, Munich Partner Site, Munich, Germany
| | - Norbert Heinrich
- Correspondence: N. Heinrich, LMU Hospital, Division for Infectious Diseases and Tropical Medicine, Georgenstr 5, 80820 Munich, Germany ()
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8
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Nwongbouwoh Muefong C, Owolabi O, Donkor S, Charalambous S, Bakuli A, Rachow A, Geldmacher C, Sutherland JS. Neutrophils Contribute to Severity of Tuberculosis Pathology and Recovery From Lung Damage Pre- and Posttreatment. Clin Infect Dis 2022; 74:1757-1766. [PMID: 34427644 PMCID: PMC9155606 DOI: 10.1093/cid/ciab729] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Despite microbiological cure, about 50% of tuberculosis (TB) patients have poor lung recovery. Neutrophils are associated with lung pathology; however, CD16/CD62L-defined subsets have not been studied in TB. Using flow cytometry, we monitored frequencies, phenotype, and function of neutrophils following stimulation with Mycobacterium tuberculosis (Mtb) whole cell lysate (WCL) and ESAT-6/CFP-10 fusion protein (EC) in relation to lung pathology. METHODS Fresh blood from 42 adult, human immunodeficiency virus (HIV)-negative TB patients were analyzed pre- and post-therapy, with disease severity determined using chest radiography and bacterial load. Flow cytometry was used to monitor frequencies, phenotype, and function (generation of reactive oxygen species [ROS], together with CD11b, tumor necrosis factor, and interleukin 10 [IL-10] expression) of neutrophils following 2-hour stimulation with Mtb-specific antigens. RESULTS Total neutrophils decreased by post-treatment compared to baseline (P = .0059); however, CD16brCD62Lbr (segmented) neutrophils increased (P = .0031) and CD16dimCD62Lbr (banded) neutrophils decreased (P = .038). Banded neutrophils were lower in patients with severe lung damage at baseline (P = .035). Following WCL stimulation, ROS from segmented neutrophils was higher in patients with low Mtb loads even after adjusting for sex (P = .038), whereas IL-10-expressing CD16dimCD62Llo cells were higher in patients with mild damage (P = .0397) at baseline. CONCLUSIONS High ROS generation, low levels of banded neutrophils, and high levels of IL-10-expressing CD16dimCD62Llo neutrophils are associated with reduced lung pathology at diagnosis. Hence, neutrophils are potential early indicators of TB severity and promising targets for TB host-directed therapy.
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Affiliation(s)
- Caleb Nwongbouwoh Muefong
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, Fajara, The Gambia
- University of Munich, Munich, Germany
| | - Olumuyiwa Owolabi
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Simon Donkor
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | | | - Abhishek Bakuli
- Division of Infectious Diseases and Tropical Medicine, University Hospital, University of Munich, Munich, Germany
| | - Andrea Rachow
- Division of Infectious Diseases and Tropical Medicine, University Hospital, University of Munich, Munich, Germany
- German Centre for Infection Research, partner site Munich, Germany
| | - Christof Geldmacher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, University of Munich, Munich, Germany
| | - Jayne S Sutherland
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, Fajara, The Gambia
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9
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Puchinger K, Castelletti N, Rubio-Acero R, Geldmacher C, Eser TM, Deák F, Paunovic I, Bakuli A, Saathoff E, von Meyer A, Markgraf A, Falk P, Reich J, Riess F, Girl P, Müller K, Radon K, Guggenbuehl Noller JM, Wölfel R, Hoelscher M, Kroidl I, Wieser A, Olbrich L, Alamoudi E, Anderson J, Baumann M, Behlen M, Beyerl J, Böhnlein R, Brauer A, Britz V, Bruger J, Caroli F, Contento L, Diekmannshemke J, Do A, Dobler G, Eberle U, Eckstein J, Frese J, Forster F, Frahnow T, Fröschl G, Geisenberger O, Gillig K, Heiber A, Hinske C, Hoefflin J, Hofberger T, Höfinger M, Hofmann L, Horn S, Huber K, Janke C, Kappl U, Kiani C, Kroidl A, Laxy M, Leidl R, Lindner F, Mayrhofer R, Mekota AM, Müller H, Metaxa D, Pattard L, Pletschette M, Prückner S, Pusl K, Raimúndez E, Rothe C, Schäfer N, Schandelmaier P, Schneider L, Schultz S, Schunk M, Schwettmann L, Seibold H, Sothmann P, Stapor P, Theis F, Thiel V, Thiesbrummel S, Thur N, Waibel J, Wallrauch C, Winter S, Wolff J, Wullinger P, Yaqine H, Zange S, Zeggini E, Zimmermann T, Zielke A, Ibraheem M, Ahmed M, Becker M, Diepers P, Schälte Y, Garí M, Pütz P, Pritsch M, Fingerle V, Le Gleut R, Gilberg L, Brand I, Diefenbach M, Eser T, Weinauer F, Martin S, Quenzel EM, Durner J, Girl P, Müller K, Radon K, Fuchs C, Hasenauer J. The interplay of viral loads, clinical presentation, and serological responses in SARS-CoV-2 – Results from a prospective cohort of outpatient COVID-19 cases. Virology 2022; 569:37-43. [PMID: 35245784 PMCID: PMC8855229 DOI: 10.1016/j.virol.2022.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/15/2022] [Accepted: 02/15/2022] [Indexed: 11/24/2022]
Abstract
Risk factors for disease progression and severity of SARS-CoV-2 infections require an understanding of acute and long-term virological and immunological dynamics. Fifty-one RT-PCR positive COVID-19 outpatients were recruited between May and December 2020 in Munich, Germany, and followed up at multiple defined timepoints for up to one year. RT-PCR and viral culture were performed and seroresponses measured. Participants were classified applying the WHO clinical progression scale. Short symptom to test time (median 5.0 days; p = 0.0016) and high viral loads (VL; median maximum VL: 3∙108 copies/mL; p = 0.0015) were indicative for viral culture positivity. Participants with WHO grade 3 at baseline had significantly higher VLs compared to those with WHO 1 and 2 (p = 0.01). VLs dropped fast within 1 week of symptom onset. Maximum VLs were positively correlated with the magnitude of Ro-N-Ig seroresponse (p = 0.022). Our results describe the dynamics of VLs and antibodies to SARS-CoV-2 in mild to moderate cases that can support public health measures during the ongoing global pandemic.
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10
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Gudina EK, Ali S, Girma E, Gize A, Tegene B, Hundie GB, Sime WT, Ambachew R, Gebreyohanns A, Bekele M, Bakuli A, Elsbernd K, Merkt S, Contento L, Hoelscher M, Hasenauer J, Wieser A, Kroidl A. Seroepidemiology and model-based prediction of SARS-CoV-2 in Ethiopia: longitudinal cohort study among front-line hospital workers and communities. Lancet Glob Health 2021; 9:e1517-e1527. [PMID: 34678196 PMCID: PMC8525918 DOI: 10.1016/s2214-109x(21)00386-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 01/01/2023]
Abstract
Background Over 1 year since the first reported case, the true COVID-19 burden in Ethiopia remains unknown due to insufficient surveillance. We aimed to investigate the seroepidemiology of SARS-CoV-2 among front-line hospital workers and communities in Ethiopia. Methods We did a population-based, longitudinal cohort study at two tertiary teaching hospitals involving hospital workers, rural residents, and urban communities in Jimma and Addis Ababa. Hospital workers were recruited at both hospitals, and community participants were recruited by convenience sampling including urban metropolitan settings, urban and semi-urban settings, and rural communities. Participants were eligible if they were aged 18 years or older, had provided written informed consent, and were willing to provide blood samples by venepuncture. Only one participant per household was recruited. Serology was done with Elecsys anti-SARS-CoV-2 anti-nucleocapsid assay in three consecutive rounds, with a mean interval of 6 weeks between tests, to obtain seroprevalence and incidence estimates within the cohorts. Findings Between Aug 5, 2020, and April 10, 2021, we did three survey rounds with a total of 1104 hospital workers and 1229 community residents participating. SARS-CoV-2 seroprevalence among hospital workers increased strongly during the study period: in Addis Ababa, it increased from 10·9% (95% credible interval [CrI] 8·3–13·8) in August, 2020, to 53·7% (44·8–62·5) in February, 2021, with an incidence rate of 2223 per 100 000 person-weeks (95% CI 1785–2696); in Jimma Town, it increased from 30·8% (95% CrI 26·9–34·8) in November, 2020, to 56·1% (51·1–61·1) in February, 2021, with an incidence rate of 3810 per 100 000 person-weeks (95% CI 3149–4540). Among urban communities, an almost 40% increase in seroprevalence was observed in early 2021, with incidence rates of 1622 per 100 000 person-weeks (1004–2429) in Jimma Town and 4646 per 100 000 person-weeks (2797–7255) in Addis Ababa. Seroprevalence in rural communities increased from 18·0% (95% CrI 13·5–23·2) in November, 2020, to 31·0% (22·3–40·3) in March, 2021. Interpretation SARS-CoV-2 spread in Ethiopia has been highly dynamic among hospital worker and urban communities. We can speculate that the greatest wave of SARS-CoV-2 infections is currently evolving in rural Ethiopia, and thus requires focused attention regarding health-care burden and disease prevention. Funding Bavarian State Ministry of Sciences, Research, and the Arts; Germany Ministry of Education and Research; EU Horizon 2020 programme; Deutsche Forschungsgemeinschaft; and Volkswagenstiftung.
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Affiliation(s)
| | - Solomon Ali
- Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Eyob Girma
- Jimma University Institute of Health, Jimma, Ethiopia
| | - Addisu Gize
- Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | | | | | | - Rozina Ambachew
- Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | | - Mahteme Bekele
- Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Abhishek Bakuli
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany; German Center for Infection Research, partner site Munich, Munich, Germany
| | - Kira Elsbernd
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology-IBE, Ludwig Maximilian University of Munich, Munich, Germany
| | - Simon Merkt
- Faculty of Mathematics and Natural Sciences, University of Bonn, Bonn, Germany
| | - Lorenzo Contento
- Faculty of Mathematics and Natural Sciences, University of Bonn, Bonn, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany; German Center for Infection Research, partner site Munich, Munich, Germany
| | - Jan Hasenauer
- Institute of Computational Biology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany; Center for Mathematics, Technische Universität München, Garching, Germany; Faculty of Mathematics and Natural Sciences, University of Bonn, Bonn, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany; German Center for Infection Research, partner site Munich, Munich, Germany
| | - Arne Kroidl
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany; German Center for Infection Research, partner site Munich, Munich, Germany
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11
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Olbrich L, Castelletti N, Schälte Y, Garí M, Pütz P, Bakuli A, Pritsch M, Kroidl I, Saathoff E, Guggenbuehl Noller JM, Fingerle V, Le Gleut R, Gilberg L, Brand I, Falk P, Markgraf A, Deák F, Riess F, Diefenbach M, Eser T, Weinauer F, Martin S, Quenzel EM, Becker M, Durner J, Girl P, Müller K, Radon K, Fuchs C, Wölfel R, Hasenauer J, Hoelscher M, Wieser A. Head-to-head evaluation of seven different seroassays including direct viral neutralisation in a representative cohort for SARS-CoV-2. J Gen Virol 2021; 102:001653. [PMID: 34623233 PMCID: PMC8604188 DOI: 10.1099/jgv.0.001653] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/20/2021] [Indexed: 12/21/2022] Open
Abstract
A number of seroassays are available for SARS-CoV-2 testing; yet, head-to-head evaluations of different testing principles are limited, especially using raw values rather than categorical data. In addition, identifying correlates of protection is of utmost importance, and comparisons of available testing systems with functional assays, such as direct viral neutralisation, are needed.We analysed 6658 samples consisting of true-positives (n=193), true-negatives (n=1091), and specimens of unknown status (n=5374). For primary testing, we used Euroimmun-Anti-SARS-CoV-2-ELISA-IgA/IgG and Roche-Elecsys-Anti-SARS-CoV-2. Subsequently virus-neutralisation, GeneScriptcPass, VIRAMED-SARS-CoV-2-ViraChip, and Mikrogen-recomLine-SARS-CoV-2-IgG were applied for confirmatory testing. Statistical modelling generated optimised assay cut-off thresholds. Sensitivity of Euroimmun-anti-S1-IgA was 64.8%, specificity 93.3% (manufacturer's cut-off); for Euroimmun-anti-S1-IgG, sensitivity was 77.2/79.8% (manufacturer's/optimised cut-offs), specificity 98.0/97.8%; Roche-anti-N sensitivity was 85.5/88.6%, specificity 99.8/99.7%. In true-positives, mean and median Euroimmun-anti-S1-IgA and -IgG titres decreased 30/90 days after RT-PCR-positivity, Roche-anti-N titres decreased significantly later. Virus-neutralisation was 80.6% sensitive, 100.0% specific (≥1:5 dilution). Neutralisation surrogate tests (GeneScriptcPass, Mikrogen-recomLine-RBD) were >94.9% sensitive and >98.1% specific. Optimised cut-offs improved test performances of several tests. Confirmatory testing with virus-neutralisation might be complemented with GeneScriptcPassTM or recomLine-RBD for certain applications. Head-to-head comparisons given here aim to contribute to the refinement of testing strategies for individual and public health use.
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Affiliation(s)
- Laura Olbrich
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany
- German Center for Infection Research (DZIF), Partner site Munich, Germany
| | - Noemi Castelletti
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany
- Institute of Radiation Medicine, Helmholtz Zentrum München, 85764 Neuherberg, Germany
| | - Yannik Schälte
- Institute of Computational Biology, Helmholtz Zentrum München, 85764 Neuherberg, Germany
- Center for Mathematics, Technische Universität München, 85748 Garching, Germany
| | - Mercè Garí
- Institute of Computational Biology, Helmholtz Zentrum München, 85764 Neuherberg, Germany
| | - Peter Pütz
- Institute of Computational Biology, Helmholtz Zentrum München, 85764 Neuherberg, Germany
- Department of Business Administration and Economics, Bielefeld University, 33615 Bielefeld, Germany
| | - Abhishek Bakuli
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany
| | - Michael Pritsch
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany
| | - Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany
- German Center for Infection Research (DZIF), Partner site Munich, Germany
| | - Elmar Saathoff
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany
- German Center for Infection Research (DZIF), Partner site Munich, Germany
| | | | - Volker Fingerle
- German Center for Infection Research (DZIF), Partner site Munich, Germany
- Bavarian Health and Food Safety Authority (LGL), Germany
| | - Ronan Le Gleut
- Institute of Computational Biology, Helmholtz Zentrum München, 85764 Neuherberg, Germany
- Core Facility Statistical Consulting, Helmholtz Zentrum München, 85764 Neuherberg, Germany
| | - Leonard Gilberg
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany
| | - Isabel Brand
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany
| | - Philine Falk
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany
| | - Alisa Markgraf
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany
| | - Flora Deák
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany
| | - Friedrich Riess
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany
| | - Max Diefenbach
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany
| | - Tabea Eser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany
| | | | | | | | - Marc Becker
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich Ludwig-Maximilians-University of Munich, Goethestr. 70, 80336 Munich, Germany
- Laboratory Becker and colleagues, Führichstr. 70, 81671 München, Germany
| | - Jürgen Durner
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich Ludwig-Maximilians-University of Munich, Goethestr. 70, 80336 Munich, Germany
- Laboratory Becker and colleagues, Führichstr. 70, 81671 München, Germany
| | - Philipp Girl
- German Center for Infection Research (DZIF), Partner site Munich, Germany
- Bundeswehr Institute of Microbiology, 80937 Munich, Germany
| | - Katharina Müller
- German Center for Infection Research (DZIF), Partner site Munich, Germany
- Bundeswehr Institute of Microbiology, 80937 Munich, Germany
| | - Katja Radon
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany
- Center for International Health (CIH), University Hospital, LMU Munich, 80336 Munich, Germany
- Comprehensive Pneumology Center (CPC) Munich, German Center for Lung Research (DZL), 80337 Munich, Germany
| | - Christiane Fuchs
- Institute of Computational Biology, Helmholtz Zentrum München, 85764 Neuherberg, Germany
- Center for Mathematics, Technische Universität München, 85748 Garching, Germany
- Department of Business Administration and Economics, Bielefeld University, 33615 Bielefeld, Germany
- Core Facility Statistical Consulting, Helmholtz Zentrum München, 85764 Neuherberg, Germany
| | - Roman Wölfel
- German Center for Infection Research (DZIF), Partner site Munich, Germany
- Bundeswehr Institute of Microbiology, 80937 Munich, Germany
| | - Jan Hasenauer
- Institute of Computational Biology, Helmholtz Zentrum München, 85764 Neuherberg, Germany
- Center for Mathematics, Technische Universität München, 85748 Garching, Germany
- Faculty of Mathematics and Natural Sciences, University of Bonn, 53113 Bonn, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany
- German Center for Infection Research (DZIF), Partner site Munich, Germany
- Center for International Health (CIH), University Hospital, LMU Munich, 80336 Munich, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany
- German Center for Infection Research (DZIF), Partner site Munich, Germany
| | - on behalf of the KoCo19-Study Group
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany
- German Center for Infection Research (DZIF), Partner site Munich, Germany
- Institute of Radiation Medicine, Helmholtz Zentrum München, 85764 Neuherberg, Germany
- Institute of Computational Biology, Helmholtz Zentrum München, 85764 Neuherberg, Germany
- Center for Mathematics, Technische Universität München, 85748 Garching, Germany
- Department of Business Administration and Economics, Bielefeld University, 33615 Bielefeld, Germany
- Bavarian Health and Food Safety Authority (LGL), Germany
- Core Facility Statistical Consulting, Helmholtz Zentrum München, 85764 Neuherberg, Germany
- BRK-Blutspendedienst, 80336 Munich, Germany
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich Ludwig-Maximilians-University of Munich, Goethestr. 70, 80336 Munich, Germany
- Laboratory Becker and colleagues, Führichstr. 70, 81671 München, Germany
- Bundeswehr Institute of Microbiology, 80937 Munich, Germany
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany
- Center for International Health (CIH), University Hospital, LMU Munich, 80336 Munich, Germany
- Comprehensive Pneumology Center (CPC) Munich, German Center for Lung Research (DZL), 80337 Munich, Germany
- Faculty of Mathematics and Natural Sciences, University of Bonn, 53113 Bonn, Germany
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Radon K, Bakuli A, Pütz P, Le Gleut R, Guggenbuehl Noller JM, Olbrich L, Saathoff E, Garí M, Schälte Y, Frahnow T, Wölfel R, Pritsch M, Rothe C, Pletschette M, Rubio-Acero R, Beyerl J, Metaxa D, Forster F, Thiel V, Castelletti N, Rieß F, Diefenbach MN, Fröschl G, Bruger J, Winter S, Frese J, Puchinger K, Brand I, Kroidl I, Wieser A, Hoelscher M, Hasenauer J, Fuchs C. From first to second wave: follow-up of the prospective COVID-19 cohort (KoCo19) in Munich (Germany). BMC Infect Dis 2021; 21:925. [PMID: 34493217 PMCID: PMC8423599 DOI: 10.1186/s12879-021-06589-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 08/19/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In the 2nd year of the COVID-19 pandemic, knowledge about the dynamics of the infection in the general population is still limited. Such information is essential for health planners, as many of those infected show no or only mild symptoms and thus, escape the surveillance system. We therefore aimed to describe the course of the pandemic in the Munich general population living in private households from April 2020 to January 2021. METHODS The KoCo19 baseline study took place from April to June 2020 including 5313 participants (age 14 years and above). From November 2020 to January 2021, we could again measure SARS-CoV-2 antibody status in 4433 of the baseline participants (response 83%). Participants were offered a self-sampling kit to take a capillary blood sample (dry blood spot; DBS). Blood was analysed using the Elecsys® Anti-SARS-CoV-2 assay (Roche). Questionnaire information on socio-demographics and potential risk factors assessed at baseline was available for all participants. In addition, follow-up information on health-risk taking behaviour and number of personal contacts outside the household (N = 2768) as well as leisure time activities (N = 1263) were collected in summer 2020. RESULTS Weighted and adjusted (for specificity and sensitivity) SARS-CoV-2 sero-prevalence at follow-up was 3.6% (95% CI 2.9-4.3%) as compared to 1.8% (95% CI 1.3-3.4%) at baseline. 91% of those tested positive at baseline were also antibody-positive at follow-up. While sero-prevalence increased from early November 2020 to January 2021, no indication of geospatial clustering across the city of Munich was found, although cases clustered within households. Taking baseline result and time to follow-up into account, men and participants in the age group 20-34 years were at the highest risk of sero-positivity. In the sensitivity analyses, differences in health-risk taking behaviour, number of personal contacts and leisure time activities partly explained these differences. CONCLUSION The number of citizens in Munich with SARS-CoV-2 antibodies was still below 5% during the 2nd wave of the pandemic. Antibodies remained present in the majority of SARS-CoV-2 sero-positive baseline participants. Besides age and sex, potentially confounded by differences in behaviour, no major risk factors could be identified. Non-pharmaceutical public health measures are thus still important.
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Affiliation(s)
- Katja Radon
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336, Munich, Germany.
- Center for International Health (CIH), University Hospital, LMU Munich, 80336, Munich, Germany.
- Comprehensive Pneumology Center (CPC) Munich, German Center for Lung Research (DZL), 89337, Munich, Germany.
| | - Abhishek Bakuli
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Peter Pütz
- Institute of Computational Biology, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764, Neuherberg, Germany
- Faculty of Business Administration and Economics, Bielefeld University, 33615, Bielefeld, Germany
| | - Ronan Le Gleut
- Institute of Computational Biology, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764, Neuherberg, Germany
- Core Facility Statistical Consulting, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | | | - Laura Olbrich
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
- German Center for Infection Research (DZIF), partner site, Munich, Germany
| | - Elmar Saathoff
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
- German Center for Infection Research (DZIF), partner site, Munich, Germany
| | - Mercè Garí
- Institute of Computational Biology, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Yannik Schälte
- Institute of Computational Biology, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764, Neuherberg, Germany
- Center for Mathematics, Technische Universität München, 85748, Garching, Germany
| | - Turid Frahnow
- Institute of Computational Biology, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764, Neuherberg, Germany
- Faculty of Business Administration and Economics, Bielefeld University, 33615, Bielefeld, Germany
| | - Roman Wölfel
- German Center for Infection Research (DZIF), partner site, Munich, Germany
- Bundeswehr Institute of Microbiology, 80937, Munich, Germany
| | - Michael Pritsch
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
- German Center for Infection Research (DZIF), partner site, Munich, Germany
| | - Camilla Rothe
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Michel Pletschette
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Raquel Rubio-Acero
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Jessica Beyerl
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Dafni Metaxa
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Felix Forster
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336, Munich, Germany
- Comprehensive Pneumology Center (CPC) Munich, German Center for Lung Research (DZL), 89337, Munich, Germany
| | - Verena Thiel
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Noemi Castelletti
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Friedrich Rieß
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
- German Center for Infection Research (DZIF), partner site, Munich, Germany
| | - Maximilian N Diefenbach
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Günter Fröschl
- Center for International Health (CIH), University Hospital, LMU Munich, 80336, Munich, Germany
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Jan Bruger
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Simon Winter
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Jonathan Frese
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Kerstin Puchinger
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Isabel Brand
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
- German Center for Infection Research (DZIF), partner site, Munich, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
- German Center for Infection Research (DZIF), partner site, Munich, Germany
| | - Michael Hoelscher
- Center for International Health (CIH), University Hospital, LMU Munich, 80336, Munich, Germany
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
- German Center for Infection Research (DZIF), partner site, Munich, Germany
| | - Jan Hasenauer
- Institute of Computational Biology, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764, Neuherberg, Germany
- Center for Mathematics, Technische Universität München, 85748, Garching, Germany
- Interdisciplinary Research Unit Mathematics and Life Sciences, University of Bonn, 53113, Bonn, Germany
| | - Christiane Fuchs
- Institute of Computational Biology, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764, Neuherberg, Germany
- Faculty of Business Administration and Economics, Bielefeld University, 33615, Bielefeld, Germany
- Core Facility Statistical Consulting, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764, Neuherberg, Germany
- Center for Mathematics, Technische Universität München, 85748, Garching, Germany
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Beyerl J, Rubio-Acero R, Castelletti N, Paunovic I, Kroidl I, Khan ZN, Bakuli A, Tautz A, Oft J, Hoelscher M, Wieser A. A dried blood spot protocol for high throughput analysis of SARS-CoV-2 serology based on the Roche Elecsys anti-N assay. EBioMedicine 2021; 70:103502. [PMID: 34333234 PMCID: PMC8320407 DOI: 10.1016/j.ebiom.2021.103502] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/12/2021] [Accepted: 07/12/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Since 2020 SARS-CoV-2 spreads pandemically, infecting more than 119 million people, causing >2·6 million fatalities. Symptoms of SARS-CoV-2 infection vary greatly, ranging from asymptomatic to fatal. Different populations react differently to the disease, making it very hard to track the spread of the infection in a population. Measuring specific anti-SARS-CoV-2 antibodies is an important tool to assess the spread of the infection or successful vaccinations. To achieve sufficient sample numbers, alternatives to venous blood sampling are needed not requiring medical personnel or cold-chains. Dried-blood-spots (DBS) on filter-cards have been used for different studies, but not routinely for serology. METHODS We developed a semi-automated protocol using self-sampled DBS for SARS-CoV-2 serology. It was validated in a cohort of matched DBS and venous-blood samples (n = 1710). Feasibility is demonstrated with two large serosurveys with 10247 company employees and a population cohort of 4465 participants. FINDINGS Sensitivity and specificity reached 99·20% and 98·65%, respectively. Providing written instructions and video tutorials, 99·87% (4465/4471) of the unsupervised home sampling DBS cards could be analysed. INTERPRETATION DBS-sampling is a valid and highly reliable tool for large scale serosurveys. We demonstrate feasibility and accuracy with a large validation cohort including unsupervised home sampling. This protocol might be of big importance for surveillance in resource-limited settings, providing low-cost highly accurate serology data. FUNDING Provided by Bavarian State Ministry of Science and the Arts, LMU University-Hospital; Helmholtz-Centre-Munich, German Ministry for Education and Research (project01KI20271); University of Bonn; University of Bielefeld; the Medical Biodefense Research Program of Bundeswehr-Medical-Service; Euroimmun, RocheDiagnostics provided discounted kits and machines.
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Affiliation(s)
- Jessica Beyerl
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich 80802, Germany
| | - Raquel Rubio-Acero
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich 80802, Germany
| | - Noemi Castelletti
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich 80802, Germany
| | - Ivana Paunovic
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich 80802, Germany
| | - Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich 80802, Germany
| | - Zohaib N Khan
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich 80802, Germany
| | - Abhishek Bakuli
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich 80802, Germany
| | - Andreas Tautz
- Corporate Health Management / Department Occupational Health; DPDHL Group, Bonn 53113, Germany
| | - Judith Oft
- Center for International Health (CIH), University Hospital, LMU Munich, Munich 80336, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich 80802, Germany; German Center for Infection Research (DZIF), Partner Site Munich, Germany; Center for International Health (CIH), University Hospital, LMU Munich, Munich 80336, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich 80802, Germany; German Center for Infection Research (DZIF), Partner Site Munich, Germany.
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14
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Rubio-Acero R, Castelletti N, Fingerle V, Olbrich L, Bakuli A, Wölfel R, Girl P, Müller K, Jochum S, Strobl M, Hoelscher M, Wieser A. In Search of the SARS-CoV-2 Protection Correlate: Head-to-Head Comparison of Two Quantitative S1 Assays in Pre-characterized Oligo-/Asymptomatic Patients. Infect Dis Ther 2021; 10:1-14. [PMID: 34155471 PMCID: PMC8208377 DOI: 10.1007/s40121-021-00475-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/28/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Quantitative serological assays detecting response to SARS-CoV-2 are needed to quantify immunity. This study analyzed the performance and correlation of two quantitative anti-S1 assays in oligo-/asymptomatic individuals from a population-based cohort. METHODS In total, 362 plasma samples (108 with reverse transcription-polymerase chain reaction [RT-PCR]-positive pharyngeal swabs, 111 negative controls, and 143 with positive serology without confirmation by RT-PCR) were tested with quantitative assays (Euroimmun Anti-SARS-CoV-2 QuantiVac enzyme-linked immunosorbent assay [EI-S1-IgG-quant]) and Roche Elecsys® Anti-SARS-CoV-2 S [Ro-RBD-Ig-quant]), which were compared with each other and confirmatory tests, including wild-type virus micro-neutralization (NT) and GenScript®cPass™. Square roots R of coefficients of determination were calculated for continuous variables and non-parametric tests were used for paired comparisons. RESULTS Quantitative anti-S1 serology correlated well with each other (true positives, 96%; true negatives, 97%). Antibody titers decreased over time (< 30 to > 240 days after initial positive RT-PCR). Agreement with GenScript-cPass was 96%/99% for true positives and true negatives, respectively, for Ro-RBD-Ig-quant and 93%/97% for EI-S1-IgG-quant. Ro-RBD-Ig-quant allowed distinct separation between positives and negatives, and less non-specific reactivity versus EI-S1-IgG-quant. Raw values (95% CI) ≥ 28.7 U/mL (22.6-36.4) for Ro-RBD-Ig-quant and ≥ 49.8 U/mL (43.4-57.1) for EI-S1-IgG-quant predicted NT > 1:5 in 95% of cases. CONCLUSIONS Our findings suggest both quantitative anti-S1 assays (EI-S1-IgG-quant and Ro-RBD-Ig-quant) may replace direct neutralization assays in quantitative measurement of immune protection against SARS-CoV-2 in certain circumstances. However, although the mean antibody titers for both assays tended to decrease over time, a higher proportion of Ro-RBD-Ig-quant values remained positive after 240 days. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40121-021-00475-x.
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Affiliation(s)
- Raquel Rubio-Acero
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Leopoldstr. 5, 80802 Munich, Germany
| | - Noemi Castelletti
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Leopoldstr. 5, 80802 Munich, Germany
- Institute of Radiation Medicine, Helmholtz Zentrum München, 85764 Neuherberg, Germany
| | - Volker Fingerle
- German Center for Infection Research (DZIF), Partner Site, Munich, Germany
- Bavarian Health and Food Safety Authority (LGL), Oberschleissheim, Germany
| | - Laura Olbrich
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Leopoldstr. 5, 80802 Munich, Germany
- German Center for Infection Research (DZIF), Partner Site, Munich, Germany
| | - Abhishek Bakuli
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Leopoldstr. 5, 80802 Munich, Germany
| | - Roman Wölfel
- German Center for Infection Research (DZIF), Partner Site, Munich, Germany
- Bundeswehr Institute of Microbiology, 80937 Munich, Germany
| | - Philipp Girl
- German Center for Infection Research (DZIF), Partner Site, Munich, Germany
- Bundeswehr Institute of Microbiology, 80937 Munich, Germany
| | - Katharina Müller
- German Center for Infection Research (DZIF), Partner Site, Munich, Germany
- Bundeswehr Institute of Microbiology, 80937 Munich, Germany
| | | | | | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Leopoldstr. 5, 80802 Munich, Germany
- German Center for Infection Research (DZIF), Partner Site, Munich, Germany
- Center for International Health (CIH), University Hospital, LMU Munich, 80336 Munich, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Leopoldstr. 5, 80802 Munich, Germany
- German Center for Infection Research (DZIF), Partner Site, Munich, Germany
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15
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Pritsch M, Radon K, Bakuli A, Le Gleut R, Olbrich L, Guggenbüehl Noller JM, Saathoff E, Castelletti N, Garí M, Pütz P, Schälte Y, Frahnow T, Wölfel R, Rothe C, Pletschette M, Metaxa D, Forster F, Thiel V, Rieß F, Diefenbach MN, Fröschl G, Bruger J, Winter S, Frese J, Puchinger K, Brand I, Kroidl I, Hasenauer J, Fuchs C, Wieser A, Hoelscher M. Prevalence and Risk Factors of Infection in the Representative COVID-19 Cohort Munich. Int J Environ Res Public Health 2021; 18:ijerph18073572. [PMID: 33808249 PMCID: PMC8038115 DOI: 10.3390/ijerph18073572] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/23/2021] [Accepted: 03/27/2021] [Indexed: 02/07/2023]
Abstract
Given the large number of mild or asymptomatic SARS-CoV-2 cases, only population-based studies can provide reliable estimates of the magnitude of the pandemic. We therefore aimed to assess the sero-prevalence of SARS-CoV-2 in the Munich general population after the first wave of the pandemic. For this purpose, we drew a representative sample of 2994 private households and invited household members 14 years and older to complete questionnaires and to provide blood samples. SARS-CoV-2 seropositivity was defined as Roche N pan-Ig ≥ 0.4218. We adjusted the prevalence for the sampling design, sensitivity, and specificity. We investigated risk factors for SARS-CoV-2 seropositivity and geospatial transmission patterns by generalized linear mixed models and permutation tests. Seropositivity for SARS-CoV-2-specific antibodies was 1.82% (95% confidence interval (CI) 1.28-2.37%) as compared to 0.46% PCR-positive cases officially registered in Munich. Loss of the sense of smell or taste was associated with seropositivity (odds ratio (OR) 47.4; 95% CI 7.2-307.0) and infections clustered within households. By this first population-based study on SARS-CoV-2 prevalence in a large German municipality not affected by a superspreading event, we could show that at least one in four cases in private households was reported and known to the health authorities. These results will help authorities to estimate the true burden of disease in the population and to take evidence-based decisions on public health measures.
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Affiliation(s)
- Michael Pritsch
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
- German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany;
| | - Katja Radon
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany; (K.R.); (F.F.)
- Center for International Health (CIH), University Hospital, LMU Munich, 80336 Munich, Germany
- Comprehensive Pneumology Center (CPC) Munich, German Center for Lung Research (DZL), 89337 Munich, Germany
| | - Abhishek Bakuli
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
| | - Ronan Le Gleut
- Helmholtz Zentrum München—German Research Center for Environmental Health, Institute of Computational Biology, 85764 Neuherberg, Germany; (R.L.G.); (M.G.); (P.P.); (Y.S.); (T.F.); (J.H.); (C.F.)
- Helmholtz Zentrum München—German Research Center for Environmental Health, Core Facility Statistical Consulting, 85764 Neuherberg, Germany
| | - Laura Olbrich
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
- German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany;
| | - Jessica Michelle Guggenbüehl Noller
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
| | - Elmar Saathoff
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
- German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany;
| | - Noemi Castelletti
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
| | - Mercè Garí
- Helmholtz Zentrum München—German Research Center for Environmental Health, Institute of Computational Biology, 85764 Neuherberg, Germany; (R.L.G.); (M.G.); (P.P.); (Y.S.); (T.F.); (J.H.); (C.F.)
| | - Peter Pütz
- Helmholtz Zentrum München—German Research Center for Environmental Health, Institute of Computational Biology, 85764 Neuherberg, Germany; (R.L.G.); (M.G.); (P.P.); (Y.S.); (T.F.); (J.H.); (C.F.)
- Faculty of Business Administration and Economics, Bielefeld University, 33615 Bielefeld, Germany
| | - Yannik Schälte
- Helmholtz Zentrum München—German Research Center for Environmental Health, Institute of Computational Biology, 85764 Neuherberg, Germany; (R.L.G.); (M.G.); (P.P.); (Y.S.); (T.F.); (J.H.); (C.F.)
- Center for Mathematics, Technische Universität München, 85748 Garching, Germany
| | - Turid Frahnow
- Helmholtz Zentrum München—German Research Center for Environmental Health, Institute of Computational Biology, 85764 Neuherberg, Germany; (R.L.G.); (M.G.); (P.P.); (Y.S.); (T.F.); (J.H.); (C.F.)
- Faculty of Business Administration and Economics, Bielefeld University, 33615 Bielefeld, Germany
| | - Roman Wölfel
- German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany;
- Bundeswehr Institute of Microbiology, 80937 Munich, Germany
| | - Camilla Rothe
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
| | - Michel Pletschette
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
| | - Dafni Metaxa
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
| | - Felix Forster
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany; (K.R.); (F.F.)
- Comprehensive Pneumology Center (CPC) Munich, German Center for Lung Research (DZL), 89337 Munich, Germany
| | - Verena Thiel
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
| | - Friedrich Rieß
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
- German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany;
| | - Maximilian Nikolaus Diefenbach
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
| | - Günter Fröschl
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
- Center for International Health (CIH), University Hospital, LMU Munich, 80336 Munich, Germany
| | - Jan Bruger
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
| | - Simon Winter
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
| | - Jonathan Frese
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
| | - Kerstin Puchinger
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
| | - Isabel Brand
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
| | - Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
- German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany;
| | - Jan Hasenauer
- Helmholtz Zentrum München—German Research Center for Environmental Health, Institute of Computational Biology, 85764 Neuherberg, Germany; (R.L.G.); (M.G.); (P.P.); (Y.S.); (T.F.); (J.H.); (C.F.)
- Center for Mathematics, Technische Universität München, 85748 Garching, Germany
- Interdisciplinary Research Unit Mathematics and Life Sciences, University of Bonn, 53113 Bonn, Germany
| | - Christiane Fuchs
- Helmholtz Zentrum München—German Research Center for Environmental Health, Institute of Computational Biology, 85764 Neuherberg, Germany; (R.L.G.); (M.G.); (P.P.); (Y.S.); (T.F.); (J.H.); (C.F.)
- Helmholtz Zentrum München—German Research Center for Environmental Health, Core Facility Statistical Consulting, 85764 Neuherberg, Germany
- Faculty of Business Administration and Economics, Bielefeld University, 33615 Bielefeld, Germany
- Center for Mathematics, Technische Universität München, 85748 Garching, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
- German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany;
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802 Munich, Germany; (M.P.); (A.B.); (L.O.); (J.M.G.N.); (E.S.); (N.C.); (C.R.); (M.P.); (D.M.); (V.T.); (F.R.); (M.N.D.); (G.F.); (J.B.); (S.W.); (J.F.); (K.P.); (I.B.); (I.K.); (A.W.)
- German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany;
- Center for International Health (CIH), University Hospital, LMU Munich, 80336 Munich, Germany
- Correspondence: ; Tel.: +49-89-44005-9801
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Muefong CN, Owolabi O, Donkor S, Charalambous S, Mendy J, Sey ICM, Bakuli A, Rachow A, Geldmacher C, Sutherland JS. Major Neutrophil-Derived Soluble Mediators Associate With Baseline Lung Pathology and Post-Treatment Recovery in Tuberculosis Patients. Front Immunol 2021; 12:740933. [PMID: 34887853 PMCID: PMC8650718 DOI: 10.3389/fimmu.2021.740933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/01/2021] [Indexed: 11/21/2022] Open
Abstract
Background The inflammatory response to Mycobacterium tuberculosis results in variable degrees of lung pathology during active TB (ATB) with central involvement of neutrophils. Little is known about neutrophil-derived mediators and their role in disease severity at baseline and recovery upon TB treatment initiation. Methods 107 adults with confirmed pulmonary TB were categorised based on lung pathology at baseline and following successful therapy using chest X-ray scores (Ralph scores) and GeneXpert bacterial load (Ct values). Plasma, sputum, and antigen-stimulated levels of MMP1, MMP3, MMP8, MMP9, MPO, S100A8/9, IL8, IL10, IL12/23(p40), GM-CSF, IFNγ, and TNF were analysed using multiplex cytokine arrays. Results At baseline, neutrophil counts correlated with plasma levels of MMP8 (rho = 0.45, p = 2.80E-06), S100A8 (rho = 0.52, p = 3.00E-08) and GM-CSF (rho = 0.43, p = 7.90E-06). Levels of MMP8 (p = 3.00E-03), MMP1 (p = 1.40E-02), S100A8 (p = 1.80E-02) and IL12/23(p40) (p = 1.00E-02) were associated with severe lung damage, while sputum MPO levels were directly linked to lung damage (p = 1.80E-03), Mtb load (p = 2.10E-02) and lung recovery (p = 2.40E-02). Six months of TB therapy significantly decreased levels of major neutrophil-derived pro-inflammatory mediators: MMP1 (p = 4.90E-12 and p = 2.20E-07), MMP8 (p = 3.40E-14 and p = 1.30E-05) and MMP9 (p = 1.60E-04 and p = 1.50E-03) in plasma and sputum, respectively. Interestingly, following H37Rv whole cell lysate stimulation, S100A8 (p = 2.80E-02), MMP9 (p = 3.60E-02) and MPO (p = 9.10E-03) levels at month 6 were significantly higher compared to baseline. Sputum MMP1 (p = 1.50E-03), MMP3 (p = 7.58E-04), MMP9 (p = 2.60E-02) and TNF (p = 3.80E-02) levels were lower at month 6 compared to baseline in patients with good lung recovery. Conclusion In this study, patients with severe lung pathology at baseline and persistent lung damage after treatment were associated with higher plasma and sputum levels of major pro-inflammatory neutrophil-derived mediators. Interestingly, low sputum MPO levels were associated with severe lung damage, higher Mtb burden and low recovery. Our data suggest that therapeutic agents which target these mediators should be considered for future studies on biomarkers and host-directed therapeutic approaches against TB-related lung pathology and/or lung recovery.
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Affiliation(s)
- Caleb Nwongbouwoh Muefong
- Vaccines and Immunity Theme, Medical Research Council (MRC) Unit The Gambia at London School of Hygiene and Tropical Medicine (LSHTM), Fajara, Gambia.,Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig Maximilian University (LMU) Munich, Munich, Germany
| | - Olumuyiwa Owolabi
- Vaccines and Immunity Theme, Medical Research Council (MRC) Unit The Gambia at London School of Hygiene and Tropical Medicine (LSHTM), Fajara, Gambia
| | - Simon Donkor
- Vaccines and Immunity Theme, Medical Research Council (MRC) Unit The Gambia at London School of Hygiene and Tropical Medicine (LSHTM), Fajara, Gambia
| | | | - Joseph Mendy
- Vaccines and Immunity Theme, Medical Research Council (MRC) Unit The Gambia at London School of Hygiene and Tropical Medicine (LSHTM), Fajara, Gambia
| | - Isatou C M Sey
- Vaccines and Immunity Theme, Medical Research Council (MRC) Unit The Gambia at London School of Hygiene and Tropical Medicine (LSHTM), Fajara, Gambia
| | - Abhishek Bakuli
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig Maximilian University (LMU) Munich, Munich, Germany.,International Clinical Trials Unit, German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Andrea Rachow
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig Maximilian University (LMU) Munich, Munich, Germany.,International Clinical Trials Unit, German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Christof Geldmacher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig Maximilian University (LMU) Munich, Munich, Germany.,International Clinical Trials Unit, German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Jayne S Sutherland
- Vaccines and Immunity Theme, Medical Research Council (MRC) Unit The Gambia at London School of Hygiene and Tropical Medicine (LSHTM), Fajara, Gambia
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Guggenbühl Noller JM, Froeschl G, Eisermann P, Jochum J, Theuring S, Reiter-Owona I, Bissinger AL, Hoelscher M, Bakuli A, von Sonnenburg FJF, Rothe C, Bretzel G, Albajar-Viñas P, Grout L, Pritsch M. Describing nearly two decades of Chagas disease in Germany and the lessons learned: a retrospective study on screening, detection, diagnosis, and treatment of Trypanosoma cruzi infection from 2000 - 2018. BMC Infect Dis 2020; 20:919. [PMID: 33272201 PMCID: PMC7713040 DOI: 10.1186/s12879-020-05600-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 11/09/2020] [Indexed: 12/19/2022] Open
Abstract
Background The highly complex and largely neglected Chagas disease (CD) has become a global health problem due to population movements between Latin America and non-endemic countries, as well as non-vectorial transmission routes. Data on CD testing and treatment from routine patient care in Germany of almost two decades was collected and analysed. Methods German laboratories offering diagnostics for chronic Trypanosoma cruzi (T. cruzi) infection in routine patient care were identified. All retrievable data on tests performed during the years of 2000–2018 were analysed. Additional clinical information regarding patients diagnosed with CD was collected through questionnaires. Results Five German laboratories with diagnostics for T. cruzi infection in routine patient care were identified. Centres in Hamburg and Munich offered two independent serological tests to confirm the CD diagnosis, as recommended by WHO during the entire time period 2000–2018. Overall, a total of n = 10,728 independent tests involving n = 5991 individuals were identified with a progressive increase in testing rates over time, only n = 130 (16.0%) of the tested individuals with known nationality came from CD endemic countries. Of all test units conducted at the included institutes, a total of n = 347/10,728 (3.2%) tests on CD were positive, of which n = 200/347 (57.6%) were ELISA, n = 133/347 (38.3%) IFT, n = 10/347 (2.9%) PCR, and n = 4/347 (1.2%) RDT. Of the n = 5991 individuals only n = 81 (1.4%) with chronic infection were identified, n = 52 females and n = 28 males. Additional clinical information could only be collected from n = 47. Conclusion The results of this study give insight into the deployment of screening, detection, diagnosis, and treatment of T. cruzi over the last two decades in Germany and existing deficits therein; the creation of guidelines for Germany could be a step forward to improve the existing gaps. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-020-05600-8.
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Affiliation(s)
- Jessica Michelle Guggenbühl Noller
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany.,Center for International Health, University Hospital, LMU Munich, Munich, Germany
| | - Guenter Froeschl
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany. .,Center for International Health, University Hospital, LMU Munich, Munich, Germany.
| | - Philip Eisermann
- National Reference Centre for Tropical Pathogens, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Johannes Jochum
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Stefanie Theuring
- Institute of Tropical Medicine and International Health, Charité -Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ingrid Reiter-Owona
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Alfred Lennart Bissinger
- Institute of Tropical Medicine, Medical Department, University Hospital Tübingen, Tübingen, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany.,German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Abhishek Bakuli
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | | | - Camilla Rothe
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Gisela Bretzel
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Pedro Albajar-Viñas
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Lise Grout
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Michael Pritsch
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
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Ivanova O, Khosa C, Bakuli A, Bhatt N, Massango I, Jani I, Saathoff E, Hoelscher M, Rachow A. Lung Function Testing and Prediction Equations in Adult Population from Maputo, Mozambique. Int J Environ Res Public Health 2020; 17:ijerph17124535. [PMID: 32599726 PMCID: PMC7344554 DOI: 10.3390/ijerph17124535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/16/2020] [Accepted: 06/22/2020] [Indexed: 12/15/2022]
Abstract
Background: Local spirometric prediction equations are of great importance for interpreting lung function results and deciding on the management strategies for respiratory patients, yet available data from African countries are scarce. The aim of this study was to collect lung function data using spirometry in healthy adults living in Maputo, Mozambique and to derive first spirometric prediction equations for this population. Methods: We applied a cross-sectional study design. Participants, who met the inclusion criteria, underwent a short interview, anthropometric measurements, and lung function testing. Different modelling approaches were followed for generating new, Mozambican, prediction equations and for comparison with the Global Lung Initiative (GLI) and South African equations. The pulmonary function performance of participants was assessed against the different reference standards. Results: A total of 212 males and females were recruited, from whom 155 usable spirometry results were obtained. The mean age of participants was 35.20 years (SD 10.99) and 93 of 155 (59.35%) were females. The predicted values for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and the FEV1/FVC ratio based on the Mozambican equations were lower than the South African—and the GLI-based predictions. Conclusions: This study provides first data on pulmonary function in healthy Mozambican adults and describes how they compare to GLI and South African reference values for spirometry.
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Affiliation(s)
- Olena Ivanova
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), 80802 Munich, Germany; (A.B.); (E.S.); (M.H.); (A.R.)
- Correspondence:
| | - Celso Khosa
- Instituto Nacional de Saúde (INS), 3943 Maputo, Mozambique; (C.K.); (N.B.); (I.M.); (I.J.)
- Center for International Health—CIH LMU, 80802 Munich, Germany
| | - Abhishek Bakuli
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), 80802 Munich, Germany; (A.B.); (E.S.); (M.H.); (A.R.)
| | - Nilesh Bhatt
- Instituto Nacional de Saúde (INS), 3943 Maputo, Mozambique; (C.K.); (N.B.); (I.M.); (I.J.)
| | - Isabel Massango
- Instituto Nacional de Saúde (INS), 3943 Maputo, Mozambique; (C.K.); (N.B.); (I.M.); (I.J.)
| | - Ilesh Jani
- Instituto Nacional de Saúde (INS), 3943 Maputo, Mozambique; (C.K.); (N.B.); (I.M.); (I.J.)
| | - Elmar Saathoff
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), 80802 Munich, Germany; (A.B.); (E.S.); (M.H.); (A.R.)
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), 80802 Munich, Germany; (A.B.); (E.S.); (M.H.); (A.R.)
- Center for International Health—CIH LMU, 80802 Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site, 80802 Munich, Germany
| | - Andrea Rachow
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), 80802 Munich, Germany; (A.B.); (E.S.); (M.H.); (A.R.)
- Center for International Health—CIH LMU, 80802 Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site, 80802 Munich, Germany
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Khosa C, Bhatt N, Massango I, Azam K, Saathoff E, Bakuli A, Riess F, Ivanova O, Hoelscher M, Rachow A. Development of chronic lung impairment in Mozambican TB patients and associated risks. BMC Pulm Med 2020; 20:127. [PMID: 32381002 PMCID: PMC7203866 DOI: 10.1186/s12890-020-1167-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 04/27/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Pulmonary tuberculosis (PTB) is frequently associated with chronic respiratory impairment despite microbiological cure. There are only a few clinical research studies that describe the course, type and severity as well as associated risk factors for lung impairment (LI) in TB patients. METHODS A prospective cohort study was conducted at TB Research Clinic of Instituto Nacional de Saúde in Mavalane, Maputo, from June 2014 to June 2016. PTB patients were prospectively enrolled and followed for 52 weeks after TB diagnosis. Lung function was evaluated by spirometry at 8, 26 and 52 weeks after TB treatment initiation, and spirometric values of below the lower limit of normality were considered as LI. Descriptive statistical analysis was performed to summarize the proportion of patients with different lung outcomes at week 52, including type and severity of LI. Risk factors were analysed using multinomial regression analysis. RESULTS A total of 69 PTB patients were enrolled, of which 62 had a valid spirometry result at week 52 after TB treatment start. At week 8, 26 and 52, the proportion of patients with LI was 78, 68.9 and 64.5%, respectively, and 35.5% had moderate or severe LI at week 52. The majority of patients with LI suffered from pulmonary restriction. Female sex, low haemoglobin and heavy smoking were significantly associated with LI. CONCLUSION Moderate or severe LI can be observed in a third of cured TB patients. Further research is urgently needed to gain deeper insight into the characteristics of post TB LI, the causal pathways and potential treatment strategies.
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Affiliation(s)
- Celso Khosa
- Instituto Nacional de Saúde (INS), Maputo, Mozambique. .,Center for International Health - CIHLMU, Munich, Germany.
| | - Nilesh Bhatt
- Instituto Nacional de Saúde (INS), Maputo, Mozambique
| | | | - Khalide Azam
- Instituto Nacional de Saúde (INS), Maputo, Mozambique.,Center for International Health - CIHLMU, Munich, Germany
| | - Elmar Saathoff
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany.,German Centre for Infection Research (DZIF), partner site, Munich, Germany
| | - Abhishek Bakuli
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Friedrich Riess
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Olena Ivanova
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Michael Hoelscher
- Center for International Health - CIHLMU, Munich, Germany.,Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany.,German Centre for Infection Research (DZIF), partner site, Munich, Germany
| | - Andrea Rachow
- Center for International Health - CIHLMU, Munich, Germany.,Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany.,German Centre for Infection Research (DZIF), partner site, Munich, Germany
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Ivanova O, Rai M, Mlahagwa W, Tumuhairwe J, Bakuli A, Nyakato VN, Kemigisha E. A cross-sectional mixed-methods study of sexual and reproductive health knowledge, experiences and access to services among refugee adolescent girls in the Nakivale refugee settlement, Uganda. Reprod Health 2019; 16:35. [PMID: 30890170 PMCID: PMC6425697 DOI: 10.1186/s12978-019-0698-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 03/12/2019] [Indexed: 11/10/2022] Open
Abstract
Abstract Background Humanitarian crises and migration make girls and women more vulnerable to poor sexual and reproductive health (SRH) outcomes. Nevertheless, there is still a dearth of information on SRH outcomes and access to SRH services among refugee girls and young women in Africa. We conducted a mixed-methods study to assess SRH experiences, knowledge and access to services of refugee girls in the Nakivale settlement, Uganda. Methods A cross-sectional survey among 260 adolescent girls 13–19 years old was conducted between March and May 2018. Concurrently, in-depth interviews were conducted among a subset of 28 adolescents. For both methods, information was collected regarding SRH knowledge, experiences and access to services and commodities. The questionnaire was entered directly on the tablets using the Magpi® app. Descriptive statistical analysis and multinomial logistic regression were performed. Qualitative data was transcribed and analysed using thematic content analysis. Results A total of 260 participants were interviewed, with a median age of 15.9 years. The majority of girls were born in DR Congo and Burundi. Of the 93% of girls who had experienced menstruation, 43% had ever missed school due to menstruation. Regarding SRH knowledge, a total of 11.7% were not aware of how HIV is prevented, 15.7% did not know any STI and 13.8% were not familiar with any method to prevent pregnancy. A total of 30 girls from 260 were sexually active, of which 11 had experienced forced sexual intercourse. The latter occurred during conflict, in transit or within the camp. A total of 27 of 260 participants had undergone female genital mutilation (FGM). The most preferred sources for SRH information was parents or guardians, although participants expressed that they were afraid or shy to discuss other sexuality topics apart from menstruation with parents. A total of 30% of the female adolescents had ever visited a SRH service centre, mostly to test for HIV and to seek medical aid for menstrual problems. Conclusions Adolescent refugee girls lack adequate SRH information, experience poor SRH outcomes including school absence due to menstruation, sexual violence and FGM. Comprehensive SRH services including sexuality education, barrier-free access to SRH services and parental involvement are recommended. Electronic supplementary material The online version of this article (10.1186/s12978-019-0698-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Olena Ivanova
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), 80802, Munich, Germany.
| | - Masna Rai
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), 80802, Munich, Germany
| | - Wendo Mlahagwa
- Faculty of Interdisciplinary Studies, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Jackline Tumuhairwe
- Faculty of Interdisciplinary Studies, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Abhishek Bakuli
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), 80802, Munich, Germany
| | - Viola N Nyakato
- Faculty of Interdisciplinary Studies, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Elizabeth Kemigisha
- Faculty of Interdisciplinary Studies, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
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Schlinkmann KM, Bakuli A, Karch A, Meyer F, Dreesman J, Monazahian M, Mikolajczyk R. Transmission of respiratory and gastrointestinal infections in German households with children attending child care. Epidemiol Infect 2018; 146:627-632. [PMID: 29478420 PMCID: PMC9134537 DOI: 10.1017/s0950268818000316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 12/25/2017] [Accepted: 01/30/2018] [Indexed: 11/06/2022] Open
Abstract
Transmission of acute respiratory infections (ARI) and acute gastroenteritis (AGE) often occurs in households. The aim of this study was to assess which proportion of ARI and AGE is introduced and transmitted by children in German households with children attending child care. We recruited families with children aged 0-6 years in Braunschweig (Germany), for a 4 months prospective cohort study in the winter period 2014/2015. Every household member was included in a health diary and used nasal swabs for pathogen identification in case of ARI. We defined a transmission if two persons had overlapping periods with symptoms and used additional definitions for sensitivity analyses. In total, 77 households participated with 282 persons. We observed 277 transmission events for ARI and 23 for AGE. In most cases, the first infected person in a household was a child (ARI: 63%, AGE: 53%), and the risk of within-household transmission was two times higher when the index case was a child. In 26 ARI-transmission events, pathogens were detected for both cases; hereof in 35% (95% confidence interval (17-56%)) the pathogens were different. Thus, symptomatic infections in household members, apparently linked in time, were in 2/3 associated with the same pathogens.
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Affiliation(s)
- K. M. Schlinkmann
- Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- PhD Programme Epidemiology, Hannover Medical School, Braunschweig-Hannover, Germany
| | - A. Bakuli
- Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- PhD Programme Epidemiology, Hannover Medical School, Braunschweig-Hannover, Germany
| | - A. Karch
- Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - F. Meyer
- Helmholtz Centre for Infection Research, KOM – Microbial Communication, Braunschweig, Germany
| | - J. Dreesman
- Governmental Institute of Public Health of Lower Saxony, Hannover, Germany
| | - M. Monazahian
- Governmental Institute of Public Health of Lower Saxony, Hannover, Germany
| | - R. Mikolajczyk
- Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
- German Center for Infection Research (DZIF), Braunschweig-Hannover, Germany
- Medical Faculty of the Martin Luther University Halle-Wittenberg, Institute for Medical Epidemiology, Biometry, and Informatics (IMEBI), Halle (Saale), Germany
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Bakuli A, Klawonn F, Karch A, Mikolajczyk R. Effects of pathogen dependency in a multi-pathogen infectious disease system including population level heterogeneity - a simulation study. Theor Biol Med Model 2017; 14:26. [PMID: 29237462 PMCID: PMC5729270 DOI: 10.1186/s12976-017-0072-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 11/22/2017] [Indexed: 01/12/2023] Open
Abstract
Background Increased computational resources have made individual based models popular for modelling epidemics. They have the advantage of incorporating heterogeneous features, including realistic population structures (like e.g. households). Existing stochastic simulation studies of epidemics, however, have been developed mainly for incorporating single pathogen scenarios although the effect of different pathogens might directly or indirectly (e.g. via contact reductions) effect the spread of each pathogen. The goal of this work was to simulate a stochastic agent based system incorporating the effect of multiple pathogens, accounting for the household based transmission process and the dependency among pathogens. Methods With the help of simulations from such a system, we observed the behaviour of the epidemics in different scenarios. The scenarios included different household size distributions, dependency versus independency of pathogens, and also the degree of dependency expressed through household isolation during symptomatic phase of individuals. Generalized additive models were used to model the association between the epidemiological parameters of interest on the variation in the parameter values from the simulation data. All the simulations and statistical analyses were performed using R 3.4.0. Results We demonstrated the importance of considering pathogen dependency using two pathogens, and showing the difference when considered independent versus dependent. Additionally for the general scenario with more pathogens, the assumption of dependency among pathogens and the household size distribution in the population cohort was found to be effective in containing the epidemic process. Additionally, populations with larger household sizes reached the epidemic peak faster than societies with smaller household sizes but dependencies among pathogens did not affect this outcome significantly. Larger households had more infections in all population cohort examples considered in our simulations. Increase in household isolation coefficient for pathogen dependency also could control the epidemic process. Conclusion Presence of multiple pathogens and their interaction can impact the behaviour of an epidemic across cohorts with different household size distributions. Future household cohort studies identifying multiple pathogens will provide useful data to verify the interaction processes in such an infectious disease system. Electronic supplementary material The online version of this article (10.1186/s12976-017-0072-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Abhishek Bakuli
- Helmholtz Centre for Infection Research, Research Group Biostatistics, Braunschweig, Germany.,PhD Programme "Epidemiology", Braunschweig-Hannover, Germany
| | - Frank Klawonn
- Helmholtz Centre for Infection Research, Research Group Biostatistics, Braunschweig, Germany.,Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbuettel, Germany
| | - André Karch
- PhD Programme "Epidemiology", Braunschweig-Hannover, Germany.,Helmholtz Centre for Infection Research, Department of Epidemiology, Braunschweig, Germany
| | - Rafael Mikolajczyk
- Helmholtz Centre for Infection Research, Department of Epidemiology, Braunschweig, Germany. .,Hannover Medical School, Hannover, Germany. .,Institute for Medical Epidemiology, Biometry, and Informatics (IMEBI), Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
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Schlinkmann KM, Bakuli A, Mikolajczyk R. Incidence and comparison of retrospective and prospective data on respiratory and gastrointestinal infections in German households. BMC Infect Dis 2017; 17:336. [PMID: 28490316 PMCID: PMC5426066 DOI: 10.1186/s12879-017-2434-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 04/30/2017] [Indexed: 11/29/2022] Open
Abstract
Background Acute respiratory infections (ARI) and acute gastrointestinal infections (AGI) are the most common childhood infections, and corresponding data can either be collected prospectively or retrospectively. The aim of this study was to estimate the incidence of respiratory and gastrointestinal episodes in German households with children attending day care and to compare results of prospective and retrospective data collection. Methods We conducted a 4 months prospective cohort study in the winter period 2014/2015 and recruited parents of children aged 0–6 years in 75 day care centers in Braunschweig, Lower Saxony, Germany. For all household members, we collected information on episodes of ARI and AGI. We applied prospective data collection in one study arm and retrospective data collection with a reporting period of 2 months in the other. Poisson regression was used to model monthly incidence rates for both study arms. Results In total, 100 households (including 404 persons) participated in the retrospective group and 77 households (282 persons) in the prospective group. Incidence estimates for ARI (retrospective group: 0.52 per person month, prospective group: 0.47) were higher than for AGI (retrospective group: 0.14, prospective group: 0.13). The adjusted incidence estimates were similar in both study arms for ARI (incidence rate ratio for retrospective versus prospective data collection: 1.11 [confidence interval (CI) 95% 0.99; 1.24], p = 0.42) as well as for AGI (1.10 [CI 95% 0.89; 1.37], p = 0.27). Conclusion If there is no need to collect biomaterials or data on severity of the diseases, incidence of infections in the household setting over a short time period (2 months) can be assessed retrospectively. Electronic supplementary material The online version of this article (doi:10.1186/s12879-017-2434-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kristin Maria Schlinkmann
- Department for Epidemiology, Helmholtz Centre for Infection Research, ESME - Epidemiological and Statistical Methods Research Group, Inhoffenstraße 7, 38124, Braunschweig, Germany.,PhD Programme "Epidemiology", Braunschweig-Hannover, Germany
| | - Abhishek Bakuli
- Department for Epidemiology, Helmholtz Centre for Infection Research, ESME - Epidemiological and Statistical Methods Research Group, Inhoffenstraße 7, 38124, Braunschweig, Germany.,PhD Programme "Epidemiology", Braunschweig-Hannover, Germany
| | - Rafael Mikolajczyk
- Department for Epidemiology, Helmholtz Centre for Infection Research, ESME - Epidemiological and Statistical Methods Research Group, Inhoffenstraße 7, 38124, Braunschweig, Germany. .,Hannover Medical School, Hannover, Germany. .,German Centre for Infection Research Site (DZIF), Braunschweig-Hannover, Germany. .,Institute for Medical Epidemiology, Medical Faculty of the Martin Luther University Halle-Wittenberg, Biometrics, and Informatics (IMEBI), Halle (Saale), Germany.
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Gupta S, Bhattacharyya S, Sonathi V, Bakuli A, Mathur AK, Leteneux C. Transition Probability Estimation Using Repeated Sampling from a Fitted Mixed Model. Value Health 2014; 17:A326. [PMID: 27200545 DOI: 10.1016/j.jval.2014.08.586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- S Gupta
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | | | - V Sonathi
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - A Bakuli
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - A K Mathur
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
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Jain M, Sonathi V, Rathi H, Bakuli A, Thomas SK, Mollon P. A DE-NOVO Model to Predict Outcomes of a New Hypothetical Intervention to Reduce CV Risk in Post Mi Patients. Value Health 2014; 17:A558. [PMID: 27201839 DOI: 10.1016/j.jval.2014.08.1837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- M Jain
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - V Sonathi
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - H Rathi
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - A Bakuli
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - S K Thomas
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - P Mollon
- Novaris Pharma AG, Basel, Switzerland
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