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Alkharaan H, Al-Qarni H, Aldosari MA, Alsaloum M, Aldakheel G, Alenazi MW, Alharbi NK. Salivary Antibody Responses to Two COVID-19 Vaccines following Different Vaccination Regimens. Vaccines (Basel) 2023; 11:vaccines11040744. [PMID: 37112657 PMCID: PMC10146373 DOI: 10.3390/vaccines11040744] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Background: To date, little is known about the salivary mucosal immune response following different COVID-19 vaccine types or after a booster (3rd) dose of the BNT162b2 (BNT) vaccine. Methods: A total of 301 saliva samples were collected from vaccinated individuals and arranged into two cohorts: cohort 1 (n = 145), samples from individuals who had received two doses against SARS-CoV-2; cohort 2 (n = 156), samples from individuals who had received a booster of BNT vaccine. Cohorts 1 and 2 were sub-stratified into three groups based on the types of first and second doses (homologous BNT/BNT, homologous ChAdOx1/ChAdOx1, or heterologous BNT/ChAdOx1vaccinations). Salivary immunoglobulin G (IgG) response to SARS-CoV-2 spike glycoprotein was measured by ELISA, and clinical demographic data were collected from hospital records or questionnaires. Results: Salivary IgG antibody responses against different vaccines, whether homologous or heterogeneous vaccination regimens, showed similar levels in cohorts 1 and 2. Compiling all groups in cohort 1 and 2 showed significant, albeit weak, negative correlations between salivary IgG levels and time (r = −0.2, p = 0.03; r = −0.27, p = 0.003, respectively). In cohort 2, the durability of salivary IgG after a booster dose of BNT162b2 significantly dropped after 3 months compared to the <1 month and 1–3 months groups. Conclusions: Different COVID-19 vaccine types and regimens elicit similar salivary anti-SARS-CoV-2 IgG with modest waning over time. Boosting with BNT162b2 vaccine did not produce an evident increase in mucosal IgG response whereby COVID-19 recovered subjects show higher salivary IgG than naive, post-vaccination subjects. The ChAdOx1/ChAdOx1 regimen showed better correlation between salivary IgG levels and durability. These findings highlight the importance of developing oral or intra-nasal vaccines to induce stronger mucosal immunity.
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Alotaibi F, Alharbi NK, Rosen LB, Asiri AY, Assiri AM, Balkhy HH, Al Jeraisy M, Mandourah Y, AlJohani S, Al Harbi S, Jokhdar HAA, Deeb AM, Memish ZA, Jose J, Ghazal S, Al Faraj S, Al Mekhlafi GA, Sherbeeni NM, Elzein FE, AlMutairi BM, Al‐Dawood A, Abdullah ML, Barhoumi T, Alenazi MW, Almasood A, Holland SM, Arabi YM. Type I interferon autoantibodies in hospitalized patients with Middle East respiratory syndrome and association with outcomes and treatment effect of interferon beta‐1b in MIRACLE clinical trial. Influenza Other Respir Viruses 2023; 17:e13116. [PMID: 36960162 PMCID: PMC10028524 DOI: 10.1111/irv.13116] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 02/06/2023] [Accepted: 02/14/2023] [Indexed: 03/24/2023] Open
Abstract
Background Type I interferons (IFNs) are essential antiviral cytokines induced upon respiratory exposure to coronaviruses. Defects in type I IFN signaling can result in severe disease upon exposure to respiratory viral infection and are associated with worse clinical outcomes. Neutralizing autoantibodies (auto‐Abs) to type I IFNs were reported as a risk factor for life‐threatening COVID‐19, but their presence has not been evaluated in patients with severe Middle East respiratory syndrome (MERS). Methods We evaluated the prevalence of type I IFN auto‐Abs in a cohort of hospitalized patients with MERS who were enrolled in a placebo‐controlled clinical trial for treatment with IFN‐β1b and lopinavir‐ritonavir (MIRACLE trial). Samples were tested for type I IFN auto‐Abs using a multiplex particle‐based assay. Results Among the 62 enrolled patients, 15 (24.2%) were positive for immunoglobulin G auto‐Abs for at least one subtype of type I IFNs. Auto‐Abs positive patients were not different from auto‐Abs negative patients in age, sex, or comorbidities. However, the majority (93.3%) of patients who were auto‐Abs positive were critically ill and admitted to the ICU at the time of enrollment compared to 66% in the auto‐Abs negative patients. The effect of treatment with IFN‐β1b and lopinavir‐ritonavir did not significantly differ between the two groups. Conclusion This study demonstrates the presence of type I IFN auto‐Abs in hospitalized patients with MERS.
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Affiliation(s)
- Faizah Alotaibi
- College of Science and Health ProfessionsKing Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Ministry of National Guard Health AffairsRiyadhSaudi Arabia
| | - Naif Khalaf Alharbi
- King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research CenterRiyadhSaudi Arabia
| | - Lindsey B. Rosen
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural ResearchNational Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)MDBethesdaUSA
| | - Ayed Y. Asiri
- Prince Mohammed bin Abdulaziz HospitalRiyadhSaudi Arabia
| | | | - Hanan H. Balkhy
- Antimicrobial Resistance DivisionWorld Health OrganizationGenevaSwitzerland
| | - Majed Al Jeraisy
- King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research CenterRiyadhSaudi Arabia
| | | | - Sameera AlJohani
- King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research CenterRiyadhSaudi Arabia
- Department of Pathology and Laboratory MedicineKing Abdulaziz Medical City, Ministry of National Guard Health AffairsRiyadhSaudi Arabia
| | - Shmeylan Al Harbi
- King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research CenterRiyadhSaudi Arabia
- Pharmaceutical Care DepartmentKing Abdulaziz Medical City, Ministry of National Guard Health AffairsRiyadhSaudi Arabia
| | | | - Ahmad M. Deeb
- King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research CenterRiyadhSaudi Arabia
| | - Ziad A. Memish
- Prince Mohammed bin Abdulaziz Hospital, Ministry of Health, College of MedicineAlfaisal University, Riyadh, Kingdom of Saudi Arabia, Hubert Department of Global Health, Rollins School of Public Health, Emory UniversityGeorgiaAtlantaUSA
| | - Jesna Jose
- King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research CenterRiyadhSaudi Arabia
| | - Sameeh Ghazal
- Prince Mohammed bin Abdulaziz HospitalRiyadhSaudi Arabia
| | | | | | | | | | - Badriah M. AlMutairi
- King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research CenterRiyadhSaudi Arabia
| | - Abdulaziz Al‐Dawood
- King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research CenterRiyadhSaudi Arabia
- Intensive Care DepartmentKing Abdulaziz Medical City, Ministry of National Guard Health AffairsRiyadhSaudi Arabia
| | - Mashan L. Abdullah
- Experimental Medicine Department, King Abdullah International Medical Research CenterKing Saud bin Abdulaziz University for Health SciencesRiyadhSaudi Arabia
| | - Tlili Barhoumi
- King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research CenterRiyadhSaudi Arabia
| | - Mohammed W. Alenazi
- King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research CenterRiyadhSaudi Arabia
| | - Abdulrahman Almasood
- King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research CenterRiyadhSaudi Arabia
| | - Steven M. Holland
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural ResearchNational Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)MDBethesdaUSA
| | - Yaseen M. Arabi
- King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research CenterRiyadhSaudi Arabia
- Intensive Care DepartmentKing Abdulaziz Medical City, Ministry of National Guard Health AffairsRiyadhSaudi Arabia
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Alharbi NK, Aljamaan F, Aljami HA, Alenazi MW, Albalawi H, Almasoud A, Alharthi FJ, Azhar EI, Barhoumi T, Bosaeed M, Gilbert SC, Hashem AM. Immunogenicity of High-Dose MVA-Based MERS Vaccine Candidate in Mice and Camels. Vaccines (Basel) 2022; 10:vaccines10081330. [PMID: 36016218 PMCID: PMC9413082 DOI: 10.3390/vaccines10081330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 11/16/2022] Open
Abstract
The Middle East respiratory syndrome coronavirus (MERS-CoV) is a zoonotic pathogen that can transmit from dromedary camels to humans, causing severe pneumonia, with a 35% mortality rate. Vaccine candidates have been developed and tested in mice, camels, and humans. Previously, we developed a vaccine based on the modified vaccinia virus Ankara (MVA) viral vector, encoding a full-length spike protein of MERS-CoV, MVA-MERS. Here, we report the immunogenicity of high-dose MVA-MERS in prime–boost vaccinations in mice and camels. Methods: Three groups of mice were immunised with MVA wild-type (MVA-wt) and MVA-MERS (MVA-wt/MVA-MERS), MVA-MERS/MVA-wt, or MVA-MERS/MVA-MERS. Camels were immunised with two doses of PBS, MVA-wt, or MVA-MERS. Antibody (Ab) responses were evaluated using ELISA and MERS pseudovirus neutralisation assays. Results: Two high doses of MVA-MERS induced strong Ab responses in both mice and camels, including neutralising antibodies. Anti-MVA Ab responses did not affect the immune responses to the vaccine antigen (MERS-CoV spike). Conclusions: MVA-MERS vaccine, administered in a homologous prime–boost regimen, induced high levels of neutralising anti-MERS-CoV antibodies in mice and camels. This could be considered for further development and evaluation as a dromedary vaccine to reduce MERS-CoV transmission to humans.
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Affiliation(s)
- Naif Khalaf Alharbi
- Vaccine Development Unit, King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia
- Correspondence:
| | - Fahad Aljamaan
- Animal Facilities, King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
| | - Haya A. Aljami
- Vaccine Development Unit, King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
| | - Mohammed W. Alenazi
- Vaccine Development Unit, King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
| | - Hind Albalawi
- Vaccine Development Unit, King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
| | - Abdulrahman Almasoud
- Vaccine Development Unit, King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
| | - Fatima J. Alharthi
- Vaccine Development Unit, King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
| | - Esam I. Azhar
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22254, Saudi Arabia
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 22254, Saudi Arabia
| | - Tlili Barhoumi
- Vaccine Development Unit, King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia
| | - Mohammad Bosaeed
- Vaccine Development Unit, King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia
- Department of Medicine, King Abdulaziz Medical City, Riyadh 12746, Saudi Arabia
| | | | - Anwar M. Hashem
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah 22254, Saudi Arabia
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 22254, Saudi Arabia
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Alenazi MW, Algaisi A, Zowawi HM, Aldibasi O, Hashem AM, Khalaf Alharbi N. Seroprevalence of COVID-19 in Riyadh City during the early increase of COVID-19 infections in Saudi Arabia, June 2020. Saudi J Biol Sci 2022; 29:103282. [PMID: 35475117 PMCID: PMC9027288 DOI: 10.1016/j.sjbs.2022.103282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 03/14/2022] [Accepted: 04/17/2022] [Indexed: 12/15/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus (SARS-CoV-2) emerged in December 2019 and caused a global pandemic of the Coronavirus Disease 2019 (COVID-19). More than 170 million cases have been reported worldwide with mortality rate of 1–3%. The detection of SARS-CoV-2 by molecular testing is limited to acute infections, therefore serological studies provide a better estimation of the virus spread in a population. This study aims to evaluate the seroprevalence of SARS-CoV-2 in the major city of Riyadh, Saudi Arabia during the sharp increase of the pandemic, in June 2020. Serum samples from non-COVID patients (n = 432), patients visiting hospitals for other complications and confirmed negative for COVID-19, and healthy blood donors (n = 350) were collected and evaluated using an in-house enzyme-linked immunosorbent assay (ELISA). The overall percentage of positive samples was 7.80% in the combined two populations (n = 782). The seroprevalence was lower in the blood donors (6%) than non-COVID-19 patients (9.25%), p = 0.0004. This seroprevalence rate is higher than the documented cases, indicating asymptomatic or mild unreported COVID-19 infections in these two populations. This warrants further national sero-surveys and highlights the importance of real-time serological surveillance during pandemics.
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Bosaeed M, Balkhy HH, Almaziad S, Aljami HA, Alhatmi H, Alanazi H, Alahmadi M, Jawhary A, Alenazi MW, Almasoud A, Alanazi R, Bittaye M, Aboagye J, Albaalharith N, Batawi S, Folegatti P, Ramos Lopez F, Ewer K, Almoaikel K, Aljeraisy M, Alothman A, Gilbert SC, Khalaf Alharbi N. Safety and immunogenicity of ChAdOx1 MERS vaccine candidate in healthy Middle Eastern adults (MERS002): an open-label, non-randomised, dose-escalation, phase 1b trial. Lancet Microbe 2022; 3:e11-e20. [PMID: 34751259 PMCID: PMC8565931 DOI: 10.1016/s2666-5247(21)00193-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND ChAdOx1-vectored vaccine candidates against several pathogens have been developed and tested in clinical trials and ChAdOx1 nCoV-19 has now been licensed for emergency use for COVID-19. We assessed the safety and immunogenicity of the ChAdOx1 MERS vaccine in a phase 1b trial in healthy Middle Eastern adults. METHOD MERS002 is an open-label, non-randomised, dose-escalation, phase 1b trial. Healthy Middle Eastern adults aged 18-50 years were included in the study. ChAdOx1 MERS was administered as a single intramuscular injection into the deltoid muscle of the non-dominant arm at three different dose groups: 5·0 × 109 viral particles in a low-dose group, 2·5 × 1010 viral particles in an intermediate-dose group, and 5·0 × 1010 viral particles in a high-dose group. The primary objective was to assess the safety and tolerability of ChAdOx1 MERS, measured by the occurrence of solicited and unsolicited adverse events after vaccination for up to 28 days and occurrence of serious adverse events up to 6 months. The study is registered with ClinicalTrials.gov, NCT04170829. FINDINGS Between Dec 17, 2019, and June 1, 2020, 24 participants were enrolled (six to the low-dose, nine to the intermediate-dose, and nine to the high-dose group) and received a dose; 23 were available for follow-up at 6 months. The one dose of ChAdOx1 MERS vaccine was well tolerated with no serious adverse event reported during the 6 months of follow-up. Most adverse events were mild (67, 74%) and moderate (17, 19%). Six (7%) severe adverse events were reported by two participants in the intermediate-dose group (two feverish, two headache, one joint pain, and one muscle pain). Pain at the injection site was the most common local and overall adverse event, reported by 15 (63%) of the 24 participants. The most common systemic adverse event was headache, reported by 14 (58%), followed by muscle pain reported by 13 (54%). The vaccine induced both antibody and T cell immune responses in all volunteers; antibodies peaked at day 28 and T cell responses peaked at day 14; and continued until the end of follow-up at 6 months. INTERPRETATION The acceptable safety and immunogenicity data from this phase 1b trial of ChAdOx1 MERS vaccine candidate in Healthy Middle Eastern adults, combined with previous safety and immunogenicity data from a trial in the UK, support selecting the ChAdOx1 MERS vaccine for advancement into phase 2 clinical evaluation. FUNDING UK Department of Health and Social Care, using UK Aid funding, managed by the UK National Institute for Health Research; and King Abdullah International Medical Research Center.
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Affiliation(s)
- Mohammad Bosaeed
- Clinical Trial Services, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Medicine, King Abdulaziz Medical City in Riyadh, Riyadh, Saudi Arabia
| | | | - Sultan Almaziad
- Department of Medicine, King Abdulaziz Medical City in Riyadh, Riyadh, Saudi Arabia
| | - Haya A Aljami
- Vaccine Development Unit, Infectious Disease Research Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Hind Alhatmi
- Department of Medicine, King Abdulaziz Medical City in Riyadh, Riyadh, Saudi Arabia
| | - Hala Alanazi
- Clinical Trial Services, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mashael Alahmadi
- Vaccine Development Unit, Infectious Disease Research Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ayah Jawhary
- Clinical Trial Services, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mohammed W Alenazi
- Vaccine Development Unit, Infectious Disease Research Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Abdulrahman Almasoud
- Vaccine Development Unit, Infectious Disease Research Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Rawan Alanazi
- Clinical Trial Services, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mustapha Bittaye
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Jeremy Aboagye
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Nahla Albaalharith
- Department of Nursing, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Sarah Batawi
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Pedro Folegatti
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Fernando Ramos Lopez
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Katie Ewer
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Khalid Almoaikel
- Clinical Trial Services, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Majed Aljeraisy
- Clinical Trial Services, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Adel Alothman
- Clinical Trial Services, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Medicine, King Abdulaziz Medical City in Riyadh, Riyadh, Saudi Arabia
| | - Sarah C Gilbert
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Naif Khalaf Alharbi
- Vaccine Development Unit, Infectious Disease Research Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Alharbi NK, Alghnam S, Algaissi A, Albalawi H, Alenazi MW, Albargawi AM, Alharbi AG, Alhazmi A, Al Qarni A, Alfarhan A, Zowawi HM, Alhatmi H, Alghamdi J, Alroqi F, Batarfi K, Arabi YM, Hashem AM, Bosaeed M, Aldibasi O. Nationwide Seroprevalence of SARS-CoV-2 in Saudi Arabia. J Infect Public Health 2021; 14:832-838. [PMID: 34118732 PMCID: PMC8188888 DOI: 10.1016/j.jiph.2021.04.006] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/18/2021] [Accepted: 04/11/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Estimated seroprevalence of Coronavirus Infectious Disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) is a critical evidence for a better evaluation of the virus spread and monitoring the progress of COVID-19 pandemic in a population. In the Kingdom of Saudi Arabia (KSA), SARS-CoV-2 seroprevalence has been reported in specific regions, but an extensive nationwide study has not been reported. Here, we report a nationwide study to determine the prevalence of SARS-CoV-2 in the population of KSA during the pandemic, using serum samples from healthy blood donors, non-COVID patients and healthcare workers (HCWs) in six different regions of the kingdom, with addition samples from COVID-19 patients. METHODS A total of 11,703 serum samples were collected from different regions of the KSA including; 5395 samples from residual healthy blood donors (D); 5877 samples from non-COVID patients collected through residual sera at clinical biochemistry labs from non-COVID patients (P); and 400 samples from consented HCWs. To determine the seroprevalence of SARS-CoV-2, all serum samples, in addition to positive control sera from RT-PCR confirmed COVID-19 patients, were subjected to in-house ELISA with a sample pooling strategy, which was further validated by testing individual samples that make up some of the pools, with a statistical estimation method to report seroprevalence estimates. RESULTS Overall (combining D and P groups) seroprevalence estimate was around 11% in Saudi Arabia; and was 5.1% (Riyadh), 1.5% (Jazan), 18.4% (Qassim), 20.8% (Hail), 14.7% (ER; Alahsa), and 18.8% in Makkah. Makkah samples were only D group and had a rate of 24.4% and 12.8% in the cities of Makkah and Jeddah, respectively. The seroprevalence in Saudi Arabia across the sampled areas would be 12 times the reported COVID-19 infection rate. Among HCWs, 7.5% (4.95-10.16 CI 95%) had reactive antibodies to SARS-CoV-2 without reporting any previously confirmed infection. This was higher in HCWs with hypertension. The study also presents the demographics and prevalence of co-morbidities in HCWs and subset of non-COVID-19 population. INTERPRETATION Our study estimates the overall national serological prevalence of COVID-19 in Saudi Arabia to be 11%, with an apparent disparity between regions. This indicates the prevalence of asymptomatic or mild unreported COVID-19 cases.
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Affiliation(s)
- Naif Khalaf Alharbi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
| | - Suliman Alghnam
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdullah Algaissi
- Department of Medical Laboratories Technology, College of Applied Medical Sciences, Medical Research Center, Jazan University, Jazan 45142, Saudi Arabia
| | - Hind Albalawi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mohammed W Alenazi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Areeb M Albargawi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | | | - Abdulaziz Alhazmi
- Department of Microbiology and Parasitology, Faculty of Medicine, Medical Research Center, Jazan University Hospital, Jazan University, Saudi Arabia
| | - Ali Al Qarni
- King Abdulaziz Hospital, Ministry of National Guard - Health Affairs, Alahsa, Saudi Arabia
| | - Ali Alfarhan
- King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Hosam M Zowawi
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Hind Alhatmi
- King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Jahad Alghamdi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Fayhan Alroqi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Khalid Batarfi
- King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Yaseen M Arabi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Anwar M Hashem
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Bosaeed
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Omar Aldibasi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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