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Salgado BB, Jordão MF, de Morais TBDN, da Silva DSS, Pereira Filho IV, Salgado Sobrinho WB, Carvalho NO, Dos Santos RO, Forato J, Barbosa PP, Toledo-Teixeira DA, Pinto KR, Correia IS, Cordeiro IB, Souza Neto JND, Assunção END, Val FFA, Melo GC, Sampaio VDS, Monteiro WM, Granja F, Souza WMD, Astolfi Filho S, Proenca-Modena JL, Lalwani JDB, Lacerda MVGD, Nogueira PA, Lalwani P. Antigen-Specific Antibody Signature Is Associated with COVID-19 Outcome. Viruses 2023; 15:v15041018. [PMID: 37112998 PMCID: PMC10143282 DOI: 10.3390/v15041018] [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: 12/20/2022] [Revised: 04/06/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
Numerous studies have focused on inflammation-related markers to understand COVID-19. In this study, we performed a comparative analysis of spike (S) and nucleocapsid (N) protein-specific IgA, total IgG and IgG subclass response in COVID-19 patients and compared this to their disease outcome. We observed that the SARS-CoV-2 infection elicits a robust IgA and IgG response against the N-terminal (N1) and C-terminal (N3) region of the N protein, whereas we failed to detect IgA antibodies and observed a weak IgG response against the disordered linker region (N2) in COVID-19 patients. N and S protein-specific IgG1, IgG2 and IgG3 response was significantly elevated in hospitalized patients with severe disease compared to outpatients with non-severe disease. IgA and total IgG antibody reactivity gradually increased after the first week of symptoms. Magnitude of RBD-ACE2 blocking antibodies identified in a competitive assay and neutralizing antibodies detected by PRNT assay correlated with disease severity. Generally, the IgA and total IgG response between the discharged and deceased COVID-19 patients was similar. However, significant differences in the ratio of IgG subclass antibodies were observed between discharged and deceased patients, especially towards the disordered linker region of the N protein. Overall, SARS-CoV-2 infection is linked to an elevated blood antibody response in severe patients compared to non-severe patients. Monitoring of antigen-specific serological response could be an important tool to accompany disease progression and improve outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Julia Forato
- Laboratory of Emerging Viruses (LEVE), Department of Genetics, Evolution, Microbiology and Immunology, Insititute of Biology, University of Campinas (UNICAMP), Campinas 13000-000, Brazil
| | - Priscilla Paschoal Barbosa
- Laboratory of Emerging Viruses (LEVE), Department of Genetics, Evolution, Microbiology and Immunology, Insititute of Biology, University of Campinas (UNICAMP), Campinas 13000-000, Brazil
| | - Daniel A Toledo-Teixeira
- Laboratory of Emerging Viruses (LEVE), Department of Genetics, Evolution, Microbiology and Immunology, Insititute of Biology, University of Campinas (UNICAMP), Campinas 13000-000, Brazil
| | - Kerollen Runa Pinto
- Instituto de Ciências Biológicas, Universidade Federal do Amazonas (UFAM), Manaus 69000-000, Brazil
| | - Ingrid Silva Correia
- Instituto de Ciências Biológicas, Universidade Federal do Amazonas (UFAM), Manaus 69000-000, Brazil
| | | | - Júlio Nino de Souza Neto
- Instituto de Ciências Biológicas, Universidade Federal do Amazonas (UFAM), Manaus 69000-000, Brazil
| | | | | | - Gisely Cardoso Melo
- Fundação de Medicina Tropical, Doutor Heitor Vieira Dourado (FMT-HVD), Manaus 69000-000, Brazil
| | | | | | - Fabiana Granja
- Centro de Estudos da Biodiversidade, Universidade Federal de Roraima (UFRR), Boa Vista 69300-000, Brazil
| | - William M de Souza
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14000-000, Brazil
| | - Spartaco Astolfi Filho
- Instituto de Ciências Biológicas, Universidade Federal do Amazonas (UFAM), Manaus 69000-000, Brazil
| | - Jose Luiz Proenca-Modena
- Laboratory of Emerging Viruses (LEVE), Department of Genetics, Evolution, Microbiology and Immunology, Insititute of Biology, University of Campinas (UNICAMP), Campinas 13000-000, Brazil
| | - Jaila Dias Borges Lalwani
- Faculdade de Ciências Farmacêuticas, Universidade Federal do Amazonas (UFAM), Manaus 69000-000, Brazil
| | - Marcus Vinícius Guimarães de Lacerda
- Instituto Leônidas e Maria Deane (ILMD), Fiocruz Amazônia, Manaus 69000-000, Brazil
- Fundação de Medicina Tropical, Doutor Heitor Vieira Dourado (FMT-HVD), Manaus 69000-000, Brazil
| | | | - Pritesh Lalwani
- Instituto Leônidas e Maria Deane (ILMD), Fiocruz Amazônia, Manaus 69000-000, Brazil
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Lalwani P, Araujo-Castillo RV, Ganoza CA, Salgado BB, Pereira Filho IV, da Silva DSS, de Morais TBDN, Jordão MF, Ortiz JV, Barbosa ARC, Sobrinho WBS, Cordeiro IB, de Souza Neto JN, de Assunção EN, da Costa CF, de Souza PE, de Albuquerque BC, Astofi-Filho S, Lalwani JDB. High anti-SARS-CoV-2 antibody seroconversion rates before the second wave in Manaus, Brazil, and the protective effect of social behaviour measures: results from the prospective DETECTCoV-19 cohort. Lancet Glob Health 2021; 9:e1508-e1516. [PMID: 34678195 PMCID: PMC8525986 DOI: 10.1016/s2214-109x(21)00355-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/11/2021] [Accepted: 07/26/2021] [Indexed: 12/15/2022]
Abstract
Background The city of Manaus, Brazil, has seen two collapses of the health system due to the COVID-19 pandemic. We report anti-SARS-CoV-2 nucleocapsid IgG antibody seroconversion rates and associated risk factors in Manaus residents before the second wave of the epidemic in Brazil. Methods A convenience sample of adult (aged ≥18 years) residents of Manaus was recruited through online and university website advertising into the DETECTCoV-19 study cohort. The current analysis of seroconversion included a subgroup of DETECTCoV-19 participants who had at least two serum sample collections separated by at least 4 weeks between Aug 19 and Oct 2, 2020 (visit 1), and Oct 19 and Nov 27, 2020 (visit 2). Those who reported (or had no data on) having a COVID-19 diagnosis before visit 1, and who were positive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at visit 1 were excluded. Using an in-house ELISA, the reactivity index (RI; calculated as the optical density ratio of the sample to the negative control) for serum anti-SARS-CoV-2 nucleocapsid IgG antibodies was measured at both visits. We calculated the incidence of seroconversion (defined as RI values ≤1·5 at visit 1 and ≥1·5 at visit 2, and a ratio >2 between the visit 2 and visit 1 RI values) during the study period, as well as incidence rate ratios (IRRs) through cluster-corrected and adjusted Poisson regression models to analyse associations between seroconversion and variables related to sociodemographic characteristics, health access, comorbidities, COVID-19 exposure, protective behaviours, and symptoms. Findings 2496 DETECTCoV-19 cohort participants returned for a follow-up visit between Oct 19 and Nov 27, 2020, of whom 204 reported having COVID-19 before the first visit and 24 had no data regarding previous disease status. 559 participants were seropositive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at baseline. Of the remaining 1709 participants who were seronegative at baseline, 71 did not meet the criteria for seroconversion and were excluded from the analyses. Among the remaining 1638 participants who were seronegative at baseline, 214 showed seroconversion at visit 2. The seroconversion incidence was 13·06% (95% CI 11·52–14·79) overall and 6·78% (5·61–8·10) for symptomatic seroconversion, over a median follow-up period of 57 days (IQR 54–61). 48·1% of seroconversion events were estimated to be asymptomatic. The sample had higher proportions of affluent and higher-educated people than those reported for the Manaus city population. In the fully adjusted and corrected model, risk factors for seroconversion before visit 2 were having a COVID-19 case in the household (IRR 1·49 [95% CI 1·21–1·83]), not wearing a mask during contact with a person with COVID-19 (1·25 [1·09–1·45]), relaxation of physical distancing (1·31 [1·05–1·64]), and having flu-like symptoms (1·79 [1·23–2·59]) or a COVID-19 diagnosis (3·57 [2·27–5·63]) between the first and second visits, whereas working remotely was associated with lower incidence (0·74 [0·56–0·97]). Interpretation An intense infection transmission period preceded the second wave of COVID-19 in Manaus. Several modifiable behaviours increased the risk of seroconversion, including non-compliance with non-pharmaceutical interventions measures such as not wearing a mask during contact, relaxation of protective measures, and non-remote working. Increased testing in high-transmission areas is needed to provide timely information about ongoing transmission and aid appropriate implementation of transmission mitigation measures. Funding Ministry of Education, Brazil; Fundação de Amparo à Pesquisa do Estado do Amazonas; Pan American Health Organization (PAHO)/WHO.
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Affiliation(s)
- Pritesh Lalwani
- Instituto Leoônidas e Maria Deane, Fiocruz Amazoônia, Manaus, Brazil.
| | | | - Christian A Ganoza
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Ivanildo Vieira Pereira Filho
- Instituto Leoônidas e Maria Deane, Fiocruz Amazoônia, Manaus, Brazil; Faculdade de Ciências Farmacêuticas, Universidade Federal do Amazonas, Manaus, Brazil
| | | | | | | | | | - Aguyda Rayany Cavalcante Barbosa
- Instituto Leoônidas e Maria Deane, Fiocruz Amazoônia, Manaus, Brazil; Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Manaus, Brazil
| | | | | | | | | | | | - Pedro Elias de Souza
- Programa de Pós-Graduação em Cirurgia, Faculdade de Medicina, Universidade Federal do Amazonas, Manaus, Brazil
| | | | - Spartaco Astofi-Filho
- Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Manaus, Brazil; Centro de Apoio Multidisciplinar, Universidade Federal do Amazonas, Manaus, Brazil
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Santana MF, Pinto RADA, Marcon BH, Medeiros LCASD, Morais TBDND, Dias LC, Souza LPD, Melo GCD, Monteiro WM, Lacerda MVG, Val FA, Lalwani PJ, Ferreira LCDL. Pathological findings and morphologic correlation of the lungs of autopsied patients with SARS-CoV-2 infection in the Brazilian Amazon using transmission electron microscopy. Rev Soc Bras Med Trop 2021; 54:e0850. [PMID: 33886821 PMCID: PMC8047700 DOI: 10.1590/0037-8682-0850-2020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 12/09/2020] [Accepted: 02/26/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION: Electron microscopy (EM) is a rapid and effective tool that can be used to create images of a whole spectrum of virus-host interactions and, as such, has long been used in the discovery and description of viral mechanisms. METHODS: Electron microscopy was used to evaluate the pulmonary pathologies of postmortem lung sections from three patients who died from infection with SARS-associated coronavirus 2 (SARS-CoV-2), a new member of the Coronaviridae family. RESULTS: Diffuse alveolar damage (DAD) was predominant in all three patients. The early exudative stage was characterized principally by edema and extravasation of red blood cells into the alveolar space with injury to the alveolar epithelial cells; this was followed by detachment, apoptosis, and necrosis of type I and II pneumocytes. The capillaries exhibited congestion, exposure of the basement membrane from denuded endothelial cells, platelet adhesion, fibrin thrombi, and rupture of the capillary walls. The proliferative stage was characterized by pronounced proliferation of type II alveolar pneumocytes and multinucleated giant cells. The cytopathic effect of SARS-CoV-2 was observed both in degenerated type II pneumocytes and freely circulating in the alveoli, with components from virions, macrophages, lymphocytes, and cellular debris. CONCLUSIONS: Viral particles consistent with the characteristics of SARS-CoV-2 were observed mainly in degenerated pneumocytes, in the endothelium, or freely circulating in the alveoli. In the final stage of illness, the alveolar spaces were replaced by fibrosis.
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Affiliation(s)
- Monique Freire Santana
- Fundação Centro de Controle de Oncologia do Estado do Amazonas, Departamento de Ensino e Pesquisa, Manaus, AM, Brasil.,Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brasil
| | | | | | | | | | - Lucas Castanhola Dias
- Instituto Nacional de Pesquisas da Amazônia, Laboratório Temático de Microscopia e Nanotecnologia, Manaus, AM, Brasil
| | | | | | | | - Marcus Vinicius Guimarães Lacerda
- Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil.,Fundação Oswaldo Cruz, Instituto Carlos Chagas, Curitiba, PR, Brasil
| | - Fernando Almeida Val
- Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brasil.,Universidade Federal do Amazonas, Programa de Pós-Graduação em Ciências da Saúde, Manaus, AM, Brasil
| | | | - Luiz Carlos de Lima Ferreira
- Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brasil.,Hospital Universitário Getúlio Vargas, Programa de Residência Médica em Patologia, Manaus, AM, Brasil.,Universidade Federal do Amazonas, Programa de Pós-Graduação em Ciências da Saúde, Manaus, AM, Brasil
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