1
|
Sheikh-Mohamed S, Isho B, Chao GY, Zuo M, Cohen C, Lustig Y, Nahass GR, Salomon-Shulman RE, Blacker G, Fazel-Zarandi M, Rathod B, Colwill K, Jamal A, Li Z, de Launay KQ, Takaoka A, Garnham-Takaoka J, Patel A, Fahim C, Paterson A, Li AX, Haq N, Barati S, Gilbert L, Green K, Mozafarihashjin M, Samaan P, Budylowski P, Siqueira WL, Mubareka S, Ostrowski M, Rini JM, Rojas OL, Weissman IL, Tal MC, McGeer A, Regev-Yochay G, Straus S, Gingras AC, Gommerman JL. Systemic and mucosal IgA responses are variably induced in response to SARS-CoV-2 mRNA vaccination and are associated with protection against subsequent infection. Mucosal Immunol 2022; 15:799-808. [PMID: 35468942 PMCID: PMC9037584 DOI: 10.1038/s41385-022-00511-0] [Citation(s) in RCA: 124] [Impact Index Per Article: 62.0] [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: 01/12/2022] [Revised: 03/02/2022] [Accepted: 03/23/2022] [Indexed: 02/04/2023]
Abstract
Although SARS-CoV-2 infects the upper respiratory tract, we know little about the amount, type, and kinetics of antibodies (Ab) generated in the oral cavity in response to COVID-19 vaccination. We collected serum and saliva samples from participants receiving two doses of mRNA COVID-19 vaccines and measured the level of anti-SARS-CoV-2 Ab. We detected anti-Spike and anti-Receptor Binding Domain (RBD) IgG and IgA, as well as anti-Spike/RBD associated secretory component in the saliva of most participants after dose 1. Administration of a second dose of mRNA boosted the IgG but not the IgA response, with only 30% of participants remaining positive for IgA at this timepoint. At 6 months post-dose 2, these participants exhibited diminished anti-Spike/RBD IgG levels, although secretory component-associated anti-Spike Ab were more stable. Examining two prospective cohorts we found that participants who experienced breakthrough infections with SARS-CoV-2 variants had lower levels of vaccine-induced serum anti-Spike/RBD IgA at 2-4 weeks post-dose 2 compared to participants who did not experience an infection, whereas IgG levels were comparable between groups. These data suggest that COVID-19 vaccines that elicit a durable IgA response may have utility in preventing infection. Our study finds that a local secretory component-associated IgA response is induced by COVID-19 mRNA vaccination that persists in some, but not all participants. The serum and saliva IgA response modestly correlate at 2-4 weeks post-dose 2. Of note, levels of anti-Spike serum IgA (but not IgG) at this timepoint are lower in participants who subsequently become infected with SARS-CoV-2. As new surges of SARS-CoV-2 variants arise, developing COVID-19 booster shots that provoke high levels of IgA has the potential to reduce person-to-person transmission.
Collapse
Affiliation(s)
| | - Baweleta Isho
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Gary Y.C. Chao
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Michelle Zuo
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Carmit Cohen
- Sheba Medical Center Tel Hashomer, Ramat Gan, Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Yaniv Lustig
- Sheba Medical Center Tel Hashomer, Ramat Gan, Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel,Central Virology Laboratory, Public Health Services, Ministry of Health, Sheba Medical Center, Tel-Hashomer, Tel-Aviv University, Tel Aviv-Yafo, Israel,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel
| | - George R. Nahass
- Institute for Stem Cell Biology and Regenerative Medicine and the Ludwig Cancer Center, Stanford University School of Medicine, Stanford, CA, USA,University of Illinois-Chicago, College of Medicine, Chicago, USA
| | - Rachel E. Salomon-Shulman
- Institute for Stem Cell Biology and Regenerative Medicine and the Ludwig Cancer Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Grace Blacker
- Institute for Stem Cell Biology and Regenerative Medicine and the Ludwig Cancer Center, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Bhavisha Rathod
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Karen Colwill
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Alainna Jamal
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Zhijie Li
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Keelia Quinn de Launay
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada,Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Alyson Takaoka
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada,Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Julia Garnham-Takaoka
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada,Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Anjali Patel
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada,Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Christine Fahim
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Aimee Paterson
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Angel Xinliu Li
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Nazrana Haq
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Shiva Barati
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Lois Gilbert
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Karen Green
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | | | - Philip Samaan
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Patrick Budylowski
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | | | - Samira Mubareka
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada,Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Mario Ostrowski
- Department of Immunology, University of Toronto, Toronto, ON, Canada,Department of Medicine, University of Toronto, Toronto, ON, Canada,Keenan Research Centre for Biomedical Science, Toronto, ON, Canada
| | - James M. Rini
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada,Department of Biochemistry, University of Toronto, Toronto, ON, Canada
| | - Olga L. Rojas
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Irving L. Weissman
- Institute for Stem Cell Biology and Regenerative Medicine and the Ludwig Cancer Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Michal Caspi Tal
- Institute for Stem Cell Biology and Regenerative Medicine and the Ludwig Cancer Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Allison McGeer
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Gili Regev-Yochay
- Sheba Medical Center Tel Hashomer, Ramat Gan, Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Sharon Straus
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada,Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | | |
Collapse
|
2
|
Sheikh-Mohamed S, Chao G, Isho B, Zuo M, Cohen C, Lustig Y, Nahass G, Salomon RE, Blacker G, Fazel-Zarandi M, Rathod B, Colwill K, Jamal AJ, Li Z, deLaunay KQ, Takaoka A, Garnham-Takaoka J, Patel A, Fahim C, Patterson A, Liu A, Haq N, Barati S, Gilbert L, Green K, Mozafarihashjin M, Samaan P, Budylowski P, Siqueira W, Mubareka S, Ostrowski M, Rini J, Rojas O, Weissman IL, Tal MC, McGeer A, Regev G, Straus S, Gingras AC, Gommerman JL. Systemic and mucosal IgA responses are variably induced in response to SARS-CoV-2 mRNA vaccination and are associated with protection against subsequent infection. The Journal of Immunology 2022. [DOI: 10.4049/jimmunol.208.supp.59.14] [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] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Abstract
SARS-CoV-2 is a novel respiratory virus that has quickly spread across the globe. The virus uses a protein called Spike and its associated receptor binding domain (RBD) to interact with angiotensin converting enzyme-2 (ACE-2) on the surface of epithelial cells in the respiratory tract. Although a definite correlate of protection against COVID-19 has yet to emerge, many studies have quantified anti-Spike and anti-RBD IgG antibody (Ab) levels, as well as neutralizing Ab in the blood to ascertain immunity. This approach misses out on Ab that are produced in the upper respiratory tract (URT) mucosa – the site of viral encounter. Whether intramuscularly (i.m.) administered COVID-19 vaccines can promote immunity in the mucosa is not well understood. We recently completed a study where we showed that anti-Spike/RBD IgG could be detected in the saliva following i.m. vaccination with either two doses of mRNA vaccines (Pfizer or Moderna) or with a heterologous dosing of Astra Zeneca followed by an mRNA vaccine. Administration of a second dose of mRNA boosted the IgG but not IgA response, with only 30% of participants remaining positive for IgA at this timepoint. At 6 months post-dose 2, these participants had diminished anti-Spike/RBD IgG levels, although secretory component associated anti-Spike Ab were more stable. Examining two prospective cohorts we found that participants who experienced breakthrough infections with SARS-CoV-2 had lower levels of vaccine-induced serum anti-Spike/RBD IgA at 2–4 weeks post-dose 2 compared to participants who did not experience an infection, whereas IgG levels were comparable between groups. These data suggest that COVID-19 vaccines that elicit a durable IgA response may have utility in preventing infection.
We received funding support from CIHR (Fund #15992), a COVID-19 Immunity Task force grant, an “Ontario Together” province of Ontario grant, a CIHR team grant to CoVARR-Net, a Donation from the Royal Bank of Canada (RBC) and a donation from the Krembil Foundation to the Sinai Health System Foundation.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Alyson Takaoka
- 9St. Michael’s Hospital, Unity Health, Toronto, ON, Canada
| | | | | | | | | | - Angel Liu
- 9St. Michael’s Hospital, Unity Health, Toronto, ON, Canada
| | - Nazrana Haq
- 8Lunenfeld-Tanenbaum Research Institute, Canada
| | | | | | - Karen Green
- 8Lunenfeld-Tanenbaum Research Institute, Canada
| | | | | | | | | | | | | | | | | | | | | | | | | | - Sharon Straus
- 9St. Michael’s Hospital, Unity Health, Toronto, ON, Canada
| | | | | |
Collapse
|
3
|
Colwill K, Galipeau Y, Stuible M, Gervais C, Arnold C, Rathod B, Abe KT, Wang JH, Pasculescu A, Maltseva M, Rocheleau L, Pelchat M, Fazel-Zarandi M, Iskilova M, Barrios-Rodiles M, Bennett L, Yau K, Cholette F, Mesa C, Li AX, Paterson A, Hladunewich MA, Goodwin PJ, Wrana JL, Drews SJ, Mubareka S, McGeer AJ, Kim J, Langlois MA, Gingras AC, Durocher Y. A scalable serology solution for profiling humoral immune responses to SARS-CoV-2 infection and vaccination. Clin Transl Immunology 2022; 11:e1380. [PMID: 35356067 PMCID: PMC8942165 DOI: 10.1002/cti2.1380] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [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: 12/17/2021] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 12/14/2022] Open
Abstract
Objectives Antibody testing against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has been instrumental in detecting previous exposures and analyzing vaccine‐elicited immune responses. Here, we describe a scalable solution to detect and quantify SARS‐CoV‐2 antibodies, discriminate between natural infection‐ and vaccination‐induced responses, and assess antibody‐mediated inhibition of the spike‐angiotensin converting enzyme 2 (ACE2) interaction. Methods We developed methods and reagents to detect SARS‐CoV‐2 antibodies by enzyme‐linked immunosorbent assay (ELISA). The main assays focus on the parallel detection of immunoglobulin (Ig)Gs against the spike trimer, its receptor binding domain (RBD) and nucleocapsid (N). We automated a surrogate neutralisation (sn)ELISA that measures inhibition of ACE2‐spike or ‐RBD interactions by antibodies. The assays were calibrated to a World Health Organization reference standard. Results Our single‐point IgG‐based ELISAs accurately distinguished non‐infected and infected individuals. For seroprevalence assessment (in a non‐vaccinated cohort), classifying a sample as positive if antibodies were detected for ≥ 2 of the 3 antigens provided the highest specificity. In vaccinated cohorts, increases in anti‐spike and ‐RBD (but not ‐N) antibodies are observed. We present detailed protocols for serum/plasma or dried blood spots analysis performed manually and on automated platforms. The snELISA can be performed automatically at single points, increasing its scalability. Conclusions Measuring antibodies to three viral antigens and identify neutralising antibodies capable of disrupting spike‐ACE2 interactions in high‐throughput enables large‐scale analyses of humoral immune responses to SARS‐CoV‐2 infection and vaccination. The reagents are available to enable scaling up of standardised serological assays, permitting inter‐laboratory data comparison and aggregation.
Collapse
Affiliation(s)
- Karen Colwill
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Yannick Galipeau
- Department of Biochemistry, Microbiology, and Immunology University of Ottawa Ottawa ON Canada
| | - Matthew Stuible
- Mammalian Cell Expression, Human Health Therapeutics Research Centre National Research Council Canada Montréal QC Canada
| | - Christian Gervais
- Mammalian Cell Expression, Human Health Therapeutics Research Centre National Research Council Canada Montréal QC Canada
| | - Corey Arnold
- Department of Biochemistry, Microbiology, and Immunology University of Ottawa Ottawa ON Canada
| | - Bhavisha Rathod
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Present address: Treadwell Therapeutics Toronto ON Canada
| | - Kento T Abe
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Department of Molecular Genetics University of Toronto Toronto ON Canada
| | - Jenny H Wang
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Adrian Pasculescu
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Mariam Maltseva
- Department of Biochemistry, Microbiology, and Immunology University of Ottawa Ottawa ON Canada
| | - Lynda Rocheleau
- Department of Biochemistry, Microbiology, and Immunology University of Ottawa Ottawa ON Canada
| | - Martin Pelchat
- Department of Biochemistry, Microbiology, and Immunology University of Ottawa Ottawa ON Canada.,The Centre for Infection, Immunity, and Inflammation University of Ottawa Ottawa ON Canada
| | - Mahya Fazel-Zarandi
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Mariam Iskilova
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Miriam Barrios-Rodiles
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Linda Bennett
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Kevin Yau
- Division of Nephrology Department of Medicine Sunnybrook Health Sciences Centre Toronto ON Canada
| | - François Cholette
- National Microbiology Laboratory Public Health Agency of Canada Winnipeg MB Canada.,Department of Medical Microbiology and Infectious Diseases University of Manitoba Winnipeg MB Canada
| | - Christine Mesa
- National Microbiology Laboratory Public Health Agency of Canada Winnipeg MB Canada
| | - Angel X Li
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Department of Microbiology, at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Aimee Paterson
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Department of Microbiology, at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Michelle A Hladunewich
- Division of Nephrology Department of Medicine Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Pamela J Goodwin
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Department of Medicine University of Toronto Toronto ON Canada
| | - Jeffrey L Wrana
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Department of Molecular Genetics University of Toronto Toronto ON Canada
| | - Steven J Drews
- Microbiology, Donation Policy and Studies Canadian Blood Services Edmonton AB Canada.,Division of Diagnostic and Applied Microbiology Department of Laboratory Medicine and Pathology University of Alberta Edmonton AB Canada
| | - Samira Mubareka
- Division of Microbiology Department of Laboratory Medicine and Molecular Diagnostics Sunnybrook Health Sciences Centre Toronto ON Canada.,Biological Sciences Sunnybrook Research Institute Toronto ON Canada.,Division of Infectious Diseases Sunnybrook Health Sciences Centre Toronto ON Canada.,Department of Laboratory Medicine and Pathology University of Toronto Toronto ON Canada
| | - Allison J McGeer
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Department of Microbiology, at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Institute of Health Policy, Management and Evaluation University of Toronto Toronto ON Canada
| | - John Kim
- National Microbiology Laboratory Public Health Agency of Canada Winnipeg MB Canada
| | - Marc-André Langlois
- Department of Biochemistry, Microbiology, and Immunology University of Ottawa Ottawa ON Canada.,The Centre for Infection, Immunity, and Inflammation University of Ottawa Ottawa ON Canada
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Department of Molecular Genetics University of Toronto Toronto ON Canada
| | - Yves Durocher
- Mammalian Cell Expression, Human Health Therapeutics Research Centre National Research Council Canada Montréal QC Canada
| |
Collapse
|
4
|
Tang X, Sharma A, Pasic M, Brown P, Colwill K, Gelband H, Birnboim HC, Nagelkerke N, Bogoch II, Bansal A, Newcombe L, Slater J, Rodriguez PS, Huang G, Fu SH, Meh C, Wu DC, Kaul R, Langlois MA, Morawski E, Hollander A, Eliopoulos D, Aloi B, Lam T, Abe KT, Rathod B, Fazel-Zarandi M, Wang J, Iskilova M, Pasculescu A, Caldwell L, Barrios-Rodiles M, Mohammed-Ali Z, Vas N, Santhanam DR, Cho ER, Qu K, Jha S, Jha V, Suraweera W, Malhotra V, Mastali K, Wen R, Sinha S, Reid A, Gingras AC, Chakraborty P, Slutsky AS, Jha P. Assessment of SARS-CoV-2 Seropositivity During the First and Second Viral Waves in 2020 and 2021 Among Canadian Adults. JAMA Netw Open 2022; 5:e2146798. [PMID: 35171263 PMCID: PMC8851304 DOI: 10.1001/jamanetworkopen.2021.46798] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE The incidence of infection during SARS-CoV-2 viral waves, the factors associated with infection, and the durability of antibody responses to infection among Canadian adults remain undocumented. OBJECTIVE To assess the cumulative incidence of SARS-CoV-2 infection during the first 2 viral waves in Canada by measuring seropositivity among adults. DESIGN, SETTING, AND PARTICIPANTS The Action to Beat Coronavirus study conducted 2 rounds of an online survey about COVID-19 experience and analyzed immunoglobulin G levels based on participant-collected dried blood spots (DBS) to assess the cumulative incidence of SARS-CoV-2 infection during the first and second viral waves in Canada. A sample of 19 994 Canadian adults (aged ≥18 years) was recruited from established members of the Angus Reid Forum, a public polling organization. The study comprised 2 phases (phase 1 from May 1 to September 30, 2020, and phase 2 from December 1, 2020, to March 31, 2021) that generally corresponded to the first (April 1 to July 31, 2020) and second (October 1, 2020, to March 1, 2021) viral waves. MAIN OUTCOMES AND MEASURES SARS-CoV-2 immunoglobulin G seropositivity (using a chemiluminescence assay) by major geographic and demographic variables and correlation with COVID-19 symptom reporting. RESULTS Among 19 994 adults who completed the online questionnaire in phase 1, the mean (SD) age was 50.9 (15.4) years, and 10 522 participants (51.9%) were female; 2948 participants (14.5%) had self-identified racial and ethnic minority group status, and 1578 participants (8.2%) were self-identified Indigenous Canadians. Among participants in phase 1, 8967 had DBS testing. In phase 2, 14 621 adults completed online questionnaires, and 7102 of those had DBS testing. Of 19 994 adults who completed the online survey in phase 1, fewer had an educational level of some college or less (4747 individuals [33.1%]) compared with the general population in Canada (45.0%). Survey respondents were otherwise representative of the general population, including in prevalence of known risk factors associated with SARS-CoV-2 infection. The cumulative incidence of SARS-CoV-2 infection among unvaccinated adults increased from 1.9% in phase 1 to 6.5% in phase 2. The seropositivity pattern was demographically and geographically heterogeneous during phase 1 but more homogeneous by phase 2 (with a cumulative incidence ranging from 6.4% to 7.0% in most regions). The exception was the Atlantic region, in which cumulative incidence reached only 3.3% (odds ratio [OR] vs Ontario, 0.46; 95% CI, 0.21-1.02). A total of 47 of 188 adults (25.3%) reporting COVID-19 symptoms during phase 2 were seropositive, and the OR of seropositivity for COVID-19 symptoms was 6.15 (95% CI, 2.02-18.69). In phase 2, 94 of 444 seropositive adults (22.2%) reported having no symptoms. Of 134 seropositive adults in phase 1 who were retested in phase 2, 111 individuals (81.8%) remained seropositive. Participants who had a history of diabetes (OR, 0.58; 95% CI, 0.38-0.90) had lower odds of having detectable antibodies in phase 2. CONCLUSIONS AND RELEVANCE The Action to Beat Coronavirus study found that the incidence of SARS-CoV-2 infection in Canada was modest until March 2021, and this incidence was lower than the levels of population immunity required to substantially reduce transmission of the virus. Ongoing vaccination efforts remain central to reducing viral transmission and mortality. Assessment of future infection-induced and vaccine-induced immunity is practicable through the use of serial online surveys and participant-collected DBS.
Collapse
Affiliation(s)
- Xuyang Tang
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Abha Sharma
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Maria Pasic
- St Joseph’s Health Centre, Unity Health Toronto, Toronto, Ontario, Canada
| | - Patrick Brown
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Karen Colwill
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | - Hellen Gelband
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - H. Chaim Birnboim
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Nico Nagelkerke
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | | | - Aiyush Bansal
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Leslie Newcombe
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Justin Slater
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Peter S. Rodriguez
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Guowen Huang
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Sze Hang Fu
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Catherine Meh
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Daphne C. Wu
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Rupert Kaul
- University Health Network, Toronto, Ontario, Canada
| | | | - Ed Morawski
- Angus Reid Institute, Vancouver, British Columbia, Canada
| | - Andy Hollander
- Angus Reid Institute, Vancouver, British Columbia, Canada
| | | | - Benjamin Aloi
- Angus Reid Institute, Vancouver, British Columbia, Canada
| | - Teresa Lam
- Angus Reid Institute, Vancouver, British Columbia, Canada
| | - Kento T. Abe
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | - Bhavisha Rathod
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | - Mahya Fazel-Zarandi
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | - Jenny Wang
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | - Mariam Iskilova
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | - Adrian Pasculescu
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | - Lauren Caldwell
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | | | | | - Nandita Vas
- St Joseph’s Health Centre, Unity Health Toronto, Toronto, Ontario, Canada
| | - Divya Raman Santhanam
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Eo Rin Cho
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Kathleen Qu
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Shreya Jha
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Vedika Jha
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Wilson Suraweera
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Varsha Malhotra
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Kathy Mastali
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Richard Wen
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Samir Sinha
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | - Angus Reid
- Angus Reid Institute, Vancouver, British Columbia, Canada
| | - Anne-Claude Gingras
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | | | | | - Prabhat Jha
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
5
|
Tang X, Sharma A, Pasic M, Brown P, Colwill K, Gelband H, Birnboim HC, Nagelkerke N, Bogoch II, Bansal A, Newcombe L, Slater J, Rodriguez PS, Huang G, Fu SH, Meh C, Wu DC, Kaul R, Langlois MA, Morawski E, Hollander A, Eliopoulos D, Aloi B, Lam T, Abe KT, Rathod B, Fazel-Zarandi M, Wang J, Iskilova M, Pasculescu A, Caldwell L, Barrios-Rodiles M, Mohammed-Ali Z, Vas N, Santhanam DR, Cho ER, Qu K, Jha S, Jha V, Suraweera W, Malhotra V, Mastali K, Wen R, Sinha S, Reid A, Gingras AC, Chakraborty P, Slutsky AS, Jha P. Assessment of SARS-CoV-2 Seropositivity During the First and Second Viral Waves in 2020 and 2021 Among Canadian Adults. JAMA Netw Open 2022. [PMID: 35171263 DOI: 10.1001/jamanetworkopen.2021.46798.pmid:35171263] [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] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
IMPORTANCE The incidence of infection during SARS-CoV-2 viral waves, the factors associated with infection, and the durability of antibody responses to infection among Canadian adults remain undocumented. OBJECTIVE To assess the cumulative incidence of SARS-CoV-2 infection during the first 2 viral waves in Canada by measuring seropositivity among adults. DESIGN, SETTING, AND PARTICIPANTS The Action to Beat Coronavirus study conducted 2 rounds of an online survey about COVID-19 experience and analyzed immunoglobulin G levels based on participant-collected dried blood spots (DBS) to assess the cumulative incidence of SARS-CoV-2 infection during the first and second viral waves in Canada. A sample of 19 994 Canadian adults (aged ≥18 years) was recruited from established members of the Angus Reid Forum, a public polling organization. The study comprised 2 phases (phase 1 from May 1 to September 30, 2020, and phase 2 from December 1, 2020, to March 31, 2021) that generally corresponded to the first (April 1 to July 31, 2020) and second (October 1, 2020, to March 1, 2021) viral waves. MAIN OUTCOMES AND MEASURES SARS-CoV-2 immunoglobulin G seropositivity (using a chemiluminescence assay) by major geographic and demographic variables and correlation with COVID-19 symptom reporting. RESULTS Among 19 994 adults who completed the online questionnaire in phase 1, the mean (SD) age was 50.9 (15.4) years, and 10 522 participants (51.9%) were female; 2948 participants (14.5%) had self-identified racial and ethnic minority group status, and 1578 participants (8.2%) were self-identified Indigenous Canadians. Among participants in phase 1, 8967 had DBS testing. In phase 2, 14 621 adults completed online questionnaires, and 7102 of those had DBS testing. Of 19 994 adults who completed the online survey in phase 1, fewer had an educational level of some college or less (4747 individuals [33.1%]) compared with the general population in Canada (45.0%). Survey respondents were otherwise representative of the general population, including in prevalence of known risk factors associated with SARS-CoV-2 infection. The cumulative incidence of SARS-CoV-2 infection among unvaccinated adults increased from 1.9% in phase 1 to 6.5% in phase 2. The seropositivity pattern was demographically and geographically heterogeneous during phase 1 but more homogeneous by phase 2 (with a cumulative incidence ranging from 6.4% to 7.0% in most regions). The exception was the Atlantic region, in which cumulative incidence reached only 3.3% (odds ratio [OR] vs Ontario, 0.46; 95% CI, 0.21-1.02). A total of 47 of 188 adults (25.3%) reporting COVID-19 symptoms during phase 2 were seropositive, and the OR of seropositivity for COVID-19 symptoms was 6.15 (95% CI, 2.02-18.69). In phase 2, 94 of 444 seropositive adults (22.2%) reported having no symptoms. Of 134 seropositive adults in phase 1 who were retested in phase 2, 111 individuals (81.8%) remained seropositive. Participants who had a history of diabetes (OR, 0.58; 95% CI, 0.38-0.90) had lower odds of having detectable antibodies in phase 2. CONCLUSIONS AND RELEVANCE The Action to Beat Coronavirus study found that the incidence of SARS-CoV-2 infection in Canada was modest until March 2021, and this incidence was lower than the levels of population immunity required to substantially reduce transmission of the virus. Ongoing vaccination efforts remain central to reducing viral transmission and mortality. Assessment of future infection-induced and vaccine-induced immunity is practicable through the use of serial online surveys and participant-collected DBS.
Collapse
Affiliation(s)
- Xuyang Tang
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Abha Sharma
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Maria Pasic
- St Joseph's Health Centre, Unity Health Toronto, Toronto, Ontario, Canada
| | - Patrick Brown
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Karen Colwill
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | - Hellen Gelband
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - H Chaim Birnboim
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Nico Nagelkerke
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | | | - Aiyush Bansal
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Leslie Newcombe
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Justin Slater
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Peter S Rodriguez
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Guowen Huang
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Sze Hang Fu
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Catherine Meh
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Daphne C Wu
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Rupert Kaul
- University Health Network, Toronto, Ontario, Canada
| | | | - Ed Morawski
- Angus Reid Institute, Vancouver, British Columbia, Canada
| | - Andy Hollander
- Angus Reid Institute, Vancouver, British Columbia, Canada
| | | | - Benjamin Aloi
- Angus Reid Institute, Vancouver, British Columbia, Canada
| | - Teresa Lam
- Angus Reid Institute, Vancouver, British Columbia, Canada
| | - Kento T Abe
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | - Bhavisha Rathod
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | - Mahya Fazel-Zarandi
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | - Jenny Wang
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | - Mariam Iskilova
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | - Adrian Pasculescu
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | - Lauren Caldwell
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | | | | | - Nandita Vas
- St Joseph's Health Centre, Unity Health Toronto, Toronto, Ontario, Canada
| | - Divya Raman Santhanam
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Eo Rin Cho
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Kathleen Qu
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Shreya Jha
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Vedika Jha
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Wilson Suraweera
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Varsha Malhotra
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Kathy Mastali
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Richard Wen
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| | - Samir Sinha
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | - Angus Reid
- Angus Reid Institute, Vancouver, British Columbia, Canada
| | - Anne-Claude Gingras
- Network Biology Collaborative Center, Sinai Health, Toronto, Ontario, Canada
| | | | | | - Prabhat Jha
- Centre for Global Health Research, Unity Health Toronto and University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
6
|
Drews SJ, Abe KT, Hu Q, Samson R, Gingras AC, Colwill K, Rathod B, Wang J, Fazel-Zarandi M, Yi QL, Robinson A, Wood H, Tuite A, Fisman D, Evans DH, Lin YCJ, O'Brien SF. Resistance of SARS-CoV-2 beta and gamma variants to plasma collected from Canadian blood donors during the spring of 2020. Transfusion 2021; 62:37-43. [PMID: 34662434 PMCID: PMC8662190 DOI: 10.1111/trf.16713] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 08/23/2021] [Revised: 10/11/2021] [Accepted: 10/11/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND This pilot study assesses the ability of plasma collected from Canadian blood donors in the first wave of the SARS-CoV-2 pandemic to neutralize later SARS-CoV-2 variants of concern (VOCs). STUDY DESIGN AND METHODS A repeated cross-sectional design was used, and a random cross-sectional sample of all available Canadian Blood Services retention samples (n = 1500/month) was drawn monthly for April and May of 2020. Qualitative IgG analysis was performed on aliquots of specimens using anti-spike, anti-receptor binding domain, and anti-nucleocapsid protein enzyme-linked immunosorbent assays as well as the Abbott Architect SARS CoV-2 IgG assay (Abbott Laboratories) against the anti-nucleocapsid protein. Selected plasma specimens were then assessed for neutralization against VOCs using pseudotyped lentivirus inhibition assays as well as plaque reduction neutralization test 50% (PRNT50 ). RESULTS Six specimens with a high neutralizing titer against wild-type SARS-CoV-2 and three specimens with a low neutralizing titer against wild-type SARS-CoV-2 were chosen for further analysis against VOCs. Four of six high neutralizing titer specimens had a reduced neutralizing capacity against beta VOCs by both neutralization methods. Three of six high neutralizing titer specimens had reduced neutralization capacity against gamma VOCs. CONCLUSIONS This preliminary data can be used as a justification for limiting the use of first wave plasma products in upcoming clinical trials but cannot be used to speculate on general trends in the immunity of Canadian blood donors to SARS-CoV-2.
Collapse
Affiliation(s)
- Steven J Drews
- Microbiology, Canadian Blood Services, Edmonton, Alberta, Canada.,Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Kento T Abe
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Queenie Hu
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Toronto, Ontario, Canada
| | - Reuben Samson
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Toronto, Ontario, Canada
| | - Anne-Claude Gingras
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Karen Colwill
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Toronto, Ontario, Canada
| | - Bhavisha Rathod
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Toronto, Ontario, Canada
| | - Jenny Wang
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Toronto, Ontario, Canada
| | - Mahya Fazel-Zarandi
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Toronto, Ontario, Canada
| | - Qi-Long Yi
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Alyssia Robinson
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Heidi Wood
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ashleigh Tuite
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - David Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - David H Evans
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, Alberta, Canada
| | - Yi-Chan J Lin
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, Alberta, Canada
| | - Sheila F O'Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|