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Collins E, Galipeau Y, Arnold C, Bhéreur A, Booth R, Buchan AC, Cooper C, Crawley AM, McCluskie PS, McGuinty M, Pelchat M, Rocheleau L, Saginur R, Gravel C, Hawken S, Langlois MA, Little J. Clinical and serological predictors of post COVID-19 condition-findings from a Canadian prospective cohort study. Front Public Health 2024; 12:1276391. [PMID: 38784593 PMCID: PMC11111987 DOI: 10.3389/fpubh.2024.1276391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 04/18/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction More than 3 years into the pandemic, there is persisting uncertainty as to the etiology, biomarkers, and risk factors of Post COVID-19 Condition (PCC). Serological research data remain a largely untapped resource. Few studies have investigated the potential relationships between post-acute serology and PCC, while accounting for clinical covariates. Methods We compared clinical and serological predictors among COVID-19 survivors with (n = 102 cases) and without (n = 122 controls) persistent symptoms ≥12 weeks post-infection. We selected four primary serological predictors (anti-nucleocapsid (N), anti-Spike, and anti-receptor binding domain (RBD) IgG titres, and neutralization efficiency), and specified clinical covariates a priori. Results Similar proportions of PCC-cases (66.7%, n = 68) and infected-controls (71.3%, n = 87) tested positive for anti-N IgG. More cases tested positive for anti-Spike (94.1%, n = 96) and anti-RBD (95.1%, n = 97) IgG, as compared with controls (anti-Spike: 89.3%, n = 109; anti-RBD: 84.4%, n = 103). Similar trends were observed among unvaccinated participants. Effects of IgG titres on PCC status were non-significant in univariate and multivariate analyses. Adjusting for age and sex, PCC-cases were more likely to be efficient neutralizers (OR 2.2, 95% CI 1.11-4.49), and odds was further increased among cases to report deterioration in quality of life (OR 3.4, 95% CI 1.64-7.31). Clinical covariates found to be significantly related to PCC included obesity (OR 2.3, p = 0.02), number of months post COVID-19 (OR 1.1, p < 0.01), allergies (OR 1.8, p = 0.04), and need for medical support (OR 4.1, p < 0.01). Conclusion Despite past COVID-19 infection, approximately one third of PCC-cases and infected-controls were seronegative for anti-N IgG. Findings suggest higher neutralization efficiency among cases as compared with controls, and that this relationship is stronger among cases with more severe PCC. Cases also required more medical support for COVID-19 symptoms, and described complex, ongoing health sequelae. More data from larger cohorts are needed to substantiate results, permit subgroup analyses of IgG titres, and explore for differences between clusters of PCC symptoms. Future assessment of IgG subtypes may also elucidate new findings.
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Affiliation(s)
- Erin Collins
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Yannick Galipeau
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Corey Arnold
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Anne Bhéreur
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Ronald Booth
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Arianne C. Buchan
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Division of Infectious Diseases, Department of Medicine, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Curtis Cooper
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Division of Infectious Diseases, Department of Medicine, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Coronavirus Variants Rapid Response Network (CoVaRR-Net), Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Centre for Infection, Immunity and Inflammation (CI3), University of Ottawa, Ottawa, ON, Canada
| | - Angela M. Crawley
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
- Coronavirus Variants Rapid Response Network (CoVaRR-Net), Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Centre for Infection, Immunity and Inflammation (CI3), University of Ottawa, Ottawa, ON, Canada
- Chronic Disease Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Pauline S. McCluskie
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Michaeline McGuinty
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Division of Infectious Diseases, Department of Medicine, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Martin Pelchat
- 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
| | - Raphael Saginur
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Division of Infectious Diseases, Department of Medicine, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Ottawa Health Science Network Research Ethics Board (OHSN-REB), Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Chris Gravel
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Mathematics and Statistics, University of Ottawa, Ottawa, ON, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Steven Hawken
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Marc-André Langlois
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
- Coronavirus Variants Rapid Response Network (CoVaRR-Net), Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Centre for Infection, Immunity and Inflammation (CI3), University of Ottawa, Ottawa, ON, Canada
| | - Julian Little
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Coronavirus Variants Rapid Response Network (CoVaRR-Net), Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- The Knowledge Synthesis and Application Unit (KSAU), University of Ottawa, Ottawa, ON, Canada
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Kadelka S, Bouman JA, Ashcroft P, Regoes RR. Correcting for Antibody Waning in Cumulative Incidence Estimation From Sequential Serosurveys. Am J Epidemiol 2024; 193:777-786. [PMID: 38012125 DOI: 10.1093/aje/kwad226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 08/31/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023] Open
Abstract
Serosurveys are a widely used tool to estimate the cumulative incidence-the fraction of a population that has been infected by a given pathogen. These surveys rely on serological assays that measure the level of pathogen-specific antibodies. Because antibody levels are waning, the fraction of previously infected individuals that have seroreverted increases with time past infection. To avoid underestimating the true cumulative incidence, it is therefore essential to correct for waning antibody levels. We present an empirically supported approach for seroreversion correction in cumulative incidence estimation when sequential serosurveys are conducted in the context of a newly emerging infectious disease. The correction is based on the observed dynamics of antibody titers in seropositive cases and validated using several in silico test scenarios. Furthermore, through this approach we revise a previous cumulative incidence estimate relying on the assumption of an exponentially declining probability of seroreversion over time, of severe acute respiratory syndrome coronavirus 2, of 76% in Manaus, Brazil, by October 2020 to 47.6% (95% confidence region: 43.5-53.5). This estimate has implications, for example, for the proximity to herd immunity in Manaus in late 2020.
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3
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Christenson RH, Hansel S, II'yasova D, Meyer WA, Puckrein G, Lee L, Landry LG, Akinboboye O. Nucleocapsid and Spike Protein-Based Anti-SARS-CoV-2 Assay Performance in the Minority and Rural Coronavirus Insights Study: Characteristics of Socioeconomically Disadvantaged Populations with Health Disparities. J Appl Lab Med 2024; 9:493-501. [PMID: 38384143 DOI: 10.1093/jalm/jfad126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/14/2023] [Indexed: 02/23/2024]
Abstract
BACKGROUND COVID-19 has had a devastating impact on Black, Hispanic, and other underserved, disadvantaged populations. Here anti-SARS-CoV-2 tests are characterized in disadvantaged patients to examine equivalence in US populations. METHODS Underserved participant adults (age > 18 years) were enrolled before the availability of SARS-CoV-2 vaccines in Federal Qualified Health Centers in California, Florida, Louisiana, Illinois, and Ohio and contributed samples to the Minority and Rural Coronavirus Insights Study (MRCIS). A subset coined the MRCIS SARS-CoV-2 Antibody Cohort of 2365 participants was tested with the Roche Anti-SARS-CoV-2 assay (Cobas e601). Five hundred ninety-five of these were also tested with the Ortho Clinical Diagnostics VITROS Anti-SARS-CoV-2 IgG assay (VITROS-5600); 1770 were also tested with the Abbott ARCHITECT SARS-CoV-2 IgG assay (ARCHITECT-2000). Assay-specific cutoffs classified negative/positive results. RESULTS Eight point four percent (199/2365) of the MRCIS SARS-CoV-2 Antibody Cohort was SARS-CoV-2 RNA positive at enrollment. Agreement between the Ortho/Roche and the Abbott/Roche antibody testing did not vary by enrollment RNA status. The Ortho (anti-spike protein) vs Roche (anti-nucleocapsid protein) comparison agreed substantially: kappa = 0.63 (95% CI: 0.57-0.69); overall agreement, 83%. However, agreement was even better for the Abbott vs Roche assays (both anti-nucleocapsid protein tests): kappa = 0.85 (95% CI: 0.81-0.87); overall agreement, 95%. Anti-SARS-CoV-2 comparisons stratified by demographic criteria demonstrated no significant variability in agreement by sex, race/ethnicity, or age. CONCLUSIONS Analytical agreement is 96.4% for anti-spike-protein vs anti-nucleocapsid-protein comparisons. Physiologically, seroreversion of anti-nucleocapsid reactivity after infection occurred in the disadvantaged population similarly to general populations. No anti-SARS-CoV-2 assays included demonstrated a clinically significant difference due to the demographics of the disadvantaged MRCIS SARS-CoV-2 Antibody Cohort.
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Affiliation(s)
- Robert H Christenson
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Shantoy Hansel
- Center for Clinical & Social Research, National Minority Quality Forum, Washington, DC, United States
| | - Dora II'yasova
- Center for Clinical & Social Research, National Minority Quality Forum, Washington, DC, United States
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, United States
| | - William A Meyer
- Medical Affairs, Quest Diagnostics, Secaucus, NJ, United States
| | - Gary Puckrein
- Center for Clinical & Social Research, National Minority Quality Forum, Washington, DC, United States
| | - LaTasha Lee
- Center for Clinical & Social Research, National Minority Quality Forum, Washington, DC, United States
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States
| | - Latrice G Landry
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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4
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Stirrup O, Tut G, Krutikov M, Bone D, Lancaster T, Azmi B, Monakhov I, Moss P, Hayward A, Copas A, Shallcross L. Anti-nucleocapsid antibody levels following initial and repeat SARS-CoV-2 infections in a cohort of long-term care facility residents in England (VIVALDI). Wellcome Open Res 2024; 9:45. [PMID: 38818129 PMCID: PMC11137476 DOI: 10.12688/wellcomeopenres.20750.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 06/01/2024] Open
Abstract
Background We have previously demonstrated that older residents of long-term care facilities (LTCF) in the UK show levels of anti-spike antibodies that are comparable to the general population following primary series and booster vaccination for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, data on the humoral response to other SARS-CoV-2 proteins associated with natural infection are scarce in this vulnerable population. Methods We measured quantitative levels of anti-nucleocapsid antibodies in blood samples taken from LTCF residents and staff after initial and repeat SARS-CoV-2 infections, between December 2020 and March 2023. Data on SARS-CoV-2 infection and vaccination were obtained through linkage to national datasets. Linear mixed effects models were used to investigate anti-nucleocapsid antibody levels, using log10 scale, in relation to time from most recent infection. This included evaluation of associations between repeat infection, staff/resident status, age, sex, Omicron infection and vaccination history and peak antibody level and slope of decline with time. Results We analysed 405 antibody observations from 220 residents and 396 observations from 215 staff. Repeat infection was associated with 8.5-fold (95%CI 4.9-14.8-fold) higher initial (peak) median anti-nucleocapsid antibody level, with steeper subsequent slope of decline. There were no significant differences in antibody level associated with resident (vs. staff) status or age, but Omicron infection was associated with 3.6-fold (95%CI 2.4-5.4-fold) higher levels. There was stronger evidence of waning of antibody levels over time in a sensitivity analysis in which observations were censored in cases with suspected undetected repeat infection. Conclusions We found similar levels of anti-nucleocapsid antibody in residents and staff of LTCFs. Repeat infection and infection with an Omicron strain were associated with higher peak values. There was evidence of waning of anti-nucleocapsid antibody levels over time.
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Affiliation(s)
- Oliver Stirrup
- Institute for Global Health, University College London, London, England, UK
| | - Gokhan Tut
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, England, UK
| | - Maria Krutikov
- Institute of Health Informatics, University College London, London, England, UK
| | - David Bone
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, England, UK
| | - Tara Lancaster
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, England, UK
| | - Borscha Azmi
- Institute of Health Informatics, University College London, London, England, UK
| | | | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, England, UK
| | - Andrew Hayward
- Institute of Epidemiology & Health Care, University College London, London, England, UK
- Health Data Research UK, London, England, UK
| | - Andrew Copas
- Institute for Global Health, University College London, London, England, UK
| | - Laura Shallcross
- Institute of Health Informatics, University College London, London, England, UK
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5
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Krutikov M, Stirrup O, Fuller C, Adams N, Azmi B, Irwin-Singer A, Sethu N, Hayward A, Altamirano H, Copas A, Shallcross L. Built Environment and SARS-CoV-2 Transmission in Long-Term Care Facilities: Cross-Sectional Survey and Data Linkage. J Am Med Dir Assoc 2024; 25:304-313.e11. [PMID: 38065220 PMCID: PMC11139658 DOI: 10.1016/j.jamda.2023.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/27/2023] [Accepted: 10/27/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVES To describe the built environment in long-term care facilities (LTCF) and its association with introduction and transmission of SARS-CoV-2 infection. DESIGN Cross-sectional survey with linkage to routine surveillance data. SETTING AND PARTICIPANTS LTCFs in England caring for adults ≥65 years old, participating in the VIVALDI study (ISRCTN14447421) were eligible. Data were included from residents and staff. METHODS Cross-sectional survey of the LTCF built environment with linkage to routinely collected asymptomatic and symptomatic SARS-CoV-2 testing and vaccination data between September 1, 2020, and March 31, 2022. We used individual and LTCF level Poisson and Negative Binomial regression models to identify risk factors for 4 outcomes: incidence rate of resident infections and outbreaks, outbreak size, and duration. We considered interactions with variant transmissibility (pre vs post Omicron dominance). RESULTS A total of 134 of 151 (88.7%) LTCFs participated in the survey, contributing data for 13,010 residents and 17,766 staff. After adjustment and stratification, outbreak incidence (measuring infection introduction) was only associated with SARS-CoV-2 incidence in the community [incidence rate ratio (IRR) for high vs low incidence, 2.84; 95% CI, 1.85-4.36]. Characteristics of the built environment were associated with transmission outcomes and differed by variant transmissibility. For resident infection incidence, factors included number of storeys (0.64; 0.43-0.97) and bedrooms (1.04; 1.02-1.06), and purpose-built vs converted buildings (1.99; 1.08-3.69). Air quality was associated with outbreak size (dry vs just right 1.46; 1.00-2.13). Funding model (0.99; 0.99-1.00), crowding (0.98; 0.96-0.99), and bedroom temperature (1.15; 1.01-1.32) were associated with outbreak duration. CONCLUSIONS AND IMPLICATIONS We describe previously undocumented diversity in LTCF built environments. LTCFs have limited opportunities to prevent SARS-CoV-2 introduction, which was only driven by community incidence. However, adjusting the built environment, for example by isolating infected residents or improving airflow, may reduce transmission, although data quality was limited by subjectivity. Identifying LTCF built environment modifications that prevent infection transmission should be a research priority.
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Affiliation(s)
- Maria Krutikov
- Institute of Health Informatics, University College London, London, UK.
| | - Oliver Stirrup
- Institute for Global Health, University College London, London, UK
| | - Chris Fuller
- Institute of Health Informatics, University College London, London, UK
| | - Natalie Adams
- Institute of Health Informatics, University College London, London, UK
| | - Borscha Azmi
- Institute of Health Informatics, University College London, London, UK
| | - Aidan Irwin-Singer
- Surveillance Testing and Immunity, UK Health Security Agency, London, UK
| | - Niyathi Sethu
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Andrew Hayward
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Hector Altamirano
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Andrew Copas
- Institute for Global Health, University College London, London, UK
| | - Laura Shallcross
- Institute of Health Informatics, University College London, London, UK
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Selvavinayagam TS, Somasundaram A, Selvam JM, Sampath P, Vijayalakshmi V, Kumar CAB, Subramaniam S, Kumarasamy P, Raju S, Avudaiselvi R, Prakash V, Yogananth N, Subramanian G, Roshini A, Dhiliban DN, Imad S, Tandel V, Parasa R, Sachdeva S, Ramachandran S, Malani A. Contribution of infection and vaccination to population-level seroprevalence through two COVID waves in Tamil Nadu, India. Sci Rep 2024; 14:2091. [PMID: 38267448 PMCID: PMC10808562 DOI: 10.1038/s41598-023-50338-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 12/19/2023] [Indexed: 01/26/2024] Open
Abstract
This study employs repeated, large panels of serological surveys to document rapid and substantial waning of SARS-CoV-2 antibodies at the population level and to calculate the extent to which infection and vaccination separately contribute to seroprevalence estimates. Four rounds of serological surveys were conducted, spanning two COVID waves (October 2020 and April-May 2021), in Tamil Nadu (population 72 million) state in India. Each round included representative populations in each district of the state, totaling ≥ 20,000 persons per round. State-level seroprevalence was 31.5% in round 1 (October-November 2020), after India's first COVID wave. Seroprevalence fell to 22.9% in round 2 (April 2021), a roughly one-third decline in 6 months, consistent with dramatic waning of SARS-Cov-2 antibodies from natural infection. Seroprevalence rose to 67.1% by round 3 (June-July 2021), with infections from the Delta-variant induced second COVID wave accounting for 74% of the increase. Seroprevalence rose to 93.1% by round 4 (December 2021-January 2022), with vaccinations accounting for 63% of the increase. Antibodies also appear to wane after vaccination. Seroprevalence in urban areas was higher than in rural areas, but the gap shrunk over time (35.7 v. 25.7% in round 1, 89.8% v. 91.4% in round 4) as the epidemic spread even in low-density rural areas.
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Affiliation(s)
- T S Selvavinayagam
- Directorate of Public Health and Preventative Medicine, Government of Tamil Nadu, Chennai, Tamil Nadu, India
| | | | - Jerard Maria Selvam
- Directorate of Public Health and Preventative Medicine, Government of Tamil Nadu, Chennai, Tamil Nadu, India
| | - P Sampath
- Directorate of Public Health and Preventative Medicine, Government of Tamil Nadu, Chennai, Tamil Nadu, India
| | - V Vijayalakshmi
- Directorate of Public Health and Preventative Medicine, Government of Tamil Nadu, Chennai, Tamil Nadu, India
| | - C Ajith Brabhu Kumar
- Directorate of Public Health and Preventative Medicine, Government of Tamil Nadu, Chennai, Tamil Nadu, India
| | | | - Parthipan Kumarasamy
- Directorate of Public Health and Preventative Medicine, Government of Tamil Nadu, Chennai, Tamil Nadu, India
| | - S Raju
- Directorate of Public Health and Preventative Medicine, Government of Tamil Nadu, Chennai, Tamil Nadu, India
| | - R Avudaiselvi
- Directorate of Public Health and Preventative Medicine, Government of Tamil Nadu, Chennai, Tamil Nadu, India
| | - V Prakash
- Directorate of Public Health and Preventative Medicine, Government of Tamil Nadu, Chennai, Tamil Nadu, India
| | - N Yogananth
- Directorate of Public Health and Preventative Medicine, Government of Tamil Nadu, Chennai, Tamil Nadu, India
| | - Gurunathan Subramanian
- Directorate of Public Health and Preventative Medicine, Government of Tamil Nadu, Chennai, Tamil Nadu, India
| | - A Roshini
- Directorate of Public Health and Preventative Medicine, Government of Tamil Nadu, Chennai, Tamil Nadu, India
| | - D N Dhiliban
- Directorate of Public Health and Preventative Medicine, Government of Tamil Nadu, Chennai, Tamil Nadu, India
| | - Sofia Imad
- Artha Global, Mumbai, Maharashtra, India
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Ganesh R, Yadav S, Hurt RT, Mueller MR, Aakre CA, Gilman EA, Grach SL, Overgaard J, Snyder MR, Collins NM, Croghan IT, Badley AD, Razonable RR, Salonen BR. Pro Inflammatory Cytokines Profiles of Patients With Long COVID Differ Between Variant Epochs. J Prim Care Community Health 2024; 15:21501319241254751. [PMID: 38808863 PMCID: PMC11138192 DOI: 10.1177/21501319241254751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Over 30% of patients with COVID-19 have persistent symptoms that last beyond 30 days and referred to as Long COVID. Long COVID has been associated with a persistent elevation in peripheral cytokines including interleukin-6, interleukin-1β, and tumor necrosis factor-α. This study reports cytokine profiles of patients in our clinic across SARS-COV-2 variant epochs. METHODS The clinical cytokine panel was analyzed in patients with Long COVID during periods that were stratified according to variant epoch. The 4 variant epochs were defined as: (1) wild-type through alpha, (2) alpha/beta/gamma, (3) delta, and (4) omicron variants. RESULTS A total of 390 patients had the clinical cytokine panel performed; the median age was 48 years (IQR 38-59) and 62% were female. Distribution by variant was wild-type and alpha, 50% (n = 196); alpha/beta/gamma, 7.9% (n = 31); delta, 18% (n = 72); and omicron, 23% (n = 91). Time to cytokine panel testing was significantly longer for the earlier epochs. Tumor necrosis factor-α (P < .001) and interleukin 1β (P < .001) were significantly more elevated in the earlier epochs (median of 558 days in wild-type through Alpha epoch vs 263 days in omicron epoch, P < .001)). Nucleocapsid antibodies were consistently detected across epochs. DISCUSSION When stratified by variant epoch, patients with early epoch Long COVID had persistently elevated peripheral pro-inflammatory cytokine levels when compared to later epoch Long COVID. Patients with Long COVID have similar clusters of symptoms across epochs, suggesting that the underlying pathology is independent of the peripheral cytokine signature.
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8
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Kato H, Kurosawa T, Horikawa K, Kimura Y, Miyakawa K, Ryo A, Goto A. Humoral response against spike protein enhanced by fifth and sixth COVID-19 mRNA vaccine in the uninfected and infected subjects. Hum Vaccin Immunother 2023; 19:2278376. [PMID: 37969091 PMCID: PMC10760318 DOI: 10.1080/21645515.2023.2278376] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/29/2023] [Indexed: 11/17/2023] Open
Abstract
Antibody obtained by the coronavirus disease-19 (COVID-19) mRNA vaccine declines over time, and additional vaccinations are offered. It is not clear how repeated vaccination affects humoral immunity in uninfected individuals. We analyzed immunoglobulin G for spike protein (S-IgG) titers in COVID-19 uninfected and infected individuals vaccinated up to six times. The geometric mean S-IgG titers were 575.9 AU/mL and 369.0 AU/mL in those who received 6 and 5 doses less than 180 days after the last vaccination in uninfected subjects. In the 180-360 days after the last vaccination, the geometric mean S-IgG titers were 237.9 AU/mL and 128.6 AU/mL in the uninfected subjects who underwent five-dose and four-dose groups, respectively. Multivariate analysis showed that S-IgG titer increased 1.261-fold with each additional dose of mRNA vaccine. The S-IgG titers were 2.039-fold higher in the COVID-infected subjects compared to uninfected subjects. The positivity rate of nucleocapsid antibodies, suggesting a history of COVID-19, decreased 82% and 30% of COVID-infected cases after 180 and 360 days of infection, respectively. This result suggested that repeated vaccination with the COVID-19 mRNA vaccine may increase antibody titer in uninfected subjects.
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Affiliation(s)
- Hideaki Kato
- Infection Prevention and Control Department, Yokohama City University Hospital, Yokohama, Japan
| | - Takayuki Kurosawa
- Clinical Laboratory Department, Yokohama City University Hospital, Yokohama, Japan
| | - Kazuo Horikawa
- Advanced Medical Research Center, Yokohama City University, Yokohama, Japan
| | - Yayoi Kimura
- Advanced Medical Research Center, Yokohama City University, Yokohama, Japan
| | - Kei Miyakawa
- Research Center for Influenza and Respiratory Viruses, National Institute of Infectious Diseases, Musashimurayama, Japan
| | - Akihide Ryo
- Department of Virology III, National Institute of Infectious Diseases, Musashimurayama, Japan
| | - Atsushi Goto
- Department of Public Health, Yokohama City University School of Medicine, Yokohama, Japan
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9
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Bešević J, Lacey B, Callen H, Omiyale W, Conroy M, Feng Q, Crook DW, Doherty N, Ebner D, Eyre DW, Fry D, Horn E, Jones EY, Marsden BD, Peto TEA, Starkey F, Stuart D, Welsh S, Wood N, Young A, Young A, Effingham M, Collins R, Holliday J, Allen N. Persistence of SARS-CoV-2 antibodies over 18 months following infection: UK Biobank COVID-19 Serology Study. J Epidemiol Community Health 2023; 78:jech-2023-220569. [PMID: 37923370 PMCID: PMC10850672 DOI: 10.1136/jech-2023-220569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 10/08/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Little is known about the persistence of antibodies after the first year following SARS-CoV-2 infection. We aimed to determine the proportion of individuals that maintain detectable levels of SARS-CoV-2 antibodies over an 18-month period following infection. METHODS Population-based prospective study of 20 000 UK Biobank participants and their adult relatives recruited in May 2020. The proportion of SARS-CoV-2 cases testing positive for immunoglobulin G (IgG) antibodies against the spike protein (IgG-S), and the nucleocapsid protein (IgG-N), was calculated at varying intervals following infection. RESULTS Overall, 20 195 participants were recruited. Their median age was 56 years (IQR 39-68), 56% were female and 88% were of white ethnicity. The proportion of SARS-CoV-2 cases with IgG-S antibodies following infection remained high (92%, 95% CI 90%-93%) at 6 months after infection. Levels of IgG-N antibodies following infection gradually decreased from 92% (95% CI 88%-95%) at 3 months to 72% (95% CI 70%-75%) at 18 months. There was no strong evidence of heterogeneity in antibody persistence by age, sex, ethnicity or socioeconomic deprivation. CONCLUSION This study adds to the limited evidence on the long-term persistence of antibodies following SARS-CoV-2 infection, with likely implications for waning immunity following infection and the use of IgG-N in population surveys.
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Affiliation(s)
- Jelena Bešević
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
| | - Ben Lacey
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
| | - Howard Callen
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
| | - Wemimo Omiyale
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
| | - Megan Conroy
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
| | - Qi Feng
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
| | - Derrick W Crook
- Nuffield Department of Medicine (NDM), University of Oxford, Oxford, UK
| | | | - Daniel Ebner
- Nuffield Department of Medicine (NDM), University of Oxford, Oxford, UK
| | - David W Eyre
- University of Oxford Big Data Institute, Oxford, UK
| | | | - Edward Horn
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
| | - E Yvonne Jones
- Nuffield Department of Medicine (NDM), University of Oxford, Oxford, UK
| | - Brian D Marsden
- Nuffield Department of Medicine (NDM), University of Oxford, Oxford, UK
| | - Tim E A Peto
- Nuffield Department of Medicine (NDM), University of Oxford, Oxford, UK
| | - Fenella Starkey
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
| | - David Stuart
- Nuffield Department of Medicine (NDM), University of Oxford, Oxford, UK
| | | | - Natasha Wood
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
| | - Alan Young
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
- UK Biobank, Stockport, UK
| | - Allen Young
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
| | | | - Rory Collins
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
- UK Biobank, Stockport, UK
| | - Jo Holliday
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
| | - Naomi Allen
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
- UK Biobank, Stockport, UK
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10
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Karkanitsa M, Li Y, Valenti S, Spathies J, Kelly S, Hunsberger S, Yee L, Croker JA, Wang J, Alfonso AL, Faust M, Mehalko J, Drew M, Denson JP, Putman Z, Fathi P, Ngo TB, Siripong N, Baus HA, Petersen B, Ford EW, Sundaresan V, Josyula A, Han A, Giurgea LT, Rosas LA, Bean R, Athota R, Czajkowski L, Klumpp-Thomas C, Cervantes-Medina A, Gouzoulis M, Reed S, Graubard B, Hall MD, Kalish H, Esposito D, Kimberly RP, Reis S, Sadtler K, Memoli MJ. Dynamics of SARS-CoV-2 Seroprevalence in a Large US population Over a Period of 12 Months. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.20.23297329. [PMID: 37904956 PMCID: PMC10614993 DOI: 10.1101/2023.10.20.23297329] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Due to a combination of asymptomatic or undiagnosed infections, the proportion of the United States population infected with SARS-CoV-2 was unclear from the beginning of the pandemic. We previously established a platform to screen for SARS-CoV-2 positivity across a representative proportion of the US population, from which we reported that almost 17 million Americans were estimated to have had undocumented infections in the Spring of 2020. Since then, vaccine rollout and prevalence of different SARS-CoV-2 variants have further altered seropositivity trends within the United States population. To explore the longitudinal impacts of the pandemic and vaccine responses on seropositivity, we re-enrolled participants from our baseline study in a 6- and 12- month follow-up study to develop a longitudinal antibody profile capable of representing seropositivity within the United States during a critical period just prior to and during the initiation of vaccine rollout. Initial measurements showed that, since July 2020, seropositivity elevated within this population from 4.8% at baseline to 36.2% and 89.3% at 6 and 12 months, respectively. We also evaluated nucleocapsid seropositivity and compared to spike seropositivity to identify trends in infection versus vaccination relative to baseline. These data serve as a window into a critical timeframe within the COVID-19 pandemic response and serve as a resource that could be used in subsequent respiratory illness outbreaks.
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Affiliation(s)
- Maria Karkanitsa
- Section on Immunoengineering, National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Bethesda MD 20894
| | - Yan Li
- Joint Program in Survey Methodology, Department of Epidemiology and Biostatistics, University of Maryland College Park, College Park, MD 20742
| | - Shannon Valenti
- Clinical and Translational Science Institute (CTSI), University of Pittsburgh, Pittsburgh, PA 15213
| | - Jacquelyn Spathies
- Trans-NIH Shared Resource on Biomedical Engineering and Physical Science (BEPS), NIBIB, NIH, Bethesda MD 20894
| | - Sophie Kelly
- Trans-NIH Shared Resource on Biomedical Engineering and Physical Science (BEPS), NIBIB, NIH, Bethesda MD 20894
| | - Sally Hunsberger
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, MD 20894
| | - Laura Yee
- Division of Cancer Treatment and Diagnosis, National Cancer Institute (NCI), NIH, MD 20894
| | - Jennifer A. Croker
- Center for Clinical and Translational Science, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jing Wang
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD 21702
| | - Andrea Lucia Alfonso
- Section on Immunoengineering, National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Bethesda MD 20894
| | - Mondreakest Faust
- Section on Immunoengineering, National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Bethesda MD 20894
| | - Jennifer Mehalko
- Protein Expression Laboratory, Frederick National Laboratory for Cancer Research, Frederick, MD, 21702
| | - Matthew Drew
- Protein Expression Laboratory, Frederick National Laboratory for Cancer Research, Frederick, MD, 21702
| | - John-Paul Denson
- Protein Expression Laboratory, Frederick National Laboratory for Cancer Research, Frederick, MD, 21702
| | - Zoe Putman
- Protein Expression Laboratory, Frederick National Laboratory for Cancer Research, Frederick, MD, 21702
| | - Parinaz Fathi
- Section on Immunoengineering, National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Bethesda MD 20894
| | - Tran B. Ngo
- Section on Immunoengineering, National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Bethesda MD 20894
| | - Nalyn Siripong
- Clinical and Translational Science Institute (CTSI), University of Pittsburgh, Pittsburgh, PA 15213
| | - Holly Ann Baus
- Laboratory of Immunoregulation, NIAID, NIH, Bethesda MD 20894
| | - Brian Petersen
- Clinical and Translational Science Institute (CTSI), University of Pittsburgh, Pittsburgh, PA 15213
| | - Eric W. Ford
- Department of Health Care Organization, and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Vanathi Sundaresan
- Section on Immunoengineering, National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Bethesda MD 20894
| | - Aditya Josyula
- Section on Immunoengineering, National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Bethesda MD 20894
| | - Alison Han
- LID Clinical Studies Unit, Laboratory of Infectious Diseases, NIAID, NIH, Bethesda, MD 20894
| | - Luca T. Giurgea
- LID Clinical Studies Unit, Laboratory of Infectious Diseases, NIAID, NIH, Bethesda, MD 20894
| | - Luz Angela Rosas
- LID Clinical Studies Unit, Laboratory of Infectious Diseases, NIAID, NIH, Bethesda, MD 20894
| | - Rachel Bean
- LID Clinical Studies Unit, Laboratory of Infectious Diseases, NIAID, NIH, Bethesda, MD 20894
| | - Rani Athota
- LID Clinical Studies Unit, Laboratory of Infectious Diseases, NIAID, NIH, Bethesda, MD 20894
| | - Lindsay Czajkowski
- LID Clinical Studies Unit, Laboratory of Infectious Diseases, NIAID, NIH, Bethesda, MD 20894
| | - Carleen Klumpp-Thomas
- National Center for Advancing Translational Sciences (NCATS), NIH, Rockville, MD 20850
| | | | - Monica Gouzoulis
- LID Clinical Studies Unit, Laboratory of Infectious Diseases, NIAID, NIH, Bethesda, MD 20894
| | - Susan Reed
- LID Clinical Studies Unit, Laboratory of Infectious Diseases, NIAID, NIH, Bethesda, MD 20894
| | - Barry Graubard
- Division of Cancer Epidemiology & Genetics, Biostatistics Branch, NCI, NIH, Bethesda, MD 20894
| | - Matthew D. Hall
- National Center for Advancing Translational Sciences (NCATS), NIH, Rockville, MD 20850
| | - Heather Kalish
- Trans-NIH Shared Resource on Biomedical Engineering and Physical Science (BEPS), NIBIB, NIH, Bethesda MD 20894
| | - Dominic Esposito
- Protein Expression Laboratory, Frederick National Laboratory for Cancer Research, Frederick, MD, 21702
| | - Robert P. Kimberly
- Center for Clinical and Translational Science, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Steven Reis
- Clinical and Translational Science Institute (CTSI), University of Pittsburgh, Pittsburgh, PA 15213
| | - Kaitlyn Sadtler
- Section on Immunoengineering, National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Bethesda MD 20894
| | - Matthew J Memoli
- LID Clinical Studies Unit, Laboratory of Infectious Diseases, NIAID, NIH, Bethesda, MD 20894
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11
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Jarlhelt I, Pérez-Alós L, Bayarri-Olmos R, Hansen CB, Petersen MS, Weihe P, Armenteros JJA, Madsen JR, Nielsen JPS, Hilsted LM, Iversen KK, Bundgaard H, Nielsen SD, Garred P. Distinguishing SARS-CoV-2 infection and vaccine responses up to 18 months post-infection using nucleocapsid protein and receptor-binding domain antibodies. Microbiol Spectr 2023; 11:e0179623. [PMID: 37738355 PMCID: PMC10580960 DOI: 10.1128/spectrum.01796-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/04/2023] [Indexed: 09/24/2023] Open
Abstract
The prediction of the durability of immunity against COVID-19 is relevant, and longitudinal studies are essential for unraveling the details regarding protective SARS-CoV-2 antibody responses. It has become challenging to discriminate between COVID-19 vaccine- and infection-induced immune responses since all approved vaccines in Europe and the USA are based on the viral spike (S) protein, which is also the most commonly used antigen in immunoassays measuring immunoglobulins (Igs) against SARS-CoV-2. We have developed a nucleocapsid (N) protein-based sandwich ELISA for detecting pan anti-SARS-CoV-2 Ig with a sensitivity and specificity of 97%. Generalized mixed models were used to determine the degree of long-term humoral immunity against the N protein and the receptor-binding domain (RBD) of the S protein in a cohort of infected individuals to distinguish between COVID-19 vaccine- and infection-induced immunity. N-specific waning could be observed in individuals who did not experience reinfection, while individuals who experienced reinfection had a new significant increase in N-specific Ig levels. In individuals that seroconverted without a reinfection, 70.1% remained anti-N seropositive after 550 days. The anti-RBD Ig dynamics were unaffected by reinfection but exhibited a clear increase in RBD-specific Ig when vaccination was initiated. In conclusion, a clear difference in the dynamics of the antibody response against N protein and RBD was observed over time. Anti-N protein-specific Igs can be detected up to 18 months after SARS-CoV-2 infection allowing long-term discrimination of infectious and vaccine antibody responses.IMPORTANCELongitudinal studies are essential to unravel details regarding the protective antibody responses after COVID-19 infection and vaccination. It has become challenging to distinguish long-term immune responses to SARS-CoV-2 infection and vaccination since most approved vaccines are based on the viral spike (S) protein, which is also mostly used in immunoassays measuring immunoglobulins (Igs) against SARS-CoV-2. We have developed a novel nucleocapsid (N) protein-based sandwich ELISA for detecting pan-anti-SARS-CoV-2 Ig, exhibiting high sensitivity and specificity. Generalized mixed models were used to determine long-term humoral immunity in a cohort of infected individuals from the Faroe Islands, distinguishing between COVID-19 vaccine- and infection-induced immunity. A clear difference in the dynamics of the antibody response against N protein and S protein was observed over time, and the anti-N protein-specific Igs could be detected up to 18 months after SARS-CoV-2 infection. This enables long-term discrimination between natural infection and vaccine-dependent antibody responses.
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Affiliation(s)
- Ida Jarlhelt
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Copenhagen, Denmark
| | - Laura Pérez-Alós
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Copenhagen, Denmark
| | - Rafael Bayarri-Olmos
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Copenhagen, Denmark
- Recombinant Protein and Antibody Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | - Cecilie Bo Hansen
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Copenhagen, Denmark
| | - Maria Skaalum Petersen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands, Denmark
- Center of Health Science, University of the Faroe Islands, Tórshavn, Faroe Islands, Denmark
| | - Pál Weihe
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands, Denmark
- Center of Health Science, University of the Faroe Islands, Tórshavn, Faroe Islands, Denmark
| | | | - Johannes Roth Madsen
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Copenhagen, Denmark
- Department of Emergency Medicine, Herlev-Gentofte Hospital, Copenhagen, Denmark
| | - Jacob Pohl Stangerup Nielsen
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Copenhagen, Denmark
- Department of Emergency Medicine, Herlev-Gentofte Hospital, Copenhagen, Denmark
| | | | - Kasper Karmark Iversen
- Department of Emergency Medicine, Herlev-Gentofte Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henning Bundgaard
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- The Heart Center, Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
| | - Susanne Dam Nielsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Viro-immunology Research Unit, Department of Infectious Diseases, Section 8632, Rigshospitalet, Copenhagen, Denmark
| | - Peter Garred
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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12
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Lee B, Ko JH, Baek JY, Kim H, Huh K, Cho SY, Kang CI, Chung DR, Peck KR, Kang ES. Clinical Utility of Sero-Immunological Responses Against SARS-CoV-2 Nucleocapsid Protein During Subsequent Prevalence of Wild-Type, Delta Variant, and Omicron Variant. J Korean Med Sci 2023; 38:e292. [PMID: 37724496 PMCID: PMC10506902 DOI: 10.3346/jkms.2023.38.e292] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 07/18/2023] [Indexed: 09/20/2023] Open
Abstract
As nucleocapsid protein of severe acute respiratory syndrome coronavirus 2 is immunogenic but not targeted in vaccines, it could be useful in distinguishing natural infection from vaccination. We aimed to investigate the clinical utility of sero-immunological responses against the nucleocapsid protein. Nucleocapsid antibody immunoassay study with 302 coronavirus disease 2019 (COVID-19) patients showed lower titers in immunocompromised patients (P < 0.001), higher titers in higher severity (P = 0.031), and different seroconversion rates and titers according to variants of concern. Longitudinal evaluation of nucleocapsid antibodies using 513 samples from 291 COVID-19 patients revealed that it could persist up to 556 days from symptom onset. Interferon gamma release assay against the nucleocapsid protein showed poor response, precluding the deduction of a cut-off for the nucleocapsid protein. In conclusion, nucleocapsid antibody provides instructive clues about the immunogenicity of nucleocapsid proteins by different seroconversion rates and titers according to the severity of infection, host immune status, and different variants of concern.
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Affiliation(s)
- Beomki Lee
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Hoon Ko
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Yang Baek
- Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, Korea
| | - Haein Kim
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyungmin Huh
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Young Cho
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Cheol-In Kang
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Doo Ryeon Chung
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Eun-Suk Kang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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13
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Hentschel V, Horsch C, Mayer B, Thies A, Qian W, Kroschel J, Seufferlein T, Perkhofer L, Müller M. A Systematic Evaluation of the SARS-CoV-2 Vaccine-Induced Anti-S-RBD-Ig Response in a Population of Health Care Workers. Vaccines (Basel) 2023; 11:1467. [PMID: 37766143 PMCID: PMC10537165 DOI: 10.3390/vaccines11091467] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/02/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
In the wake of the COVID-19 pandemic, the novel class of mRNA vaccines has been granted first-time approval for active immunization against SARS-CoV-2 alongside the already established viral vector-based vaccines. In this prospective single-center study, we set out to determine the vaccine-induced humoral immune response in a population of 1512 health care employees after the second and third vaccination, respectively. Anti-SARS-CoV-2 receptor-binding domain (RBD) and nucleocapsid antigen antibody concentrations were assessed using commercially available immunoassays. We could show that, in particular, young study subjects aged below 30 years, as well as those with a prior SARS-CoV-2 infection, developed significantly higher antibody concentrations. Our data further suggest that being in physically close contact with formerly SARS-CoV-2-positive people positively affects the post-vaccination response. Surprisingly, study subjects with a BMI > 30 produced the highest anti-S-RBD Ig antibody levels if they had recently received their third vaccination. Also, heterologous dual vaccine regimens consisting of a BNT162b2 and ChAdOx1 n-CoV-19, a homologous triple combination of BNT162b2, and an application of mRNA-1273 as the third vaccine, were most efficient at eliciting a humoral immune response. Our study substantiates existing evidence, but beyond that, scrutinizes the impact of vaccine agents and their respective combinations, as well as different time intervals on humoral immunogenicity.
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Affiliation(s)
- Viktoria Hentschel
- Department of Internal Medicine I, Ulm University Hospital, 89081 Ulm, Germany; (V.H.); (A.T.); (W.Q.); (T.S.); (L.P.)
| | - Cornelia Horsch
- Institute for Epidemiology and Medical Biometry, Ulm University, 89075 Ulm, Germany; (C.H.); (B.M.)
| | - Benjamin Mayer
- Institute for Epidemiology and Medical Biometry, Ulm University, 89075 Ulm, Germany; (C.H.); (B.M.)
| | - Annsophie Thies
- Department of Internal Medicine I, Ulm University Hospital, 89081 Ulm, Germany; (V.H.); (A.T.); (W.Q.); (T.S.); (L.P.)
| | - Will Qian
- Department of Internal Medicine I, Ulm University Hospital, 89081 Ulm, Germany; (V.H.); (A.T.); (W.Q.); (T.S.); (L.P.)
| | - Joris Kroschel
- Central Department of Clinical Chemistry, Ulm University Hospital, 89081 Ulm, Germany;
| | - Thomas Seufferlein
- Department of Internal Medicine I, Ulm University Hospital, 89081 Ulm, Germany; (V.H.); (A.T.); (W.Q.); (T.S.); (L.P.)
| | - Lukas Perkhofer
- Department of Internal Medicine I, Ulm University Hospital, 89081 Ulm, Germany; (V.H.); (A.T.); (W.Q.); (T.S.); (L.P.)
- Institute of Molecular Oncology and Stem Cell Biology, Ulm University Hospital, 89081 Ulm, Germany
| | - Martin Müller
- Department of Internal Medicine I, Ulm University Hospital, 89081 Ulm, Germany; (V.H.); (A.T.); (W.Q.); (T.S.); (L.P.)
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14
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Han J, Baek HJ, Noh E, Yoon K, Kim JA, Ryu S, Lee KO, Park NY, Jung E, Kim S, Lee H, Hwang YS, Jung J, Lee HJ, Cho SI, Oh S, Kim M, Oh CM, Yu B, Hong YS, Kim K, Jung S, Han MA, Lee MS, Lee JJ, Hwangbo Y, Yim HW, Kim YM, Lee J, Lee WY, Park JH, Oh S, Jo HS, Kim H, Kang G, Nam HS, Lee JH, Oh GJ, Shin MH, Ryu S, Hwang TY, Park SW, Kim SK, Seol R, Park KS, Kim SY, Kwon JW, Kim SS, Kim B, Lee JW, Jang EY, Kim AR, Nam J, Lee SY, Kim DH. Korea Seroprevalence Study of Monitoring of SARS-COV-2 Antibody Retention and Transmission (K-SEROSMART): findings from national representative sample. Epidemiol Health 2023; 45:e2023075. [PMID: 37591786 PMCID: PMC10728614 DOI: 10.4178/epih.e2023075] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/13/2023] [Indexed: 08/19/2023] Open
Abstract
OBJECTIVES We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.
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Affiliation(s)
- Jina Han
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Hye Jin Baek
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Eunbi Noh
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Kyuhyun Yoon
- Institute of Health and Environment, Seoul National University, Seoul, Korea
| | - Jung Ae Kim
- Department of Nursing, Kyungmin University, Uijeongbu, Korea
| | - Sukhyun Ryu
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea
| | | | - No Yai Park
- Graduate School of Public Health, Inje University, Seoul, Korea
| | - Eunok Jung
- Department of Mathematics, Konkuk University, Seoul, Korea
| | - Sangil Kim
- Department of Internal Medicine, College of Medicine, The Catholic University, Seoul, Korea
| | - Hyukmin Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | | | - Jaehun Jung
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Hun Jae Lee
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Korea
| | - Sung-il Cho
- Institute of Health and Environment, Seoul National University, Seoul, Korea
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | | | | | - Chang-Mo Oh
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Byengchul Yu
- Department of Preventive Medicine, Kosin University College of Medicine, Busan, Korea
| | - Young-Seoub Hong
- Department of Preventive Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Keonyeop Kim
- Department of Preventive Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sunjae Jung
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Mi Ah Han
- Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Moo-Sik Lee
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Jung-Jeung Lee
- Department of Preventive Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Young Hwangbo
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University, Seoul, Korea
| | - Yu-Mi Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
- School of Public Health, Hanyang University, Seoul, Korea
| | - Joongyub Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea
| | - Weon-Young Lee
- Department of Preventive Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jae-Hyun Park
- Department of Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Sungsoo Oh
- Department of Occupational & Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Heui Sug Jo
- Department of Health Policy and Management, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Hyeongsu Kim
- Department of Preventive Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Gilwon Kang
- Department of Health Information and Management, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hae-Sung Nam
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Ju-Hyung Lee
- Department of Preventive Medicine, Jeonbuk National University Medical School, Jeonju, Korea
| | - Gyung-Jae Oh
- Department of Preventive Medicine, Wonkwang University School of Medicine, Iksan, Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Soyeon Ryu
- Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Tae-Yoon Hwang
- Department of Preventive Medicine & Public Health, Yeungnam University College of Medicine, Gyeongsan, Korea
| | - Soon-Woo Park
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Gyeongsan, Korea
| | - Sang Kyu Kim
- Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea
| | - Roma Seol
- Department of Preventive Medicine, Inje University College of Medicine, Busan, Korea
| | - Ki-Soo Park
- Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Su Young Kim
- Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Jun-wook Kwon
- National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sung Soon Kim
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Byoungguk Kim
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - June-Woo Lee
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - Eun Young Jang
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - Ah-Ra Kim
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - Jeonghyun Nam
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - The Korea Community Health Survey Group
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
- Institute of Health and Environment, Seoul National University, Seoul, Korea
- Department of Nursing, Kyungmin University, Uijeongbu, Korea
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea
- Gallup Korea, Seoul, Korea
- Graduate School of Public Health, Inje University, Seoul, Korea
- Department of Mathematics, Konkuk University, Seoul, Korea
- Department of Internal Medicine, College of Medicine, The Catholic University, Seoul, Korea
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
- Seegene Medical Foundation, Seoul, Korea
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Korea
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
- MAPO-gu Public Health Center, Seoul, Korea
- GUNPO-si Public Health Center, Gunpo, Korea
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
- Department of Preventive Medicine, Kosin University College of Medicine, Busan, Korea
- Department of Preventive Medicine, Dong-A University College of Medicine, Busan, Korea
- Department of Preventive Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea
- Department of Preventive Medicine, Keimyung University School of Medicine, Daegu, Korea
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
- Department of Preventive Medicine, College of Medicine, The Catholic University, Seoul, Korea
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
- School of Public Health, Hanyang University, Seoul, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea
- Department of Preventive Medicine, Chung-Ang University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
- Department of Occupational & Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Health Policy and Management, Kangwon National University School of Medicine, Chuncheon, Korea
- Department of Preventive Medicine, Konkuk University School of Medicine, Seoul, Korea
- Department of Health Information and Management, Chungbuk National University College of Medicine, Cheongju, Korea
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea
- Department of Preventive Medicine, Jeonbuk National University Medical School, Jeonju, Korea
- Department of Preventive Medicine, Wonkwang University School of Medicine, Iksan, Korea
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
- Department of Preventive Medicine & Public Health, Yeungnam University College of Medicine, Gyeongsan, Korea
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Gyeongsan, Korea
- Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea
- Department of Preventive Medicine, Inje University College of Medicine, Busan, Korea
- Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea
- Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
- National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Korea
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea Disease Control and Prevention Agency, Cheongju, Korea
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Soon Young Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Dong-Hyun Kim
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea
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15
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Hou CW, Williams S, Taylor K, Boyle V, Bobbett B, Kouvetakis J, Nguyen K, McDonald A, Harris V, Nussle B, Scharf P, Jehn ML, Lant T, Magee M, Chung Y, LaBaer J, Murugan V. Serological survey to estimate SARS-CoV-2 infection and antibody seroprevalence at a large public university: A cross-sectional study. BMJ Open 2023; 13:e072627. [PMID: 37536960 PMCID: PMC10401225 DOI: 10.1136/bmjopen-2023-072627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/26/2023] [Indexed: 08/05/2023] Open
Abstract
OBJECTIVE This study investigated the seroprevalence of SARS-CoV-2 antibodies among adults over 18 years. DESIGN Prospective cohort study. SETTINGS A large public university. PARTICIPANTS This study took volunteers over 5 days and recruited 1064 adult participants. PRIMARY OUTCOME MEASURES Seroprevalence of SARS-CoV-2-specific antibodies due to previous exposure to SARS-CoV-2 and/or vaccination. RESULTS The seroprevalence of the antireceptor binding domain (RBD) antibody was 90% by a lateral flow assay and 88% by a semiquantitative chemiluminescent immunoassay. The seroprevalence for antinucleocapsid was 20%. In addition, individuals with previous natural COVID-19 infection plus vaccination had higher anti-RBD antibody levels compared with those who had vaccination only or infection only. Individuals who had a breakthrough infection had the highest anti-RBD antibody levels. CONCLUSION Accurate estimates of the cumulative incidence of SARS-CoV-2 infection can inform the development of university risk mitigation protocols such as encouraging booster shots, extending mask mandates or reverting to online classes. It could help us to have clear guidance to act at the first sign of the next surge as well, especially since there is a surge of COVID-19 subvariant infections.
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Affiliation(s)
- Ching-Wen Hou
- Virginia G. Piper Center for Personalized Diagnostics, Biodesign Institute, Arizona State University, Tempe, Arizona, USA
| | - Stacy Williams
- Virginia G. Piper Center for Personalized Diagnostics, Biodesign Institute, Arizona State University, Tempe, Arizona, USA
| | - Kylee Taylor
- Virginia G. Piper Center for Personalized Diagnostics, Biodesign Institute, Arizona State University, Tempe, Arizona, USA
| | - Veronica Boyle
- Virginia G. Piper Center for Personalized Diagnostics, Biodesign Institute, Arizona State University, Tempe, Arizona, USA
| | - Bradley Bobbett
- Virginia G. Piper Center for Personalized Diagnostics, Biodesign Institute, Arizona State University, Tempe, Arizona, USA
| | - Joseph Kouvetakis
- Virginia G. Piper Center for Personalized Diagnostics, Biodesign Institute, Arizona State University, Tempe, Arizona, USA
| | - Keana Nguyen
- Virginia G. Piper Center for Personalized Diagnostics, Biodesign Institute, Arizona State University, Tempe, Arizona, USA
| | - Aaron McDonald
- Virginia G. Piper Center for Personalized Diagnostics, Biodesign Institute, Arizona State University, Tempe, Arizona, USA
| | - Valerie Harris
- Office of VP Research Development, Arizona State University, Tempe, AZ, USA
| | - Benjamin Nussle
- Virginia G. Piper Center for Personalized Diagnostics, Biodesign Institute, Arizona State University, Tempe, Arizona, USA
| | - Phillip Scharf
- College of Liberal Arts and Sciences, Arizona State University, Tempe, AZ, USA
| | - Megan L Jehn
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
| | - Timothy Lant
- Office of VP Research Development, Arizona State University, Tempe, AZ, USA
| | - Mitchell Magee
- Virginia G. Piper Center for Personalized Diagnostics, Biodesign Institute, Arizona State University, Tempe, Arizona, USA
| | - Yunro Chung
- Virginia G. Piper Center for Personalized Diagnostics, Biodesign Institute, Arizona State University, Tempe, Arizona, USA
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Joshua LaBaer
- Virginia G. Piper Center for Personalized Diagnostics, Biodesign Institute, Arizona State University, Tempe, Arizona, USA
| | - Vel Murugan
- Virginia G. Piper Center for Personalized Diagnostics, Biodesign Institute, Arizona State University, Tempe, Arizona, USA
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16
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Stirrup O, Shrotri M, Adams NL, Krutikov M, Azmi B, Monakhov I, Tut G, Moss P, Hayward A, Copas A, Shallcross L. Effectiveness of successive booster vaccine doses against SARS-CoV-2 related mortality in residents of long-term care facilities in the VIVALDI study. Age Ageing 2023; 52:afad141. [PMID: 37595069 PMCID: PMC10438206 DOI: 10.1093/ageing/afad141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused severe disease in unvaccinated long-term care facility (LTCF) residents. Initial booster vaccination following primary vaccination is known to provide strong short-term protection, but data are limited on duration of protection and the protective effect of further booster vaccinations. OBJECTIVE To evaluate the effectiveness of third, fourth and fifth dose booster vaccination against SARS-CoV-2 related mortality amongst older residents of LTCFs. DESIGN Prospective cohort study. SETTING LTCFs for older people in England participating in the VIVALDI study. METHODS Residents aged >65 years at participating LTCFs were eligible for inclusion if they had at least one polymerase chain reaction or lateral flow device result within the analysis period 1 January 2022 to 31 December 2022. We excluded individuals who had not received at least two vaccine doses before the analysis period. Cox regression was used to estimate relative hazards of SARS-CoV-2 related mortality following 1-3 booster vaccinations compared with primary vaccination, stratified by previous SARS-CoV-2 infection and adjusting for age, sex and LTCF size (total beds). RESULTS A total of 13,407 residents were included. Our results indicate that third, fourth and fifth dose booster vaccination provide additional short-term protection against SARS-CoV-2 related mortality relative to primary vaccination, with consistent stabilisation beyond 112 days to 45-75% reduction in risk relative to primary vaccination. CONCLUSIONS Successive booster vaccination doses provide additional short-term protection against SARS-CoV-2 related mortality amongst older LTCF residents. However, we did not find evidence of a longer-term reduction in risk beyond that provided by initial booster vaccination.
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Affiliation(s)
- Oliver Stirrup
- Institute for Global Health, University College London, London, UK
| | - Madhumita Shrotri
- UCL Institute of Health Informatics, University College London, London, UK
| | - Natalie L Adams
- UCL Institute of Health Informatics, University College London, London, UK
| | - Maria Krutikov
- UCL Institute of Health Informatics, University College London, London, UK
| | - Borscha Azmi
- UCL Institute of Health Informatics, University College London, London, UK
| | | | - Gokhan Tut
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Andrew Hayward
- UCL Institute of Epidemiology & Healthcare, University College London, London, UK
- Health Data Research UK, London, UK
| | - Andrew Copas
- Institute for Global Health, University College London, London, UK
| | - Laura Shallcross
- UCL Institute of Health Informatics, University College London, London, UK
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17
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Tyson GB, Jones S, Montreuil-Spencer C, Logan N, Scott S, Sasvari H, McDonald M, Marshall L, Murcia PR, Willett BJ, Weir W, Hosie MJ. Increase in SARS-CoV-2 Seroprevalence in UK Domestic Felids Despite Weak Immunogenicity of Post-Omicron Variants. Viruses 2023; 15:1661. [PMID: 37632004 PMCID: PMC10458763 DOI: 10.3390/v15081661] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023] Open
Abstract
Throughout the COVID-19 pandemic, SARS-CoV-2 infections in domestic cats have caused concern for both animal health and the potential for inter-species transmission. Cats are known to be susceptible to the Omicron variant and its descendants, however, the feline immune response to these variants is not well defined. We aimed to estimate the current seroprevalence of SARS-CoV-2 in UK pet cats, as well as characterise the neutralising antibody response to the Omicron (BA.1) variant. A neutralising seroprevalence of 4.4% and an overall seroprevalence of 13.9% was observed. Both purebred and male cats were found to have the highest levels of seroprevalence, as well as cats aged between two and five years. The Omicron variant was found to have a lower immunogenicity in cats than the B.1, Alpha and Delta variants, which reflects previous reports of immune and vaccine evasion in humans. These results further underline the importance of surveillance of SARS-CoV-2 infections in UK cats as the virus continues to evolve.
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Affiliation(s)
- Grace B. Tyson
- MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow G61 1QH, UK
| | - Sarah Jones
- MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow G61 1QH, UK
| | - Chloe Montreuil-Spencer
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow G61 1QH, UK
| | - Nicola Logan
- MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK
| | - Sam Scott
- MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK
| | - Hagar Sasvari
- MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK
| | - Michael McDonald
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow G61 1QH, UK
| | - Leigh Marshall
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow G61 1QH, UK
| | - Pablo R. Murcia
- MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK
| | - Brian J. Willett
- MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK
| | - William Weir
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow G61 1QH, UK
| | - Margaret J. Hosie
- MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow G61 1QH, UK
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18
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Hertz T, Levy S, Ostrovsky D, Oppenheimer H, Zismanov S, Kuzmina A, Friedman LM, Trifkovic S, Brice D, Chun-Yang L, Cohen-Lavi L, Shemer-Avni Y, Cohen-Lahav M, Amichay D, Keren-Naus A, Voloshin O, Weber G, Najjar-Debbiny R, Chazan B, McGargill MA, Webby R, Chowers M, Novack L, Novack V, Taube R, Nesher L, Weinstein O. Correlates of protection for booster doses of the SARS-CoV-2 vaccine BNT162b2. Nat Commun 2023; 14:4575. [PMID: 37516771 PMCID: PMC10387073 DOI: 10.1038/s41467-023-39816-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/28/2023] [Indexed: 07/31/2023] Open
Abstract
Vaccination, especially with multiple doses, provides substantial population-level protection against COVID-19, but emerging variants of concern (VOC) and waning immunity represent significant risks at the individual level. Here we identify correlates of protection (COP) in a multicenter prospective study following 607 healthy individuals who received three doses of the Pfizer-BNT162b2 vaccine approximately six months prior to enrollment. We compared 242 individuals who received a fourth dose to 365 who did not. Within 90 days of enrollment, 239 individuals contracted COVID-19, 45% of the 3-dose group and 30% of the four-dose group. The fourth dose elicited a significant rise in antibody binding and neutralizing titers against multiple VOCs reducing the risk of symptomatic infection by 37% [95%CI, 15%-54%]. However, a group of individuals, characterized by low baseline titers of binding antibodies, remained susceptible to infection despite significantly increased neutralizing antibody titers upon boosting. A combination of reduced IgG levels to RBD mutants and reduced VOC-recognizing IgA antibodies represented the strongest COP in both the 3-dose group (HR = 6.34, p = 0.008) and four-dose group (HR = 8.14, p = 0.018). We validated our findings in an independent second cohort. In summary combination IgA and IgG baseline binding antibody levels may identify individuals most at risk from future infections.
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Affiliation(s)
- Tomer Hertz
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
- National Institute of Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
- Vaccine and Infectious Disease Division, Fred Hutch Cancer Research Center, Seattle, USA.
| | - Shlomia Levy
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- National Institute of Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Daniel Ostrovsky
- Clinical Research Center, Soroka University Medical Center, and the faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hanna Oppenheimer
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- National Institute of Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Shosh Zismanov
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- National Institute of Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Alona Kuzmina
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Lilach M Friedman
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- National Institute of Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Sanja Trifkovic
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - David Brice
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Lin Chun-Yang
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Liel Cohen-Lavi
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- National Institute of Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yonat Shemer-Avni
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Laboratory of Virology, Soroka University Medical Center, Beer-Sheva, Israel
| | - Merav Cohen-Lahav
- Laboratory of Management, Soroka University Medical Center, Beer-Sheva, Israel
| | - Doron Amichay
- Central Laboratory, Clalit Health Services & Dept. of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
| | - Ayelet Keren-Naus
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Laboratory of Virology, Soroka University Medical Center, Beer-Sheva, Israel
| | - Olga Voloshin
- Laboratory of Virology, Soroka University Medical Center, Beer-Sheva, Israel
| | - Gabriel Weber
- Infectious Diseases Unit, Lady Davis Carmel Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ronza Najjar-Debbiny
- Infectious Diseases Unit, Lady Davis Carmel Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Bibiana Chazan
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Infectious Diseases Unit, Emek Medical Center, Afula, Israel
| | - Maureen A McGargill
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Richard Webby
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Michal Chowers
- School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Meir Medical Center, Kfar Saba, Israel
| | - Lena Novack
- Clinical Research Center, Soroka University Medical Center, and the faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Victor Novack
- Clinical Research Center, Soroka University Medical Center, and the faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ran Taube
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Lior Nesher
- Infectious Disease Institute, Soroka University Medical Center, and Faculty of Health Sciences, Ben-Gurion University, Beer Sheba, Israel.
| | - Orly Weinstein
- Dept. of Health systems management, faculty of health sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Hospital division, Clalit Health Services, Tel Aviv, Israel
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19
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Pallett SJC, Heskin J, Keating F, Mazzella A, Taylor H, Patel A, Lamb G, Sturdy D, Eisler N, Denny S, Charani E, Randell P, Mughal N, Parker E, de Oliveira CR, Rayment M, Jones R, Tedder R, McClure M, Groppelli E, Davies GW, O'Shea MK, Moore LSP. Hybrid immunity in older adults is associated with reduced SARS-CoV-2 infections following BNT162b2 COVID-19 immunisation. COMMUNICATIONS MEDICINE 2023; 3:83. [PMID: 37328651 DOI: 10.1038/s43856-023-00303-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/09/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Older adults, particularly in long-term care facilities (LTCF), remain at considerable risk from SARS-CoV-2. Data on the protective effect and mechanisms of hybrid immunity are skewed towards young adults precluding targeted vaccination strategies. METHODS A single-centre longitudinal seroprevalence vaccine response study was conducted with 280 LCTF participants (median 82 yrs, IQR 76-88 yrs; 95.4% male). Screening by SARS-CoV-2 polymerase chain reaction with weekly asymptomatic/symptomatic testing (March 2020-October 2021) and serology pre-/post-two-dose Pfizer-BioNTech BNT162b2 vaccination for (i) anti-nucleocapsid, (ii) quantified anti-receptor binding domain (RBD) antibodies at three time-intervals, (iii) pseudovirus neutralisation, and (iv) inhibition by anti-RBD competitive ELISA were conducted. Neutralisation activity: antibody titre relationship was assessed via beta linear-log regression and RBD antibody-binding inhibition: post-vaccine infection relationship by Wilcoxon rank sum test. RESULTS Here we show neutralising antibody titres are 9.2-fold (95% CI 5.8-14.5) higher associated with hybrid immunity (p < 0.00001); +7.5-fold (95% CI 4.6-12.1) with asymptomatic infection; +20.3-fold, 95% (CI 9.7-42.5) with symptomatic infection. A strong association is observed between antibody titre: neutralising activity (p < 0.00001) and rising anti-RBD antibody titre: RBD antibody-binding inhibition (p < 0.001), although 18/169 (10.7%) participants with high anti-RBD titre (>100BAU/ml), show inhibition <75%. Higher RBD antibody-binding inhibition values are associated with hybrid immunity and reduced likelihood of infection (p = 0.003). CONCLUSIONS Hybrid immunity in older adults was associated with considerably higher antibody titres, neutralisation and inhibition capacity. Instances of high anti-RBD titre with lower inhibition suggests antibody quantity and quality as independent potential correlates of protection, highlighting added value of measuring inhibition over antibody titre alone to inform vaccine strategy.
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Affiliation(s)
- Scott J C Pallett
- Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Joseph Heskin
- Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK
| | | | - Andrea Mazzella
- Institute for Infection and Immunity, St George's University of London, London, UK
| | | | - Aatish Patel
- Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Georgia Lamb
- Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Deborah Sturdy
- Royal Hospital Chelsea, Royal Hospital Road, London, UK
- Chief Nurse, Adult Social Care, UK Department of Health and Social Care, London, UK
| | | | - Sarah Denny
- Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Esmita Charani
- Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK
| | | | - Nabeela Mughal
- Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK
- North West London Pathology, London, UK
| | - Eleanor Parker
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | | | - Michael Rayment
- Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Rachael Jones
- Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Richard Tedder
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Myra McClure
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Elisabetta Groppelli
- Institute for Infection and Immunity, St George's University of London, London, UK
| | - Gary W Davies
- Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Matthew K O'Shea
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
- Institute of Immunology and Immunotherapy, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK
| | - Luke S P Moore
- Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK.
- North West London Pathology, London, UK.
- Imperial College London, NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, London, UK.
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20
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Lippi G, Henry BM, Pighi L, De Nitto S, Salvagno GL. Are anti-SARS-CoV-2 S/N IgG/IgM antibodies always predictive of previous SARS-CoV-2 infection? ADVANCES IN LABORATORY MEDICINE 2023; 4:175-184. [PMID: 38075941 PMCID: PMC10701493 DOI: 10.1515/almed-2023-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 02/22/2023] [Indexed: 04/05/2024]
Abstract
Objectives We planned this study to verify whether immunoassays for quantifying anti-SARS-CoV-2 IgG/IgM antibodies against both spike (S) and nucleocapsid (N) proteins may be used for identifying previous SARS-CoV-2 infections. Methods The study population consisted of a cohort of fully vaccinated healthcare workers. All study subjects underwent regular medical visits and molecular testing for diagnosing SARS-CoV-2 infections every 2-4 weeks between 2020-2022. Venous blood was drawn for measuring anti-SARS-CoV-2 antibodies with MAGLUMI 2019-nCoV lgG/IgM CLIA Assays directed against both SARS-CoV-2 S and N proteins. Results Overall, 31/53 (58.5%) subjects had tested positive for SARS-CoV-2 by RT-PCR throughout the study (24 once, 7 twice). No positive correlation was found between anti-SARS-CoV-2 S/N IgM antibodies and molecular test positivity. In univariate regression analysis, both a molecular test positivity (r=0.33; p=0.015) and the number of positive molecular tests (r=0.43; p=0.001), but not vaccine doses (r=-0.12; p=0.392), were significantly correlated with anti-SARS-CoV-2 S/N IgG antibodies. These two associations remained significant in multiple linear regression analysis (p=0.029 and p<0.001, respectively) after adjusting for sex, age, body mass index, and vaccine doses. In ROC curve analysis, anti-SARS-CoV-2 S/N IgG antibodies significantly predicted molecular test positivity (AUC, 0.69; 95% CI; 0.55-0.84), with the best cutoff of 0.05 AU/mL displaying 67.9% accuracy, 0.97 sensitivity, and 0.27 specificity. Conclusions Although anti-SARS-CoV-2 S/N IgG antibodies provide helpful information for identifying previous SARS-CoV-2 infections, a lower cutoff than that of sample reactivity should be used. Anti-SARS-CoV-2 S/N IgM antibodies using conventional cutoffs seem useless for this purpose.
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Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Brandon M. Henry
- Clinical Laboratory, Division of Nephrology and Hypertension, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Laura Pighi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
- Service of Laboratory Medicine, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Simone De Nitto
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
- Service of Laboratory Medicine, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Gian Luca Salvagno
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
- Service of Laboratory Medicine, Pederzoli Hospital, Peschiera del Garda, Italy
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21
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Westphal T, Mader M, Karsten H, Cords L, Knapp M, Schulte S, Hermanussen L, Peine S, Ditt V, Grifoni A, Addo MM, Huber S, Sette A, Lütgehetmann M, Pischke S, Kwok WW, Sidney J, Schulze zur Wiesch J. Evidence for broad cross-reactivity of the SARS-CoV-2 NSP12-directed CD4 + T-cell response with pre-primed responses directed against common cold coronaviruses. Front Immunol 2023; 14:1182504. [PMID: 37215095 PMCID: PMC10196118 DOI: 10.3389/fimmu.2023.1182504] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/06/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction The nonstructural protein 12 (NSP12) of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has a high sequence identity with common cold coronaviruses (CCC). Methods Here, we comprehensively assessed the breadth and specificity of the NSP12-specific T-cell response after in vitro T-cell expansion with 185 overlapping 15-mer peptides covering the entire SARS-CoV-2 NSP12 at single-peptide resolution in a cohort of 27 coronavirus disease 2019 (COVID-19) patients. Samples of nine uninfected seronegative individuals, as well as five pre-pandemic controls, were also examined to assess potential cross-reactivity with CCCs. Results Surprisingly, there was a comparable breadth of individual NSP12 peptide-specific CD4+ T-cell responses between COVID-19 patients (mean: 12.82 responses; range: 0-25) and seronegative controls including pre-pandemic samples (mean: 12.71 responses; range: 0-21). However, the NSP12-specific T-cell responses detected in acute COVID-19 patients were on average of a higher magnitude. The most frequently detected CD4+ T-cell peptide specificities in COVID-19 patients were aa236-250 (37%) and aa246-260 (44%), whereas the peptide specificities aa686-700 (50%) and aa741-755 (36%), were the most frequently detected in seronegative controls. In CCC-specific peptide-expanded T-cell cultures of seronegative individuals, the corresponding SARS-CoV-2 NSP12 peptide specificities also elicited responses in vitro. However, the NSP12 peptide-specific CD4+ T-cell response repertoire only partially overlapped in patients analyzed longitudinally before and after a SARS-CoV-2 infection. Discussion The results of the current study indicate the presence of pre-primed, cross-reactive CCC-specific T-cell responses targeting conserved regions of SARS-CoV-2, but they also underline the complexity of the analysis and the limited understanding of the role of the SARS-CoV-2 specific T-cell response and cross-reactivity with the CCCs.
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Affiliation(s)
- Tim Westphal
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research Deutsches Zentrum für Infektionsforschung (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | - Maria Mader
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hendrik Karsten
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Leon Cords
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maximilian Knapp
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sophia Schulte
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lennart Hermanussen
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Peine
- Institute of Transfusion Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Vanessa Ditt
- Institute of Transfusion Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alba Grifoni
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA, United States
| | - Marylyn Martina Addo
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research Deutsches Zentrum für Infektionsforschung (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
- Department for Clinical Immunology of Infectious Diseases, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- Institute of Infection Research and Vaccine Development, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Samuel Huber
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA, United States
| | - Marc Lütgehetmann
- German Center for Infection Research Deutsches Zentrum für Infektionsforschung (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Pischke
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research Deutsches Zentrum für Infektionsforschung (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | - William W. Kwok
- Benaroya Research Institute at Virginia Mason, Seattle, WA, United States
| | - John Sidney
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA, United States
| | - Julian Schulze zur Wiesch
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research Deutsches Zentrum für Infektionsforschung (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
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22
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Vicenti I, Basso M, Pirola N, Bragato B, Rossi MC, Giobbia M, Pascoli S, Vinci A, Caputo S, Varasi I, Biba C, Fiaschi L, Zazzi M, Parisi SG. SARS-CoV-2 Neutralizing Antibodies to B.1 and to BA.5 Variant after Booster Dose of BNT162b2 Vaccine in HIV Patients COVID-Naïve and on Successful Antiretroviral Therapy. Vaccines (Basel) 2023; 11:vaccines11040871. [PMID: 37112782 PMCID: PMC10144758 DOI: 10.3390/vaccines11040871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/14/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
Live virus neutralization is the gold standard to investigate immunity. This prospective observational study aimed to determine the magnitude of response against the original B.1 lineage and against the BA.5 lineage six months after the third BNT162b2 mRNA vaccine dose in patients with HIV infection on successful antiretroviral treatment and no previous SARS-CoV-2 infection. A total of 100 subjects (M/F 83/17, median age 54 years) were included in the analysis: 95 had plasma HIV RNA <40 copies/mL, the median CD4+ T cell count at the administration of the third dose was 580 cells/mm3, and the median nadir CD4+ T cell count was 258 cells/mm3. Neutralizing antibodies (NtAb) against B.1 were detectable in all the subjects, but those to BA.5 were only detected in 88 (p < 0.001). The median NtAb titer to B.1 was significantly higher than that to BA.5 (393 vs. 60, p < 0.0001), and there was a strong positive correlation between the paired measurements (p < 0.0001). Linear regression on a subset of 87 patients excluding outlier NtAb titers showed that 48% of the changes in NtAb titers to BA.5 are related to the changes in value titers to B.1. SARS-CoV-2 variants evolve rapidly, challenging the efficacy of vaccines, and data on comparative NtAb responses may help in tailoring intervals between vaccine doses and in predicting vaccine efficacy.
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Affiliation(s)
- Ilaria Vicenti
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Monica Basso
- Department of Molecular Medicine, University of Padova, 35100 Padova, Italy
| | - Nicole Pirola
- Department of Molecular Medicine, University of Padova, 35100 Padova, Italy
| | - Beatrice Bragato
- Department of Molecular Medicine, University of Padova, 35100 Padova, Italy
| | | | - Mario Giobbia
- Infectious Diseases Unit, Treviso Hospital, 31100 Treviso, Italy
| | - Susanna Pascoli
- Microbiology Unit, Department of Specialist and Laboratory Medicine, Ca' Foncello University Hospital, 31100 Treviso, Italy
| | - Antonio Vinci
- Hospital Health Management Area, Local Health Authority "Roma 1", Borgo Santo Spirito 3, 00193 Rome, Italy
| | - Sara Caputo
- Department of Molecular Medicine, University of Padova, 35100 Padova, Italy
| | - Ilenia Varasi
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Camilla Biba
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Lia Fiaschi
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Maurizio Zazzi
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
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23
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Alcorta-Nuñez F, Pérez-Ibave DC, Burciaga-Flores CH, Garza MÁ, González-Escamilla M, Rodríguez-Niño P, González-Guerrero JF, Alcorta-Garza A, Vidal-Gutiérrez O, Ramírez-Correa GA, Garza-Rodríguez ML. SARS-CoV-2 Neutralizing Antibodies in Mexican Population: A Five Vaccine Comparison. Diagnostics (Basel) 2023; 13:diagnostics13061194. [PMID: 36980502 PMCID: PMC10046906 DOI: 10.3390/diagnostics13061194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/11/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Neutralizing antibodies (NAs) are key immunological markers and are part of the humoral response of the adaptive immune system. NA assays determine the presence of functional antibodies to prevent SARS-CoV-2 infection. We performed a real-world evidence study to detect NAs that confer protection against SARS-CoV-2 after the application of five vaccines (Pfizer/BioNTech, AstraZeneca, Sinovac, Moderna, and CanSino) in the Mexican population. Side effects of COVID-19 vaccines and clinical and demographic factors associated with low immunogenicity were also evaluated. A total of 242 SARS-CoV-2-vaccinated subjects were recruited. Pfizer/BioNTech and Moderna proved the highest percentage of inhibition in a mono-vaccine scheme. Muscular pain, headache, and fatigue were the most common adverse events. None of the patients reported severe adverse events. We found an estimated contagion-free time of 207 (IQR: 182-231) and 187 (IQR: 184-189) days for Pfizer/BioNTech and CanSino in 12 cases in each group. On the basis of our results, we consider that the emerging vaccination strategy in Mexico is effective and safe.
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Affiliation(s)
- Fernando Alcorta-Nuñez
- Servicio de Oncología, Centro Universitario Contra el Cáncer (CUCC), Hospital Universitario "Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey 64460, Nuevo León, Mexico
- ONCARE Treatment Center, Valle Unit, San Pedro Garza García 66220, Nuevo León, Mexico
| | - Diana Cristina Pérez-Ibave
- Servicio de Oncología, Centro Universitario Contra el Cáncer (CUCC), Hospital Universitario "Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey 64460, Nuevo León, Mexico
| | - Carlos Horacio Burciaga-Flores
- Servicio de Oncología, Centro Universitario Contra el Cáncer (CUCC), Hospital Universitario "Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey 64460, Nuevo León, Mexico
- Unidad Médica de Alta Especialidad, Hospital de Gineco Obstetricia (HGO) No. 23, Doctor Ignacio Morones Prieto, Monterrey 64000, Nuevo León, Mexico
| | - Miguel Ángel Garza
- Department of Molecular Science, U.T. Health Rio Grande Valley, McAllen, TX 78503, USA
| | - Moisés González-Escamilla
- Servicio de Oncología, Centro Universitario Contra el Cáncer (CUCC), Hospital Universitario "Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey 64460, Nuevo León, Mexico
| | - Patricia Rodríguez-Niño
- Servicio de Oncología, Centro Universitario Contra el Cáncer (CUCC), Hospital Universitario "Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey 64460, Nuevo León, Mexico
| | - Juan Francisco González-Guerrero
- Servicio de Oncología, Centro Universitario Contra el Cáncer (CUCC), Hospital Universitario "Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey 64460, Nuevo León, Mexico
- ONCARE Treatment Center, Valle Unit, San Pedro Garza García 66220, Nuevo León, Mexico
| | - Adelina Alcorta-Garza
- Servicio de Oncología, Centro Universitario Contra el Cáncer (CUCC), Hospital Universitario "Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey 64460, Nuevo León, Mexico
- ONCARE Treatment Center, Valle Unit, San Pedro Garza García 66220, Nuevo León, Mexico
| | - Oscar Vidal-Gutiérrez
- Servicio de Oncología, Centro Universitario Contra el Cáncer (CUCC), Hospital Universitario "Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey 64460, Nuevo León, Mexico
| | - Genaro A Ramírez-Correa
- Department of Molecular Science, U.T. Health Rio Grande Valley, McAllen, TX 78503, USA
- Department of Pediatrics, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - María Lourdes Garza-Rodríguez
- Servicio de Oncología, Centro Universitario Contra el Cáncer (CUCC), Hospital Universitario "Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey 64460, Nuevo León, Mexico
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24
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Breznik JA, Rahim A, Kajaks T, Hagerman M, Bilaver L, Colwill K, Dayam RM, Gingras AC, Verschoor CP, McElhaney JE, Bramson JL, Bowdish DME, Costa AP. Protection From Omicron Infection in Residents of Nursing and Retirement Homes in Ontario, Canada. J Am Med Dir Assoc 2023; 24:753-758. [PMID: 37001559 PMCID: PMC10046272 DOI: 10.1016/j.jamda.2023.02.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVES To identify factors that contribute to protection from infection with the Omicron variant of SARS-CoV-2 in older adults in nursing and retirement homes. DESIGN Longitudinal cohort study with retrospective analysis of infection risk. SETTING AND PARTICIPANTS 997 residents of nursing and retirement homes from XXXX, Canada, in the XXXXXXXXX study. METHODS Residents with 3 messenger RNA (mRNA) dose vaccinations were included in the study. SARS-CoV-2 infection was determined by positive nasopharyngeal polymerase chain reaction test and/or circulating antinucleocapsid IgG antibodies. Cumulative probability of Omicron infection after recent COVID-19 was assessed by log-rank test of Kaplan-Meier curves. Cox regression was used to assess risk of Omicron infection by age, sex, mRNA vaccine combination, whether individuals received a fourth dose, as well as recent COVID-19. RESULTS In total, 171 residents (17.2%) had a presumed Omicron variant SARS-CoV-2 infection between December 15, 2021 (local start of the first Omicron wave) and May 3, 2022. Risk of Omicron infection was not different by age [hazard ratio (95% confidence interval) 1.01 (0.99‒1.02)], or in women compared with men [0.97 (0.70‒1.34)], but infection risk decreased 47% with 3 vaccine doses of mRNA-1273 (Moderna) compared with BNT162b2 (Pfizer) [0.53 (0.31-0.90)], 81% with any fourth mRNA vaccine dose [0.19 (0.12‒0.30)], and 48% with SARS-CoV-2 infection in the 3 months prior to beginning of the Omicron wave [0.52, (0.27‒0.99)]. CONCLUSIONS AND IMPLICATIONS Vaccine type (ie, mRNA-1273/Spikevax vs BNT162b2/Cominarty), any fourth vaccine dose, and hybrid immunity from recent COVID-19, were protective against infection with the Omicron variant. These data emphasize the importance of vaccine type, and number of vaccine doses, in maintenance of protective immunity and reduction of risk of Omicron variant breakthrough infection. These findings promote continued public health efforts to support vaccination programs and monitor vaccine immunogenicity in older adults.
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Affiliation(s)
- Jessica A Breznik
- McMaster Immunology Research Center, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Ahmad Rahim
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Tara Kajaks
- McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Megan Hagerman
- McMaster Immunology Research Center, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Lucas Bilaver
- McMaster Immunology Research Center, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Karen Colwill
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health, Toronto, Ontario, Canada
| | - Roaya M Dayam
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health, Toronto, Ontario, Canada
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health, Toronto, Ontario, Canada; Department of Molecular Genetics University of Toronto, Toronto, Ontario, Canada
| | - Chris P Verschoor
- McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Health Sciences North Research Institute, Sudbury, Ontario, Canada
| | - Janet E McElhaney
- Health Sciences North Research Institute, Sudbury, Ontario, Canada; Posthumous
| | - Jonathan L Bramson
- McMaster Immunology Research Center, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada; Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Dawn M E Bowdish
- McMaster Immunology Research Center, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada; Firestone Institute of Respiratory Health, St Joseph's Healthcare, Hamilton, Ontario, Canada.
| | - Andrew P Costa
- Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Centre for Integrated Care, St. Joseph's Health System, Hamilton, Ontario, Canada.
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25
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Amati R, Piumatti G, Franscella G, Buttaroni P, Camerini AL, Corna L, Levati S, Fadda M, Fiordelli M, Annoni AM, Bezani K, Amendola A, Fragoso Corti C, Sabatini S, Kaufmann M, Frei A, Puhan MA, Crivelli L, Albanese E. Trajectories of Seroprevalence and Neutralizing Activity of Antibodies against SARS-CoV-2 in Southern Switzerland between July 2020 and July 2021: An Ongoing, Prospective Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3703. [PMID: 36834397 PMCID: PMC9964112 DOI: 10.3390/ijerph20043703] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES The COVID-19 pandemic continues, and evidence on infection- and vaccine-induced immunity is key. We assessed COVID-19 immunity and the neutralizing antibody response to virus variants across age groups in the Swiss population. STUDY DESIGN We conducted a cohort study in representative community-dwelling residents aged five years or older in southern Switzerland (total population 353,343), and we collected blood samples in July 2020 (in adults only, N = 646), November-December 2020 (N = 1457), and June-July 2021 (N = 885). METHODS We used a previously validated Luminex assay to measure antibodies targeting the spike (S) and the nucleocapsid (N) proteins of the virus and a high-throughput cell-free neutralization assay optimized for multiple spike protein variants. We calculated seroprevalence with a Bayesian logistic regression model accounting for the population's sociodemographic structure and the test performance, and we compared the neutralizing activity between vaccinated and convalescent participants across virus variants. RESULTS The overall seroprevalence was 7.8% (95% CI: 5.4-10.4) by July 2020 and 20.2% (16.4-24.4) by December 2020. By July 2021, the overall seroprevalence increased substantially to 72.5% (69.1-76.4), with the highest estimates of 95.6% (92.8-97.8) among older adults, who developed up to 10.3 more antibodies via vaccination than after infection compared to 3.7 times more in adults. The neutralizing activity was significantly higher for vaccine-induced than infection-induced antibodies for all virus variants (all p values < 0.037). CONCLUSIONS Vaccination chiefly contributed to the reduction in immunonaive individuals, particularly those in older age groups. Our findings on the greater neutralizing activity of vaccine-induced antibodies than infection-induced antibodies are greatly informative for future vaccination campaigns.
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Affiliation(s)
- Rebecca Amati
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | | | - Giovanni Franscella
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Peter Buttaroni
- Faculty of Informatics, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Anne-Linda Camerini
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Laurie Corna
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland
| | - Sara Levati
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland
| | - Marta Fadda
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Maddalena Fiordelli
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
- Department of Health Sciences, University of Lucerne, 6002 Lucerne, Switzerland
| | - Anna Maria Annoni
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Kleona Bezani
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Antonio Amendola
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland
| | - Cristina Fragoso Corti
- Institute of Microbiology, University of Applied Sciences and Arts of Southern Switzerland, 6501 Bellinzona, Switzerland
| | - Serena Sabatini
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Marco Kaufmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
| | - Milo Alan Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
| | - Luca Crivelli
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland
| | - Emiliano Albanese
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
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26
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Impact of BNT162b2 Booster Dose on SARS-CoV-2 Anti-Trimeric Spike Antibody Dynamics in a Large Cohort of Italian Health Care Workers. Vaccines (Basel) 2023; 11:vaccines11020463. [PMID: 36851340 PMCID: PMC9959637 DOI: 10.3390/vaccines11020463] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
Accurate studies on the dynamics of Pfizer-Biontech BNT162b2-induced antibodies are crucial to better tailor booster dose administration depending on age, comorbidities, and previous natural infection with SARS-CoV-2. To date, little is known about the durability and kinetics of antibody titers months after receiving a booster dose. In this work, we studied the dynamic of anti-Trimeric Spike (anti-TrimericS) IgG titer in the healthcare worker population of a large academic hospital in Northern Italy, in those who had received two vaccine doses plus a booster dose. Blood samples were collected on the day of dose 1, dose 2, then 1 month, 3 months, and 6 months after dose 2, the day of the administration of the booster dose, then 1 month and 3 months after the booster dose. The vaccination immunogenicity was evaluated by dosing anti-TrimericS IgG titer, which was further studied in relation to SARS-CoV-2 infection status, age, and sex. Our results suggest that after the booster dose, the anti-TrimericS IgG production was higher in the subjects that were infected only after the completion of the vaccination cycle, compared to those that were infected both before and after the vaccination campaign. Moreover, the booster dose administration exerts a leveling effect, mitigating the differences in the immunogenicity dependent on sex and age.
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Almendro-Vázquez P, Laguna-Goya R, Paz-Artal E. Defending against SARS-CoV-2: The T cell perspective. Front Immunol 2023; 14:1107803. [PMID: 36776863 PMCID: PMC9911802 DOI: 10.3389/fimmu.2023.1107803] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/16/2023] [Indexed: 01/28/2023] Open
Abstract
SARS-CoV-2-specific T cell response has been proven essential for viral clearance, COVID-19 outcome and long-term memory. Impaired early T cell-driven immunity leads to a severe form of the disease associated with lymphopenia, hyperinflammation and imbalanced humoral response. Analyses of acute SARS-CoV-2 infection have revealed that mild COVID-19 course is characterized by an early induction of specific T cells within the first 7 days of symptoms, coordinately followed by antibody production for an effective control of viral infection. In contrast, patients who do not develop an early specific cellular response and initiate a humoral immune response with subsequent production of high levels of antibodies, develop severe symptoms. Yet, delayed and persistent bystander CD8+ T cell activation has been also reported in hospitalized patients and could be a driver of lung pathology. Literature supports that long-term maintenance of T cell response appears more stable than antibody titters. Up to date, virus-specific T cell memory has been detected 22 months post-symptom onset, with a predominant IL-2 memory response compared to IFN-γ. Furthermore, T cell responses are conserved against the emerging variants of concern (VoCs) while these variants are mostly able to evade humoral responses. This could be partly explained by the high HLA polymorphism whereby the viral epitope repertoire recognized could differ among individuals, greatly decreasing the likelihood of immune escape. Current COVID-19-vaccination has been shown to elicit Th1-driven spike-specific T cell response, as does natural infection, which provides substantial protection against severe COVID-19 and death. In addition, mucosal vaccination has been reported to induce strong adaptive responses both locally and systemically and to protect against VoCs in animal models. The optimization of vaccine formulations by including a variety of viral regions, innovative adjuvants or diverse administration routes could result in a desirable enhanced cellular response and memory, and help to prevent breakthrough infections. In summary, the increasing evidence highlights the relevance of monitoring SARS-CoV-2-specific cellular immune response, and not only antibody levels, as a correlate for protection after infection and/or vaccination. Moreover, it may help to better identify target populations that could benefit most from booster doses and to personalize vaccination strategies.
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Affiliation(s)
- Patricia Almendro-Vázquez
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Rocío Laguna-Goya
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Estela Paz-Artal
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine, Madrid, Spain
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28
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Wand O, Breslavsky A, Bar-Shai A, Levy C, Maayan S, Rimler A, Zwahra M, Cohen-Hagai K, Harish A, Zacks N, Bilenko N. One-year dynamics of antibody titers after three doses of SARS-CoV-2 BNT162b2 vaccine. Vaccine 2023; 41:871-874. [PMID: 36566162 PMCID: PMC9767891 DOI: 10.1016/j.vaccine.2022.12.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 12/14/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND A third dose of the BNT162b2 SARS-CoV-2 vaccine leads to a significant increase in antibody levels, however, concerns regarding the long-term persistence of this response exist. We assessed the humoral response for one year following vaccination. METHODS A prospective study among immunocompetent healthcare workers (HCW) who received three doses of BNT162b2. anti-spike antibody titers were measured at six predefined timepoints, from before the second vaccine dose, and up to one year afterwards, which is 4-6 months after the third dose. HCW with a history of SARS-CoV-2 infection were excluded. RESULTS Seventy-six HCW had all the six serological measurements. Antibody titers significantly increased shortly following the third vaccine dose, and while declining, remained higher from all previous measurements for up to six months. CONCLUSIONS A third dose of BNT162b2 leads to a profound humoral response, which remains significantly higher than previous measurements, even after 6 months.
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Affiliation(s)
- Ori Wand
- Division of Pulmonary Medicine, Barzilai Medical Center, Ashkelon, Israel,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel,Corresponding author at: Division of Pulmonary Medicine, Barzilai Medical Center, Hahistadrut St. 2, Ashkelon, Israel
| | - Anna Breslavsky
- Division of Pulmonary Medicine, Barzilai Medical Center, Ashkelon, Israel,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Amir Bar-Shai
- Institute of Pulmonary Medicine, Tel Aviv Medical Center, Tel Aviv, Israel,Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Chezy Levy
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel,Administration Department, Barzilai Medical Center, Ashkelon, Israel
| | - Shlomo Maayan
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel,Department of Infectious Diseases, Barzilai Medical Center, Ashkelon, Israel
| | - Avi Rimler
- Department of Medical Laboratories, Barzilai Medical Center, Ashkelon, Israel
| | - Moatasem Zwahra
- Department of Medical Laboratories, Barzilai Medical Center, Ashkelon, Israel
| | | | - Alma Harish
- Division of Pulmonary Medicine, Barzilai Medical Center, Ashkelon, Israel
| | - Nadav Zacks
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Natalya Bilenko
- School of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel,Medical Office of Southern District, Ministry of Health, Ashkelon, Israel
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29
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Cellular and humoral immune response to the fourth Pfizer-BioNTech COVID-19 vaccine dose in individuals aged 60 years and older. Vaccine 2023; 41:914-921. [PMID: 36572602 PMCID: PMC9767892 DOI: 10.1016/j.vaccine.2022.12.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 11/08/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
With the emergence of the severe acute respiratory syndrome 2 (SARS-CoV-2) B.1.1.529/BA.1 (Omicron) variant in early 2022, Israel began vaccinating individuals 6o years of age or older with a fourth BNT162b2 vaccine. While the decision was based on little experimental data, longer follow-up showed clinical effectiveness of the fourth dose with reduction in the number of severely affected individuals. However, the immune response to fourth vaccine dose in this age group was not yet characterized, and little is known about the immunogenicity of repeated vaccine dosing in this age group. We therefore aimed to evaluate the humoral and cellular immune response pre- and 3-week post- the fourth vaccine dose in patients age 60 years or older. For this purpose, blood samples were collected from donors age 60 years or older, all received their 3rd vaccine dose 5 months prior. Serum samples were evaluated for the presence of anti-Spike protein (anti-S) antibodies (N = 133), and peripheral blood mononuclear cells (PBMCs) were evaluated by flow cytometry for their ability to respond to the SARS-CoV-2 wild type Spike-glycoprotein peptide mix, Membrane-glycoprotein (M) peptide mix and to the mutated Spike-regions of the Omicron variant (N = 34). Three weeks after the fourth vaccine dose, 24 out of 34 donors (70.5%) showed significant increase in the number of cells responding to the wild type S-peptide mix. Of note, out of 34 donors, 11 donors (32.3%) had pre-boost anti-M T-cell response, none of which had history of confirmed COVID-19, suggesting possible asymptomatic exposure. Interestingly, in M non-responding individuals, no statistically significant increase in the cellular response was observed following stimulation with omicron S-mutated regions. While there are limited data regarding the longevity of the observed response, our results are in accordance with the described clinical efficacy, provide mechanistic evidence to support it and argue against vaccine-induced or age-related immunosenescence.
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30
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Schnizer C, Andreas N, Vivas W, Kamradt T, Baier M, Kiehntopf M, Glöckner S, Scherag A, Löffler B, Kolanos S, Guerra J, Pletz MW, Weis S. Persistent humoral and CD4 + T H cell immunity after mild SARS-COV-2 infection-The CoNAN long-term study. Front Immunol 2023; 13:1095129. [PMID: 36713390 PMCID: PMC9880277 DOI: 10.3389/fimmu.2022.1095129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/27/2022] [Indexed: 01/15/2023] Open
Abstract
Understanding persistent cellular and humoral immune responses to SARS-CoV-2 will be of major importance to terminate the ongoing pandemic. Here, we assessed long-term immunity in individuals with mild COVID-19 up to 1 year after a localized SARS-CoV-2 outbreak. CoNAN was a longitudinal population-based cohort study performed 1.5 months, 6 months, and 12 months after a SARS-CoV-2 outbreak in a rural German community. We performed a time series of five different IgG immunoassays assessing SARS-CoV-2 antibody responses on serum samples from individuals that had been tested positive after a SARS-CoV-2 outbreak and in control individuals who had a negative PCR result. These analyses were complemented with the determination of spike-antigen specific TH cell responses in the same individuals. All infected participants were presented as asymptomatic or mild cases. Participants initially tested positive for SARS-CoV-2 infection either with PCR, antibody testing, or both had a rapid initial decline in the serum antibody levels in all serological tests but showed a persisting TH cell immunity as assessed by the detection of SARS-CoV-2 specificity of TH cells for up to 1 year after infection. Our data support the notion of a persistent T-cell immunity in mild and asymptomatic cases of SARS-CoV-2 up to 1 year after infection. We show that antibody titers decline over 1 year, but considering several test results, complete seroreversion is rare. Trial registration German Clinical Trials Register DRKS00022416.
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Affiliation(s)
- Clara Schnizer
- Institute for Infectious Diseases and Infection Control, Jena University Hospital- Friedrich Schiller University, Jena, Germany
| | - Nico Andreas
- Institute of Immunology, Jena University Hospital - Friedrich Schiller University, Jena, Germany
| | - Wolfgang Vivas
- Institute for Infectious Diseases and Infection Control, Jena University Hospital- Friedrich Schiller University, Jena, Germany,Leibniz Institute for Natural Product Research and Infection Biology – Hans Knöll Institute (HKI), Jena, Germany,Department of Anesthesiology and Intensive Care, Jena University Hospital- Friedrich Schiller University, Jena, Germany
| | - Thomas Kamradt
- Institute of Immunology, Jena University Hospital - Friedrich Schiller University, Jena, Germany
| | - Michael Baier
- Institute of Medical Microbiology, Jena University Hospital- Friedrich Schiller University, Jena, Germany
| | - Michael Kiehntopf
- Institute of Clinical Chemistry and Laboratory Diagnostics and Integrated Biobank Jena (IBBJ), Jena University Hospital- Friedrich Schiller University, Jena, Germany
| | - Stefan Glöckner
- Institute of Medical Microbiology, Jena University Hospital- Friedrich Schiller University, Jena, Germany
| | - André Scherag
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital- Friedrich Schiller University, Jena, Germany
| | - Bettina Löffler
- Institute of Medical Microbiology, Jena University Hospital- Friedrich Schiller University, Jena, Germany
| | - Steffi Kolanos
- Institute for Infectious Diseases and Infection Control, Jena University Hospital- Friedrich Schiller University, Jena, Germany
| | - Joel Guerra
- Institute for Infectious Diseases and Infection Control, Jena University Hospital- Friedrich Schiller University, Jena, Germany,Department of Anesthesiology and Intensive Care, Jena University Hospital- Friedrich Schiller University, Jena, Germany
| | - Mathias W. Pletz
- Institute for Infectious Diseases and Infection Control, Jena University Hospital- Friedrich Schiller University, Jena, Germany,Center for Sepsis Control and Care, Jena University Hospital- Friedrich Schiller University, Jena, Germany,*Correspondence: Sebastian Weis, ; Mathias W. Pletz,
| | - Sebastian Weis
- Institute for Infectious Diseases and Infection Control, Jena University Hospital- Friedrich Schiller University, Jena, Germany,Leibniz Institute for Natural Product Research and Infection Biology – Hans Knöll Institute (HKI), Jena, Germany,Department of Anesthesiology and Intensive Care, Jena University Hospital- Friedrich Schiller University, Jena, Germany,*Correspondence: Sebastian Weis, ; Mathias W. Pletz,
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31
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Tut G, Lancaster T, Krutikov M, Sylla P, Bone D, Spalkova E, Bentley C, Amin U, Jadir A, Hulme S, Kaur N, Tut E, Bruton R, Wu MY, Harvey R, Carr EJ, Beale R, Stirrup O, Shrotri M, Azmi B, Fuller C, Baynton V, Irwin-Singer A, Hayward A, Copas A, Shallcross L, Moss P. Strong peak immunogenicity but rapid antibody waning following third vaccine dose in older residents of care homes. NATURE AGING 2023; 3:93-104. [PMID: 37118525 PMCID: PMC10154221 DOI: 10.1038/s43587-022-00328-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/03/2022] [Indexed: 04/30/2023]
Abstract
Third-dose coronavirus disease 2019 vaccines are being deployed widely but their efficacy has not been assessed adequately in vulnerable older people who exhibit suboptimal responses after primary vaccination series. This observational study, which was carried out by the VIVALDI study based in England, looked at spike-specific immune responses in 341 staff and residents in long-term care facilities who received an mRNA vaccine following dual primary series vaccination with BNT162b2 or ChAdOx1. Third-dose vaccination strongly increased antibody responses with preferential relative enhancement in older people and was required to elicit neutralization of Omicron. Cellular immune responses were also enhanced with strong cross-reactive recognition of Omicron. However, antibody titers fell 21-78% within 100 d after vaccine and 27% of participants developed a breakthrough Omicron infection. These findings reveal strong immunogenicity of a third vaccine in one of the most vulnerable population groups and endorse an approach for widespread delivery across this population. Ongoing assessment will be required to determine the stability of immune protection.
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Affiliation(s)
- Gokhan Tut
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Tara Lancaster
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | | | - Panagiota Sylla
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - David Bone
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Eliska Spalkova
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Christopher Bentley
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Umayr Amin
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Azar Jadir
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Samuel Hulme
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Nayandeep Kaur
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Elif Tut
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Rachel Bruton
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Mary Y Wu
- Covid Surveillance Unit, The Francis Crick Institute, London, UK
| | - Ruth Harvey
- Worldwide Influenza Centre, The Francis Crick Institute London, London, UK
| | | | - Rupert Beale
- The Francis Crick Institute, London, UK
- Genotype-to-Phenotype UK National Virology Consortium (G2P-UK), London, UK
- UCL Department of Renal Medicine, Royal Free Hospital, London, UK
| | | | | | | | | | | | | | | | | | | | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
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32
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Dehgani-Mobaraki P, Wang C, Floridi A, Floridi E, Dawoodi S, Zaidi AK. Long-term persistence of IgG antibodies in recovered COVID-19 individuals at 18 months post-infection and the impact of two-dose BNT162b2 (Pfizer-BioNTech) mRNA vaccination on the antibody response: Analysis using fixed-effects linear regression model. Virology 2023; 578:111-116. [PMID: 36516688 PMCID: PMC9725186 DOI: 10.1016/j.virol.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/21/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
This era of emerging variants needs a thorough evaluation of data on the long-term efficacy of immune responses in vaccinated as well as recovered individuals, to understand the overall evolution of the pandemic. In this study, we aimed to assess the dynamics of IgG response over 18 months in n = 36 patients from the Umbria region in Italy, who had a documented history of COVID-19 infection in March 2020, and then compared the impact of two-dose BNT162b2 (Pfizer-BioNTech) vaccination on the antibody responses of these patients with the ones who did not receive any dose of vaccine. This is the longest observation (March 2020-September 2021) for the presence of antibodies against SARS-CoV-2 in recovered individuals along with the impact of 2 dose-BNT162b2 vaccination on these responses. Fixed-effect regression models were used for statistical analysis which could be also used to predict future titer trends. At 18 months, 97% participants tested positive for anti-NCP hinting towards the persistence of infection-induced immunity even for the vaccinated individuals. Our study findings demonstrate that while double dose vaccination boosted the IgG levels in recovered individuals 161 times, this "boost" was relatively short-lived. The unvaccinated recovered individuals, in contrast, continued to show a steady decline but detectable antibody levels. Further studies are required to re-evaluate the timing and dose regimen of vaccines for an adequate immune response in recovered individuals.
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Affiliation(s)
- Puya Dehgani-Mobaraki
- Associazione Naso Sano, Umbria Regional Registry of Volunteer Activities, Via Luca Benincasa 2, San Mariano, 06073, Perugia, Italy.
| | - Chao Wang
- Health & Social Care Statistic, Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, London, SW17 0RE, UK.
| | | | - Emanuela Floridi
- Centro Ricerche Analisi Biochimico Specialistiche, Perugia, Italy.
| | | | - Asiya K Zaidi
- Associazione Naso Sano, Umbria Regional Registry of Volunteer Activities and Research, San Mariano, Italy.
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33
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Avila J, Degirmenci HB, Contreras Chavez P, Battinelli EM, Fleisher J. Rapid Onset Severe Immune Thrombocytopenia following mRNA COVID-19 Vaccine in a Young Patient. Case Rep Hematol 2023; 2023:7877536. [PMID: 36950529 PMCID: PMC10027455 DOI: 10.1155/2023/7877536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 01/03/2023] [Accepted: 03/07/2023] [Indexed: 03/14/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has affected millions of people around the world. Vaccination against COVID-19 has been approved for the following three vaccines in the United States: Pfizer-BioNTech, Moderna, and Janssen. Hematological complications of vaccination have been reported in the literature but remain as a rare phenomenon. We present the case of a patient who developed severe thrombocytopenia within twenty-four hours following the Pfizer-BioNTech vaccination. Commonly encountered differentials including heparin-induced thrombocytopenia and common viral etiologies were ruled out, and other causes such as drug reactions deemed unlikely as the etiology of this presentation after a broad workup. Nucleocapsid antibodies against COVID-19 were found to be positive which indicated that vaccination was at least the second encounter with this virus for our patient, which has been reported previously as the cause of immune thrombocytopenia (ITP), and this might be the culprit for sudden onset. He responded to the first-line ITP treatment with corticosteroids and intravenous immunoglobulin (IVIG) as evidenced by the fast recovery of platelet count and lack of recurrence of thrombocytopenia.
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Affiliation(s)
- Jorge Avila
- 1Department of Medicine, St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Huseyin Berk Degirmenci
- 1Department of Medicine, St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | | | - Elisabeth M. Battinelli
- 3Division of Hematology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jorge Fleisher
- 1Department of Medicine, St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA, USA
- 4Division of Infectious Diseases, St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA, USA
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34
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Humoral Response after Two Doses of BNT162b2 mRNA Vaccine Has a Role in Predicting Response after Three Doses That Is Related to Plasma HIV Viremia and Nadir CD4+ Cell Count in HIV-Positive Patients. Vaccines (Basel) 2022; 11:vaccines11010082. [PMID: 36679927 PMCID: PMC9862719 DOI: 10.3390/vaccines11010082] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/21/2022] [Accepted: 12/28/2022] [Indexed: 01/01/2023] Open
Abstract
We investigated the spike IgG levels of HIV+ patients on antiretroviral therapy six months after they received their second dose (T2) and six months after the third dose (T3) of the BNT162b2 mRNA vaccine, as well as the influence of different levels of plasma HIV viremia of overall CD4+ cell count and nadir value on the humoral time course. One hundred eighty-four patients were enrolled. The median age was 55 years, the median CD4+ cell count was 639 cells/mm3 and the median nadir value was 258 cells/mm3. On the basis of all tests performed during the study period, persistently undetectable plasma HIV RNA (PUD) was found in 66 patients, low-level viremia (LLV) in 57 and ongoing viremia (OV) in 61. Serum levels of IgG antibodies against a trimeric S-protein antigen were tested with DiaSorin Liaison SARS-CoV-2 TrimericS IgG and the response was classified as optimal (>75th percentile), intermediate (50th−25th percentile) and low (<25th percentile). The frequencies of the three different patterns of plasma HIV viremia (PUD, LLV and OV) were comparable in patients with low, intermediate and optimal IgG response evaluated at T2, with no difference in overall CD4+ cell count or nadir count. At T3, 92.9% of patients achieved an optimal response: T2 response proved to be the most important factor in predicting T3 optimal response in patients with LLV and OV.A nadir value ≤ 330 cells/mm3 had 100% sensitivity in predicting a non-optimal response. In conclusion, we demonstrated the persistence of anti-spike IgG, with high serum levels occurring in most patients six months after the third dose of the BNT162b2 mRNA vaccine and a predictive role of humoral response at T2 in subjects with detectable plasma HIV viremia. Immunological alterations related to past immunodeficiency may persist despite immune reconstitution, and the nadir value could be a useful tool for elaborating personalized vaccine schedules.
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35
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Stirrup O, Shrotri M, Adams NL, Krutikov M, Nacer-Laidi H, Azmi B, Palmer T, Fuller C, Irwin-Singer A, Baynton V, Tut G, Moss P, Hayward A, Copas A, Shallcross L. Clinical Effectiveness of SARS-CoV-2 Booster Vaccine Against Omicron Infection in Residents and Staff of Long-term Care Facilities: A Prospective Cohort Study (VIVALDI). Open Forum Infect Dis 2022; 10:ofac694. [PMID: 36713473 PMCID: PMC9874026 DOI: 10.1093/ofid/ofac694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/28/2022] [Indexed: 12/30/2022] Open
Abstract
Background Successive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have caused severe disease in long-term care facility (LTCF) residents. Primary vaccination provides strong short-term protection, but data are limited on duration of protection following booster vaccines, particularly against the Omicron variant. We investigated the effectiveness of booster vaccination against infections, hospitalizations, and deaths among LTCF residents and staff in England. Methods We included residents and staff of LTCFs within the VIVALDI study (ISRCTN 14447421) who underwent routine, asymptomatic testing (December 12, 2021-March 31, 2022). Cox regression was used to estimate relative hazards of SARS-CoV-2 infection, and associated hospitalization and death at 0-13, 14-48, 49-83, 84-111, 112-139, and 140+ days after dose 3 of SARS-CoV-2 vaccination compared with 2 doses (after 84+ days), stratified by previous SARS-CoV-2 infection and adjusting for age, sex, LTCF capacity, and local SARS-CoV-2 incidence. Results A total of 14 175 residents and 19 793 staff were included. In residents without prior SARS-CoV-2 infection, infection risk was reduced 0-111 days after the first booster, but no protection was apparent after 112 days. Additional protection following booster vaccination waned but was still present at 140+ days for COVID-associated hospitalization (adjusted hazard ratio [aHR], 0.20; 95% CI, 0.06-0.63) and death (aHR, 0.50; 95% CI, 0.20-1.27). Most residents (64.4%) had received primary course vaccine of AstraZeneca, but this did not impact pre- or postbooster risk. Staff showed a similar pattern of waning booster effectiveness against infection, with few hospitalizations and no deaths. Conclusions Our findings suggest that booster vaccination provided sustained protection against severe outcomes following infection with the Omicron variant, but no protection against infection from 4 months onwards. Ongoing surveillance for SARS-CoV-2 in LTCFs is crucial.
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Affiliation(s)
- Oliver Stirrup
- Correspondence: Oliver Stirrup, PhD, UCL Institute for Global Health, 222 Euston Road, London NW1 2DA, UK ()
| | | | | | - Maria Krutikov
- UCL Institute of Health Informatics, London, United Kingdom
| | | | - Borscha Azmi
- UCL Institute of Health Informatics, London, United Kingdom
| | - Tom Palmer
- Institute for Global Health, University College London, London, United Kingdom
| | | | | | - Verity Baynton
- Department of Health and Social Care, London, United Kingdom
| | - Gokhan Tut
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
| | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
| | - Andrew Hayward
- UCL Institute of Epidemiology & Healthcare, London, United Kingdom,Health Data Research UK, London, United Kingdom
| | - Andrew Copas
- Institute for Global Health, University College London, London, United Kingdom
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Sansone E, Bonfanti C, Sala E, Renzetti S, Terlenghi L, Matteelli A, Tiraboschi MM, Pedrazzi T, Lombardo M, Rossi C, Indelicato AM, Caruso A, De Palma G. Immune Responses to SARS-CoV-2 Infection and Vaccine in a Big Italian COVID-19 Hospital: An 18-Month Follow-Up. Vaccines (Basel) 2022; 11:vaccines11010008. [PMID: 36679853 PMCID: PMC9864433 DOI: 10.3390/vaccines11010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES This is a longitudinal prospective study which was designed to assess the trend of anti-SARS-CoV-2 antibodies targeting the Spike (anti-S) and Nucleocapside protein (anti-N) viral antigens over a 9-month period after the administration of an anti-SARS-CoV-2 vaccine in a big COVID-19 hospital located in Northern Italy. PARTICIPANTS 7411 vaccinated workers were included in a linear mixed-effect model analysis performed to model the anti-S decay over the 9 months following the vaccination, during serological screening performed approximately 2, 4, and 9 months following the first jab administration. Serological tests performed in the 9 months preceding vaccine administration were retrospectively analysed to identify the burden of infections occurring before vaccination. RESULTS The serological assays were used for monitoring the antibody titres during the observational period. Vaccination significantly reduced the rate of infection and elicited a specific humoral response, which lasted during the whole observational period (9 months). A decay was observed in all considered subgroups. At 35 weeks, workers with no history of pre-vaccine infection showed a significantly lower anti-S titre (-2522 U/mL on average (-2589.7 to -2445.7)); younger workers showed significantly higher anti-S titres (140.2 U/mL on average (82.4 to 201.3)). Only seven immunocompromised workers did not show significant levels of anti-S antibodies; three of them, all females, showed a specific T-cell response. CONCLUSIONS Comparing the 9-month periods before and after the first vaccine dose, a significant reduction in infection rate was observed (1708 cases vs. 156). Pre-vaccine infection, especially if contracted during the first pandemic wave, greatly enhanced the response to vaccination, which was significantly affected also by age both in extent and duration (inversely related). A gender effect on the T-cell immune response was observed in a small group of workers who did not produce antibodies after vaccine administration.
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Affiliation(s)
- Emanuele Sansone
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Unit of Occupational Health and Industrial Hygiene, University of Brescia, 25123 Brescia, Italy
| | - Carlo Bonfanti
- Department of Molecular and Translational Medicine, Institute of Microbiology, University of Brescia—ASST Spedali Civili, 25123 Brescia, Italy
| | - Emma Sala
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, University Hospital ASST Spedali Civili, 25123 Brescia, Italy
| | - Stefano Renzetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Unit of Occupational Health and Industrial Hygiene, University of Brescia, 25123 Brescia, Italy
| | - Luigina Terlenghi
- Department of Molecular and Translational Medicine, Institute of Microbiology, University of Brescia—ASST Spedali Civili, 25123 Brescia, Italy
| | - Alberto Matteelli
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, 25123 Brescia, Italy
| | - Mara Maria Tiraboschi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Unit of Occupational Health and Industrial Hygiene, University of Brescia, 25123 Brescia, Italy
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, University Hospital ASST Spedali Civili, 25123 Brescia, Italy
| | - Tatiana Pedrazzi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Unit of Occupational Health and Industrial Hygiene, University of Brescia, 25123 Brescia, Italy
| | - Massimo Lombardo
- Chief Executive Office, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Camillo Rossi
- Chief Executive Office, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | | | - Arnaldo Caruso
- Department of Molecular and Translational Medicine, Institute of Microbiology, University of Brescia—ASST Spedali Civili, 25123 Brescia, Italy
| | - Giuseppe De Palma
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Unit of Occupational Health and Industrial Hygiene, University of Brescia, 25123 Brescia, Italy
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, University Hospital ASST Spedali Civili, 25123 Brescia, Italy
- Correspondence:
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Assessing the Pre-Vaccination Anti-SARS-CoV-2 IgG Seroprevalence among Residents and Staff in Nursing Home in Niigata, Japan, November 2020. Viruses 2022; 14:v14112581. [PMID: 36423190 PMCID: PMC9698805 DOI: 10.3390/v14112581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022] Open
Abstract
An outbreak of coronavirus disease 2019 (COVID-19) occurred in a nursing home in Niigata, Japan, November 2020, with an attack rate of 32.0% (63/197). The present study was aimed at assessing the pre-vaccination seroprevalence almost half a year after the COVID-19 outbreak in residents and staff in the facility, along with an assessment of the performance of the enzyme-linked immunosorbent assay (ELISA) and the chemiluminescent immunoassay (CLIA), regarding test seropositivity and seronegativity in detecting immunoglobulin G (IgG) anti-severe acute respiratory syndrome 2 (SARS-CoV-2) antibodies (anti-nucleocapsid (N) and spike (S) proteins). A total of 101 people (30 reverse transcription PCR (RT-PCR)-positive and 71 RT-PCR-negative at the time of the outbreak in November 2020) were tested for anti-IgG antibody titers in April 2021, and the seroprevalence was approximately 40.0-60.0% for residents and 10.0-20.0% for staff, which was almost consistent with the RT-PCR test results that were implemented during the outbreak. The seropositivity for anti-S antibodies showed 90.0% and was almost identical to the RT-PCR positives even after approximately six months of infections, suggesting that the anti-S antibody titer test is reliable for a close assessment of the infection history. Meanwhile, seropositivity for anti-N antibodies was relatively low, at 66.7%. There was one staff member and one resident that were RT-PCR-negative but seropositive for both anti-S and anti-N antibody, indicating overlooked infections despite periodical RT-PCR testing at the time of the outbreak. Our study indicated the impact of transmission of SARS-CoV-2 in a vulnerable elderly nursing home in the pre-vaccination period and the value of a serological study to supplement RT-PCR results retrospectively.
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Kenny G, Negi R, O'Reilly S, Garcia-Leon A, Alalwan D, Gaillard CM, Saini G, Inzitari R, Feeney ER, Yousif O, Cotter AG, de Barra E, Sadlier C, Crispie F, Doran P, Gautier V, Mallon PW. Performance and validation of an adaptable multiplex assay for detection of serologic response to SARS-CoV-2 infection or vaccination. J Immunol Methods 2022; 510:113345. [PMID: 36055441 PMCID: PMC9425705 DOI: 10.1016/j.jim.2022.113345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 12/31/2022]
Abstract
Measurement of quantitative antibody responses are increasingly important in evaluating the immune response to infection and vaccination. In this study we describe the validation of a quantitative, multiplex serologic assay utilising an electrochemiluminescence platform, which measures IgG against the receptor binding domain (RBD), spike S1 and S2 subunits and nucleocapsid antigens of SARS-CoV-2. The assay displayed a sensitivity ranging from 73 to 91% and specificity from 90 to 96% in detecting previous infection with SARS-CoV-2 depending on antigenic target and time since infection, and this assay highly correlated with commercially available assays. The within-plate coefficient of variation ranged from 3.8-3.9% and the inter-plate coefficient of variation from 11 to 13% for each antigen.
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Affiliation(s)
- Grace Kenny
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland,Department of Infectious Diseases, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland,Corresponding author at: Centre for Experimental Pathogen Host Research, University College Dublin, Ireland
| | - Riya Negi
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Sophie O'Reilly
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Alejandro Garcia-Leon
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Dana Alalwan
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Colette Marie Gaillard
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Gurvin Saini
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Rosana Inzitari
- School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Eoin R. Feeney
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland,Department of Infectious Diseases, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Obada Yousif
- Endocrinology Department, Wexford General Hospital, Carricklawn, Wexford, Ireland
| | - Aoife G Cotter
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland,Department of Infectious Diseases, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland
| | - Eoghan de Barra
- Department of Infectious Diseases, Beaumont Hospital, Beaumont, Dublin 9, Ireland,Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Corinna Sadlier
- Department of Infectious Diseases, Cork University Hospital, Wilton, Co Cork, Ireland
| | - Fiona Crispie
- Teagasc Food Research Centre, Moorepark, Ireland,APC Microbiome Ireland, Cork, Ireland
| | - Peter Doran
- School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Virginie Gautier
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Patrick W.G. Mallon
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland,Department of Infectious Diseases, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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Analysis of anti-SARS-CoV-2 Omicron-neutralizing antibody titers in different vaccinated and unvaccinated convalescent plasma sources. Nat Commun 2022; 13:6478. [PMID: 36309490 PMCID: PMC9617541 DOI: 10.1038/s41467-022-33864-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/04/2022] [Indexed: 01/19/2023] Open
Abstract
The latest SARS-CoV-2 variant of concern Omicron, with its immune escape from therapeutic anti-Spike monoclonal antibodies and WA-1 vaccine-elicited sera, demonstrates the continued relevance of COVID-19 convalescent plasma (CCP) therapies. Lessons learnt from previous usage of CCP suggests focusing on early outpatients and immunocompromised recipients, with high neutralizing antibody titer units. Here, we systematically review Omicron-neutralizing plasma activity data, and report that approximately 47% (424/902) of CCP samples from unvaccinated pre-Omicron donors neutralizes Omicron BA.1 with a very low geometric mean of geometric mean titers for 50% neutralization GM(GMT50) of ~13, representing a > 20-fold reduction from WA-1 neutralization. Non-convalescent subjects who had received two doses of mRNA vaccines had a GM(GMT50) for Omicron BA.1 neutralization of ~27. However, plasma from vaccinees recovering from either previous pre-Omicron variants of concern infection, Omicron BA.1 infection, or third-dose uninfected vaccinees was nearly 100% neutralizing against Omicron BA.1, BA.2 and BA.4/5 with GM(GMT(50)) all over 189, 10 times higher than pre-Omicron CCP. Fully vaccinated and post-BA.1 plasma (Vax-CCP) had a GM(GMT50) > 450 for BA.4/5 and >1,500 for BA.1 and BA.2. These findings have implications for both CCP stocks collected in prior pandemic periods and for future plans to restart CCP collections. Thus, Vax-CCP provides an effective tool to combat ongoing variants that escape therapeutic monoclonal antibodies.
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40
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Focosi D, Franchini M, Casadevall A. On the Need to Determine the Contribution of Anti-Nucleocapsid Antibodies as Potential Contributors to COVID-19 Convalescent Plasma Efficacy. Viruses 2022; 14:v14112378. [PMID: 36366476 PMCID: PMC9697776 DOI: 10.3390/v14112378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 01/31/2023] Open
Abstract
Historically the therapeutic potential of polyclonal passive immunotherapies in viral diseases has been related to antiviral neutralizing antibodies, but there is also considerable evidence that non-neutralizing antibodies can translate into clinical benefit as well. In the setting of SARS-CoV-2 infection, we review here in vitro and in vivo evidence supporting a contributing role for anti-nucleocapsid antibodies. Retrospective investigation of anti-nucleocapsid antibody levels in randomized clinical trials of COVID-19 convalescent plasma is warranted to better understand whether there is an association with efficacy or lack thereof.
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Affiliation(s)
- Daniele Focosi
- North-Western Tuscany Blood Bank, Pisa University Hospital, 56124 Pisa, Italy
- Correspondence:
| | - Massimo Franchini
- Division of Hematology and Transfusion Medicine, Carlo Poma Hospital, 46100 Mantua, Italy
| | - Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21287, USA
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41
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Matsuba I, Takuma T, Hatori N, Takai M, Watanabe Y, Takada N, Kishi S, Matsuzawa Y, Nishikawa T, Kunishima T, Degawa H, Nishikawa M, Ono Y, Miyakawa M, Hatori Y, Kanamori A. The Proportion of Long-term Response to Anti-N IgG Antibody after 12 Months for COVID-19 Subclinical Infections and a Longitudinal Survey for COVID-19 Subclinical Infections in 2021. Intern Med 2022; 61:3053-3062. [PMID: 35945024 PMCID: PMC9646357 DOI: 10.2169/internalmedicine.9628-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective To examine the continuation of antibody prevalence status after 12 months and background factors in antibody-positive subjects following asymptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods We initially determined the SARS-CoV-2 anti-nucleocapsid protein immunoglobulin G (anti-N IgG) antibody prevalence in 1,603 patients, doctors, and nurses at 65 medical institutions in Kanagawa Prefecture, Japan. We then obtained consent from 33 of the 39 subjects who tested positive and performed follow-up for 12 months. Results Follow-up for up to 12 months showed that a long-term response of the anti-N IgG antibody could be detected in 6 of the 33 participants (18.2%). The proportions with hypertension, using an angiotensin-receptor blocker, and without a drinking habit were higher among the participants with a long-term anti-N IgG antibody response for up to 12 months than among those without a long-term antibody response. Conclusions The proportion of individuals with subclinical COVID-19 who continuously had a positive result for the anti-N IgG antibody at 12 months was low.
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Müller L, Andrée M, Moskorz W, Drexler I, Hauka S, Ptok J, Walotka L, Grothmann R, Hillebrandt J, Ritchie A, Peter L, Walker A, Timm J, Adams O, Schaal H. Adjusted COVID-19 booster schedules balance age-dependent differences in antibody titers benefitting risk populations. FRONTIERS IN AGING 2022; 3:1027885. [PMID: 36313184 PMCID: PMC9596780 DOI: 10.3389/fragi.2022.1027885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022]
Abstract
We provide follow-up data on the humoral immune response after COVID-19 vaccinations of two distinct cohorts aged below 60 and over 80 years to screen for age-related differences in the longevity and magnitude of the induction of the antibody responses post booster-vaccinations. While anti-SARS-CoV-2 spike-specific IgG and neutralization capacity waned rapidly after the initial vaccination schedule, additional boosters highly benefitted the humoral immune responses especially in the elderly cohort, including the neutralization of Omikron variants. Thus, adjusted COVID-19 booster vaccination schedules are an appropriate tool to overcome limitations in the success of vaccinations.
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Affiliation(s)
- Lisa Müller
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany,*Correspondence: Lisa Müller,
| | - Marcel Andrée
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Wiebke Moskorz
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Ingo Drexler
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Sandra Hauka
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Johannes Ptok
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Lara Walotka
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Ramona Grothmann
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Jonas Hillebrandt
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany,Department of Nephrology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Anastasia Ritchie
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Laura Peter
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Andreas Walker
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Jörg Timm
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Ortwin Adams
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Heiner Schaal
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
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Lone KS, Khan SMS, Qurieshi MA, Majid S, Pandit MI, Haq I, Ahmad J, Bhat AA, Bashir K, Bilquees S, Fazili AB, Hassan M, Jan Y, Kaul RUR, Khan ZA, Mushtaq B, Nazir F, Qureshi UA, Raja MW, Rasool M, Asma A, Bhat AA, Chowdri IN, Ismail S, Jeelani A, Kawoosa MF, Khan MA, Khan MS, Kousar R, Lone AA, Nabi S, Qazi TB, Rather RH, Sabah I, Sumji IA. Seroprevalence of SARS-CoV-2-specific anti-spike IgM, IgG, and anti-nucleocapsid IgG antibodies during the second wave of the pandemic: A population-based cross-sectional survey across Kashmir, India. Front Public Health 2022; 10:967447. [PMID: 36276377 PMCID: PMC9582950 DOI: 10.3389/fpubh.2022.967447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 09/12/2022] [Indexed: 01/25/2023] Open
Abstract
Background Within Kashmir, which is one of the topographically distinct areas in the Himalayan belt of India, a total of 2,236 cumulative deaths occurred by the end of the second wave. We aimed to conduct this population-based study in the age group of 7 years and above to estimate the seropositivity and its attributes in Kashmir valley. Methods We conducted a community-based household-level cross-sectional study, with a multistage, population-stratified, probability-proportionate-to-size, cluster sampling method to select 400 participants from each of the 10 districts of Kashmir. We also selected a quota of healthcare workers, police personnel, and antenatal women from each of the districts. Households were selected from each cluster and all family members with age 7 years or more were invited to participate. Information was collected through a standardized questionnaire and entered into Epicollect 5 software. Trained healthcare personnel were assigned for collecting venous blood samples from each of the participants which were transferred and processed for immunological testing. Testing was done for the presence of SARS-CoV-2-specific anti-spike IgM, IgG antibodies, and anti-nucleocapsid IgG antibodies. Weighted seropositivity was estimated along with the adjustment done for the sensitivity and specificity of the test used. Findings The data were collected from a total of 4,229 participants from the general population within the 10 districts of Kashmir. Our results showed that 84.84% (95% CI 84.51-85.18%) of the participants were seropositive in the weighted imputed data among the general population. In multiple logistic regression, the variables significantly affecting the seroprevalence were the age group 45-59 years (odds ratio of 0.73; 95% CI 0.67-0.78), self-reported history of comorbidity (odds ratio of 1.47; 95% CI 1.33-1.61), and positive vaccination history (odds ratio of 0.85; 95% CI 0.79-0.90) for anti-nucleocapsid IgG antibodies. The entire assessed variables showed a significant role during multiple logistic regression analysis for affecting IgM anti-spike antibodies with an odds ratio of 1.45 (95% CI 1.32-1.57) for age more than 60 years, 1.21 (95% CI 1.15-1.27) for the female gender, 0.87 (95% CI 0.82-0.92) for urban residents, 0.86 (95% CI 0.76-0.92) for self-reported comorbidity, and an odds ratio of 1.16 (95% CI 1.08-1.24) for a positive history of vaccination. The estimated infection fatality ratio was 0.033% (95% CI: 0.034-0.032%) between 22 May and 31 July 2021 against the seropositivity for IgM antibodies. Interpretation During the second wave of the SARS-CoV-2 pandemic, 84.84% (95% CI 84.51-85.18%) of participants from this population-based cross-sectional sample were seropositive against SARS-CoV-2. Despite a comparatively lower number of cases reported and lower vaccination coverage in the region, our study found such high seropositivity across all age groups, which indicates the higher number of subclinical and less severe unnoticed caseload in the community.
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Affiliation(s)
- Kouser Sideeq Lone
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
| | | | - Mariya Amin Qurieshi
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
| | - Sabhiya Majid
- Department of Biochemistry, Government Medical College Srinagar, Srinagar, India
| | - Mohammad Iqbal Pandit
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
| | - Inaamul Haq
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India,*Correspondence: Inaamul Haq
| | - Javid Ahmad
- Department of Community Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Ashfaq Ahmad Bhat
- Department of Community Medicine, SKIMS Medical College Srinagar, Srinagar, India
| | - Khalid Bashir
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
| | - Sufoora Bilquees
- Department of Community Medicine, Government Medical College Baramulla, Baramulla, India
| | - Anjum Bashir Fazili
- Department of Community Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Muzamil Hassan
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
| | - Yasmeen Jan
- Department of Community Medicine, SKIMS Medical College Srinagar, Srinagar, India
| | - Rauf-ur Rashid Kaul
- Department of Community Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Zahid Ali Khan
- Department of Community Medicine, Government Medical College Baramulla, Baramulla, India
| | - Beenish Mushtaq
- Department of Community Medicine, SKIMS Medical College Srinagar, Srinagar, India
| | - Fouzia Nazir
- Department of Community Medicine, Government Medical College Anantnag, Anantnag, India
| | - Uruj Altaf Qureshi
- Department of Community Medicine, Government Medical College Baramulla, Baramulla, India
| | - Malik Waseem Raja
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
| | - Mahbooba Rasool
- Department of Community Medicine, Government Medical College Anantnag, Anantnag, India
| | - Anjum Asma
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
| | - Arif Akbar Bhat
- Department of Biochemistry, Government Medical College Srinagar, Srinagar, India
| | - Iqra Nisar Chowdri
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
| | - Shaista Ismail
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
| | - Asif Jeelani
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
| | - Misbah Ferooz Kawoosa
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
| | - Mehvish Afzal Khan
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
| | - Mosin Saleem Khan
- Department of Biochemistry, Government Medical College Srinagar, Srinagar, India
| | - Rafiya Kousar
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
| | - Ab Aziz Lone
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
| | - Shahroz Nabi
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
| | - Tanzeela Bashir Qazi
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
| | - Rouf Hussain Rather
- Directorate of Health Services Kashmir, Government of Jammu and Kashmir, Srinagar, India
| | - Iram Sabah
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
| | - Ishtiyaq Ahmad Sumji
- Department of Community Medicine, Government Medical College Srinagar, Srinagar, India
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Navaratnam AMD, Shrotri M, Nguyen V, Braithwaite I, Beale S, Byrne TE, Fong WLE, Fragaszy E, Geismar C, Hoskins S, Kovar J, Patel P, Yavlinsky A, Aryee A, Rodger A, Hayward AC, Aldridge RW. Nucleocapsid and spike antibody responses following virologically confirmed SARS-CoV-2 infection: an observational analysis in the Virus Watch community cohort. Int J Infect Dis 2022; 123:104-111. [PMID: 35987470 PMCID: PMC9385348 DOI: 10.1016/j.ijid.2022.07.053] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Seroprevalence studies can provide a measure of SARS-CoV-2 cumulative incidence, but a better understanding of spike and nucleocapsid (anti-N) antibody dynamics following infection is needed to assess the longevity of detectability. METHODS Adults aged ≥18 years, from households enrolled in the Virus Watch prospective community cohort study in England and Wales, provided monthly capillary blood samples, which were tested for spike antibody and anti-N. Participants self-reported vaccination dates and past medical history. Previous polymerase chain reaction (PCR) swabs were obtained through Second Generation Surveillance System linkage data. The primary outcome variables were seropositivity and total anti-N and spike antibody levels after PCR-confirmed infection. RESULTS A total of 13,802 eligible individuals provided 58,770 capillary blood samples. A total of 537 of these had a previous positive PCR-confirmed SARS-CoV-2 infection within 0-269 days of antibody sample date, among them 432 (80.45%) having a positive anti-N result. Median anti-N levels peaked between days 90 and 119 after PCR results and then began to decline. There is evidence of anti-N waning from 120 days onwards, with earlier waning for females and younger age categories. CONCLUSION Our findings suggest that anti-N has around 80% sensitivity for identifying previous COVID-19 infection, and the duration of detectability is affected by sex and age.
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Affiliation(s)
| | - Madhumita Shrotri
- Institute of Health Informatics, University College London, United Kingdom
| | - Vincent Nguyen
- Institute of Health Informatics, University College London, United Kingdom
| | - Isobel Braithwaite
- Institute of Health Informatics, University College London, United Kingdom
| | - Sarah Beale
- Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Thomas E Byrne
- Institute of Health Informatics, University College London, United Kingdom
| | | | - Ellen Fragaszy
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom
| | - Cyril Geismar
- Institute of Health Informatics, University College London, United Kingdom
| | - Susan Hoskins
- Institute of Health Informatics, University College London, United Kingdom
| | - Jana Kovar
- Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Parth Patel
- Institute of Health Informatics, University College London, United Kingdom
| | - Alexei Yavlinsky
- Institute of Health Informatics, University College London, United Kingdom
| | - Anna Aryee
- Institute of Health Informatics, University College London, United Kingdom
| | - Alison Rodger
- Institute for Global Health, University College London, London, United Kingdom
| | - Andrew C Hayward
- Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Robert W Aldridge
- Institute of Health Informatics, University College London, United Kingdom.
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45
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Willeit P, Kimpel J, Winner H, Harthaller T, Schäfer H, Bante D, Falkensammer B, Rössler A, Riepler L, Ower C, Sacher M, von Laer D, Borena W. Seroprevalence of SARS-CoV-2 infection in the Tyrolean district of Schwaz at the time of the rapid mass vaccination in March 2021 following B.1.351-variant outbreak. Front Public Health 2022; 10:989337. [PMID: 36159252 PMCID: PMC9500479 DOI: 10.3389/fpubh.2022.989337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/17/2022] [Indexed: 01/26/2023] Open
Abstract
In order to curb the rapid dissemination of the B.1.351 variant of SARS-CoV-2 in the district of Schwaz and beyond, the EU allocated additional vaccine doses at the beginning of March 2021 to implement a rapid mass vaccination of the population (16+). The aim of our study was to determine the seroprevalence of SARS-CoV-2 among the adult population in the district of Schwaz at the time of the implementation. Data on previous history of infections, symptoms and immunization status were collected using a structured questionnaire. Blood samples were used to determine SARS-CoV-2 specific anti-spike, anti-nucleocapsid and neutralizing antibodies. We recruited 2,474 individuals with a median age (IQR) of 42 (31-54) years. Using the official data on distribution of age and sex, we found a standardized prevalence of undocumented infections at 15.0% (95% CI: 13.2-16.7). Taken together with the officially documented infections, we estimated that 24.0% (95% CI: 22.5-25.6) of the adult population had prior SARS-CoV-2 infection. Hence, the proportion of undocumented infections identified by our study was 55.8% (95% CI: 52.7-58.5). With a vaccination coverage of 10% among the adults population at that time, we imply that a minimum of two-thirds of the target popuation was susceptible to the circulating threat when this unique campaign started.
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Affiliation(s)
- Peter Willeit
- Clinical Epidemiology Team, Medical University of Innsbruck, Innsbruck, Austria,Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Janine Kimpel
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Hannes Winner
- Department of Economics, University of Salzburg, Salzburg, Austria
| | - Teresa Harthaller
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Helena Schäfer
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - David Bante
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Barbara Falkensammer
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Annika Rössler
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Lydia Riepler
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Cornelia Ower
- Department of Surgery, University Hospital of Trauma Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Magdalena Sacher
- Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Dorothee von Laer
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Wegene Borena
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria,*Correspondence: Wegene Borena
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46
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Struck NS, Lorenz E, Deschermeier C, Eibach D, Kettenbeil J, Loag W, Brieger SA, Ginsbach AM, Obirikorang C, Maiga-Ascofare O, Sarkodie YA, Boham EEA, Adu EA, Asare G, Amoako-Adusei A, Yawson A, Boakye AO, Deke J, Almoustapha NS, Adu-Amoah L, Duah IK, Ouedraogo TA, Boudo V, Rushton B, Ehmen C, Fusco D, Gunga L, Benke D, Höppner Y, Rasolojaona ZT, Rasamoelina T, Rakotoarivelo RA, Rakotozandrindrainy R, Coulibaly B, Sié A, Awuah AAA, Amuasi JH, Souares A, May J. High seroprevalence of SARS-CoV-2 in Burkina-Faso, Ghana and Madagascar in 2021: a population-based study. BMC Public Health 2022; 22:1676. [PMID: 36064368 PMCID: PMC9441841 DOI: 10.1186/s12889-022-13918-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/07/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The current COVID-19 pandemic affects the entire world population and has serious health, economic and social consequences. Assessing the prevalence of COVID-19 through population-based serological surveys is essential to monitor the progression of the epidemic, especially in African countries where the extent of SARS-CoV-2 spread remains unclear. METHODS A two-stage cluster population-based SARS-CoV-2 seroprevalence survey was conducted in Bobo-Dioulasso and in Ouagadougou, Burkina Faso, Fianarantsoa, Madagascar and Kumasi, Ghana between February and June 2021. IgG seropositivity was determined in 2,163 households with a specificity improved SARS-CoV-2 Enzyme-linked Immunosorbent Assay. Population seroprevalence was evaluated using a Bayesian logistic regression model that accounted for test performance and age, sex and neighbourhood of the participants. RESULTS Seroprevalence adjusted for test performance and population characteristics were 55.7% [95% Credible Interval (CrI) 49·0; 62·8] in Bobo-Dioulasso, 37·4% [95% CrI 31·3; 43·5] in Ouagadougou, 41·5% [95% CrI 36·5; 47·2] in Fianarantsoa, and 41·2% [95% CrI 34·5; 49·0] in Kumasi. Within the study population, less than 6% of participants performed a test for acute SARS-CoV-2 infection since the onset of the pandemic. CONCLUSIONS High exposure to SARS-CoV-2 was found in the surveyed regions albeit below the herd immunity threshold and with a low rate of previous testing for acute infections. Despite the high seroprevalence in our study population, the duration of protection from naturally acquired immunity remains unclear and new virus variants continue to emerge. This highlights the importance of vaccine deployment and continued preventive measures to protect the population at risk.
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Affiliation(s)
- Nicole S Struck
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany. .,German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Heidelberg, Germany.
| | - Eva Lorenz
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Heidelberg, Germany.,Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg, University Mainz, Mainz, Germany
| | - Christina Deschermeier
- Diagnostics Development Laboratory, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Daniel Eibach
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Heidelberg, Germany
| | - Jenny Kettenbeil
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany
| | - Wibke Loag
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany
| | - Steven A Brieger
- University of Sussex Business School, University of Sussex, Falmer, UK
| | - Anna M Ginsbach
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany
| | - Christian Obirikorang
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Oumou Maiga-Ascofare
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany.,Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Yaw Adu Sarkodie
- Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eric Ebenezer Amprofi Boham
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Evans Asamoah Adu
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Gracelyn Asare
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Amos Amoako-Adusei
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alfred Yawson
- Department of Community Health, University of Ghana, Accra, Ghana
| | - Alexander Owusu Boakye
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - James Deke
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Nana Safi Almoustapha
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Louis Adu-Amoah
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ibrahim Kwaku Duah
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Valentin Boudo
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Ben Rushton
- Diagnostics Development Laboratory, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Christa Ehmen
- Diagnostics Development Laboratory, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Daniela Fusco
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Heidelberg, Germany
| | - Leonard Gunga
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany
| | - Dominik Benke
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany
| | - Yannick Höppner
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany
| | | | | | | | | | - Boubacar Coulibaly
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Heidelberg, Germany.,Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Ali Sié
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Heidelberg, Germany.,Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso.,Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Anthony Afum-Adjei Awuah
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - John H Amuasi
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany.,Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Global and International Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Aurélia Souares
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Heidelberg, Germany.,Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Jürgen May
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Heidelberg, Germany.,Department of Tropical Medicine I, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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47
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Kanduc D. SARS-CoV-2-Induced Immunosuppression: A Molecular Mimicry Syndrome. Glob Med Genet 2022; 9:191-199. [PMID: 35846107 PMCID: PMC9282940 DOI: 10.1055/s-0042-1748170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background
Contrary to immunological expectations, decay of adaptive responses against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) characterizes recovered patients compared with patients who had a severe disease course or died following SARS-CoV-2 infection. This raises the question of the causes of the virus-induced immune immunosuppression. Searching for molecular link(s) between SARS-CoV-2 immunization and the decay of the adaptive immune responses, SARS-CoV-2 proteome was analyzed for molecular mimicry with human proteins related to immunodeficiency. The aim was to verify the possibility of cross-reactions capable of destroying the adaptive immune response triggered by SARS-CoV-2.
Materials and Methods
Human immunodeficiency–related proteins were collected from UniProt database and analyzed for sharing of minimal immune determinants with the SARS-CoV-2 proteome.
Results
Molecular mimicry and consequent potential cross-reactivity exist between SARS-CoV-2 proteome and human immunoregulatory proteins such as nuclear factor kappa B (NFKB), and variable diversity joining V(D)J recombination-activating gene (RAG).
Conclusion
The data (1) support molecular mimicry and the associated potential cross-reactivity as a mechanism that can underlie self-reactivity against proteins involved in B- and T-cells activation/development, and (2) suggest that the extent of the immunosuppression is dictated by the extent of the immune responses themselves. The higher the titer of the immune responses triggered by SARS-CoV-2 immunization, the more severe can be the cross-reactions against the human immunodeficiency–related proteins, the more severe the immunosuppression. Hence, SARS-CoV-2-induced immunosuppression can be defined as a molecular mimicry syndrome. Clinically, the data imply that booster doses of SARS-CoV-2 vaccines may have opposite results to those expected.
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Affiliation(s)
- Darja Kanduc
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
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48
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Dyer AH, Fallon A, Noonan C, Dolphin H, O'Farrelly C, Bourke NM, O'Neill D, Kennelly SP. Managing the Impact of COVID-19 in Nursing Homes and Long-Term Care Facilities: An Update. J Am Med Dir Assoc 2022; 23:1590-1602. [PMID: 35922016 PMCID: PMC9250924 DOI: 10.1016/j.jamda.2022.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 11/26/2022]
Abstract
Older adults in nursing homes are at greatest risk of morbidity and mortality from SARS-CoV-2 infection. Nursing home residents constituted one-third to more than half of all deaths during the early waves of the COVID-19 pandemic. Following this, widespread adaptation of infection prevention and control measures and the supply and use of personal protective equipment resulted in a significant decrease in nursing home infections and deaths. For nursing homes, the most important determinant of experiencing a SARS-CoV-2 outbreak in the first instance appears to be community-transmission levels (particularly with variants of concern), although nursing home size and quality, for-profit status, and sociodemographic characteristics are also important. Use of visitation bans, imposed to reduce the impact of COVID-19 on residents, must be delicately balanced against their impact on resident, friend or family, and staff well-being. The successful rollout of primary vaccination has resulted in a sharp decrease in morbidity and mortality from SARS-CoV-2 in nursing homes. However, emerging evidence suggests that vaccine efficacy may wane over time, and the use of a third or additional vaccine "booster" doses in nursing home residents restores protection afforded by primary vaccination. Ongoing monitoring of vaccine efficacy in terms of infection, morbidity, and mortality is crucial in this vulnerable group in informing ongoing SARS-CoV-2 vaccine boosting strategies. Here, we detail the impact of SARS-CoV-2 on nursing home residents and discuss important considerations in the management of nursing home SARS-CoV-2 outbreaks. We additionally examine the use of testing strategies, nonpharmacologic outbreak control measures and vaccination strategies in this cohort. Finally, the impact of SARS-CoV-2 on the sector is reflected on as we emphasize the need for adoption of universal standards of medical care and integration with wider public health infrastructure in nursing homes in order to provide a safe and effective long-term care sector.
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Affiliation(s)
- Adam H Dyer
- Department of Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland.
| | - Aoife Fallon
- Department of Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Claire Noonan
- Department of Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland
| | - Helena Dolphin
- Department of Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland
| | - Cliona O'Farrelly
- Comparative Immunology, School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Dublin, Ireland; School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Nollaig M Bourke
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland; Inflammageing Research Group, Trinity Translational Medicine Institute, Dublin, Ireland
| | - Desmond O'Neill
- Department of Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Sean P Kennelly
- Department of Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
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49
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Sullivan DJ, Franchini M, Joyner MJ, Casadevall A, Focosi D. Analysis of anti-Omicron neutralizing antibody titers in different vaccinated and unvaccinated convalescent plasma sources. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2021.12.24.21268317. [PMID: 35982681 PMCID: PMC9387146 DOI: 10.1101/2021.12.24.21268317] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The latest SARS-CoV-2 variant of concern Omicron, with its immune escape from therapeutic anti-Spike monoclonal antibodies and WA-1 vaccine-elicited sera, demonstrates the continued relevance of COVID-19 convalescent plasma (CCP) therapies. Lessons learnt from previous usage of CCP suggests focusing on early outpatients and immunocompromised recipients, with high neutralizing antibody (nAb) titer units. In this analysis we systematically reviewed Omicron-neutralizing plasma activity data, and found that approximately 47% (424/902) of CCP from unvaccinated pre-Omicron donors neutralizes Omicron BA.1 with a very low geomean of geometric mean titers for 50% neutralization GM(GMT50) of about 13, representing a more than 20-fold reduction from WA-1 neutralization. Two doses of mRNA vaccines in nonconvalescent subjects had a similar 50% percent neutralization with Omicron BA.1 neutralization GM(GMT(50)) of about 27. However, plasma from vaccinees recovered from either previous pre-Omicron variants of concern infection, Omicron BA.1 infection, or third-dose uninfected vaccinees was nearly 100% neutralizing against Omicron BA.1, BA.2 and BA.4/5 with GM(GMT(50)) all over 189, 10 times higher than pre-Omicron CCP. Fully vaccinated and post-BA.1 plasma (Vax-CCP) had GM(GMT50) over 450 for BA.4/5 and over 1500 for BA.1 and BA.2. These findings have implications for both CCP stocks collected in prior pandemic periods and plans to restart CCP collections. Thus, Vax-CCP provides an effective tool to combat ongoing variants that defeat therapeutic monoclonal antibodies.
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Affiliation(s)
- David J Sullivan
- Johns Hopkins Bloomberg School of Public Health and School of Medicine, Baltimore, MD 21218, USA
| | - Massimo Franchini
- Division of Transfusion Medicine, Carlo Poma Hospital, 46100 Mantua, Italy
| | - Michael J. Joyner
- Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Rochester, MN 55902, USA
| | - Arturo Casadevall
- Johns Hopkins Bloomberg School of Public Health and School of Medicine, Baltimore, MD 21218, USA
| | - Daniele Focosi
- North-Western Tuscany Blood Bank, Pisa University Hospital, 56124 Pisa, Italy
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50
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Wang L, Min J, Doig R, Elliott LT, Colijn C. Estimation of SARS‐CoV‐2 antibody prevalence through serological uncertainty and daily incidence. CAN J STAT 2022; 50:734-750. [PMID: 36248322 PMCID: PMC9538003 DOI: 10.1002/cjs.11722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 04/11/2022] [Indexed: 11/17/2022]
Abstract
Serology tests for SARS‐CoV‐2 provide a paradigm for estimating the number of individuals who have had an infection in the past (including cases that are not detected by routine testing, which has varied over the course of the pandemic and between jurisdictions). Such estimation is challenging in cases for which we only have limited serological data and do not take into account the uncertainty of the serology test. In this work, we provide a joint Bayesian model to improve the estimation of the sero‐prevalence (the proportion of the population with SARS‐CoV‐2 antibodies) through integrating multiple sources of data, priors on the sensitivity and specificity of the serological test, and an effective epidemiological dynamics model. We apply our model to the Greater Vancouver area, British Columbia, Canada, with data acquired during the pandemic from the end of January to May 2020. Our estimated sero‐prevalence is consistent with previous literature but with a tighter credible interval.
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Affiliation(s)
- Liangliang Wang
- Department of Statistics and Actuarial Science Simon Fraser University Burnaby BC Canada
| | - Joosung Min
- Department of Statistics and Actuarial Science Simon Fraser University Burnaby BC Canada
| | - Renny Doig
- Department of Statistics and Actuarial Science Simon Fraser University Burnaby BC Canada
| | - Lloyd T. Elliott
- Department of Statistics and Actuarial Science Simon Fraser University Burnaby BC Canada
| | - Caroline Colijn
- Department of Mathematics Simon Fraser University Burnaby BC Canada
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