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Tian X, Jiang W, Zhang H, Lu X, Li L, Liu W, Li J. Persistence of the SARS-CoV-2 Antibody Response in Asymptomatic Patients in Correctional Facilities. Front Microbiol 2021; 12:789374. [PMID: 34858383 PMCID: PMC8631518 DOI: 10.3389/fmicb.2021.789374] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 10/21/2021] [Indexed: 12/23/2022] Open
Abstract
SARS-CoV-2 has caused a global health disaster with millions of death worldwide, and the substantial proportion of asymptomatic carriers poses a huge threat to public health. The long-term antibody responses and neutralization activity during natural asymptomatic SARS-CoV-2 infection are unknown. In this study, we used enzyme-linked immunosorbent assays (ELISA) and neutralization assay with purified SARS-CoV-2S and N proteins to study the antibody responses of 156 individuals with natural asymptomatic infection. We found robust antibody responses to SARS-CoV-2 in 156 patients from 6 to 12 months. Although the antibody responses gradually decreased, S-IgG was more stable than N-IgG. S-IgG was still detected in 79% of naturally infected individuals after 12 months of infection. Moderate to potent neutralization activities were also observed in 98.74% of patients 6 months after infection. However, this proportion decreased at 8-month (46.15%) and 10-month (39.11%) after infection, respectively. Only 23.72% of patients displayed potent neutralization activity at 12 months. This study strongly supports the long-term presence of antibodies against SARS-CoV-2 in individuals with natural asymptomatic infection, although the magnitude of the antibody responses started to cripple 6 months after infection.
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Affiliation(s)
- Xiaodong Tian
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
- School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Wenguo Jiang
- Jining Center for Disease Control and Prevention, Shandong, China
| | - He Zhang
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
| | - XiXi Lu
- Jining Center for Disease Control and Prevention, Shandong, China
| | - Libo Li
- Jining Center for Disease Control and Prevention, Shandong, China
| | - Wenjun Liu
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
- School of Life Sciences, University of Science and Technology of China, Hefei, China
- Savaid Medical School, University of the Chinese Academy of Sciences, Beijing, China
- Institute of Microbiology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Beijing, China
| | - Jing Li
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
- Savaid Medical School, University of the Chinese Academy of Sciences, Beijing, China
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Takahashi S, Peluso MJ, Hakim J, Turcios K, Janson O, Routledge I, Busch MP, Hoh R, Tai V, Kelly JD, Martin JN, Deeks SG, Henrich TJ, Greenhouse B, Rodríguez-Barraquer I. SARS-CoV-2 serology across scales: a framework for unbiased seroprevalence estimation incorporating antibody kinetics and epidemic recency. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.09.09.21263139. [PMID: 34545373 PMCID: PMC8452112 DOI: 10.1101/2021.09.09.21263139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Serosurveys are a key resource for measuring SARS-CoV-2 cumulative incidence. A growing body of evidence suggests that asymptomatic and mild infections (together making up over 95% of all infections) are associated with lower antibody titers than severe infections. Antibody levels also peak a few weeks after infection and decay gradually. We developed a statistical approach to produce adjusted estimates of seroprevalence from raw serosurvey results that account for these sources of spectrum bias. We incorporate data on antibody responses on multiple assays from a post-infection longitudinal cohort, along with epidemic time series to account for the timing of a serosurvey relative to how recently individuals may have been infected. We applied this method to produce adjusted seroprevalence estimates from five large-scale SARS-CoV-2 serosurveys across different settings and study designs. We identify substantial differences between reported and adjusted estimates of over two-fold in the results of some surveys, and provide a tool for practitioners to generate adjusted estimates with pre-set or custom parameter values. While unprecedented efforts have been launched to generate SARS-CoV-2 seroprevalence estimates over this past year, interpretation of results from these studies requires properly accounting for both population-level epidemiologic context and individual-level immune dynamics.
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Affiliation(s)
- Saki Takahashi
- Division of HIV, Infectious Diseases & Global Medicine, University of California, San Francisco, USA
| | - Michael J. Peluso
- Division of HIV, Infectious Diseases & Global Medicine, University of California, San Francisco, USA
| | - Jill Hakim
- Division of HIV, Infectious Diseases & Global Medicine, University of California, San Francisco, USA
| | - Keirstinne Turcios
- Division of HIV, Infectious Diseases & Global Medicine, University of California, San Francisco, USA
| | - Owen Janson
- Division of HIV, Infectious Diseases & Global Medicine, University of California, San Francisco, USA
| | - Isobel Routledge
- Division of HIV, Infectious Diseases & Global Medicine, University of California, San Francisco, USA
| | - Michael P. Busch
- Department of Laboratory Medicine, University of California, San Francisco, USA
- Vitalant Research Institute, San Francisco, USA
| | - Rebecca Hoh
- Division of HIV, Infectious Diseases & Global Medicine, University of California, San Francisco, USA
| | - Viva Tai
- Division of HIV, Infectious Diseases & Global Medicine, University of California, San Francisco, USA
| | - J. Daniel Kelly
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
- Institute for Global Health Sciences, University of California, San Francisco, USA
- F.I. Proctor Foundation, University of California, San Francisco, USA
| | - Jeffrey N. Martin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Steven G. Deeks
- Division of HIV, Infectious Diseases & Global Medicine, University of California, San Francisco, USA
| | - Timothy J. Henrich
- Division of Experimental Medicine, University of California, San Francisco, USA
| | - Bryan Greenhouse
- Division of HIV, Infectious Diseases & Global Medicine, University of California, San Francisco, USA
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Peluso MJ, Kelly JD, Lu S, Goldberg SA, Davidson MC, Mathur S, Durstenfeld MS, Spinelli MA, Hoh R, Tai V, Fehrman EA, Torres L, Hernandez Y, Williams MC, Arreguin MI, Bautista JA, Ngo LH, Deswal M, Munter SE, Martinez EO, Anglin KA, Romero MD, Tavs J, Rugart PR, Chen JY, Sans HM, Murray VW, Ellis PK, Donohue KC, Massachi JA, Weiss JO, Mehdi I, Pineda-Ramirez J, Tang AF, Wenger M, Assenzio M, Yuan Y, Krone M, Rutishauser RL, Rodriguez-Barraquer I, Greenhouse B, Sauceda JA, Gandhi M, Hsue PY, Henrich TJ, Deeks SG, Martin JN. Rapid implementation of a cohort for the study of post-acute sequelae of SARS-CoV-2 infection/COVID-19. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.03.11.21252311. [PMID: 33758895 PMCID: PMC7987054 DOI: 10.1101/2021.03.11.21252311] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND As the coronavirus disease 2019 (COVID-19) pandemic continues and millions remain vulnerable to infection with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), attention has turned to characterizing post-acute sequelae of SARS-CoV-2 infection (PASC). METHODS From April 21 to December 31, 2020, we assembled a cohort of consecutive volunteers who a) had documented history of SARS-CoV-2 RNA-positivity; b) were ≥ 2 weeks past onset of COVID-19 symptoms or, if asymptomatic, first test for SARS-CoV-2; and c) were able to travel to our site in San Francisco. Participants learned about the study by being identified on medical center-based registries and being notified or by responding to advertisements. At 4-month intervals, we asked participants about physical symptoms that were new or worse compared to the period prior to COVID-19, mental health symptoms and quality of life. We described 4 time periods: 1) acute illness (0-3 weeks), 2) early recovery (3-10 weeks), 3) late recovery 1 (12-20 weeks), and 4) late recovery 2 (28-36 weeks). Blood and oral specimens were collected at each visit. RESULTS We have, to date, enrolled 179 adults. During acute SARS-CoV-2 infection, 10 had been asymptomatic, 125 symptomatic but not hospitalized, and 44 symptomatic and hospitalized. In the acute phase, the most common symptoms were fatigue, fever, myalgia, cough and anosmia/dysgeusia. During the post-acute phase, fatigue, shortness of breath, concentration problems, headaches, trouble sleeping and anosmia/dysgeusia were the most commonly reported symptoms, but a variety of others were endorsed by at least some participants. Some experienced symptoms of depression, anxiety, and post-traumatic stress, as well as difficulties with ambulation and performance of usual activities. The median visual analogue scale value rating of general health was lower at 4 and 8 months (80, interquartile range [IQR]: 70-90; and 80, IQR 75-90) compared to prior to COVID-19 (85; IQR 75-90). Biospecimens were collected at nearly 600 participant-visits. CONCLUSION Among a cohort of participants enrolled in the post-acute phase of SARS-CoV-2 infection, we found many with persistent physical symptoms through 8 months following onset of COVID-19 with an impact on self-rated overall health. The presence of participants with and without symptoms and ample biological specimens will facilitate study of PASC pathogenesis. Similar evaluations in a population-representative sample will be needed to estimate the population-level prevalence of PASC.
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Affiliation(s)
- Michael J. Peluso
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - J. Daniel Kelly
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
- Department of Ophthalmology, University of California, San Francisco, USA
| | - Scott Lu
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Sarah A. Goldberg
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Michelle C. Davidson
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Sujata Mathur
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Matthew S. Durstenfeld
- Division of Cardiology, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - Matthew A. Spinelli
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - Rebecca Hoh
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - Viva Tai
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - Emily A. Fehrman
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - Leonel Torres
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
- Division of Experimental Medicine, University of California, San Francisco, USA
| | - Yanel Hernandez
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - Meghann C. Williams
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - Mireya I. Arreguin
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - Jennifer A. Bautista
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - Lynn H. Ngo
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - Monika Deswal
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - Sadie E. Munter
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
- Division of Experimental Medicine, University of California, San Francisco, USA
| | - Enrique O. Martinez
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Khamal A. Anglin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Mariela D. Romero
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Jacqueline Tavs
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Paulina R. Rugart
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Jessica Y. Chen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
- Division of Experimental Medicine, University of California, San Francisco, USA
| | - Hannah M. Sans
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Victoria W. Murray
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - Payton K. Ellis
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Kevin C. Donohue
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Jonathan A. Massachi
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Jacob O. Weiss
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Irum Mehdi
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Jesus Pineda-Ramirez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Alex F. Tang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Megan Wenger
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Melissa Assenzio
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Yan Yuan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Melissa Krone
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | | | - Isabel Rodriguez-Barraquer
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - Bryan Greenhouse
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - John A. Sauceda
- Center for AIDS Prevention Studies, University of California, San Francisco, USA
| | - Monica Gandhi
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - Priscilla Y. Hsue
- Division of Cardiology, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - Timothy J. Henrich
- Division of Experimental Medicine, University of California, San Francisco, USA
| | - Steven G. Deeks
- Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, USA
| | - Jeffrey N. Martin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
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