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Gupta R, Gupta P, Wang S, Melnykov A, Jiang Q, Seth A, Wang Z, Morrissey JJ, George I, Gandra S, Sinha P, Storch GA, Parikh BA, Genin GM, Singamaneni S. Ultrasensitive lateral-flow assays via plasmonically active antibody-conjugated fluorescent nanoparticles. Nat Biomed Eng 2023; 7:1556-1570. [PMID: 36732621 DOI: 10.1038/s41551-022-01001-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 12/20/2022] [Indexed: 02/04/2023]
Abstract
Lateral-flow assays (LFAs) are rapid and inexpensive, yet they are nearly 1,000-fold less sensitive than laboratory-based tests. Here we show that plasmonically active antibody-conjugated fluorescent gold nanorods can make conventional LFAs ultrasensitive. With sample-to-answer times within 20 min, plasmonically enhanced LFAs read out via a standard benchtop fluorescence scanner attained about 30-fold improvements in dynamic range and in detection limits over 4-h-long gold-standard enzyme-linked immunosorbent assays, and achieved 95% clinical sensitivity and 100% specificity for antibodies in plasma and for antigens in nasopharyngeal swabs from individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Comparable improvements in the assay's performance can also be achieved via an inexpensive portable scanner, as we show for the detection of interleukin-6 in human serum samples and of the nucleocapsid protein of SARS-CoV-2 in nasopharyngeal samples. Plasmonically enhanced LFAs outperform standard laboratory tests in sensitivity, speed, dynamic range, ease of use and cost, and may provide advantages in point-of-care diagnostics.
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Affiliation(s)
- Rohit Gupta
- Department of Mechanical Engineering and Materials Science, Institute of Materials Science and Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Prashant Gupta
- Department of Mechanical Engineering and Materials Science, Institute of Materials Science and Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Sean Wang
- Department of Biology, Washington University in St. Louis, St. Louis, MO, USA
| | | | | | - Anushree Seth
- Department of Mechanical Engineering and Materials Science, Institute of Materials Science and Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Zheyu Wang
- Department of Mechanical Engineering and Materials Science, Institute of Materials Science and Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Jeremiah J Morrissey
- Department of Anesthesiology, Division of Clinical and Translational Research, Washington University in St. Louis, St. Louis, MO, USA
- Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Ige George
- Department of Internal Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Sumanth Gandra
- Department of Internal Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Pratik Sinha
- Department of Anesthesiology, Division of Clinical and Translational Research, Washington University in St. Louis, St. Louis, MO, USA
| | - Gregory A Storch
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Bijal A Parikh
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Guy M Genin
- Department of Mechanical Engineering and Materials Science, Institute of Materials Science and Engineering, Washington University in St. Louis, St. Louis, MO, USA
- NSF Science and Technology Center for Engineering MechanoBiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Srikanth Singamaneni
- Department of Mechanical Engineering and Materials Science, Institute of Materials Science and Engineering, Washington University in St. Louis, St. Louis, MO, USA.
- Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA.
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Andreeva D, Gill C, Brockbank A, Hejmej J, Conti‐Ramsden F, Doores KJ, Seed PT, Poston L. Trends in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and vaccine antibody prevalence in a multi-ethnic inner-city antenatal population: A cross-sectional surveillance study. BJOG 2023; 130:1135-1144. [PMID: 37113111 PMCID: PMC10718194 DOI: 10.1111/1471-0528.17508] [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: 10/11/2022] [Revised: 01/14/2023] [Accepted: 01/24/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE To determine severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence in pregnancy in an inner-city setting and assess associations with demographic factors and vaccination timing. DESIGN Repeated cross-sectional surveillance study. SETTING London maternity centre. SAMPLE A total of 906 pregnant women attending nuchal scans, July 2020-January 2022. METHODS Blood samples were tested for IgG antibodies against SARS-CoV-2 nucleocapsid (N) and spike (S) proteins. Self-reported vaccination status and coronavirus disease 2019 (COVID-19) infection were recorded. Multivariable regression models determined demographic factors associated with seroprevalence and antibody titres. MAIN OUTCOME MEASURES Immunoglobulin G N- and S-protein antibody titres. RESULTS Of the 960 women, 196 (20.4%) were SARS-CoV-2 seropositive from previous infection. Of these, 70 (35.7%) self-reported previous infection. Among unvaccinated women, women of black ethnic backgrounds were most likely to be SARS-CoV-2 seropositive (versus white adjusted risk ratio [aRR] 1.88, 95% CI 1.35-2.61, p < 0.001). Women from black and mixed ethnic backgrounds were least likely to have a history of vaccination with seropositivity to S-protein (versus white aRR 0.58, 95% CI 0.40-0.84, p = 0.004; aRR 0.56, 95% CI 0.34-0.92, p = 0.021, respectively). Double vaccinated, previously infected women had higher IgG S-protein antibody titres than unvaccinated, previously infected women (mean difference 4.76 fold-change, 95% CI 2.65-6.86, p < 0.001). Vaccination timing before versus during pregnancy did not affect IgG S-antibody titres (mean difference -0.28 fold-change, 95% CI -2.61 to 2.04, p = 0.785). CONCLUSIONS This cross-sectional study demonstrates high rates of asymptomatic SARS-CoV-2 infection with women of black ethnic backgrounds having higher infection risk and lower vaccine uptake. SARS-CoV-2 antibody titres were highest among double-vaccinated, infected women.
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Affiliation(s)
- Daria Andreeva
- Department of Women and Children's Health, School of Life Course and Population SciencesKing's College LondonLondonUK
| | - Carolyn Gill
- Department of Women and Children's Health, School of Life Course and Population SciencesKing's College LondonLondonUK
| | - Anna Brockbank
- Department of Women and Children's Health, School of Life Course and Population SciencesKing's College LondonLondonUK
| | - Joanna Hejmej
- Department of Women and Children's Health, School of Life Course and Population SciencesKing's College LondonLondonUK
| | - Fran Conti‐Ramsden
- Department of Women and Children's Health, School of Life Course and Population SciencesKing's College LondonLondonUK
| | - Katie J. Doores
- Department of Infectious Diseases, School of Immunology and Microbial SciencesKing's College LondonLondonUK
| | - Paul T. Seed
- Department of Women and Children's Health, School of Life Course and Population SciencesKing's College LondonLondonUK
| | - Lucilla Poston
- Department of Women and Children's Health, School of Life Course and Population SciencesKing's College LondonLondonUK
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Goenka MK, Goenka U, Patil VU, Das SS, Afzalpurkar S, Jajodia S, Mukherjee M, Shah BB, Moitra S. Kinetics of Covid-19 antibodies in terms of titre and duration among healthcare workers: A longitudinal study. THE NATIONAL MEDICAL JOURNAL OF INDIA 2023; 35:201-205. [PMID: 36715043 DOI: 10.25259/nmji_109_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Most individuals with Covid-19 infection develop antibodies specific to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the dynamics of these antibodies is variable and not well-studied. We aimed to determine the titres of naturally acquired antibodies over a 12-week follow-up. Methods We recruited healthcare workers who had tested positive on a specific quantitative reverse transcription-polymerase chain reaction (qRT-PCR) for SARS-CoV-2, and then tested for the presence of immunoglobulin G (IgG) antibody against the same virus at baseline and again at 6 and 12 weeks. The antibody titre was determined by a semi-quantitative assay based on signal/cut-off ratio. Healthcare workers with antibody positivity were divided into those with high titre (ratio ≥12) and low titre (<12). Their demographic details and risk factors were surveyed through a Google form and analysed in relation to the antibody titres at three time-points. Results Of the 286 healthcare workers, 10.48% had high antibody titres. Healthcare workers who had tested positive by qRT-PCR and those who had received the Bacille Calmette-Guérin (BCG) vaccination or other immune-boosters had a higher frequency of high antibody titres. While there was a significant decline in antibody titres at 6 and 12 weeks, 87.46% of individuals positive for IgG antibody persisted to have the antibody even at 12 weeks. Conclusion Healthcare workers who tested positive for SARS-CoV-2 on qRT-PCR had a high positivity for the specific antibody, which continued to express in them even at 12 weeks. Further follow-up is likely to enhance our understanding of antibody kinetics following SARS-CoV-2 infection.
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Affiliation(s)
- Mahesh Kumar Goenka
- Department of Clinical Imaging and Interventional Radiology, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
| | - Usha Goenka
- Department of Clinical Imaging and Interventional Radiology, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
| | - Vikram Uttam Patil
- Department of Clinical Imaging and Interventional Radiology, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
| | - Sudipta Sekhar Das
- Department of Transfusion Medicine and Blood Bank, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
| | - Shivaraj Afzalpurkar
- Department of Clinical Imaging and Interventional Radiology, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
| | - Surabhi Jajodia
- Department of Clinical Imaging and Interventional Radiology, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
| | - Muhuya Mukherjee
- Department of Biostatistics, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
| | - Bhavik Bharat Shah
- Department of Clinical Imaging and Interventional Radiology, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
| | - Saibal Moitra
- Department of Allergy and Asthma Research Centre, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
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Pohanka M. Immunosensors for Assay of Toxic Biological Warfare Agents. BIOSENSORS 2023; 13:402. [PMID: 36979614 PMCID: PMC10046508 DOI: 10.3390/bios13030402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 06/18/2023]
Abstract
An immunosensor for the assay of toxic biological warfare agents is a biosensor suitable for detecting hazardous substances such as aflatoxin, botulinum toxin, ricin, Shiga toxin, and others. The application of immunosensors is used in outdoor assays, point-of-care tests, as a spare method for more expensive devices, and even in the laboratory as a standard analytical method. Some immunosensors, such as automated flow-through analyzers or lateral flow tests, have been successfully commercialized as tools for toxins assay, but the research is ongoing. New devices are being developed, and the use of advanced materials and assay techniques make immunosensors highly competitive analytical devices in the field of toxic biological warfare agents assay. This review summarizes facts about current applications and new trends of immunosensors regarding recent papers in this area.
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Affiliation(s)
- Miroslav Pohanka
- Faculty of Military Health Sciences, University of Defense, Trebesska 1575, CZ-50001 Hradec Kralove, Czech Republic
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Serwanga J, Ankunda V, Sembera J, Kato L, Oluka GK, Baine C, Odoch G, Kayiwa J, Auma BO, Jjuuko M, Nsereko C, Cotten M, Onyachi N, Muwanga M, Lutalo T, Fox J, Musenero M, Kaleebu P. Rapid, early, and potent Spike-directed IgG, IgM, and IgA distinguish asymptomatic from mildly symptomatic COVID-19 in Uganda, with IgG persisting for 28 months. Front Immunol 2023; 14:1152522. [PMID: 37006272 PMCID: PMC10060567 DOI: 10.3389/fimmu.2023.1152522] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/28/2023] [Indexed: 04/04/2023] Open
Abstract
Introduction Understanding how spike (S)-, nucleoprotein (N)-, and RBD-directed antibody responses evolved in mild and asymptomatic COVID-19 in Africa and their interactions with SARS-CoV-2 might inform development of targeted treatments and vaccines. Methods Here, we used a validated indirect in-house ELISA to characterise development and persistence of S- and N-directed IgG, IgM, and IgA antibody responses for 2430 SARS-CoV-2 rt-PCR-diagnosed Ugandan specimens from 320 mild and asymptomatic COVID-19 cases, 50 uninfected contacts, and 54 uninfected non-contacts collected weekly for one month, then monthly for 28 months. Results During acute infection, asymptomatic patients mounted a faster and more robust spike-directed IgG, IgM, and IgA response than those with mild symptoms (Wilcoxon rank test, p-values 0.046, 0.053, and 0.057); this was more pronounced in males than females. Spike IgG antibodies peaked between 25 and 37 days (86.46; IQR 29.47-242.56 BAU/ml), were significantly higher and more durable than N- and RBD IgG antibodies and lasted for 28 months. Anti-spike seroconversion rates consistently exceeded RBD and nucleoprotein rates. Spike- and RBD-directed IgG antibodies were positively correlated until 14 months (Spearman's rank correlation test, p-values 0.0001 to 0.05), although RBD diminished faster. Significant anti-spike immunity persisted without RBD. 64% and 59% of PCR-negative, non-infected non-contacts and suspects, exhibited baseline SARS-CoV-2 N-IgM serological cross-reactivity, suggesting undetected exposure or abortive infection. N-IgG levels waned after 787 days, while N-IgM levels remained undetectable throughout. Discussion Lower N-IgG seroconversion rates and the absence of N-IgM indicate that these markers substantially underestimate the prior exposure rates. Our findings provide insights into the development of S-directed antibody responses in mild and asymptomatic infections, with varying degrees of symptoms eliciting distinct immune responses, suggesting distinct pathogenic pathways. These longer-lasting data inform vaccine design, boosting strategies, and surveillance efforts in this and comparable settings.
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Affiliation(s)
- Jennifer Serwanga
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
| | - Violet Ankunda
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
| | - Jackson Sembera
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
| | - Laban Kato
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Gerald Kevin Oluka
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
| | - Claire Baine
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
| | - Geoffrey Odoch
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - John Kayiwa
- Department of Virology, Uganda Virus Research Institute, Entebbe, Uganda
| | - Betty Oliver Auma
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Mark Jjuuko
- Department of Internal Medicine, Masaka Regional Referral Hospital, Masaka, Uganda
| | - Christopher Nsereko
- Department of Internal Medicine, Entebbe Regional Referral Hospital, Entebbe, Uganda
| | - Matthew Cotten
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
- Medical Research Council, University of Glasgow Centre for Virus Research, Glasgow, United Kingdom
| | - Nathan Onyachi
- Department of Internal Medicine, Masaka Regional Referral Hospital, Masaka, Uganda
| | - Moses Muwanga
- Department of Internal Medicine, Entebbe Regional Referral Hospital, Entebbe, Uganda
| | - Tom Lutalo
- Department of Epidemiology and Data Management, Uganda Virus Research Institute, Entebbe, Uganda
| | - Julie Fox
- Guy’s and St Thomas’ National Health Services Foundation Trust, King’s College London, London, United Kingdom
| | - Monica Musenero
- Science, Technology, and Innovation Secretariat, Office of the President, Government of Uganda, Kampala, Uganda
| | - Pontiano Kaleebu
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
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Oluka GK, Namubiru P, Kato L, Ankunda V, Gombe B, Cotten M, Musenero M, Kaleebu P, Fox J, Serwanga J. Optimisation and Validation of a conventional ELISA and cut-offs for detecting and quantifying anti-SARS-CoV-2 Spike, RBD, and Nucleoprotein IgG, IgM, and IgA antibodies in Uganda. Front Immunol 2023; 14:1113194. [PMID: 36999017 PMCID: PMC10045470 DOI: 10.3389/fimmu.2023.1113194] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/17/2023] [Indexed: 04/01/2023] Open
Abstract
There is an urgent need for better immunoassays to measure antibody responses as part of immune-surveillance activities and to profile immunological responses to emerging SARS-CoV-2 variants. We optimised and validated an in-house conventional ELISA to identify and quantify SARS-CoV-2 spike- (S-), receptor binding domain- (RBD-), and nucleoprotein- (N-) directed IgG, IgM, and IgA binding antibodies in the Ugandan population and similar settings. Pre- and post-pandemic specimens were used to compare the utility of mean ± 2SD, mean ± 3SD, 4-fold above blanks, bootstrapping, and receiver operating characteristic (ROC) analyses in determining optimal cut-off optical densities at 450 nm (OD) for discriminating between antibody positives and negatives. "Limits of detection" (LOD) and "limits of quantitation" (LOQ) were validated alongside the assay's uniformity, accuracy, inter-assay and inter-operator precision, and parallelism. With spike-directed sensitivity and specificity of 95.33 and 94.15%, respectively, and nucleoprotein sensitivity and specificity of 82.69 and 79.71%, ROC was chosen as the best method for determining cutoffs. Accuracy measurements were within the expected CV range of 25%. Serum and plasma OD values were highly correlated (r = 0.93, p=0.0001). ROC-derived cut-offs for S-, RBD-, and N-directed IgG, IgM, and IgA were 0.432, 0.356, 0.201 (S), 0.214, 0.350, 0.303 (RBD), and 0.395, 0.229, 0.188 (N). The sensitivity and specificity of the S-IgG cut-off were equivalent to the WHO 20/B770-02 S-IgG reference standard at 100% level. Spike negative IgG, IgM, and IgA ODs corresponded to median antibody concentrations of 1.49, 3.16, and 0 BAU/mL, respectively, consistent with WHO low titre estimates. Anti-spike IgG, IgM, and IgA cut-offs were equivalent to 18.94, 20.06, and 55.08 BAU/mL. For the first time, we provide validated parameters and cut-off criteria for the in-house detection of subclinical SARS-CoV-2 infection and vaccine-elicited binding antibodies in the context of Sub-Saharan Africa and populations with comparable risk factors.
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Affiliation(s)
- Gerald Kevin Oluka
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
| | - Patricia Namubiru
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Laban Kato
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Violet Ankunda
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
| | - Ben Gombe
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Matthew Cotten
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
- Medical Research Council, University of Glasgow Centre for Virus Research, Glasgow, United Kingdom
| | - Monica Musenero
- Science, Technology, and Innovation Secretariat, Office of the President, Government of Uganda, Kampala, Uganda
| | - Pontiano Kaleebu
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
| | - Julie Fox
- Guy’s and St Thomas’ National Health Services Foundation Trust, King’s College London, London, United Kingdom
| | - Jennifer Serwanga
- Pathogen Genomics, Phenotype, and Immunity Program, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
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Kurshan A, Snell LB, Prior L, Tam JCH, Graham C, Thangarajah R, Edgeworth JD, Nebbia G, Doores KJ. Endogenous antibody responses in REGN-COV2-treated SARS-CoV-2-infected individuals. OXFORD OPEN IMMUNOLOGY 2023; 4:iqac012. [PMID: 36844257 PMCID: PMC9914479 DOI: 10.1093/oxfimm/iqac012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/21/2022] [Accepted: 12/20/2022] [Indexed: 01/09/2023] Open
Abstract
Neutralizing monoclonal antibodies (mAbs) targeting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Spike glycoprotein have been developed for the treatment of COVID-19. Whilst antibody therapy has been shown to reduce the risk of COVID-19-associated hospitalization and death, there is limited understanding of the endogenous immunity to SARS-CoV-2 generated in mAb-treated patients and therefore ongoing susceptibility to future infections. Here we measure the endogenous antibody response in SARS-CoV-2-infected individuals treated with REGN-COV2 (Ronapreve). We show that in the majority of unvaccinated, delta-infected REGN-COV2-treated individuals, an endogenous antibody response is generated, but, like untreated, delta-infected individuals, there was a limited neutralization breadth. However, some vaccinated individuals who were seronegative at SARS-CoV-2 infection baseline and some unvaccinated individuals failed to produce an endogenous immune response following infection and REGN-COV2 treatment demonstrating the importance of mAb therapy in some patient populations.
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Affiliation(s)
- Ashwini Kurshan
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, UK
| | - Luke B Snell
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, UK
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Lucie Prior
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, UK
| | - Jerry C H Tam
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, UK
| | - Carl Graham
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, UK
| | - Rajeni Thangarajah
- Department of Infectious Diseases, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Department of Pharmacy, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Jonathan D Edgeworth
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Gaia Nebbia
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Katie J Doores
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, UK
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CXCL12 and CXCL13 Cytokine Serum Levels Are Associated with the Magnitude and the Quality of SARS-CoV-2 Humoral Responses. Viruses 2022; 14:v14122665. [PMID: 36560669 PMCID: PMC9785906 DOI: 10.3390/v14122665] [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: 10/13/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 11/30/2022] Open
Abstract
A better understanding of the immunological markers associated with long-lasting immune responses to SARS-CoV-2 infection is of paramount importance. In the present study, we characterized SARS-CoV-2-specific humoral responses in hospitalized (ICU and non-ICU) and non-hospitalized individuals at six months post-onset of symptoms (POS) (N = 95). We showed that the proportion of individuals with detectable anti-SARS-CoV-2 IgG or neutralizing (NAb) responses and the titers of antibodies were significantly reduced in non-hospitalized individuals, compared to ICU- or non-ICU-hospitalized individuals at 6 months POS. Interestingly, SARS-CoV-2-specific memory B cells persist at 6 months POS in both ICU and non-ICU patients and were enriched in cells harboring an activated and/or exhausted phenotype. The frequency/phenotype of SARS-CoV-2-specific memory B cells and the magnitude of IgG or NAb responses at 6 months POS correlated with the serum immune signature detected at patient admission. In particular, the serum levels of CXCL13, IL-1RA, and G-CSF directly correlated with the frequency of Spike-specific B cells and the magnitude of Spike-specific IgG or NAb, while the serum levels of CXCL12 showed an antagonizing effect. Our results indicate that the balance between CXCL12 and CXCL13 is an early marker associated with the magnitude and the quality of the SARS-CoV-2 humoral memory.
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Fox T, Geppert J, Dinnes J, Scandrett K, Bigio J, Sulis G, Hettiarachchi D, Mathangasinghe Y, Weeratunga P, Wickramasinghe D, Bergman H, Buckley BS, Probyn K, Sguassero Y, Davenport C, Cunningham J, Dittrich S, Emperador D, Hooft L, Leeflang MM, McInnes MD, Spijker R, Struyf T, Van den Bruel A, Verbakel JY, Takwoingi Y, Taylor-Phillips S, Deeks JJ. Antibody tests for identification of current and past infection with SARS-CoV-2. Cochrane Database Syst Rev 2022; 11:CD013652. [PMID: 36394900 PMCID: PMC9671206 DOI: 10.1002/14651858.cd013652.pub2] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The diagnostic challenges associated with the COVID-19 pandemic resulted in rapid development of diagnostic test methods for detecting SARS-CoV-2 infection. Serology tests to detect the presence of antibodies to SARS-CoV-2 enable detection of past infection and may detect cases of SARS-CoV-2 infection that were missed by earlier diagnostic tests. Understanding the diagnostic accuracy of serology tests for SARS-CoV-2 infection may enable development of effective diagnostic and management pathways, inform public health management decisions and understanding of SARS-CoV-2 epidemiology. OBJECTIVES To assess the accuracy of antibody tests, firstly, to determine if a person presenting in the community, or in primary or secondary care has current SARS-CoV-2 infection according to time after onset of infection and, secondly, to determine if a person has previously been infected with SARS-CoV-2. Sources of heterogeneity investigated included: timing of test, test method, SARS-CoV-2 antigen used, test brand, and reference standard for non-SARS-CoV-2 cases. SEARCH METHODS The COVID-19 Open Access Project living evidence database from the University of Bern (which includes daily updates from PubMed and Embase and preprints from medRxiv and bioRxiv) was searched on 30 September 2020. We included additional publications from the Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre) 'COVID-19: Living map of the evidence' and the Norwegian Institute of Public Health 'NIPH systematic and living map on COVID-19 evidence'. We did not apply language restrictions. SELECTION CRITERIA We included test accuracy studies of any design that evaluated commercially produced serology tests, targeting IgG, IgM, IgA alone, or in combination. Studies must have provided data for sensitivity, that could be allocated to a predefined time period after onset of symptoms, or after a positive RT-PCR test. Small studies with fewer than 25 SARS-CoV-2 infection cases were excluded. We included any reference standard to define the presence or absence of SARS-CoV-2 (including reverse transcription polymerase chain reaction tests (RT-PCR), clinical diagnostic criteria, and pre-pandemic samples). DATA COLLECTION AND ANALYSIS We use standard screening procedures with three reviewers. Quality assessment (using the QUADAS-2 tool) and numeric study results were extracted independently by two people. Other study characteristics were extracted by one reviewer and checked by a second. We present sensitivity and specificity with 95% confidence intervals (CIs) for each test and, for meta-analysis, we fitted univariate random-effects logistic regression models for sensitivity by eligible time period and for specificity by reference standard group. Heterogeneity was investigated by including indicator variables in the random-effects logistic regression models. We tabulated results by test manufacturer and summarised results for tests that were evaluated in 200 or more samples and that met a modification of UK Medicines and Healthcare products Regulatory Agency (MHRA) target performance criteria. MAIN RESULTS We included 178 separate studies (described in 177 study reports, with 45 as pre-prints) providing 527 test evaluations. The studies included 64,688 samples including 25,724 from people with confirmed SARS-CoV-2; most compared the accuracy of two or more assays (102/178, 57%). Participants with confirmed SARS-CoV-2 infection were most commonly hospital inpatients (78/178, 44%), and pre-pandemic samples were used by 45% (81/178) to estimate specificity. Over two-thirds of studies recruited participants based on known SARS-CoV-2 infection status (123/178, 69%). All studies were conducted prior to the introduction of SARS-CoV-2 vaccines and present data for naturally acquired antibody responses. Seventy-nine percent (141/178) of studies reported sensitivity by week after symptom onset and 66% (117/178) for convalescent phase infection. Studies evaluated enzyme-linked immunosorbent assays (ELISA) (165/527; 31%), chemiluminescent assays (CLIA) (167/527; 32%) or lateral flow assays (LFA) (188/527; 36%). Risk of bias was high because of participant selection (172, 97%); application and interpretation of the index test (35, 20%); weaknesses in the reference standard (38, 21%); and issues related to participant flow and timing (148, 82%). We judged that there were high concerns about the applicability of the evidence related to participants in 170 (96%) studies, and about the applicability of the reference standard in 162 (91%) studies. Average sensitivities for current SARS-CoV-2 infection increased by week after onset for all target antibodies. Average sensitivity for the combination of either IgG or IgM was 41.1% in week one (95% CI 38.1 to 44.2; 103 evaluations; 3881 samples, 1593 cases), 74.9% in week two (95% CI 72.4 to 77.3; 96 evaluations, 3948 samples, 2904 cases) and 88.0% by week three after onset of symptoms (95% CI 86.3 to 89.5; 103 evaluations, 2929 samples, 2571 cases). Average sensitivity during the convalescent phase of infection (up to a maximum of 100 days since onset of symptoms, where reported) was 89.8% for IgG (95% CI 88.5 to 90.9; 253 evaluations, 16,846 samples, 14,183 cases), 92.9% for IgG or IgM combined (95% CI 91.0 to 94.4; 108 evaluations, 3571 samples, 3206 cases) and 94.3% for total antibodies (95% CI 92.8 to 95.5; 58 evaluations, 7063 samples, 6652 cases). Average sensitivities for IgM alone followed a similar pattern but were of a lower test accuracy in every time slot. Average specificities were consistently high and precise, particularly for pre-pandemic samples which provide the least biased estimates of specificity (ranging from 98.6% for IgM to 99.8% for total antibodies). Subgroup analyses suggested small differences in sensitivity and specificity by test technology however heterogeneity in study results, timing of sample collection, and smaller sample numbers in some groups made comparisons difficult. For IgG, CLIAs were the most sensitive (convalescent-phase infection) and specific (pre-pandemic samples) compared to both ELISAs and LFAs (P < 0.001 for differences across test methods). The antigen(s) used (whether from the Spike-protein or nucleocapsid) appeared to have some effect on average sensitivity in the first weeks after onset but there was no clear evidence of an effect during convalescent-phase infection. Investigations of test performance by brand showed considerable variation in sensitivity between tests, and in results between studies evaluating the same test. For tests that were evaluated in 200 or more samples, the lower bound of the 95% CI for sensitivity was 90% or more for only a small number of tests (IgG, n = 5; IgG or IgM, n = 1; total antibodies, n = 4). More test brands met the MHRA minimum criteria for specificity of 98% or above (IgG, n = 16; IgG or IgM, n = 5; total antibodies, n = 7). Seven assays met the specified criteria for both sensitivity and specificity. In a low-prevalence (2%) setting, where antibody testing is used to diagnose COVID-19 in people with symptoms but who have had a negative PCR test, we would anticipate that 1 (1 to 2) case would be missed and 8 (5 to 15) would be falsely positive in 1000 people undergoing IgG or IgM testing in week three after onset of SARS-CoV-2 infection. In a seroprevalence survey, where prevalence of prior infection is 50%, we would anticipate that 51 (46 to 58) cases would be missed and 6 (5 to 7) would be falsely positive in 1000 people having IgG tests during the convalescent phase (21 to 100 days post-symptom onset or post-positive PCR) of SARS-CoV-2 infection. AUTHORS' CONCLUSIONS Some antibody tests could be a useful diagnostic tool for those in whom molecular- or antigen-based tests have failed to detect the SARS-CoV-2 virus, including in those with ongoing symptoms of acute infection (from week three onwards) or those presenting with post-acute sequelae of COVID-19. However, antibody tests have an increasing likelihood of detecting an immune response to infection as time since onset of infection progresses and have demonstrated adequate performance for detection of prior infection for sero-epidemiological purposes. The applicability of results for detection of vaccination-induced antibodies is uncertain.
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Affiliation(s)
- Tilly Fox
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Julia Geppert
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Jacqueline Dinnes
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Katie Scandrett
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jacob Bigio
- Research Institute of the McGill University Health Centre, Montreal, Canada
- McGill International TB Centre, Montreal, Canada
| | - Giorgia Sulis
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Dineshani Hettiarachchi
- Department of Anatomy Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Yasith Mathangasinghe
- Department of Anatomy Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- Australian Regenerative Medicine Institute, Monash University, Clayton, Australia
| | - Praveen Weeratunga
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | | | - Brian S Buckley
- Cochrane Response, Cochrane, London, UK
- Department of Surgery, University of the Philippines, Manila, Philippines
| | | | | | - Clare Davenport
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Jane Cunningham
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | | | | | - Lotty Hooft
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht , Netherlands
| | - Mariska Mg Leeflang
- Epidemiology and Data Science, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Amsterdam, Netherlands
| | | | - René Spijker
- Medical Library, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health, Amsterdam, Netherlands
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Thomas Struyf
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Ann Van den Bruel
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Jan Y Verbakel
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Yemisi Takwoingi
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Sian Taylor-Phillips
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jonathan J Deeks
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
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Österdahl MF, Christakou E, Hart D, Harris F, Shahrabi Y, Pollock E, Wadud M, Spector TD, Brown MA, Seow J, Malim MH, Steves CJ, Doores KJ, Duncan EL, Tree T. Concordance of B- and T-cell responses to SARS-CoV-2 infection, irrespective of symptoms suggestive of COVID-19. J Med Virol 2022; 94:5217-5224. [PMID: 35864567 PMCID: PMC9349709 DOI: 10.1002/jmv.28016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 12/15/2022]
Abstract
This study assessed T-cell responses in individuals with and without a positive antibody response to SARS-CoV-2, in symptomatic and asymptomatic individuals during the COVID-19 pandemic. Participants were drawn from the TwinsUK cohort, grouped by (a) presence or absence of COVID-associated symptoms (S+, S-), logged prospectively through the COVID Symptom Study app, and (b) anti-IgG Spike and anti-IgG Nucleocapsid antibodies measured by ELISA (Ab+, Ab-), during the first wave of the UK pandemic. T-cell helper and regulatory responses after stimulation with SARS-CoV-2 peptides were assessed. Thirty-two participants were included in the final analysis. Fourteen of 15 with IgG Spike antibodies had a T-cell response to SARS-CoV-2-specific peptides; none of 17 participants without IgG Spike antibodies had a T-cell response (χ2 : 28.2, p < 0.001). Quantitative T-cell responses correlated strongly with fold-change in IgG Spike antibody titer (ρ = 0.79, p < 0.0001) but not to symptom score (ρ = 0.17, p = 0.35). Humoral and cellular immune responses to SARS-CoV-2 are highly correlated. We found no evidence of cellular immunity suggestive of SARS-CoV2 infection in individuals with a COVID-19-like illness but negative antibodies.
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Affiliation(s)
- Marc F. Österdahl
- Department of Twin Research & Genetic Epidemiology, School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- Department of Ageing and HealthGuy's and St Thomas' NHS Foundation TrustLondonUK
| | - Eleni Christakou
- Department of Immunobiology, School of Immunology & Microbial SciencesKing's College LondonLondonUK
| | - Deborah Hart
- Department of Twin Research & Genetic Epidemiology, School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
| | - Ffion Harris
- Department of Immunobiology, School of Immunology & Microbial SciencesKing's College LondonLondonUK
| | - Yasaman Shahrabi
- Department of Immunobiology, School of Immunology & Microbial SciencesKing's College LondonLondonUK
| | - Emily Pollock
- Department of Immunobiology, School of Immunology & Microbial SciencesKing's College LondonLondonUK
| | - Muntaha Wadud
- Department of Immunobiology, School of Immunology & Microbial SciencesKing's College LondonLondonUK
| | - Tim D. Spector
- Department of Twin Research & Genetic Epidemiology, School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
| | - Matthew A. Brown
- Guy's and St Thomas' NHS Foundation Trust and King's College London NIHR Biomedical Research CentreKing's College LondonLondonUK
| | - Jeffrey Seow
- Department of Infectious Diseases, School of Immunology & Microbial SciencesKing's College LondonLondonUK
| | - Michael H. Malim
- Department of Infectious Diseases, School of Immunology & Microbial SciencesKing's College LondonLondonUK
| | - Claire J. Steves
- Department of Twin Research & Genetic Epidemiology, School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- Department of Ageing and HealthGuy's and St Thomas' NHS Foundation TrustLondonUK
| | - Katie J. Doores
- Department of Infectious Diseases, School of Immunology & Microbial SciencesKing's College LondonLondonUK
| | - Emma L. Duncan
- Department of Twin Research & Genetic Epidemiology, School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- Department of EndocrinologyGuy's and St Thomas' NHS Foundation TrustLondonUK
| | - Timothy Tree
- Department of Immunobiology, School of Immunology & Microbial SciencesKing's College LondonLondonUK
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11
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Rakshit S, Adiga V, Ahmed A, Parthiban C, Chetan Kumar N, Dwarkanath P, Shivalingaiah S, Rao S, D’Souza G, Dias M, Maguire TJA, Doores KJ, Zoodsma M, Geckin B, Dasgupta P, Babji S, van Meijgaarden KE, Joosten SA, Ottenhoff THM, Li Y, Netea MG, Stuart KD, De Rosa SC, McElrath MJ, Vyakarnam A. Evidence for the heterologous benefits of prior BCG vaccination on COVISHIELD™ vaccine-induced immune responses in SARS-CoV-2 seronegative young Indian adults. Front Immunol 2022; 13:985938. [PMID: 36268023 PMCID: PMC9577398 DOI: 10.3389/fimmu.2022.985938] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/26/2022] [Indexed: 11/15/2022] Open
Abstract
This proof-of-concept study tested if prior BCG revaccination can qualitatively and quantitively enhance antibody and T-cell responses induced by Oxford/AstraZeneca ChAdOx1nCoV-19 or COVISHIELD™, an efficacious and the most widely distributed vaccine in India. We compared COVISHIELD™ induced longitudinal immune responses in 21 BCG re-vaccinees (BCG-RV) and 13 BCG-non-revaccinees (BCG-NRV), all of whom were BCG vaccinated at birth; latent tuberculosis negative and SARS-CoV-2 seronegative prior to COVISHIELD™ vaccination. Compared to BCG-NRV, BCG-RV displayed significantly higher and persistent spike-specific neutralizing (n) Ab titers and polyfunctional CD4+ and CD8+ T-cells for eight months post COVISHIELD™ booster, including distinct CD4+IFN-γ+ and CD4+IFN-γ- effector memory (EM) subsets co-expressing IL-2, TNF-α and activation induced markers (AIM) CD154/CD137 as well as CD8+IFN-γ+ EM,TEMRA (T cell EM expressing RA) subset combinations co-expressing TNF-α and AIM CD137/CD69. Additionally, elevated nAb and T-cell responses to the Delta mutant in BCG-RV highlighted greater immune response breadth. Mechanistically, these BCG adjuvant effects were associated with elevated markers of trained immunity, including higher IL-1β and TNF-α expression in CD14+HLA-DR+monocytes and changes in chromatin accessibility highlighting BCG-induced epigenetic changes. This study provides first in-depth analysis of both antibody and memory T-cell responses induced by COVISHIELD™ in SARS-CoV-2 seronegative young adults in India with strong evidence of a BCG-induced booster effect and therefore a rational basis to validate BCG, a low-cost and globally available vaccine, as an adjuvant to enhance heterologous adaptive immune responses to current and emerging COVID-19 vaccines.
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Affiliation(s)
- Srabanti Rakshit
- Centre for Infectious Disease Research, Indian Institute of Science, Bangalore, India
- Infectious Disease Unit, St. John’s Research Institute, Bangalore, India
| | - Vasista Adiga
- Centre for Infectious Disease Research, Indian Institute of Science, Bangalore, India
- Infectious Disease Unit, St. John’s Research Institute, Bangalore, India
- Department of Biotechnology, PES University, Bangalore, India
| | - Asma Ahmed
- Centre for Infectious Disease Research, Indian Institute of Science, Bangalore, India
- Infectious Disease Unit, St. John’s Research Institute, Bangalore, India
| | - Chaitra Parthiban
- Centre for Infectious Disease Research, Indian Institute of Science, Bangalore, India
- Infectious Disease Unit, St. John’s Research Institute, Bangalore, India
| | - Nirutha Chetan Kumar
- Centre for Infectious Disease Research, Indian Institute of Science, Bangalore, India
- Infectious Disease Unit, St. John’s Research Institute, Bangalore, India
| | | | | | - Srishti Rao
- Infectious Disease Unit, St. John’s Research Institute, Bangalore, India
| | - George D’Souza
- Division of Nutrition, St. John’s Research Institute, Bangalore, India
| | - Mary Dias
- Infectious Disease Unit, St. John’s Research Institute, Bangalore, India
| | | | - Katie J. Doores
- Department of Pulmonary Medicine, St. John’s Medical College, Bangalore, India
| | - Martijn Zoodsma
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
- Department of Computational Biology for Individualized Infection Medicine, Centre for Individualized Infection Medicine (CiiM), a joint venture between the Helmholtz Centre for Infection Research (HZI) and the Hannover Medical School (MHH), Hannover, Germany
| | - Busranur Geckin
- TWINCORE, a joint venture between the Helmholtz Centre for Infection Research, (HZI) and the Hannover Medical School (MHH), Hannover, Germany
| | - Prokar Dasgupta
- Department of Internal Medicine and Radboud Center for infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands
| | - Sudhir Babji
- Peter Gorer Department of Immunobiology, Liver Renal Urology Transplant Gastro/Gastrointestinal Surgery, Inflammation Biology, King’s College London, London, United Kingdom
| | | | - Simone A. Joosten
- The Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India
| | - Tom H. M. Ottenhoff
- The Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India
| | - Yang Li
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
- Department of Computational Biology for Individualized Infection Medicine, Centre for Individualized Infection Medicine (CiiM), a joint venture between the Helmholtz Centre for Infection Research (HZI) and the Hannover Medical School (MHH), Hannover, Germany
| | - Mihai G. Netea
- TWINCORE, a joint venture between the Helmholtz Centre for Infection Research, (HZI) and the Hannover Medical School (MHH), Hannover, Germany
| | - Kenneth D. Stuart
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Stephen C. De Rosa
- Centre for Global Infectious Disease Research, Seattle Children’s Research Institute, Seattle, WA, United States
| | - M. Juliana McElrath
- Centre for Global Infectious Disease Research, Seattle Children’s Research Institute, Seattle, WA, United States
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Centre, Seattle, WA, United States
| | - Annapurna Vyakarnam
- Centre for Infectious Disease Research, Indian Institute of Science, Bangalore, India
- Infectious Disease Unit, St. John’s Research Institute, Bangalore, India
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, United States
- *Correspondence: Annapurna Vyakarnam, ;
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12
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The effect of Omicron breakthrough infection and extended BNT162b2 booster dosing on neutralization breadth against SARS-CoV-2 variants of concern. PLoS Pathog 2022; 18:e1010882. [PMID: 36191037 PMCID: PMC9560610 DOI: 10.1371/journal.ppat.1010882] [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: 07/06/2022] [Revised: 10/13/2022] [Accepted: 09/15/2022] [Indexed: 11/06/2022] Open
Abstract
COVID-19 vaccines are playing a vital role in controlling the COVID-19 pandemic. As SARS-CoV-2 variants encoding mutations in the surface glycoprotein, Spike, continue to emerge, there is increased need to identify immunogens and vaccination regimens that provide the broadest and most durable immune responses. We compared the magnitude and breadth of the neutralizing antibody response, as well as levels of Spike-reactive memory B cells, in individuals receiving a second dose of BNT162b2 at a short (3–4 week) or extended interval (8–12 weeks) and following a third vaccination approximately 6–8 months later. We show that whilst an extended interval between the first two vaccinations can greatly increase the breadth of the immune response and generate a higher proportion of Spike reactive memory B cells, a third vaccination leads to similar levels between the two groups. Furthermore, we show that the third vaccine dose enhances neutralization activity against omicron lineage members BA.1, BA.2 and BA.4/BA.5 and this is further increased following breakthrough infection during the UK omicron wave. These findings are relevant for vaccination strategies in populations where COVID-19 vaccine coverage remains low. COVID-19 vaccines have been vital in controlling the current pandemic. With the emergence of SARS-CoV-2 viral variants, it is important to understand factors that influence the neutralization breadth of vaccine responses. Here we study the impact of the interval between the 1st and 2nd BNT162b2 vaccine dose on neutralization breadth and how this is further affected by vaccine boosters and breakthrough infections.
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13
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Seow J, Khan H, Rosa A, Calvaresi V, Graham C, Pickering S, Pye VE, Cronin NB, Huettner I, Malim MH, Politis A, Cherepanov P, Doores KJ. A neutralizing epitope on the SD1 domain of SARS-CoV-2 spike targeted following infection and vaccination. Cell Rep 2022; 40:111276. [PMID: 35981534 PMCID: PMC9365860 DOI: 10.1016/j.celrep.2022.111276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/25/2022] [Accepted: 08/05/2022] [Indexed: 02/06/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike is the target for neutralizing antibodies elicited following both infection and vaccination. While extensive research has shown that the receptor binding domain (RBD) and, to a lesser extent, the N-terminal domain (NTD) are the predominant targets for neutralizing antibodies, identification of neutralizing epitopes beyond these regions is important for informing vaccine development and understanding antibody-mediated immune escape. Here, we identify a class of broadly neutralizing antibodies that bind an epitope on the spike subdomain 1 (SD1) and that have arisen from infection or vaccination. Using cryo-electron microscopy (cryo-EM) and hydrogen-deuterium exchange coupled to mass spectrometry (HDX-MS), we show that SD1-specific antibody P008_60 binds an epitope that is not accessible within the canonical prefusion states of the SARS-CoV-2 spike, suggesting a transient conformation of the viral glycoprotein that is vulnerable to neutralization.
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Affiliation(s)
- Jeffrey Seow
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Hataf Khan
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Annachiara Rosa
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | | | - Carl Graham
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Suzanne Pickering
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Valerie E Pye
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Nora B Cronin
- LonCEM Facility, The Francis Crick Institute, London, UK
| | - Isabella Huettner
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Michael H Malim
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | | | - Peter Cherepanov
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK; Department of Infectious Disease, St-Mary's Campus, Imperial College London, London, UK.
| | - Katie J Doores
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK.
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14
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Malic L, Brassard D, Da Fonte D, Nassif C, Mounier M, Ponton A, Geissler M, Shiu M, Morton KJ, Veres T. Automated sample-to-answer centrifugal microfluidic system for rapid molecular diagnostics of SARS-CoV-2. LAB ON A CHIP 2022; 22:3157-3171. [PMID: 35670202 DOI: 10.1039/d2lc00242f] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Testing for SARS-CoV-2 is one of the most important assets in COVID-19 management and mitigation. At the onset of the pandemic, SARS-CoV-2 testing was uniquely performed in central laboratories using RT-qPCR. RT-qPCR relies on trained personnel operating complex instrumentation, while time-to-result can be lengthy (e.g., 24 to 72 h). Now, two years into the pandemic, with the surge in cases driven by the highly transmissible Omicron variant, COVID-19 testing capabilities have been stretched to their limit worldwide. Rapid antigen tests are playing an increasingly important role in quelling outbreaks by expanding testing capacity outside the realm of clinical laboratories. These tests can be deployed in settings where repeat and rapid testing is essential, but they often come at the expense of limited accuracy and sensitivity. Reverse transcription loop-mediated isothermal amplification (RT-LAMP) provides a number of advantages to SARS-CoV-2 testing in standard laboratories and at the point-of-need. In contrast to RT-qPCR, RT-LAMP is performed at a constant temperature, which circumvents the need for thermal cycling and translates into a shorter analysis time (e.g., <1 h). In addition, RT-LAMP is compatible with colorimetric detection, facilitating visualization and read-out. However, even with these benefits, RT-LAMP is not yet clinically deployed at its full capacity. Lack of automation and integration of sample preparation, such as RNA extraction, limits the sensitivity and specificity of the method. Furthermore, the need for cold storage of reagents complicates its use at the point of need. The developments presented in this work address these limitations: We describe a fully automated SARS-CoV-2 detection method using RT-LAMP, which also includes up-front lysis and extraction of viral RNA, performed on a centrifugal platform with active pneumatic pumping, a disposable, all-polymer-based microfluidic cartridge and lyophilized reagents. We demonstrate that the limit of detection of the RT-LAMP assay itself is 0.2 copies per μL using N and E genes as target sequences. When combined with integrated RNA extraction, the assay sensitivity is 0.5 copies per μL, which is highly competitive to RT-qPCR. We tested the automated assay using 12 clinical swab specimens from patients and were able to distinguish positive and negative samples for SARS-CoV-2 within 60 min, thereby obtaining 100% agreement with RT-qPCR results.
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Affiliation(s)
- Lidija Malic
- Life Sciences Division, National Research Council of Canada, 75 de Mortagne Boulevard, Boucherville, QC, J4B 6Y4, Canada.
| | - Daniel Brassard
- Life Sciences Division, National Research Council of Canada, 75 de Mortagne Boulevard, Boucherville, QC, J4B 6Y4, Canada.
| | - Dillon Da Fonte
- Life Sciences Division, National Research Council of Canada, 75 de Mortagne Boulevard, Boucherville, QC, J4B 6Y4, Canada.
| | - Christina Nassif
- Life Sciences Division, National Research Council of Canada, 75 de Mortagne Boulevard, Boucherville, QC, J4B 6Y4, Canada.
| | - Maxence Mounier
- Life Sciences Division, National Research Council of Canada, 75 de Mortagne Boulevard, Boucherville, QC, J4B 6Y4, Canada.
| | - André Ponton
- Life Sciences Division, National Research Council of Canada, 75 de Mortagne Boulevard, Boucherville, QC, J4B 6Y4, Canada.
| | - Matthias Geissler
- Life Sciences Division, National Research Council of Canada, 75 de Mortagne Boulevard, Boucherville, QC, J4B 6Y4, Canada.
| | - Matthew Shiu
- Life Sciences Division, National Research Council of Canada, 75 de Mortagne Boulevard, Boucherville, QC, J4B 6Y4, Canada.
| | - Keith J Morton
- Life Sciences Division, National Research Council of Canada, 75 de Mortagne Boulevard, Boucherville, QC, J4B 6Y4, Canada.
| | - Teodor Veres
- Life Sciences Division, National Research Council of Canada, 75 de Mortagne Boulevard, Boucherville, QC, J4B 6Y4, Canada.
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15
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Qavi AJ, Wu C, Lloyd M, Zaman MMU, Luan J, Ballman C, Leung DW, Crick SL, Farnsworth CW, Amarasinghe GK. Plasmonic Fluor-Enhanced Antigen Arrays for High-Throughput, Serological Studies of SARS-CoV-2. ACS Infect Dis 2022; 8:1468-1479. [PMID: 35867632 PMCID: PMC9344907 DOI: 10.1021/acsinfecdis.2c00086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Serological testing for acute infection or prior exposure is critical for patient management and coordination of public health decisions during outbreaks. Current methods have several limitations, including variable performance, relatively low analytical and clinical sensitivity, and poor detection due to antigenic drift. Serological methods for SARS-CoV-2 detection for the ongoing COVID-19 pandemic suffer from several of these limitations and serves as a reminder of the critical need for new technologies. Here, we describe the use of ultrabright fluorescent reagents, Plasmonic Fluors, coupled with antigen arrays that address a subset of these limitations. We demonstrate its application using patient samples in SARS-CoV-2 serological assays. In our multiplexed assay, SARS-CoV-2 antigens were spotted into 48-plex arrays within a single well of a 96-well plate and used to evaluate remnant laboratory samples of SARS-CoV-2 positive patients. Signal-readout was performed with Auragent Bioscience's Empower microplate reader, and microarray analysis software. Sample volumes of 1 μL were used. High sensitivity of the Plasmonic Fluors combined with the array format enabled us to profile patient serological response to eight distinct SARS-CoV-2 antigens and evaluate responses to IgG, IgM, and IgA. Sensitivities for SARS-CoV-2 antigens during the symptomatic state ranged between 72.5 and 95.0%, specificity between 62.5 and 100%, and the resulting area under the curve values between 0.76 and 0.97. Together, these results highlight the increased sensitivity for low sample volumes and multiplex capability. These characteristics make Plasmonic Fluor-enhanced antigen arrays an attractive technology for serological studies for the COVID-19 pandemic and beyond.
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Affiliation(s)
- Abraham J. Qavi
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
| | - Chao Wu
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
| | - Matthew Lloyd
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
| | | | - Jingyi Luan
- Auragent
Bioscience, St. Louis, Missouri 63108, United
States
| | - Claire Ballman
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
| | - Daisy W. Leung
- Department
of Internal Medicine, Washington University
School of Medicine, St. Louis, Missouri 63110, United States
| | - Scott L. Crick
- Auragent
Bioscience, St. Louis, Missouri 63108, United
States
| | - Christopher W. Farnsworth
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
| | - Gaya K. Amarasinghe
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
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16
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Davis KAS, Carr E, Leightley D, Vitiello V, Bergin-Cartwright G, Lavelle G, Wickersham A, Malim MH, Oetzmann C, Polling C, Stevelink SAM, Razavi R, Hotopf M. Indicators of recent COVID-19 infection status: findings from a large occupational cohort of staff and postgraduate research students from a UK university. BMC Public Health 2022; 22:1514. [PMID: 35945541 PMCID: PMC9363143 DOI: 10.1186/s12889-022-13889-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/22/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Researchers conducting cohort studies may wish to investigate the effect of episodes of COVID-19 illness on participants. A definitive diagnosis of COVID-19 is not always available, so studies have to rely on proxy indicators. This paper seeks to contribute evidence that may assist the use and interpretation of these COVID-indicators. METHODS We described five potential COVID-indicators: self-reported core symptoms, a symptom algorithm; self-reported suspicion of COVID-19; self-reported external results; and home antibody testing based on a 'lateral flow' antibody (IgG/IgM) test cassette. Included were staff and postgraduate research students at a large London university who volunteered for the study and were living in the UK in June 2020. Excluded were those who did not return a valid antibody test result. We provide descriptive statistics of prevalence and overlap of the five indicators. RESULTS Core symptoms were the most common COVID-indicator (770/1882 participants positive, 41%), followed by suspicion of COVID-19 (n = 509/1882, 27%), a positive symptom algorithm (n = 298/1882, 16%), study antibody lateral flow positive (n = 124/1882, 7%) and a positive external test result (n = 39/1882, 2%), thus a 20-fold difference between least and most common. Meeting any one indicator increased the likelihood of all others, with concordance between 65 and 94%. Report of a low suspicion of having had COVID-19 predicted a negative antibody test in 98%, but positive suspicion predicted a positive antibody test in only 20%. Those who reported previous external antibody tests were more likely to have received a positive result from the external test (24%) than the study test (15%). CONCLUSIONS Our results support the use of proxy indicators of past COVID-19, with the caveat that none is perfect. Differences from previous antibody studies, most significantly in lower proportions of participants positive for antibodies, may be partly due to a decline in antibody detection over time. Subsequent to our study, vaccination may have further complicated the interpretation of COVID-indicators, only strengthening the need to critically evaluate what criteria should be used to define COVID-19 cases when designing studies and interpreting study results.
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Affiliation(s)
- Katrina A S Davis
- King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK.
- South London and Maudsley NHS Foundation Trust, London, UK.
| | - Ewan Carr
- King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Daniel Leightley
- King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Valentina Vitiello
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Gabriella Bergin-Cartwright
- King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Grace Lavelle
- King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Alice Wickersham
- King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Michael H Malim
- Faculty of Life Sciences and Medicine, King's College London School of Immunology & Microbial Sciences, London, UK
| | - Carolin Oetzmann
- King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Catherine Polling
- King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Sharon A M Stevelink
- King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Reza Razavi
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Matthew Hotopf
- King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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17
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Abstract
The SARS-CoV-2 pandemic has demonstrated the importance of studying antiviral immunity within sites of infection to gain insights into mechanisms for immune protection and disease pathology. As SARS-CoV-2 is tropic to the respiratory tract, many studies of airway washes, lymph node aspirates, and postmortem lung tissue have revealed site-specific immune dynamics that are associated with the protection or immunopathology but are not readily observed in circulation. This review summarizes the growing body of work identifying immune processes in tissues and their interplay with immune responses in circulation during acute SARS-CoV-2 infection, severe disease, and memory persistence. Establishment of tissue resident immunity also may have implications for vaccination and the durability of immune memory and protection.
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Affiliation(s)
- Ksenia Rybkina
- Department of Microbiology and ImmunologyColumbia University Vagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - Julia Davis‐Porada
- Department of Microbiology and ImmunologyColumbia University Vagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - Donna L. Farber
- Department of Microbiology and ImmunologyColumbia University Vagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
- Department of SurgeryColumbia University Irving Medical CenterNew YorkNew YorkUSA
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18
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El-Sayed Moustafa JS, Jackson AU, Brotman SM, Guan L, Villicaña S, Roberts AL, Zito A, Bonnycastle L, Erdos MR, Narisu N, Stringham HM, Welch R, Yan T, Lakka T, Parker S, Tuomilehto J, Seow J, Graham C, Huettner I, Acors S, Kouphou N, Wadge S, Duncan EL, Steves CJ, Doores KJ, Malim MH, Collins FS, Pajukanta P, Boehnke M, Koistinen HA, Laakso M, Falchi M, Bell JT, Scott LJ, Mohlke KL, Small KS. ACE2 expression in adipose tissue is associated with cardio-metabolic risk factors and cell type composition-implications for COVID-19. Int J Obes (Lond) 2022; 46:1478-1486. [PMID: 35589964 PMCID: PMC9119844 DOI: 10.1038/s41366-022-01136-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 04/21/2022] [Accepted: 04/28/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND COVID-19 severity varies widely. Although some demographic and cardio-metabolic factors, including age and obesity, are associated with increasing risk of severe illness, the underlying mechanism(s) are uncertain. SUBJECTS/METHODS In a meta-analysis of three independent studies of 1471 participants in total, we investigated phenotypic and genetic factors associated with subcutaneous adipose tissue expression of Angiotensin I Converting Enzyme 2 (ACE2), measured by RNA-Seq, which acts as a receptor for SARS-CoV-2 cellular entry. RESULTS Lower adipose tissue ACE2 expression was associated with multiple adverse cardio-metabolic health indices, including type 2 diabetes (T2D) (P = 9.14 × 10-6), obesity status (P = 4.81 × 10-5), higher serum fasting insulin (P = 5.32 × 10-4), BMI (P = 3.94 × 10-4), and lower serum HDL levels (P = 1.92 × 10-7). ACE2 expression was also associated with estimated proportions of cell types in adipose tissue: lower expression was associated with a lower proportion of microvascular endothelial cells (P = 4.25 × 10-4) and higher proportion of macrophages (P = 2.74 × 10-5). Despite an estimated heritability of 32%, we did not identify any proximal or distal expression quantitative trait loci (eQTLs) associated with adipose tissue ACE2 expression. CONCLUSIONS Our results demonstrate that individuals with cardio-metabolic features known to increase risk of severe COVID-19 have lower background ACE2 levels in this highly relevant tissue. Reduced adipose tissue ACE2 expression may contribute to the pathophysiology of cardio-metabolic diseases, as well as the associated increased risk of severe COVID-19.
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Affiliation(s)
| | - Anne U Jackson
- Department of Biostatistics and Center for Statistical Genetics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Sarah M Brotman
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
| | - Li Guan
- Department of Computational Medicine & Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Sergio Villicaña
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Amy L Roberts
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Antonino Zito
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
- Department of Molecular Biology, Massachusetts General Hospital, Boston, MA, 02114, USA
- Department of Genetics, Harvard Medical School, Boston, MA, 02114, USA
| | - Lori Bonnycastle
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Michael R Erdos
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Narisu Narisu
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Heather M Stringham
- Department of Biostatistics and Center for Statistical Genetics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Ryan Welch
- Department of Biostatistics and Center for Statistical Genetics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Tingfen Yan
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Timo Lakka
- Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | - Stephen Parker
- Department of Computational Medicine & Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Jaakko Tuomilehto
- University of Helsinki and Department of Medicine, Helsinki University Hospital, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jeffrey Seow
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Carl Graham
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Isabella Huettner
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Sam Acors
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Neophytos Kouphou
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Samuel Wadge
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Emma L Duncan
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Claire J Steves
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Katie J Doores
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Michael H Malim
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Francis S Collins
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Päivi Pajukanta
- Department of Human Genetics and Institute for Precision Health, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Michael Boehnke
- Department of Biostatistics and Center for Statistical Genetics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Heikki A Koistinen
- University of Helsinki and Department of Medicine, Helsinki University Hospital, Helsinki, Finland
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Markku Laakso
- Department of Medicine, University of Eastern Finland, Kuopio, Finland
- Kuopio University Hospital, Kuopio, Finland
| | - Mario Falchi
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Jordana T Bell
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Laura J Scott
- Department of Biostatistics and Center for Statistical Genetics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Karen L Mohlke
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
| | - Kerrin S Small
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.
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19
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Callegari I, Schneider M, Berloffa G, Mühlethaler T, Holdermann S, Galli E, Roloff T, Boss R, Infanti L, Khanna N, Egli A, Buser A, Zimmer G, Derfuss T, Sanderson NSR. Potent neutralization by monoclonal human IgM against SARS-CoV-2 is impaired by class switch. EMBO Rep 2022; 23:e53956. [PMID: 35548920 PMCID: PMC9253785 DOI: 10.15252/embr.202153956] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 04/13/2022] [Accepted: 04/27/2022] [Indexed: 01/11/2023] Open
Abstract
To investigate the class‐dependent properties of anti‐viral IgM antibodies, we use membrane antigen capture activated cell sorting to isolate spike‐protein‐specific B cells from donors recently infected with SARS‐CoV‐2, allowing production of recombinant antibodies. We isolate 20, spike‐protein‐specific antibodies of classes IgM, IgG, and IgA, none of which shows any antigen‐independent binding to human cells. Two antibodies of class IgM mediate virus neutralization at picomolar concentrations, but this potency is lost following artificial switch to IgG. Although, as expected, the IgG versions of the antibodies appear to have lower avidity than their IgM parents, this is not sufficient to explain the loss of potency.
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Affiliation(s)
- Ilaria Callegari
- Department of Biomedicine, University of Basel and University Hospital Basel, Basel, Switzerland.,MS Center, Neurologic Clinic and Policlinic, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Basel, Switzerland
| | - Mika Schneider
- Department of Biomedicine, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Giuliano Berloffa
- Department of Biomedicine, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Tobias Mühlethaler
- Biophysics Facility, Biozentrum, University of Basel, Basel, Switzerland
| | - Sebastian Holdermann
- Department of Biomedicine, University of Basel and University Hospital Basel, Basel, Switzerland.,MS Center, Neurologic Clinic and Policlinic, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Basel, Switzerland
| | - Edoardo Galli
- Department of Biomedicine, University of Basel and University Hospital Basel, Basel, Switzerland.,MS Center, Neurologic Clinic and Policlinic, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Basel, Switzerland
| | - Tim Roloff
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland.,Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland
| | - Renate Boss
- Federal Food Safety and Veterinary Office, Bern, Switzerland
| | - Laura Infanti
- Regional Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland
| | - Nina Khanna
- Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Adrian Egli
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland.,Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland
| | - Andreas Buser
- Regional Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland
| | - Gert Zimmer
- Institute of Virology and Immunology, Bern & Mittelhäusern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Tobias Derfuss
- Department of Biomedicine, University of Basel and University Hospital Basel, Basel, Switzerland.,MS Center, Neurologic Clinic and Policlinic, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Basel, Switzerland
| | - Nicholas S R Sanderson
- Department of Biomedicine, University of Basel and University Hospital Basel, Basel, Switzerland.,MS Center, Neurologic Clinic and Policlinic, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Basel, Switzerland
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20
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Immunity after COVID-19 Recovery and Vaccination: Similarities and Differences. Vaccines (Basel) 2022; 10:vaccines10071068. [PMID: 35891232 PMCID: PMC9322013 DOI: 10.3390/vaccines10071068] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/20/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with a robust immune response. The development of systemic inflammation leads to a hyperinflammatory state due to cytokine release syndrome during severe COVID-19. The emergence of many new SARS-CoV-2 variants across the world deteriorates the protective antiviral immunity induced after infection or vaccination. The innate immune response to SARS-CoV-2 is crucial for determining the fate of COVID-19 symptomatology. T cell-mediated immunity is the main factor of the antiviral immune response; moreover, SARS-CoV-2 infection initiates a rapid B-cell response. In this paper, we present the current state of knowledge on immunity after COVID-19 infection and vaccination. We discuss the mechanisms of immune response to various types of vaccines (nucleoside-modified, adenovirus-vectored, inactivated virus vaccines and recombinant protein adjuvanted formulations). This includes specific aspects of vaccination in selected patient populations with altered immune activity (the elderly, children, pregnant women, solid organ transplant recipients, patients with systemic rheumatic diseases or malignancies). We also present diagnostic and research tools available to study the anti-SARS-CoV-2 cellular and humoral immune responses.
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21
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Thompson EJ, Williams DM, Walker AJ, Mitchell RE, Niedzwiedz CL, Yang TC, Huggins CF, Kwong ASF, Silverwood RJ, Di Gessa G, Bowyer RCE, Northstone K, Hou B, Green MJ, Dodgeon B, Doores KJ, Duncan EL, Williams FMK, Steptoe A, Porteous DJ, McEachan RRC, Tomlinson L, Goldacre B, Patalay P, Ploubidis GB, Katikireddi SV, Tilling K, Rentsch CT, Timpson NJ, Chaturvedi N, Steves CJ. Long COVID burden and risk factors in 10 UK longitudinal studies and electronic health records. Nat Commun 2022; 13:3528. [PMID: 35764621 PMCID: PMC9240035 DOI: 10.1038/s41467-022-30836-0] [Citation(s) in RCA: 183] [Impact Index Per Article: 91.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 05/19/2022] [Indexed: 12/14/2022] Open
Abstract
The frequency of, and risk factors for, long COVID are unclear among community-based individuals with a history of COVID-19. To elucidate the burden and possible causes of long COVID in the community, we coordinated analyses of survey data from 6907 individuals with self-reported COVID-19 from 10 UK longitudinal study (LS) samples and 1.1 million individuals with COVID-19 diagnostic codes in electronic healthcare records (EHR) collected by spring 2021. Proportions of presumed COVID-19 cases in LS reporting any symptoms for 12+ weeks ranged from 7.8% and 17% (with 1.2 to 4.8% reporting debilitating symptoms). Increasing age, female sex, white ethnicity, poor pre-pandemic general and mental health, overweight/obesity, and asthma were associated with prolonged symptoms in both LS and EHR data, but findings for other factors, such as cardio-metabolic parameters, were inconclusive.
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Affiliation(s)
- Ellen J Thompson
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK.
| | - Dylan M Williams
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Alex J Walker
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxfort, UK
| | - Ruth E Mitchell
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Tiffany C Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Charlotte F Huggins
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Alex S F Kwong
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Richard J Silverwood
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, UK
| | - Giorgio Di Gessa
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Ruth C E Bowyer
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Kate Northstone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Bo Hou
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Michael J Green
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Brian Dodgeon
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, UK
| | - Katie J Doores
- School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Emma L Duncan
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Frances M K Williams
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
| | - David J Porteous
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Rosemary R C McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Laurie Tomlinson
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Ben Goldacre
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxfort, UK
| | - Praveetha Patalay
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, UK
| | - George B Ploubidis
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, UK
| | | | - Kate Tilling
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Christopher T Rentsch
- Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Nicholas J Timpson
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nishi Chaturvedi
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Claire J Steves
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK.
- Department of Ageing and Health, Guys and St Thomas's NHS Foundation Trust, London, UK.
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22
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Barros Ferreira N, Pereira H, Pereira AM, Azevedo LF, Santos M, Maranhão P, Correia R, Fonseca JA, Canedo P, da Costa Pereira A, Sousa-Pinto B. Seroprevalence of SARS-CoV-2 and assessment of epidemiologic determinants in Portuguese municipal workers. Int J Occup Med Environ Health 2022; 35:297-307. [PMID: 35142298 PMCID: PMC10464733 DOI: 10.13075/ijomeh.1896.01878] [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: 05/26/2021] [Accepted: 11/04/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES To assess the seroprevalence of SARS-CoV-2 antibodies in municipal employees of Northern Portugal during the first pandemic wave (May-June 2020) and its association with potentially related risk factors for infection. MATERIAL AND METHODS The authors assessed municipal employees of 2 cities in Northern Portugal, in whom serological tests to SARS-CoV-2 and an epidemiological survey were applied. The authors assessed the proportion of individuals presenting IgM and/or IgG antibodies to SARS-CoV-2, and evaluated the association between having positive serological test results, epidemiologic variables and clinical presentations. Reported symptoms were evaluated on their sensitivity, specificity, and predictive values. RESULTS The authors assessed 1696 employees, of whom 22.0% were firefighters, 10.4% were police officers, 10.3% were maintenance workers, and 8.1% were administrative assistants. The seroprevalence of SARS-CoV-2 infection was 2.9% (95% CI: 2.1-3.7%). Administrative assistants comprised the professional group with highest seroprevalence of SARS-CoV-2 (OR = 1.9 in the comparison with other occupational groups, 95% CI: 0.8-4.3, p = 0.126). The seroprevalence of SARS-CoV-2 infection among those who were in direct contact with COVID-19 patients in their professional activity was 3.9%, compared to 2.7% among those who were not in direct contact with such patients (OR = 1.5, 95% CI: 0.8-2.8, p = 0.222). The highest risk of infection was associated with the presence of a confirmed SARS-CoV-2 infection in the household (OR = 17.4, 95% CI: 8.3-36.8, p < 0.001). Living with a healthcare professional was not associated with a higher risk of infection (OR = 1.0, 95% CI: 0.4-2.5, p = 0.934). Anosmia/ dysgeusia was the symptom with the highest positive predictive value (52.2%, 95% CI: 31.8-72.6, p < 0.001) and specificity (99.3%, 95% CI: 98.9-99.7, p < 0.001), while cough was the most prevalent symptom among SARS-CoV-2 seropositive participants (36%). CONCLUSIONS The authors observed a SARS-CoV-2 seroprevalence of 2.9% among assessed municipal employees. Anosmia/dysgeusia was the COVID-19 symptom which displayed the highest positive predictive value and specificity. Int J Occup Med Environ Health. 2022;35(3):297-307.
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Affiliation(s)
| | - Helena Pereira
- University of Porto, Porto, Portugal (Faculty of Medicine)
| | - Ana Margarida Pereira
- University of Porto, Porto, Portugal (MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine)
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - Luís Filipe Azevedo
- University of Porto, Porto, Portugal (MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine)
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - Mariana Santos
- University of Porto, Porto, Portugal (MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine)
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - Priscila Maranhão
- University of Porto, Porto, Portugal (MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine)
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - Ricardo Correia
- University of Porto, Porto, Portugal (MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine)
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - João Almeida Fonseca
- University of Porto, Porto, Portugal (MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine)
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - Paulo Canedo
- University of Porto, Porto, Portugal (IPATIMUP, Institute of Molecular Pathology and Immunology)
| | - Altamiro da Costa Pereira
- University of Porto, Porto, Portugal (Faculty of Medicine)
- University of Porto, Porto, Portugal (MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine)
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - Bernardo Sousa-Pinto
- University of Porto, Porto, Portugal (Faculty of Medicine)
- University of Porto, Porto, Portugal (MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine)
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
- University of Porto, Porto, Portugal (Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine)
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23
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Villacrés B, Paz E, Burbano MJ, Villacrés-Granda I, Armijos D, Aguirre M. Neutralizing activity to SARS-CoV-2 in 1.2 to 10.0 month convalescent plasma samples of COVID-19: a transversal surrogate in vitro study performed in Quito-Ecuador. J Med Virol 2022; 94:4246-4252. [PMID: 35585654 PMCID: PMC9347805 DOI: 10.1002/jmv.27866] [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: 01/05/2022] [Revised: 04/26/2022] [Accepted: 05/17/2022] [Indexed: 12/03/2022]
Abstract
Coronavirus disease 2019 (COVID‐19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection, was first reported in Wuhan, China, in December 2019. Diagnostic methods for the detection of the virus and seroconversion of neutralizing antibodies (NAbs) in plasma have been developed specifically, but some of them require a BSL3 facility. In this study, we used the SARS‐CoV‐2 Surrogate Virus Neutralization Test Kit to determine the presence or absence of NAbs anti‐receptor binding domain of the viral spike (S) glycoprotein in a BSL2 facility. The sample population was chosen in Quito, Ecuador, with a total of 88 COVID‐19 positive convalescent patients. We determined that 97.7% of the analyzed convalescent sera maintained the presence of NAbs with neutralizing activity, and this activity remained until 10 months after the infection in some cases. In addition, the relationship between the presence of NAbs and immunoglobulin G was significant compared to immunoglobulin M, which tended to be absent over time.
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Affiliation(s)
| | - Elius Paz
- Centro de Investigación Genética y Genómica - UTE, Quito, Ecuador
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24
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Seow J, Graham C, Hallett SR, Lechmere T, Maguire TJA, Huettner I, Cox D, Khan H, Pickering S, Roberts R, Waters A, Ward CC, Mant C, Pitcher MJ, Spencer J, Fox J, Malim MH, Doores KJ. ChAdOx1 nCoV-19 vaccine elicits monoclonal antibodies with cross-neutralizing activity against SARS-CoV-2 viral variants. Cell Rep 2022; 39:110757. [PMID: 35477023 PMCID: PMC9010245 DOI: 10.1016/j.celrep.2022.110757] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 03/14/2022] [Accepted: 04/06/2022] [Indexed: 11/29/2022] Open
Abstract
Although the antibody response to COVID-19 vaccination has been studied extensively at the polyclonal level using immune sera, little has been reported on the antibody response at the monoclonal level. Here, we isolate a panel of 44 anti-SARS-CoV-2 monoclonal antibodies (mAbs) from an individual who received two doses of the ChAdOx1 nCoV-19 (AZD1222) vaccine at a 12-week interval. We show that, despite a relatively low serum neutralization titer, Spike-reactive IgG+ B cells are still detectable 9 months post-boost. Furthermore, mAbs with potent neutralizing activity against the current SARS-CoV-2 variants of concern (Alpha, Gamma, Beta, Delta, and Omicron) are present. The vaccine-elicited neutralizing mAbs form eight distinct competition groups and bind epitopes overlapping with neutralizing mAbs elicited following SARS-CoV-2 infection. AZD1222-elicited mAbs are more mutated than mAbs isolated from convalescent donors 1-2 months post-infection. These findings provide molecular insights into the AZD1222 vaccine-elicited antibody response.
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Affiliation(s)
- Jeffrey Seow
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Carl Graham
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Sadie R Hallett
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Thomas Lechmere
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Thomas J A Maguire
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Isabella Huettner
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Daniel Cox
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Hataf Khan
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Suzanne Pickering
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | | | - Anele Waters
- Harrison Wing, Guy's and St Thomas' NHS Trust, London, UK
| | - Christopher C Ward
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Christine Mant
- Infectious Diseases Biobank, Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Michael J Pitcher
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Jo Spencer
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Julie Fox
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK; Harrison Wing, Guy's and St Thomas' NHS Trust, London, UK
| | - Michael H Malim
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Katie J Doores
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK.
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25
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McCance K, Wise H, Simpson J, Batchelor B, Hale H, McDonald L, Zorzoli A, Furrie E, Chopra C, Muecksch F, Hatziioannou T, Bieniasz PD, Templeton K, Jenks S. Evaluation of SARS-CoV-2 antibody point of care devices in the laboratory and clinical setting. PLoS One 2022; 17:e0266086. [PMID: 35358263 PMCID: PMC8970483 DOI: 10.1371/journal.pone.0266086] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/13/2022] [Indexed: 01/11/2023] Open
Abstract
SARS-CoV-2 antibody tests have been marketed to diagnose previous SARS-CoV-2 infection and as a test of immune status. There is a lack of evidence on the performance and clinical utility of these tests. We aimed to carry out an evaluation of 14 point of care (POC) SARS-CoV-2 antibody tests. Serum from participants with previous RT-PCR (real-time polymerase chain reaction) confirmed SARS-CoV-2 infection and pre-pandemic serum controls were used to determine specificity and sensitivity of each POC device. Changes in sensitivity with increasing time from infection were determined on a cohort of study participants. Corresponding neutralising antibody status was measured to establish whether the detection of antibodies by the POC device correlated with immune status. Paired capillary and serum samples were collected to ascertain whether POC devices performed comparably on capillary samples. Sensitivity and specificity varied between the POC devices and in general did not meet the manufacturers’ reported performance characteristics, which signifies the importance of independent evaluation of these tests. The sensitivity peaked at ≥20 days following onset of symptoms, however sensitivity of 3 of the POC devices evaluated at extended time points showed that sensitivity declined with time. This was particularly marked at >140 days post infection. This is relevant if the tests are to be used for sero-prevalence studies. Neutralising antibody data showed that positive antibody results on POC devices did not necessarily confer high neutralising antibody titres, and that these POC devices cannot be used to determine immune status to the SARS-CoV-2 virus. Comparison of paired serum and capillary results showed that there was a decline in sensitivity using capillary blood. This has implications in the utility of the tests as they are designed to be used on capillary blood by the general population.
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Affiliation(s)
- Kirsty McCance
- Department of Biochemistry, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland
- * E-mail:
| | - Helen Wise
- Department of Biochemistry, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland
| | - Jennifer Simpson
- Department of Biochemistry, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland
| | | | - Harriet Hale
- Western General Hospital, NHS Lothian, Edinburgh, Scotland
| | - Lindsay McDonald
- Department of Biochemistry, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland
| | - Azul Zorzoli
- Department of Biochemistry, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland
| | - Elizabeth Furrie
- Ninewells Hospital and Medical School, NHS Tayside, Dundee, Scotland
| | - Charu Chopra
- Department of Immunology, Royal Infirmary of Edinburgh, NHS Lothian, Scotland
| | - Frauke Muecksch
- Laboratory of Retrovirology, The Rockefeller University, New York, New York, United States of America
| | - Theodora Hatziioannou
- Laboratory of Retrovirology, The Rockefeller University, New York, New York, United States of America
| | - Paul D. Bieniasz
- Laboratory of Retrovirology, The Rockefeller University, New York, New York, United States of America
- Howard Hughes Medical Institute, The Rockefeller University, New York, New York, United States of America
| | - Kate Templeton
- Department of Biochemistry, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland
| | - Sara Jenks
- Department of Biochemistry, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland
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26
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Ochola L, Ogongo P, Mungai S, Gitaka J, Suliman S. Performance Evaluation of Lateral Flow Assays for Coronavirus Disease-19 Serology. Clin Lab Med 2022; 42:31-56. [PMID: 35153047 PMCID: PMC8563367 DOI: 10.1016/j.cll.2021.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The coronavirus disease of 2019 (COVID-19) pandemic, caused by infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has undoubtedly resulted in significant morbidities, mortalities, and economic disruptions across the globe. Affordable and scalable tools to monitor the transmission dynamics of the SARS-CoV-2 virus and the longevity of induced antibodies will be paramount to monitor and control the pandemic as multiple waves continue to rage in many countries. Serologic assays detect humoral responses to the virus, to determine seroprevalence in target populations, or induction of antibodies at the individual level following either natural infection or vaccination. With multiple vaccines rolling out globally, serologic assays to detect anti-SARS-CoV-2 antibodies will be important tools to monitor the development of herd immunity. To address this need, serologic lateral flow assays (LFAs), which can be easily implemented for both population surveillance and home use, will be vital to monitor the evolution of the pandemic and inform containment measures. Such assays are particularly important for monitoring the transmission dynamics and durability of immunity generated by natural infections and vaccination, particularly in resource-limited settings. In this review, we discuss considerations for evaluating the accuracy of these LFAs, their suitability for different use cases, and implementation opportunities.
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Affiliation(s)
- Lucy Ochola
- Department of Tropical and Infectious Diseases, Institute of Primate Research, National Museums of Kenya, PO Box 24481, Nairobi 00502, Kenya
| | - Paul Ogongo
- Department of Tropical and Infectious Diseases, Institute of Primate Research, National Museums of Kenya, PO Box 24481, Nairobi 00502, Kenya; Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Samuel Mungai
- Directorate of Research and Innovation, Mount Kenya University, PO Box 342-01000, Thika, Kenya
| | - Jesse Gitaka
- Directorate of Research and Innovation, Mount Kenya University, PO Box 342-01000, Thika, Kenya
| | - Sara Suliman
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA; Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA 02115, USA.
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27
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Gupta R, Gupta P, Wang Z, Seth A, Morrissey J, George I, Gandra S, Storch G, Parikh B, Genin G, Singamaneni S. Plasmon-enhanced Quantitative Lateral Flow Assay for Femtomolar Detection of SARS-CoV-2 Antibodies and Antigens. RESEARCH SQUARE 2022:rs.3.rs-1258688. [PMID: 35194598 PMCID: PMC8863156 DOI: 10.21203/rs.3.rs-1258688/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Lateral flow assays (LFAs) are the cornerstone of point-of-care diagnostics. Although rapid and inexpensive, they are 1000-fold less sensitive than laboratory-based tests and cannot be used for definitive negative diagnosis. Here, we overcome this fundamental limitation by employing plasmonically-enhanced nanoscale colorimetric and fluorescent labels. Plasmonic LFAs (p-LFAs) enabled ultrasensitive detection and quantification of low abundance analytes, without compromising the direct visual detection of conventional LFAs. Dynamic ranges and limits of detection were up to 100-fold superior to "gold standard" ELISA (enzyme-linked immunosorbent assay). p-LFAs had sample-to-answer time of 20 min, compared to 4 hours for ELISA, while achieving over 95% analytical sensitivity and 100% analytical specificity for antibodies and antigens of SARS-CoV-2 in human specimens. We also demonstrate that the p-LFAs enable quantitative detection of the target analytes in a standard-free manner. p-LFAs offer potential as a broadly adaptable point-of-care diagnostic platform that outperforms standard laboratory tests in sensitivity, speed, dynamic range, ease of use, and cost.
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28
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User experience of home-based AbC-19 SARS-CoV-2 antibody rapid lateral flow immunoassay test. Sci Rep 2022; 12:1173. [PMID: 35064150 PMCID: PMC8782985 DOI: 10.1038/s41598-022-05097-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/29/2021] [Indexed: 01/01/2023] Open
Abstract
The urgent need to scale up testing capacity during the COVID-19 pandemic has prompted the rapid development of point-of-care diagnostic tools such as lateral flow immunoassays (LFIA) for large-scale community-based rapid testing. However, studies of how the general public perform when using LFIA tests in different environmental settings are scarce. This user experience (UX) study of 264 participants in Northern Ireland aimed to gather a better understanding of how self-administered LFIA tests were performed by the general public at home. The UX performance was assessed via analysis of a post-test questionnaire including 30 polar questions and 11 7-point Likert scale questions, which covers the multidimensional aspects of UX in terms of ease of use, effectiveness, efficiency, accuracy and satisfaction. Results show that 96.6% of participants completed the test with an overall average UX score of 95.27% [95% confidence interval (CI) 92.71–97.83%], which suggests a good degree of user experience and effectiveness. Efficiency was assessed based on the use of physical resources and human support received, together with the mental effort of self-administering the test measured via NASA Task Load Index (TLX). The results for six TLX subscales show that the participants scored the test highest for mental demand and lowest for physical demand, but the average TLX score suggests that the general public have a relatively low level of mental workload when using LFIA self-testing at home. Five printed LFIA testing results (i.e. the ‘simulated’ results) were used as the ground truth to assess the participant’s performance in interpreting the test results. The overall agreement (accuracy) was 80.63% [95% CI 75.21–86.05%] with a Kappa score 0.67 [95% CI 0.58–0.75] indicating substantial agreement. The users scored lower in confidence when interpreting test results that were weak positive cases (due to the relatively low signal intensity in the test-line) compared to strong positive cases. The end-users also found that the kit was easier to use than they expected (p < 0.001) and 231 of 264 (87.5%) reported that the test kit would meet their requirements if they needed an antibody testing kit. The overall findings provide an insight into the opportunities for improving the design of self-administered SARS-CoV-2 antibody testing kits for the general public and to inform protocols for future UX studies of LFIA rapid test kits.
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29
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Deshpande PS, Abraham IE, Pitamberwale A, Dhote RH. Review of Clinical Performance of Serology Based Commercial Diagnostic Assays for Detection of Severe Acute Respiratory Syndrome Coronavirus 2 Antibodies. Viral Immunol 2022; 35:82-111. [PMID: 35007431 DOI: 10.1089/vim.2020.0313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, which caused the coronavirus disease 2019 (COVID-19) pandemic as declared by the World Health Organization, has created havoc worldwide. The highly transmissible infection can be contained only by accurate diagnosis, quarantining, and exercising social distancing. Therefore, quick and massive deployment of SARS-CoV-2 testing plays a crucial role in the identification and isolation of infected patients. Reverse transcription-polymerase chain reaction is the gold standard for COVID-19 detection; however, it needs expertise, facilities, and time. Hence, for the ease of population-wide screening, serology-based diagnostic assays were introduced. These can help determine the prevalence of infection, understand the epidemiology of the disease, and assist in suitable public health interventions while being user-friendly and less time consuming. Although serological testing kits in markets soared, their sensitivity and specificity were questioned in reports from different parts of the world. In this article, we have reviewed 40 Food and Drug Administration (FDA) and CE-approved clinically evaluated serological kits (8 enzyme-linked immunosorbent assay [ELISA] kits, 10 chemiluminescent immunoassay [CLIA] kits, and 22 lateral flow immunoassay [LFIA] kits) for their sensitivity and specificity and discussed the apparent reasons behind their performance. We observed appreciable sensitivity in the kits detecting total antibodies compared to the kits targeting single isotype antibodies. Tests that determined antibodies against nucleocapsid protein were found to be more sensitive and those detecting antibodies against spike protein were found to have greater specificity. This study was conducted to help the decision-making while acquiring antibody kits and concurrently to be mindful of their shortcomings.
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Affiliation(s)
- Poonam S Deshpande
- Biochemistry Division, Department of Chemistry, Fergusson College, Pune, India
| | - Irene E Abraham
- Biochemistry Division, Department of Chemistry, Fergusson College, Pune, India
| | - Anjali Pitamberwale
- Biochemistry Division, Department of Chemistry, Fergusson College, Pune, India
| | - Radhika H Dhote
- Biochemistry Division, Department of Chemistry, Fergusson College, Pune, India
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30
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Cobb BL, Lloyd M, Hock KG, Farnsworth CW. OUP accepted manuscript. J Appl Lab Med 2022; 7:827-833. [PMID: 35296885 PMCID: PMC8992344 DOI: 10.1093/jalm/jfac003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/13/2021] [Indexed: 11/27/2022]
Abstract
Background Serological assays for SARS-CoV-2 are important tools for diagnosis in patients with negative RT-PCR testing, pediatric patients with multisystem inflammatory syndrome, and serosurveillance studies. However, lateral flow-based serological assays have previously demonstrated poor analytical and clinical performance, limiting their utility. Methods We assessed the ADEXUSDx COVID-19 lateral flow assay for agreement with diagnostic RT-PCR testing using 120 specimens from RT-PCR–positive patients, 77 specimens from symptomatic RT-PCR–negative patients, and 47 specimens obtained prepandemic. Specimens collected <14 days from symptom onset in RT-PCR–positive patients were compared relative to the Abbott SARS-CoV-2 IgG assay. Results The ADEXUSDx COVID-19 Test yielded an overall positive percent agreement (PPA) of 92.5% (95%CI 85.8 to 96.3) and negative percent agreement of 99.2% (95% CI 94.9–100.0) relative to RT-PCR and in prepandemic specimens. Relative to days from symptom onset, the PPA after 13 days was 100% (95% CI 94.2–100); from 7 to 13 days, 89.7 (95% CI 71.5–97.2); and from 0 to 7 days, 53.8 (95% CI 26.1–79.6). The overall agreement between the Abbott and ADEXUSDx assays was 80.9%. Twenty-five specimens were positive by both assays, 9 specimens were negative by both assays, and 8 specimens were positive by only the ADEXUSDx assay. Conclusions We demonstrate high PPA and negative percent agreement of the ADEXUSDx COVID-19 assay and diagnostic testing by RT-PCR, with PPA approximately 90% by 7 days following symptom onset. The use of waived testing for antibodies to SARS-CoV-2 with high sensitivity and specificity provide a further tool for combatting the COVID-19 pandemic.
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Affiliation(s)
| | - Matthew Lloyd
- Department of Pathology & Immunology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Karl G Hock
- Department of Pathology & Immunology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Christopher W Farnsworth
- Department of Pathology & Immunology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
- Address correspondence to this author at: Department of Pathology & Immunology, Washington University in St. Louis, 660 S. Euclid Ave., Campus Box 8118, St. Louis, MO 63110, USA. Fax 314 362-1461; e-mail
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31
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Ding S, Adam D, Beaudoin-Bussières G, Tauzin A, Gong SY, Gasser R, Laumaea A, Anand SP, Privé A, Bourassa C, Medjahed H, Prévost J, Charest H, Richard J, Brochiero E, Finzi A. SARS-CoV-2 Spike Expression at the Surface of Infected Primary Human Airway Epithelial Cells. Viruses 2021; 14:5. [PMID: 35062211 PMCID: PMC8778294 DOI: 10.3390/v14010005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 12/17/2022] Open
Abstract
Different serological assays were rapidly generated to study humoral responses against the SARS-CoV-2 Spike glycoprotein. Due to the intrinsic difficulty of working with SARS-CoV-2 authentic virus, most serological assays use recombinant forms of the Spike glycoprotein or its receptor binding domain (RBD). Cell-based assays expressing different forms of the Spike, as well as pseudoviral assays, are also widely used. To evaluate whether these assays recapitulate findings generated when the Spike is expressed in its physiological context (at the surface of the infected primary cells), we developed an intracellular staining against the SARS-CoV-2 nucleocapsid (N) to distinguish infected from uninfected cells. Human airway epithelial cells (pAECs) were infected with authentic SARS-CoV-2 D614G or Alpha variants. We observed robust cell-surface expression of the SARS-CoV-2 Spike at the surface of the infected pAECs using the conformational-independent anti-S2 CV3-25 antibody. The infected cells were also readily recognized by plasma from convalescent and vaccinated individuals and correlated with several serological assays. This suggests that the antigenicity of the Spike present at the surface of the infected primary cells is maintained in serological assays involving expression of the native full-length Spike.
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Affiliation(s)
- Shilei Ding
- Centre de Recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada; (S.D.); (D.A.); (G.B.-B.); (A.T.); (S.Y.G.); (R.G.); (A.L.); (S.P.A.); (A.P.); (C.B.); (H.M.); (J.P.); (J.R.); (E.B.)
| | - Damien Adam
- Centre de Recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada; (S.D.); (D.A.); (G.B.-B.); (A.T.); (S.Y.G.); (R.G.); (A.L.); (S.P.A.); (A.P.); (C.B.); (H.M.); (J.P.); (J.R.); (E.B.)
- Département de Médicine, Université de Montréal, Montréal, QC H2X 0A9, Canada
| | - Guillaume Beaudoin-Bussières
- Centre de Recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada; (S.D.); (D.A.); (G.B.-B.); (A.T.); (S.Y.G.); (R.G.); (A.L.); (S.P.A.); (A.P.); (C.B.); (H.M.); (J.P.); (J.R.); (E.B.)
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, QC H2X 0A9, Canada
| | - Alexandra Tauzin
- Centre de Recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada; (S.D.); (D.A.); (G.B.-B.); (A.T.); (S.Y.G.); (R.G.); (A.L.); (S.P.A.); (A.P.); (C.B.); (H.M.); (J.P.); (J.R.); (E.B.)
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, QC H2X 0A9, Canada
| | - Shang Yu Gong
- Centre de Recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada; (S.D.); (D.A.); (G.B.-B.); (A.T.); (S.Y.G.); (R.G.); (A.L.); (S.P.A.); (A.P.); (C.B.); (H.M.); (J.P.); (J.R.); (E.B.)
- Department of Microbiology and Immunology, McGill University, Montreal, QC H3A 2B4, Canada
| | - Romain Gasser
- Centre de Recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada; (S.D.); (D.A.); (G.B.-B.); (A.T.); (S.Y.G.); (R.G.); (A.L.); (S.P.A.); (A.P.); (C.B.); (H.M.); (J.P.); (J.R.); (E.B.)
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, QC H2X 0A9, Canada
| | - Annemarie Laumaea
- Centre de Recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada; (S.D.); (D.A.); (G.B.-B.); (A.T.); (S.Y.G.); (R.G.); (A.L.); (S.P.A.); (A.P.); (C.B.); (H.M.); (J.P.); (J.R.); (E.B.)
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, QC H2X 0A9, Canada
| | - Sai Priya Anand
- Centre de Recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada; (S.D.); (D.A.); (G.B.-B.); (A.T.); (S.Y.G.); (R.G.); (A.L.); (S.P.A.); (A.P.); (C.B.); (H.M.); (J.P.); (J.R.); (E.B.)
- Department of Microbiology and Immunology, McGill University, Montreal, QC H3A 2B4, Canada
| | - Anik Privé
- Centre de Recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada; (S.D.); (D.A.); (G.B.-B.); (A.T.); (S.Y.G.); (R.G.); (A.L.); (S.P.A.); (A.P.); (C.B.); (H.M.); (J.P.); (J.R.); (E.B.)
| | - Catherine Bourassa
- Centre de Recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada; (S.D.); (D.A.); (G.B.-B.); (A.T.); (S.Y.G.); (R.G.); (A.L.); (S.P.A.); (A.P.); (C.B.); (H.M.); (J.P.); (J.R.); (E.B.)
| | - Halima Medjahed
- Centre de Recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada; (S.D.); (D.A.); (G.B.-B.); (A.T.); (S.Y.G.); (R.G.); (A.L.); (S.P.A.); (A.P.); (C.B.); (H.M.); (J.P.); (J.R.); (E.B.)
| | - Jérémie Prévost
- Centre de Recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada; (S.D.); (D.A.); (G.B.-B.); (A.T.); (S.Y.G.); (R.G.); (A.L.); (S.P.A.); (A.P.); (C.B.); (H.M.); (J.P.); (J.R.); (E.B.)
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, QC H2X 0A9, Canada
| | - Hugues Charest
- Laboratoire de Santé Publique du Québec, Institut Nationale de Santé Publique du Québec, Sainte-Anne-de-Bellevue, QC H9X 3R5, Canada;
| | - Jonathan Richard
- Centre de Recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada; (S.D.); (D.A.); (G.B.-B.); (A.T.); (S.Y.G.); (R.G.); (A.L.); (S.P.A.); (A.P.); (C.B.); (H.M.); (J.P.); (J.R.); (E.B.)
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, QC H2X 0A9, Canada
| | - Emmanuelle Brochiero
- Centre de Recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada; (S.D.); (D.A.); (G.B.-B.); (A.T.); (S.Y.G.); (R.G.); (A.L.); (S.P.A.); (A.P.); (C.B.); (H.M.); (J.P.); (J.R.); (E.B.)
- Département de Médicine, Université de Montréal, Montréal, QC H2X 0A9, Canada
| | - Andrés Finzi
- Centre de Recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada; (S.D.); (D.A.); (G.B.-B.); (A.T.); (S.Y.G.); (R.G.); (A.L.); (S.P.A.); (A.P.); (C.B.); (H.M.); (J.P.); (J.R.); (E.B.)
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, QC H2X 0A9, Canada
- Department of Microbiology and Immunology, McGill University, Montreal, QC H3A 2B4, Canada
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SARS-CoV-2 and Variant Diagnostic Testing Approaches in the United States. Viruses 2021; 13:v13122492. [PMID: 34960762 PMCID: PMC8703625 DOI: 10.3390/v13122492] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/29/2021] [Accepted: 12/08/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose of Review Given the rapid development of diagnostic approaches to test for and diagnose infection with SARS-CoV-2 and its associated variants including Omicron (B.1.1.529), many options are available to diagnose infection. Multiple established diagnostic companies are now providing testing platforms whereas initially, testing was being performed with simple PCR-based tests using standard laboratory reagents. Recent Findings Additional testing platforms continue to be developed, including those to detect specific variants, but challenges with testing, including obtaining testing reagents and other related supplies, are frequently encountered. With time, the testing supply chain has improved, and more established companies are providing materials to support these testing efforts. In the United States (U.S.), the need for rapid assay development and subsequent approval through the attainment of emergency use authorization (EUA) has superseded the traditional arduous diagnostic testing approval workflow mandated by the FDA. Through these efforts, the U.S. has been able to continue to significantly increase its testing capabilities to address this pandemic; however, challenges still remain due to the diversity of the performance characteristics of tests being utilized and newly discovered viral variants. Summary This review provides an overview of the current diagnostic testing landscape, with pertinent information related to SARS-CoV-2 virology, variants and antibody responses that are available to diagnose infection in the U.S.
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Owen SI, Williams CT, Garrod G, Fraser AJ, Menzies S, Baldwin L, Brown L, Byrne RL, Collins AM, Cubas-Atienzar AI, de Vos M, Edwards T, Escadafal C, Ferreira DM, Fletcher T, Hyder-Wright A, Kay GA, Kontogianni K, Mason J, Mitsi E, Planche T, Sacks JA, Taylor J, Todd S, Tully C, Cuevas LE, Adams ER. Twelve lateral flow immunoassays (LFAs) to detect SARS-CoV-2 antibodies. J Infect 2021; 84:355-360. [PMID: 34906597 PMCID: PMC8664720 DOI: 10.1016/j.jinf.2021.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 12/08/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND There are an abundance of commercially available lateral flow assays (LFAs) that detect antibodies to SARS-CoV-2. Whilst these are usually evaluated by the manufacturer, externally performed diagnostic accuracy studies to assess performance are essential. Herein we present an evaluation of 12 LFAs. METHODS Sera from 100 SARS-CoV-2 reverse-transcriptase polymerase chain reaction (RT-PCR) positive participants were recruited through the FASTER study. A total of 105 pre-pandemic sera from participants with other infections were included as negative samples. RESULTS At presentation sensitivity against RT-PCR ranged from 37.4 to 79% for IgM/IgG, 30.3-74% for IgG, and 21.2-67% for IgM. Sensitivity for IgM/IgG improved ≥ 21 days post symptom onset for 10/12 tests. Specificity ranged from 74.3 to 99.1% for IgM/IgG, 82.9-100% for IgG, and 75.2-98% for IgM. Compared to the EuroImmun IgG enzyme-linked immunosorbent assay (ELISA), sensitivity and specificity ranged from 44.6 to 95.4% and 85.4-100%, respectively. CONCLUSION There are many LFAs available with varied sensitivity and specificity. Understanding the diagnostic accuracy of these tests will be vital as we come to rely more on the antibody status of a person moving forward, and as such manufacturer-independent evaluations are crucial.
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Affiliation(s)
- Sophie I Owen
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | - Christopher T Williams
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | - Gala Garrod
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | - Alice J Fraser
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | - Stefanie Menzies
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | - Lisa Baldwin
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | - Lottie Brown
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | - Rachel L Byrne
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | - Andrea M Collins
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom; Department of Clinical Sciences, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | - Ana I Cubas-Atienzar
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | | | - Thomas Edwards
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | | | - Daniela M Ferreira
- Department of Clinical Sciences, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | - Tom Fletcher
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Angela Hyder-Wright
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom; Department of Clinical Sciences, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | - Grant A Kay
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | - Konstantina Kontogianni
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | - Jenifer Mason
- Liverpool Clinical Laboratories, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Elena Mitsi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | - Tim Planche
- Institute for Infection and Immunity, St George's University of London, London, United Kingdom; St George's University Hospitals NHS Foundation Trust, London, United Kingdom
| | | | - Joseph Taylor
- Liverpool Clinical Laboratories, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Stacy Todd
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | | | - Luis E Cuevas
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | - Emily R Adams
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom.
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Harrington P, de Lavallade H, Doores KJ, O'Reilly A, Seow J, Graham C, Lechmere T, Radia D, Dillon R, Shanmugharaj Y, Espehana A, Woodley C, Saunders J, Curto-Garcia N, O'Sullivan J, Raj K, Kordasti S, Malim MH, Harrison CN, McLornan DP. Single dose of BNT162b2 mRNA vaccine against SARS-CoV-2 induces high frequency of neutralising antibody and polyfunctional T-cell responses in patients with myeloproliferative neoplasms. Leukemia 2021; 35:3573-3577. [PMID: 34023850 PMCID: PMC8140572 DOI: 10.1038/s41375-021-01300-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/04/2021] [Accepted: 05/12/2021] [Indexed: 12/21/2022]
Affiliation(s)
- Patrick Harrington
- Department of Clinical Haematology, Guy's & St Thomas' NHS Foundation Trust, London, UK
- School of Cancer and Pharmaceutical Science, King's College London, London, UK
| | - Hugues de Lavallade
- Department of Clinical Haematology, Guy's & St Thomas' NHS Foundation Trust, London, UK
- School of Cancer and Pharmaceutical Science, King's College London, London, UK
- Department of Haematological Medicine, King's College London School of Medicine, London, UK
| | - Katie J Doores
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Amy O'Reilly
- Department of Clinical Haematology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Jeffrey Seow
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Carl Graham
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Thomas Lechmere
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Deepti Radia
- Department of Clinical Haematology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Richard Dillon
- Department of Clinical Haematology, Guy's & St Thomas' NHS Foundation Trust, London, UK
- Department of Medicine and Molecular Genetics, King's College London, London, UK
| | - Yogita Shanmugharaj
- Department of Clinical Haematology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Andreas Espehana
- Department of Clinical Haematology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Claire Woodley
- Department of Clinical Haematology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Jamie Saunders
- Department of Clinical Haematology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Natalia Curto-Garcia
- Department of Clinical Haematology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Jennifer O'Sullivan
- Department of Clinical Haematology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Kavita Raj
- Department of Clinical Haematology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Shahram Kordasti
- Department of Clinical Haematology, Guy's & St Thomas' NHS Foundation Trust, London, UK
- School of Cancer and Pharmaceutical Science, King's College London, London, UK
| | - Michael H Malim
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Claire N Harrison
- Department of Clinical Haematology, Guy's & St Thomas' NHS Foundation Trust, London, UK
- School of Cancer and Pharmaceutical Science, King's College London, London, UK
| | - Donal P McLornan
- Department of Clinical Haematology, Guy's & St Thomas' NHS Foundation Trust, London, UK.
- School of Cancer and Pharmaceutical Science, King's College London, London, UK.
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35
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Gee S, Chandiramani M, Seow J, Pollock E, Modestini C, Das A, Tree T, Doores KJ, Tribe RM, Gibbons DL. The legacy of maternal SARS-CoV-2 infection on the immunology of the neonate. Nat Immunol 2021; 22:1490-1502. [PMID: 34616036 DOI: 10.1038/s41590-021-01049-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/14/2021] [Indexed: 02/08/2023]
Abstract
Despite extensive studies into severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the effect of maternal infection on the neonate is unclear. To investigate this, we characterized the immunology of neonates born to mothers with confirmed SARS-CoV-2 infection during pregnancy. Here we show that maternal SARS-CoV-2 infection affects the neonatal immune system. Despite similar proportions of B cells, CD4+ T cells and CD8+ T cells, increased percentages of natural killer cells, Vδ2+ γδ T cells and regulatory T cells were detected in neonates born to mothers with recent or ongoing infection compared with those born to recovered or uninfected mothers. Increased plasma cytokine levels were also evident in neonates and mothers within the recent or ongoing infection group. Cytokine functionality was enhanced in neonates born to SARS-CoV-2-exposed mothers, compared to those born to uninfected mothers. In most neonates, this immune imprinting was nonspecific, suggesting vertical transmission of SARS-CoV-2 is limited, a finding supported by a lack of SARS-CoV-2-specific IgM in neonates despite maternal IgG transfer.
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Affiliation(s)
- Sarah Gee
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK
| | - Manju Chandiramani
- Department of Women's Health, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK
| | - Jeffrey Seow
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK
| | - Emily Pollock
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK
| | - Carlotta Modestini
- Department of Women's Health, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK
| | - Abhishek Das
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK
| | - Timothy Tree
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK
| | - Katie J Doores
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK
| | - Rachel M Tribe
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, St Thomas' Hospital, London, UK
| | - Deena L Gibbons
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK.
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36
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Merrick B, Noronha M, Batra R, Douthwaite S, Nebbia G, Snell L, Pickering S, Galao R, Whitfield J, Jahangeer A, Gunawardena R, Godfrey T, Laifa R, Webber K, Cliff P, Cunningham E, Neil S, Gettings H, Edgeworth J, Harrison H. Real-world deployment of lateral flow SARS-CoV-2 antigen detection in the emergency department to provide rapid, accurate and safe diagnosis of COVID-19. Infect Prev Pract 2021; 3:100186. [PMID: 34812417 PMCID: PMC8598289 DOI: 10.1016/j.infpip.2021.100186] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/10/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Point-of-care (POC) SARS-CoV-2 lateral-flow antigen detection (LFD) testing in the emergency department (ED) could inform rapid infection control decisions but requirements for safe deployment have not been fully defined. METHODS Review of LFD test results, laboratory and POC-RT-PCR results and ED-performance metrics during a two-week high SARS-CoV-2 prevalence period followed by several months of falling prevalence. AIM Determine whether LFD testing can be safely deployed in ED to provide an effective universal SARS-CoV-2 testing capability. FINDINGS 93% (345/371) of COVID-19 patients left ED with a virological diagnosis during the 2-week universal LFD evaluation period compared to 77% with targeted POC-RT-PCR deployment alone, on background of approximately one-third having an NHS Track and Trace RT-PCR test-result at presentation. LFD sensitivity and specificity was 70.7% and 99.1% respectively providing a PPV of 97.7% and NPV of 86.4% with disease prevalence of 34.7%. ED discharge-delays (breaches) attributable to COVID-19 fell to 33/3532 (0.94%) compared with the preceding POC-RT-PCR period (107/4114 (2.6%); p=<0.0001). Importantly, LFD testing identified 1 or 2 clinically-unsuspected COVID-19 patients/day. Three clinically-confirmed LFD false positive patients were appropriately triaged based on LFD action-card flowchart, and only 5 of 95 false-negative LFD results were inappropriately admitted to non-COVID-19 areas where no onward-transmission was identified. LFD testing was restricted to asymptomatic patients when disease prevalence fell below 5% and detected 1-3 cases/week. CONCLUSION Universal SARS-CoV-2 LFD testing can be safely and effectively deployed in ED alongside POC-RT-PCR testing during periods of high and low disease prevalence.
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Affiliation(s)
- B. Merrick
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, UK
- Directorate of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M. Noronha
- Emergency Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - R. Batra
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, UK
- Directorate of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - S. Douthwaite
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, UK
- Directorate of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - G. Nebbia
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, UK
- Directorate of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - L.B. Snell
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, UK
- Directorate of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - S. Pickering
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, UK
| | - R.P. Galao
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, UK
| | - J. Whitfield
- Guy's King's and Thomas' School of Medicine, King's College London, UK
| | - A. Jahangeer
- Guy's King's and Thomas' School of Medicine, King's College London, UK
| | - R. Gunawardena
- Guy's King's and Thomas' School of Medicine, King's College London, UK
| | - T. Godfrey
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, UK
| | - R. Laifa
- Emergency Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | | | | | - S.J.D. Neil
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, UK
| | - H. Gettings
- Emergency Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - J.D. Edgeworth
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, UK
- Directorate of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - H.L. Harrison
- Emergency Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
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37
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Dupont L, Snell LB, Graham C, Seow J, Merrick B, Lechmere T, Maguire TJA, Hallett SR, Pickering S, Charalampous T, Alcolea-Medina A, Huettner I, Jimenez-Guardeño JM, Acors S, Almeida N, Cox D, Dickenson RE, Galao RP, Kouphou N, Lista MJ, Ortega-Prieto AM, Wilson H, Winstone H, Fairhead C, Su JZ, Nebbia G, Batra R, Neil S, Shankar-Hari M, Edgeworth JD, Malim MH, Doores KJ. Neutralizing antibody activity in convalescent sera from infection in humans with SARS-CoV-2 and variants of concern. Nat Microbiol 2021; 6:1433-1442. [PMID: 34654917 PMCID: PMC8556155 DOI: 10.1038/s41564-021-00974-0] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/03/2021] [Indexed: 12/17/2022]
Abstract
COVID-19 vaccine design and vaccination rollout need to take into account a detailed understanding of antibody durability and cross-neutralizing potential against SARS-CoV-2 and emerging variants of concern (VOCs). Analyses of convalescent sera provide unique insights into antibody longevity and cross-neutralizing activity induced by variant spike proteins, which are putative vaccine candidates. Using sera from 38 individuals infected in wave 1, we show that cross-neutralizing activity can be detected up to 305 days pos onset of symptoms, although sera were less potent against B.1.1.7 (Alpha) and B1.351 (Beta). Over time, despite a reduction in overall neutralization activity, differences in sera neutralization potency against SARS-CoV-2 and the Alpha and Beta variants decreased, which suggests that continued antibody maturation improves tolerance to spike mutations. We also compared the cross-neutralizing activity of wave 1 sera with sera from individuals infected with the Alpha, the Beta or the B.1.617.2 (Delta) variants up to 79 days post onset of symptoms. While these sera neutralize the infecting VOC and parental virus to similar levels, cross-neutralization of different SARS-CoV-2 VOC lineages is reduced. These findings will inform the optimization of vaccines to protect against SARS-CoV-2 variants.
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Affiliation(s)
- Liane Dupont
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Luke B Snell
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Carl Graham
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Jeffrey Seow
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Blair Merrick
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Thomas Lechmere
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Thomas J A Maguire
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Sadie R Hallett
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Suzanne Pickering
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Themoula Charalampous
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Adela Alcolea-Medina
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Isabella Huettner
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Jose M Jimenez-Guardeño
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Sam Acors
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Nathalia Almeida
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Daniel Cox
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Ruth E Dickenson
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Rui Pedro Galao
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Neophytos Kouphou
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Marie Jose Lista
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Ana Maria Ortega-Prieto
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Harry Wilson
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Helena Winstone
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Cassandra Fairhead
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Jia Zhe Su
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Gaia Nebbia
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Rahul Batra
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Stuart Neil
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Manu Shankar-Hari
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Jonathan D Edgeworth
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Michael H Malim
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Katie J Doores
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK.
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Thomas E, Delabat S, Andrews DM. Diagnostic Testing for SARS-CoV-2 Infection. CURRENT HEPATOLOGY REPORTS 2021; 20:166-174. [PMID: 34725630 PMCID: PMC8550867 DOI: 10.1007/s11901-021-00567-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW Given the rapid development of diagnostic approaches to test for and diagnose infection with SARS-CoV-2, many options are available to assess infection. Multiple established diagnostic companies are now providing testing platforms whereas initially, testing was being performed with simple PCR-based tests using standard laboratory reagents. RECENT FINDINGS Additional testing platforms continue to be developed but challenges with testing, including obtaining testing reagents and other related supplies, are frequently encountered. With time, the testing supply chain will improve and more companies will be providing materials to support these testing efforts. In the USA, the need for rapid assay development and subsequent approval through attainment of emergency use authorization (EUA) has superseded the traditional arduous diagnostic testing approval workflow mandated by the FDA. It is anticipated that the USA will be able to continue to significantly increase its testing capabilities to address this pandemic; however, challenges remain due to the diversity of the performance characteristics of tests being utilized. SUMMARY This review provides an overview of the current diagnostic testing landscape, with pertinent information related to SARS-CoV-2 virology and antibody responses, that is available to diagnose infection.
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Affiliation(s)
- Emmanuel Thomas
- Department of Microbiology & Immunology, University of Miami Miller School of Medicine, Miami, FL USA
- Schiff Center for Liver Disease, University of Miami Miller School of Medicine, 1550 NW 10th Ave., Papanicolaou Bldg., RM PAP 514, Miami, FL 33136 USA
| | - Stephanie Delabat
- Department of Microbiology & Immunology, University of Miami Miller School of Medicine, Miami, FL USA
| | - David M. Andrews
- Department of Pathology, University of Miami Miller School of Medicine, Miami, FL USA
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Alrubayyi A, Gea-Mallorquí E, Touizer E, Hameiri-Bowen D, Kopycinski J, Charlton B, Fisher-Pearson N, Muir L, Rosa A, Roustan C, Earl C, Cherepanov P, Pellegrino P, Waters L, Burns F, Kinloch S, Dong T, Dorrell L, Rowland-Jones S, McCoy LE, Peppa D. Characterization of humoral and SARS-CoV-2 specific T cell responses in people living with HIV. Nat Commun 2021; 12:5839. [PMID: 34611163 PMCID: PMC8492866 DOI: 10.1038/s41467-021-26137-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/17/2021] [Indexed: 01/10/2023] Open
Abstract
There is an urgent need to understand the nature of immune responses against SARS-CoV-2, to inform risk-mitigation strategies for people living with HIV (PLWH). Here we show that the majority of PLWH with ART suppressed HIV viral load, mount a detectable adaptive immune response to SARS-CoV-2. Humoral and SARS-CoV-2-specific T cell responses are comparable between HIV-positive and negative subjects and persist 5-7 months following predominately mild COVID-19 disease. T cell responses against Spike, Membrane and Nucleoprotein are the most prominent, with SARS-CoV-2-specific CD4 T cells outnumbering CD8 T cells. We further show that the overall magnitude of SARS-CoV-2-specific T cell responses relates to the size of the naive CD4 T cell pool and the CD4:CD8 ratio in PLWH. These findings suggest that inadequate immune reconstitution on ART, could hinder immune responses to SARS-CoV-2 with implications for the individual management and vaccine effectiveness in PLWH.
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Affiliation(s)
| | | | - Emma Touizer
- Division of Infection and Immunity, University College London, London, UK
| | - Dan Hameiri-Bowen
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Jakub Kopycinski
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Bethany Charlton
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | | | - Luke Muir
- Division of Infection and Immunity, University College London, London, UK
| | - Annachiara Rosa
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Chloe Roustan
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Christopher Earl
- Signalling and Structural Biology Laboratory, Francis Crick Institute, London, UK
| | - Peter Cherepanov
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Pierre Pellegrino
- Mortimer Market Centre, Department of HIV, CNWL NHS Trust, London, UK
| | - Laura Waters
- Mortimer Market Centre, Department of HIV, CNWL NHS Trust, London, UK
| | - Fiona Burns
- Institute for Global Health UCL, London, UK
- Royal Free London NHS Foundation Trust, London, UK
| | - Sabine Kinloch
- Royal Free London NHS Foundation Trust, London, UK
- Department of Immunology, Royal Free Campus, UCL, London, UK
| | - Tao Dong
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Lucy Dorrell
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | | | - Laura E McCoy
- Division of Infection and Immunity, University College London, London, UK.
| | - Dimitra Peppa
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
- Division of Infection and Immunity, University College London, London, UK.
- Mortimer Market Centre, Department of HIV, CNWL NHS Trust, London, UK.
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40
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Mohit E, Rostami Z, Vahidi H. A comparative review of immunoassays for COVID-19 detection. Expert Rev Clin Immunol 2021; 17:573-599. [PMID: 33787412 DOI: 10.1080/1744666x.2021.1908886] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: The gold standard for diagnosis of coronavirus disease 2019 (COVID-19) is detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR), which is expensive, time-consuming and may result in false-negative results. Serological tests can be employed for RT-PCR negative patients, contact tracing, determining the probability of protection against re-infection, and seroepidemiological studies.Areas covered: The main methodologies of serology-based tests for the detection of SARS-CoV-2 including enzyme-linked immunosorbent assays (ELISAs), chemiluminescent immunoassays (CLIAs) and lateral flow immunoassays (LFIAs) were reviewed and their diagnostic performances were compared. Herein, a literature review on the databases of PubMed, Scopus and Google Scholar between January 1, 2020 and June 30, 2020 based on the main serological methods for COVID-19 detection with the focus on comparative experiments was performed. The review was updated on December 31, 2020.Expert opinion: Serology testing could be considered as a part of diagnostic panel two-week post symptom onset. Higher sensitivity for serology-based tests could be achieved by determining combined IgG/IgM titers. Furthermore, higher sensitive serological test detecting neutralization antibody could be developed by targeting spike (S) antigen. It was also demonstrated that the sensitivity of ELISA/CLIA-based methods are higher than LFIA devices.
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Affiliation(s)
- Elham Mohit
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Rostami
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Vahidi
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Salzer R, Clark JJ, Vaysburd M, Chang VT, Albecka A, Kiss L, Sharma P, Gonzalez Llamazares A, Kipar A, Hiscox JA, Owen A, Aricescu AR, Stewart JP, James LC, Löwe J. Single-dose immunisation with a multimerised SARS-CoV-2 receptor binding domain (RBD) induces an enhanced and protective response in mice. FEBS Lett 2021; 595:2323-2340. [PMID: 34331769 PMCID: PMC8426897 DOI: 10.1002/1873-3468.14171] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/02/2021] [Accepted: 07/13/2021] [Indexed: 11/23/2022]
Abstract
The COVID-19 pandemic, caused by the SARS-CoV-2 coronavirus, has triggered a worldwide health emergency. Here, we show that ferritin-like Dps from hyperthermophilic Sulfolobus islandicus, covalently coupled with SARS-CoV-2 antigens via the SpyCatcher system, forms stable multivalent dodecameric vaccine nanoparticles that remain intact even after lyophilisation. Immunisation experiments in mice demonstrated that the SARS-CoV-2 receptor binding domain (RBD) coupled to Dps (RBD-S-Dps) elicited a higher antibody titre and an enhanced neutralising antibody response compared to monomeric RBD. A single immunisation with RBD-S-Dps completely protected hACE2-expressing mice from serious illness and led to viral clearance from the lungs upon SARS-CoV-2 infection. Our data highlight that multimerised SARS-CoV-2 subunit vaccines are a highly efficacious modality, particularly when combined with an ultra-stable scaffold.
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Affiliation(s)
- Ralf Salzer
- MRC Laboratory of Molecular BiologyCambridgeUK
| | - Jordan J. Clark
- Institute of Infection, Veterinary and Ecological SciencesUniversity of LiverpoolUK
| | | | | | | | - Leo Kiss
- MRC Laboratory of Molecular BiologyCambridgeUK
| | - Parul Sharma
- Institute of Infection, Veterinary and Ecological SciencesUniversity of LiverpoolUK
| | | | - Anja Kipar
- Institute of Infection, Veterinary and Ecological SciencesUniversity of LiverpoolUK
- Laboratory for Animal Model PathologyInstitute of Veterinary PathologyVetsuisse FacultyUniversity of ZurichSwitzerland
| | - Julian A. Hiscox
- Institute of Infection, Veterinary and Ecological SciencesUniversity of LiverpoolUK
| | - Andrew Owen
- Department of Pharmacology and TherapeuticsCentre of Excellence in Long‐acting Therapeutics (CELT)University of LiverpoolUK
| | | | - James P. Stewart
- Institute of Infection, Veterinary and Ecological SciencesUniversity of LiverpoolUK
| | | | - Jan Löwe
- MRC Laboratory of Molecular BiologyCambridgeUK
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Pickering S, Batra R, Merrick B, Snell LB, Nebbia G, Douthwaite S, Reid F, Patel A, Kia Ik MT, Patel B, Charalampous T, Alcolea-Medina A, Lista MJ, Cliff PR, Cunningham E, Mullen J, Doores KJ, Edgeworth JD, Malim MH, Neil SJD, Galão RP. Comparative performance of SARS-CoV-2 lateral flow antigen tests and association with detection of infectious virus in clinical specimens: a single-centre laboratory evaluation study. THE LANCET. MICROBE 2021; 2:e461-e471. [PMID: 34226893 PMCID: PMC8245061 DOI: 10.1016/s2666-5247(21)00143-9] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Lateral flow devices (LFDs) for rapid antigen testing are set to become a cornerstone of SARS-CoV-2 mass community testing, although their reduced sensitivity compared with PCR has raised questions of how well they identify infectious cases. Understanding their capabilities and limitations is, therefore, essential for successful implementation. We evaluated six commercial LFDs and assessed their correlation with infectious virus culture and PCR cycle threshold (Ct) values. METHODS In a single-centre, laboratory evaluation study, we did a head-to-head comparison of six LFDs commercially available in the UK: Innova Rapid SARS-CoV-2 Antigen Test, Spring Healthcare SARS-CoV-2 Antigen Rapid Test Cassette, E25Bio Rapid Diagnostic Test, Encode SARS-CoV-2 Antigen Rapid Test Device, SureScreen COVID-19 Rapid Antigen Test Cassette, and SureScreen COVID-19 Rapid Fluorescence Antigen Test. We estimated the specificities and sensitivities of the LFDs using stored naso-oropharyngeal swabs collected at St Thomas' Hospital (London, UK) for routine diagnostic SARS-CoV-2 testing by real-time RT-PCR (RT-rtPCR). Swabs were from inpatients and outpatients from all departments of St Thomas' Hospital, and from health-care staff (all departments) and their household contacts. SARS-CoV-2-negative swabs from the same population (confirmed by RT-rtPCR) were used for comparative specificity determinations. All samples were collected between March 23 and Oct 27, 2020. We determined the limit of detection (LOD) for each test using viral plaque-forming units (PFUs) and viral RNA copy numbers of laboratory-grown SARS-CoV-2. Additionally, LFDs were selected to assess the correlation of antigen test result with RT-rtPCR Ct values and positive viral culture in Vero E6 cells. This analysis included longitudinal swabs from five infected inpatients with varying disease severities. Furthermore, the sensitivities of available LFDs were assessed in swabs (n=23; collected from Dec 4, 2020, to Jan 12, 2021) confirmed to be positive (RT-rtPCR and whole-genome sequencing) for the B.1.1.7 variant, which was the dominant genotype in the UK at the time of study completion. FINDINGS All LFDs showed high specificity (≥98·0%), except for the E25Bio test (86·0% [95% CI 77·9-99·9]), and most tests reliably detected 50 PFU/test (equivalent SARS-CoV-2 N gene Ct value of 23·7, or RNA copy number of 3 × 106/mL). Sensitivities of the LFDs on clinical samples ranged from 65·0% (55·2-73·6) to 89·0% (81·4-93·8). These sensitivities increased to greater than 90% for samples with Ct values of lower than 25 for all tests except the SureScreen fluorescence (SureScreen-F) test. Positive virus culture was identified in 57 (40·4%) of 141 samples; 54 (94·7%) of the positive cultures were from swabs with Ct values lower than 25. Among the three LFDs selected for detailed comparisons (the tests with highest sensitivity [Innova], highest specificity [Encode], and alternative technology [SureScreen-F]), sensitivity of the LFDs increased to at least 94·7% when only including samples with detected viral growth. Longitudinal studies of RT-rtPCR-positive samples (tested with Innova, Encode, and both SureScreen-F and the SureScreen visual [SureScreen-V] test) showed that most of the tests identified all infectious samples as positive. Test performance (assessed for Innova and SureScreen-V) was not affected when reassessed on swabs positive for the UK variant B.1.1.7. INTERPRETATION In this comprehensive comparison of antigen LFDs and virus infectivity, we found a clear relationship between Ct values, quantitative culture of infectious virus, and antigen LFD positivity in clinical samples. Our data support regular testing of target groups with LFDs to supplement the current PCR testing capacity, which would help to rapidly identify infected individuals in situations in which they would otherwise go undetected. FUNDING King's Together Rapid COVID-19, Medical Research Council, Wellcome Trust, Huo Family Foundation, UK Department of Health, National Institute for Health Research Comprehensive Biomedical Research Centre.
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Affiliation(s)
- Suzanne Pickering
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Rahul Batra
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Blair Merrick
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Luke B Snell
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Gaia Nebbia
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sam Douthwaite
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Fiona Reid
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Amita Patel
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Mark Tan Kia Ik
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Bindi Patel
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Themoula Charalampous
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Adela Alcolea-Medina
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Viapath Group, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Maria Jose Lista
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Penelope R Cliff
- Viapath Group, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Emma Cunningham
- Viapath Group, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Jane Mullen
- Viapath Group, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Katie J Doores
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Jonathan D Edgeworth
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Michael H Malim
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Stuart J D Neil
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Rui Pedro Galão
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
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Harrington P, Doores KJ, Radia D, O’Reilly A, Lam HPJ, Seow J, Graham C, Lechmere T, McLornan D, Dillon R, Shanmugharaj Y, Espehana A, Woodley C, Saunders J, Curto-Garcia N, O'Sullivan J, Raj K, Kordasti S, Malim MH, Harrison C, de Lavallade H. Single dose of BNT162b2 mRNA vaccine against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) induces neutralising antibody and polyfunctional T-cell responses in patients with chronic myeloid leukaemia. Br J Haematol 2021; 194:999-1006. [PMID: 34085278 PMCID: PMC8239833 DOI: 10.1111/bjh.17568] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 12/19/2022]
Abstract
Patients receiving targeted cancer treatments such as tyrosine kinase inhibitors (TKIs) have been classified in the clinically extremely vulnerable group to develop severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), including patients with chronic myeloid leukaemia (CML) taking TKIs. In addition, concerns that immunocompromised individuals with solid and haematological malignancies may not mount an adequate immune response to a single dose of SARS-CoV-2 BNT162b2 (Pfizer-BioNTech) vaccine have been raised. In the present study, we evaluated humoral and cellular immune responses after a first injection of BNT162b2 vaccine in 16 patients with CML. Seroconversion and cellular immune response before and after vaccination were assessed. By day 21 after vaccination, anti-Spike immunoglobulin G was detected in 14/16 (87·5%) of the patients with CML and all developed a neutralising antibody response [serum dilution that inhibits 50% infection (ID50 ) >50], including medium (ID50 of 200-500) or high (ID50 of 501-2000) neutralising antibodies titres in nine of the 16 (56·25%) patients. T-cell response was seen in 14/15 (93·3%) evaluable patients, with polyfunctional responses seen in 12/15 (80%) patients (polyfunctional CD4+ response nine of 15, polyfunctional CD8+ T-cell response nine of 15). These data demonstrate the immunogenicity of a single dose of SARS-CoV-2 BNT162b2 vaccine in most patients with CML, with both neutralising antibodies and polyfunctional T-cell responses seen in contrast to patients with solid tumour or lymphoid haematological malignancies.
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MESH Headings
- Adult
- Aged
- Antibodies, Neutralizing/immunology
- Antibodies, Viral/immunology
- BNT162 Vaccine
- CD4-Positive T-Lymphocytes/immunology
- CD8-Positive T-Lymphocytes/immunology
- COVID-19/immunology
- COVID-19/prevention & control
- COVID-19 Vaccines/administration & dosage
- COVID-19 Vaccines/immunology
- Female
- Hematologic Neoplasms/drug therapy
- Hematologic Neoplasms/immunology
- Humans
- Immunity, Cellular/drug effects
- Immunoglobulin G/immunology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/immunology
- Male
- Middle Aged
- Protein Kinase Inhibitors/administration & dosage
- SARS-CoV-2/immunology
- Spike Glycoprotein, Coronavirus/immunology
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Affiliation(s)
- Patrick Harrington
- Department of Clinical HaematologyGuy’s and St Thomas’ NHS Foundation TrustLondonUK
- School of Cancer and Pharmaceutical ScienceKing’s College LondonLondonUK
| | - Katie J. Doores
- Department of Infectious DiseasesSchool of Immunology and Microbial SciencesKing’s College LondonLondonUK
| | - Deepti Radia
- Department of Clinical HaematologyGuy’s and St Thomas’ NHS Foundation TrustLondonUK
| | - Amy O’Reilly
- Department of Clinical HaematologyGuy’s and St Thomas’ NHS Foundation TrustLondonUK
| | - Ho Pui Jeff Lam
- Department of Clinical HaematologyGuy’s and St Thomas’ NHS Foundation TrustLondonUK
| | - Jeffrey Seow
- Department of Infectious DiseasesSchool of Immunology and Microbial SciencesKing’s College LondonLondonUK
| | - Carl Graham
- Department of Infectious DiseasesSchool of Immunology and Microbial SciencesKing’s College LondonLondonUK
| | - Thomas Lechmere
- Department of Infectious DiseasesSchool of Immunology and Microbial SciencesKing’s College LondonLondonUK
| | - Donal McLornan
- Department of Clinical HaematologyGuy’s and St Thomas’ NHS Foundation TrustLondonUK
- School of Cancer and Pharmaceutical ScienceKing’s College LondonLondonUK
| | - Richard Dillon
- Department of Clinical HaematologyGuy’s and St Thomas’ NHS Foundation TrustLondonUK
- Department of Medicine and Molecular GeneticsKing’s College LondonLondonUK
| | - Yogita Shanmugharaj
- Department of Clinical HaematologyGuy’s and St Thomas’ NHS Foundation TrustLondonUK
| | - Andreas Espehana
- Department of Clinical HaematologyGuy’s and St Thomas’ NHS Foundation TrustLondonUK
| | - Claire Woodley
- Department of Clinical HaematologyGuy’s and St Thomas’ NHS Foundation TrustLondonUK
| | - Jamie Saunders
- Department of Clinical HaematologyGuy’s and St Thomas’ NHS Foundation TrustLondonUK
| | - Natalia Curto-Garcia
- Department of Clinical HaematologyGuy’s and St Thomas’ NHS Foundation TrustLondonUK
| | - Jennifer O'Sullivan
- Department of Clinical HaematologyGuy’s and St Thomas’ NHS Foundation TrustLondonUK
| | - Kavita Raj
- Department of Clinical HaematologyGuy’s and St Thomas’ NHS Foundation TrustLondonUK
| | - Shahram Kordasti
- Department of Clinical HaematologyGuy’s and St Thomas’ NHS Foundation TrustLondonUK
- School of Cancer and Pharmaceutical ScienceKing’s College LondonLondonUK
| | - Michael H. Malim
- Department of Infectious DiseasesSchool of Immunology and Microbial SciencesKing’s College LondonLondonUK
| | - Claire Harrison
- Department of Clinical HaematologyGuy’s and St Thomas’ NHS Foundation TrustLondonUK
- School of Cancer and Pharmaceutical ScienceKing’s College LondonLondonUK
| | - Hugues de Lavallade
- Department of Clinical HaematologyGuy’s and St Thomas’ NHS Foundation TrustLondonUK
- School of Cancer and Pharmaceutical ScienceKing’s College LondonLondonUK
- Department of Haematological MedicineKing’s College London School of MedicineLondonUK
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44
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Affiliation(s)
- Elizabeth Smerczak
- Detroit Medical Center University Laboratories, Sinai-Grace Hospital, Detroit, Michigan, USA
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45
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Sekirov I, Barakauskas VE, Simons J, Cook D, Bates B, Burns L, Masud S, Charles M, McLennan M, Mak A, Chahil N, Vijh R, Hayden A, Goldfarb D, Levett PN, Krajden M, Morshed M. SARS-CoV-2 serology: Validation of high-throughput chemiluminescent immunoassay (CLIA) platforms and a field study in British Columbia. J Clin Virol 2021; 142:104914. [PMID: 34304088 PMCID: PMC8282439 DOI: 10.1016/j.jcv.2021.104914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/25/2021] [Accepted: 07/04/2021] [Indexed: 12/29/2022]
Abstract
Background SARS-CoV-2 antibody testing is required for estimating population seroprevalence and vaccine response studies. It may also increase case identification when used as an adjunct to routine molecular testing. We performed a validation study and evaluated the use of automated high-throughput assays in a field study of COVID-19-affected care facilities. Methods Six automated assays were assessed: 1) DiaSorin LIAISONTM SARS-CoV-2 S1/S2 IgG; 2) Abbott ARCHITECTTM SARS-CoV-2 IgG; 3) Ortho VITROSTM Anti-SARS-CoV-2 Total; 4) VITROSTM Anti-SARS-CoV-2 IgG; 5) Siemens SARS-CoV-2 Total Assay; and 6) Roche ElecsysTM Anti-SARS-CoV-2. The validation study included 107 samples (42 known positive; 65 presumed negative). The field study included 296 samples (92 PCR positive; 204 PCR negative or not PCR tested). All samples were tested by the six assays. Results All assays had sensitivities >90% in the field study, while in the validation study, 5/6 assays were >90% sensitive and DiaSorin was 79% sensitive. Specificities and negative predictive values were >95% for all assays. Field study estimated positive predictive values at 1–10% disease prevalence were 100% for Siemens, Abbott and Roche, while DiaSorin and Ortho assays had lower PPVs at 1% prevalence, but PPVs increased at 5–10% prevalence. In the field study, addition of serology increased diagnoses by 16% compared to PCR testing alone. Conclusions All assays evaluated in this study demonstrated high sensitivity and specificity for samples collected at least 14 days post-symptom onset, while sensitivity was variable 0–14 days after infection. The addition of serology to the outbreak investigations increased case detection by 16%.
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Affiliation(s)
- Inna Sekirov
- BCCDC Public Health Laboratory, BC Centre for Disease Control, Vancouver BC, Canada; Pathology and Laboratory Medicine, University of British Columbia, Vancouver BC, Canada
| | - Vilte E Barakauskas
- Pathology and Laboratory Medicine, University of British Columbia, Vancouver BC, Canada; BC Children's and Women's Hospital, Vancouver BC, Canada
| | - Janet Simons
- BC Children's and Women's Hospital, Vancouver BC, Canada; Department of Laboratory Medicine, Providence Health Care, Vancouver BC, Canada
| | - Darrel Cook
- BCCDC Public Health Laboratory, BC Centre for Disease Control, Vancouver BC, Canada
| | - Brandon Bates
- Pathology and Laboratory Medicine, University of British Columbia, Vancouver BC, Canada; BC Children's and Women's Hospital, Vancouver BC, Canada
| | - Laura Burns
- Pathology and Laboratory Medicine, University of British Columbia, Vancouver BC, Canada; BC Children's and Women's Hospital, Vancouver BC, Canada
| | - Shazia Masud
- Pathology and Laboratory Medicine, University of British Columbia, Vancouver BC, Canada; Surrey Memorial Hospital, Surrey BC, Canada
| | - Marthe Charles
- Pathology and Laboratory Medicine, University of British Columbia, Vancouver BC, Canada; Vancouver General Hospital, Vancouver BC, Canada
| | | | - Annie Mak
- BCCDC Public Health Laboratory, BC Centre for Disease Control, Vancouver BC, Canada
| | - Navdeep Chahil
- BCCDC Public Health Laboratory, BC Centre for Disease Control, Vancouver BC, Canada
| | - Rohit Vijh
- Vancouver Coastal Health, Vancouver BC, Canada
| | | | - David Goldfarb
- Pathology and Laboratory Medicine, University of British Columbia, Vancouver BC, Canada; BC Children's and Women's Hospital, Vancouver BC, Canada
| | - Paul N Levett
- BCCDC Public Health Laboratory, BC Centre for Disease Control, Vancouver BC, Canada; Pathology and Laboratory Medicine, University of British Columbia, Vancouver BC, Canada
| | - Mel Krajden
- BCCDC Public Health Laboratory, BC Centre for Disease Control, Vancouver BC, Canada; Pathology and Laboratory Medicine, University of British Columbia, Vancouver BC, Canada
| | - Muhammad Morshed
- BCCDC Public Health Laboratory, BC Centre for Disease Control, Vancouver BC, Canada; Pathology and Laboratory Medicine, University of British Columbia, Vancouver BC, Canada.
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46
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Zhou K, Blanc-Lapierre A, Seegers V, Boisdron-Celle M, Bigot F, Bourdon M, Mahammedi H, Lambert A, Campone M, Conroy T, Penault-Llorca F, Bellanger MM, Raoul JL. Anosmia but Not Ageusia as a COVID-19-Related Symptom among Cancer Patients-First Results from the PAPESCO-19 Cohort Study. Cancers (Basel) 2021; 13:3389. [PMID: 34298605 PMCID: PMC8303411 DOI: 10.3390/cancers13143389] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Cancer patients may fail to distinguish COVID-19 symptoms such as anosmia, dysgeusia/ageusia, anorexia, headache, and fatigue, which are frequent after cancer treatments. We aimed to identify symptoms associated with COVID-19 and to assess the strength of their association in cancer and cancer-free populations. Methods: The multicenter cohort study PAPESCO-19 included 878 cancer patients and 940 healthcare workers (HCWs). At baseline and quarterly thereafter, they reported the presence or absence of 13 COVID-19 symptoms observed over 3 months and the results of routine screening RT-PCR, and they were systematically tested for SARS-CoV-2-specific antibodies. We identified the symptom combinations significantly associated with COVID-19. Results: Eight percent of cancer patients were COVID-19 positive, and 32% were symptomatic. Among the HCWs, these proportions were 9.5 and 52%, respectively. Anosmia, anorexia, fever, headache, and rhinorrhea together accurately discriminated (c-statistic = 0.7027) COVID-19 cases from cancer patients. Anosmia, dysgeusia/ageusia, muscle pain, intense fatigue, headache, and chest pain better discriminated (c-statistic = 0.8830) COVID-19 cases among the HCWs. Anosmia had the strongest association in both the cancer patients (OR = 7.48, 95% CI: 2.96-18.89) and HCWs (OR = 5.71, 95% CI: 2.21-14.75). Conclusions: COVID-19 symptoms and their diagnostic performance differ in the cancer patients and HCWs. Anosmia is associated with COVID-19 in cancer patients, while dysgeusia/ageusia is not. Cancer patients deserve tailored preventive measures due to their particular COVID-19 symptom pattern.
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Affiliation(s)
- Ke Zhou
- Department of Human and Social Sciences, Institut de Cancérologie de l’Ouest (ICO), 44805 Saint-Herblain, France; (M.B.); (M.M.B.)
| | - Audrey Blanc-Lapierre
- Department of Biostatistic, Institut de Cancérologie de l’Ouest, 44805 Saint-Herblain, France; (A.B.-L.); (V.S.)
| | - Valérie Seegers
- Department of Biostatistic, Institut de Cancérologie de l’Ouest, 44805 Saint-Herblain, France; (A.B.-L.); (V.S.)
| | | | - Frédéric Bigot
- Department of Medical Oncology, Institut de Cancérologie de l’Ouest, 49055 Angers, France;
| | - Marianne Bourdon
- Department of Human and Social Sciences, Institut de Cancérologie de l’Ouest (ICO), 44805 Saint-Herblain, France; (M.B.); (M.M.B.)
- Research Unit UMR INSERM 1246 SPHERE, Universités de Nantes et Tours, 44035 Nantes, France
| | - Hakim Mahammedi
- Department of Medical Oncology, Centre Jean Perrin, 63011 Clermont-Ferrand, France;
| | - Aurélien Lambert
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, 54511 Vandoeuvre-lès-Nancy, France; (A.L.); (T.C.)
| | - Mario Campone
- Department of Medical Oncology, Institut de Cancérologie de l’Ouest, 44805 Saint-Herblain, France; (M.C.); (J.-L.R.)
| | - Thierry Conroy
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, 54511 Vandoeuvre-lès-Nancy, France; (A.L.); (T.C.)
| | | | - Martine M. Bellanger
- Department of Human and Social Sciences, Institut de Cancérologie de l’Ouest (ICO), 44805 Saint-Herblain, France; (M.B.); (M.M.B.)
- Department of Social Sciences, EHESP School of Public Health, 35043 Rennes, France
| | - Jean-Luc Raoul
- Department of Medical Oncology, Institut de Cancérologie de l’Ouest, 44805 Saint-Herblain, France; (M.C.); (J.-L.R.)
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47
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Muir L, Jaffer A, Rees-Spear C, Gopalan V, Chang FY, Fernando R, Vaitkute G, Roustan C, Rosa A, Earl C, Rajakaruna GK, Cherepanov P, Salama A, McCoy LE, Motallebzadeh R. Neutralizing Antibody Responses After SARS-CoV-2 Infection in End-Stage Kidney Disease and Protection Against Reinfection. Kidney Int Rep 2021; 6:1799-1809. [PMID: 33942026 PMCID: PMC8081267 DOI: 10.1016/j.ekir.2021.03.902] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/25/2021] [Accepted: 03/29/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Patients with end-stage kidney disease (ESKD) represent a vulnerable group with multiple risk factors that are associated with poor outcomes after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Despite established susceptibility to infectious complications and the importance of humoral immunity in protection against SARS-CoV-2, few studies have investigated the humoral immune response to SARS-CoV-2 within this population. Here, we evaluate the seroprevalence of SARS-CoV-2 in patients awaiting renal transplantation and determine whether seroconverted patients with ESKD have durable and functional neutralizing activity against SARS-CoV-2. METHODS Serum samples were obtained from 164 patients with ESKD by August 2020. Humoral immune responses were evaluated by SARS-CoV-2 spike S1 subunit and nucleoprotein semiquantitative enzyme-linked immunosorbent assay (ELISA) and SARS-CoV-2 spike pseudotype neutralization assay. RESULTS All patients with ESKD with reverse-transcriptase polymerase chain reaction (RT-PCR)-confirmed infection (n = 17) except for 1 individual seroconverted against SARS-CoV-2. Overall seroprevalence (anti-S1 and/or anti-N IgG) was 36% and was higher in patients on hemodialysis (44.2%). A total of 35.6% of individuals who seroconverted were asymptomatic. Seroconversion in the absence of a neutralizing antibody (nAb) titer was observed in 12 patients, all of whom were asymptomatic. Repeat measurements at a median of 93 days from baseline sampling revealed that most individuals retained detectable responses although a significant drop in S1, N and nAb titers was observed. CONCLUSION Patients with ESKD, including those who develop asymptomatic disease, routinely seroconvert and produce detectable nAb titers against SARS-CoV-2. Although IgG levels wane over time, the neutralizing antibodies remain detectable in most patients, suggesting some level of protection is likely maintained, particularly in those who originally develop stronger responses.
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Affiliation(s)
- Luke Muir
- UCL Institute of Immunity & Transplantation, University College London, London, UK
- UCL Division of Infection & Immunity, University College London, London, UK
| | - Aneesa Jaffer
- Department of Nephrology & Transplantation, Royal Free London NHS Trust, London, UK
| | - Chloe Rees-Spear
- UCL Institute of Immunity & Transplantation, University College London, London, UK
- UCL Division of Infection & Immunity, University College London, London, UK
| | - Vignesh Gopalan
- Department of Nephrology & Transplantation, Royal Free London NHS Trust, London, UK
| | - Fernando Y. Chang
- Research Department of Surgical Biotechnology, UCL Division of Surgery and Interventional Science, University College London, London, UK
| | - Raymond Fernando
- Department of Nephrology & Transplantation, Royal Free London NHS Trust, London, UK
| | - Gintare Vaitkute
- Research Department of Surgical Biotechnology, UCL Division of Surgery and Interventional Science, University College London, London, UK
| | | | | | | | - Gayathri K. Rajakaruna
- Centre for Transplantation, Department of Renal Medicine, University College London, London, UK
| | | | - Alan Salama
- Department of Nephrology & Transplantation, Royal Free London NHS Trust, London, UK
- Centre for Transplantation, Department of Renal Medicine, University College London, London, UK
| | - Laura E. McCoy
- UCL Institute of Immunity & Transplantation, University College London, London, UK
- UCL Division of Infection & Immunity, University College London, London, UK
| | - Reza Motallebzadeh
- UCL Institute of Immunity & Transplantation, University College London, London, UK
- Department of Nephrology & Transplantation, Royal Free London NHS Trust, London, UK
- Research Department of Surgical Biotechnology, UCL Division of Surgery and Interventional Science, University College London, London, UK
- Centre for Transplantation, Department of Renal Medicine, University College London, London, UK
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48
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Trombetta BA, Kandigian SE, Kitchen RR, Grauwet K, Webb PK, Miller GA, Jennings CG, Jain S, Miller S, Kuo Y, Sweeney T, Gilboa T, Norman M, Simmons DP, Ramirez CE, Bedard M, Fink C, Ko J, De León Peralta EJ, Watts G, Gomez-Rivas E, Davis V, Barilla RM, Wang J, Cunin P, Bates S, Morrison-Smith C, Nicholson B, Wong E, El-Mufti L, Kann M, Bolling A, Fortin B, Ventresca H, Zhou W, Pardo S, Kwock M, Hazra A, Cheng L, Ahmad QR, Toombs JA, Larson R, Pleskow H, Luo NM, Samaha C, Pandya UM, De Silva P, Zhou S, Ganhadeiro Z, Yohannes S, Gay R, Slavik J, Mukerji SS, Jarolim P, Walt DR, Carlyle BC, Ritterhouse LL, Suliman S. Evaluation of serological lateral flow assays for severe acute respiratory syndrome coronavirus-2. BMC Infect Dis 2021; 21:580. [PMID: 34134647 PMCID: PMC8206878 DOI: 10.1186/s12879-021-06257-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/25/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND COVID-19 has resulted in significant morbidity and mortality worldwide. Lateral flow assays can detect anti-Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) antibodies to monitor transmission. However, standardized evaluation of their accuracy and tools to aid in interpreting results are needed. METHODS We evaluated 20 IgG and IgM assays selected from available tests in April 2020. We evaluated the assays' performance using 56 pre-pandemic negative and 56 SARS-CoV-2-positive plasma samples, collected 10-40 days after symptom onset, confirmed by a molecular test and analyzed by an ultra-sensitive immunoassay. Finally, we developed a user-friendly web app to extrapolate the positive predictive values based on their accuracy and local prevalence. RESULTS Combined IgG + IgM sensitivities ranged from 33.9 to 94.6%, while combined specificities ranged from 92.6 to 100%. The highest sensitivities were detected in Lumiquick for IgG (98.2%), BioHit for both IgM (96.4%), and combined IgG + IgM sensitivity (94.6%). Furthermore, 11 LFAs and 8 LFAs showed perfect specificity for IgG and IgM, respectively, with 15 LFAs showing perfect combined IgG + IgM specificity. Lumiquick had the lowest estimated limit-of-detection (LOD) (0.1 μg/mL), followed by a similar LOD of 1.5 μg/mL for CareHealth, Cellex, KHB, and Vivachek. CONCLUSION We provide a public resource of the accuracy of select lateral flow assays with potential for home testing. The cost-effectiveness, scalable manufacturing process, and suitability for self-testing makes LFAs an attractive option for monitoring disease prevalence and assessing vaccine responsiveness. Our web tool provides an easy-to-use interface to demonstrate the impact of prevalence and test accuracy on the positive predictive values.
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Affiliation(s)
- Bianca A Trombetta
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Savannah E Kandigian
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Robert R Kitchen
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Mass General Brigham Innovation, Boston, MA, USA
| | - Korneel Grauwet
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
| | - Pia Kivisäkk Webb
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Charles G Jennings
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sejal Jain
- Department of Medical Oncology and Center for Cancer-Genome Discovery, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Pathology, Harvard Medical School, Boston, MA, USA
| | - Samara Miller
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Stem Cell Institute, Cambridge, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Yikai Kuo
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
| | - Thadryan Sweeney
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
| | - Tal Gilboa
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Maia Norman
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Sackler School of Biomedical Sciences, Tufts University School of Medicine, Boston, MA, USA
| | - Daimon P Simmons
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Christopher E Ramirez
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Melissa Bedard
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Catherine Fink
- Medical Diagnostic Technology Evaluation, LLC, Carlisle, MA, USA
| | - Jina Ko
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA
| | - Esmarline J De León Peralta
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
- Wellman Center for Photomedicine, Massachusetts General Research Institute, Boston, MA, USA
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Gerald Watts
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Emma Gomez-Rivas
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Vannessa Davis
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rocky M Barilla
- Evergrande Center for Immunologic Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Jianing Wang
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Pierre Cunin
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Samuel Bates
- Functional Genomics Laboratory, Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Chevaun Morrison-Smith
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Benjamin Nicholson
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Edmond Wong
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Leena El-Mufti
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Michael Kann
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Anna Bolling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Brooke Fortin
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Hayden Ventresca
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Wen Zhou
- Division of Nephrology and Endocrine Unit Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Santiago Pardo
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Megan Kwock
- Cancer Center Protocol Office, Massachusetts General Hospital, Boston, MA, USA
| | - Aditi Hazra
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Preventative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Leo Cheng
- Radiology and pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Q Rushdy Ahmad
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - James A Toombs
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
| | - Rebecca Larson
- Immunology Program, Harvard Medical School, Boston, MA, USA
- Cellular Immunotherapy Program, Cancer Center, Massachusetts General Hospital, Boston, MA, USA
| | - Haley Pleskow
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Unnati M Pandya
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Vincent Center for Reproductive Biology, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA
| | - Pushpamali De Silva
- Wellman Center for Photomedicine, Massachusetts General Research Institute, Boston, MA, USA
| | - Sally Zhou
- Department of Biology, Northeastern University, Boston, MA, USA
- College of Science, Northeastern University, Boston, MA, USA
| | - Zakary Ganhadeiro
- Department of Biology, Northeastern University, Boston, MA, USA
- College of Science, Northeastern University, Boston, MA, USA
| | - Sara Yohannes
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
| | - Rakiesha Gay
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
- College of Science, Northeastern University, Boston, MA, USA
| | - Jacqueline Slavik
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
| | - Shibani S Mukerji
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Petr Jarolim
- Department of Pathology, Harvard Medical School, Boston, MA, USA
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - David R Walt
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Mass General Brigham COVID Center for Innovation, Diagnostics Accelerator, Boston, MA, USA
| | - Becky C Carlyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Lauren L Ritterhouse
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
- Mass General Brigham COVID Center for Innovation, Diagnostics Accelerator, Boston, MA, USA
| | - Sara Suliman
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA.
- Mass General Brigham COVID Center for Innovation, Diagnostics Accelerator, Boston, MA, USA.
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Koller G, Morrell AP, Galão RP, Pickering S, MacMahon E, Johnson J, Ignatyev K, Neil SJD, Elsharkawy S, Fleck R, Machado PMP, Addison O. More than the Eye Can See: Shedding New Light on SARS-CoV-2 Lateral Flow Device-Based Immunoassays. ACS APPLIED MATERIALS & INTERFACES 2021; 13:25694-25700. [PMID: 34048220 PMCID: PMC8188736 DOI: 10.1021/acsami.1c04283] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 05/14/2021] [Indexed: 06/12/2023]
Abstract
Containing the global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been an unprecedented challenge due to high horizontal transmissivity and asymptomatic carriage rates. Lateral flow device (LFD) immunoassays were introduced in late 2020 to detect SARS-CoV-2 infection in asymptomatic or presymptomatic individuals rapidly. While LFD technologies have been used for over 60 years, their widespread use as a public health tool during a pandemic is unprecedented. By the end of 2020, data from studies into the efficacy of the LFDs emerged and showed these point-of-care devices to have very high specificity (ability to identify true negatives) but inadequate sensitivity with high false-negative rates. The low sensitivity (<50%) shown in several studies is a critical public health concern, as asymptomatic or presymptomatic carriers may wrongly be assumed to be noninfectious, posing a significant risk of further spread in the community. Here, we show that the direct visual readout of SARS-CoV-2 LFDs is an inadequate approach to discriminate a potentially infective viral concentration in a biosample. We quantified significant immobilized antigen-antibody-labeled conjugate complexes within the LFDs visually scored as negative using high-sensitivity synchrotron X-ray fluorescence imaging. Correlating quantitative X-ray fluorescence measurements and quantitative reverse transcription-polymerase chain reaction (qRT-PCR) determined numbers of viral copies, we identified that negatively scored samples could contain up to 100 PFU (equivalent here to ∼10 000 RNA copies/test). The study demonstrates where the shortcomings arise in many of the current direct-readout SARS-CoV-2 LFDs, namely, being a deficiency in the readout as opposed to the potential level of detection of the test, which is orders of magnitude higher. The present findings are of importance both to public health monitoring during the Coronavirus Disease 2019 (COVID-19) pandemic and to the rapid refinement of these tools for immediate and future applications.
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Affiliation(s)
- Garrit Koller
- Centre
for Host Microbiome Interactions, Faculty of Dentistry, Oral &
Craniofacial Sciences, Kingʼs College
London, London, SE1 9RT, United Kingdom
| | - Alexander P. Morrell
- Centre
for Oral, Clinical & Translational Sciences, Faculty of Dentistry,
Oral & Craniofacial Sciences, Kingʼs
College London, London SE1 9RT, United Kingdom.
| | - Rui Pedro Galão
- Department
of Infectious Diseases, School of Immunology & Microbial Sciences, Kingʼs College London, London SE1 9RT, United Kingdom
| | - Suzanne Pickering
- Department
of Infectious Diseases, School of Immunology & Microbial Sciences, Kingʼs College London, London SE1 9RT, United Kingdom
| | - Eithne MacMahon
- Department
of Infectious Diseases, School of Immunology & Microbial Sciences, Kingʼs College London, London SE1 9RT, United Kingdom
- Guyʼs
and St Thomasʼ NHS Foundation Trust, London SE1 9RT, United Kingdom
| | - Joanna Johnson
- Guyʼs
and St Thomasʼ NHS Foundation Trust, London SE1 9RT, United Kingdom
| | | | - Stuart J. D. Neil
- Department
of Infectious Diseases, School of Immunology & Microbial Sciences, Kingʼs College London, London SE1 9RT, United Kingdom
| | - Sherif Elsharkawy
- Centre
for Oral, Clinical & Translational Sciences, Faculty of Dentistry,
Oral & Craniofacial Sciences, Kingʼs
College London, London SE1 9RT, United Kingdom.
| | - Roland Fleck
- Centre for
Ultrastructural Imaging, Kingʼs College
London, London SE1 9RT, United Kingdom
| | | | - Owen Addison
- Centre
for Oral, Clinical & Translational Sciences, Faculty of Dentistry,
Oral & Craniofacial Sciences, Kingʼs
College London, London SE1 9RT, United Kingdom.
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Dupont L, Snell LB, Graham C, Seow J, Merrick B, Lechmere T, Hallett SR, Charalampous T, Alcolea-Medina A, Huettner I, Maguire TJA, Acors S, Almeida N, Cox D, Dickenson RE, Galao RP, Jimenez-Guardeño JM, Kouphou N, Lista MJ, Pickering S, Ortega-Prieto AM, Wilson H, Winstone H, Fairhead C, Su J, Nebbia G, Batra R, Neil S, Shankar-Hari M, Edgeworth JD, Malim MH, Doores KJ. Antibody longevity and cross-neutralizing activity following SARS-CoV-2 wave 1 and B.1.1.7 infections. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.06.07.21258351. [PMID: 34127977 PMCID: PMC8202432 DOI: 10.1101/2021.06.07.21258351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
As SARS-CoV-2 variants continue to emerge globally, a major challenge for COVID-19 vaccination is the generation of a durable antibody response with cross-neutralizing activity against both current and newly emerging viral variants. Cross-neutralizing activity against major variants of concern (B.1.1.7, P.1 and B.1.351) has been observed following vaccination, albeit at a reduced potency, but whether vaccines based on the Spike glycoprotein of these viral variants will produce a superior cross-neutralizing antibody response has not been fully investigated. Here, we used sera from individuals infected in wave 1 in the UK to study the long-term cross-neutralization up to 10 months post onset of symptoms (POS), as well as sera from individuals infected with the B.1.1.7 variant to compare cross-neutralizing activity profiles. We show that neutralizing antibodies with cross-neutralizing activity can be detected from wave 1 up to 10 months POS. Although neutralization of B.1.1.7 and B.1.351 is lower, the difference in neutralization potency decreases at later timepoints suggesting continued antibody maturation and improved tolerance to Spike mutations. Interestingly, we found that B.1.1.7 infection also generates a cross-neutralizing antibody response, which, although still less potent against B.1.351, can neutralize parental wave 1 virus to a similar degree as B.1.1.7. These findings have implications for the optimization of vaccines that protect against newly emerging viral variants.
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Affiliation(s)
- Liane Dupont
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Luke B Snell
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Carl Graham
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Jeffrey Seow
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Blair Merrick
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Thomas Lechmere
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Sadie R Hallett
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Themoula Charalampous
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Adela Alcolea-Medina
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Isabella Huettner
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Thomas J A Maguire
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Sam Acors
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Nathalia Almeida
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Daniel Cox
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Ruth E Dickenson
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Rui Pedro Galao
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Jose M Jimenez-Guardeño
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Neophytos Kouphou
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Marie Jose Lista
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Suzanne Pickering
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Ana Maria Ortega-Prieto
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Harry Wilson
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Helena Winstone
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Cassandra Fairhead
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Jia Su
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Gaia Nebbia
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Rahul Batra
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Stuart Neil
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Manu Shankar-Hari
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Jonathan D Edgeworth
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Michael H Malim
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Katie J Doores
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
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