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Dukes CW, Rossetti RAM, Hensel JA, Snedal S, Cubitt CL, Schell MJ, Abrahamsen M, Isaacs-Soriano K, Kennedy K, Mangual LN, Whiting J, Martinez-Brockhus V, Islam JY, Rathwell J, Beatty M, Hall AM, Abate-Daga D, Giuliano AR, Pilon-Thomas S. SARS-CoV-2 antibody response duration and neutralization following natural infection. J Clin Virol Plus 2023; 3:100158. [PMID: 37654784 PMCID: PMC10470471 DOI: 10.1016/j.jcvp.2023.100158] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Background The role of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) neutralizing antibody response from natural infection and vaccination, and the potential determinants of this response are poorly understood. Characterizing this antibody response and the factors associated with neutralization can help inform future prevention efforts and improve clinical outcomes in those infected. Objectives The goals of this study were to prospectively evaluate SARS-CoV-2 antibody levels and the neutralizing antibody responses among naturally infected adults and to determine demographic and behavioral factors independently associated with these responses. Methods Serum was collected from seropositive individuals at baseline, four-weeks, and three-months following their first study visit to be evaluated for antibody levels. Detection of neutralizing antibodies was performed at baseline. Participant demographic and behavioral information was collected via web questionnaire prior to their first visit. Results At baseline, higher antibody levels were associated with better neutralization capacity, with 83% of participants having detectable neutralizing antibodies. We found an age-dependent effect on antibody level and neutralization capacity with participants over 65 years having significantly higher levels. Ethnicity, heart disease, autoimmune disease, and COVID symptoms were associated with higher antibody levels, but not with increased neutralization capacity. Work environment during the pandemic correlated with increased neutralization capacity, while kidney or liver disease and traveling out of state after February 2020 correlated with decreased neutralization capacity, however neither correlated with antibody levels. Conclusions Our data show that natural infection by SARS-CoV-2 can induce a humoral response reflected by high antibody levels and neutralization capacity.
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Affiliation(s)
- Christopher W Dukes
- Department of Immunology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, United States of America
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, Florida, 33612, United States of America
| | - Renata AM Rossetti
- Department of Immunology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, United States of America
| | - Jonathan A Hensel
- Department of Immunology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, United States of America
| | - Sebastian Snedal
- Department of Immunology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, United States of America
| | - Christopher L Cubitt
- Immune Monitoring Core Facility, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, Florida, 33612, United States of America
| | - Michael J Schell
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, Florida, 33612, United States of America
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, Florida, 33612, United States of America
| | - Martha Abrahamsen
- Department of Cancer Epidemiology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, Florida, 33612, United States of America
| | - Kimberly Isaacs-Soriano
- Department of Cancer Epidemiology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, Florida, 33612, United States of America
| | - Kayoko Kennedy
- Department of Cancer Epidemiology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, Florida, 33612, United States of America
| | - Leslie N Mangual
- Department of Cancer Epidemiology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, Florida, 33612, United States of America
| | - Junmin Whiting
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, Florida, 33612, United States of America
| | - Veronica Martinez-Brockhus
- Department of Immunology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, United States of America
| | - Jessica Y Islam
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, Florida, 33612, United States of America
- Department of Cancer Epidemiology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, Florida, 33612, United States of America
| | - Julie Rathwell
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, Florida, 33612, United States of America
- Department of Cancer Epidemiology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, Florida, 33612, United States of America
| | - Matthew Beatty
- Department of Immunology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, United States of America
| | - Amy M Hall
- Department of Immunology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, United States of America
| | - Daniel Abate-Daga
- Department of Immunology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, United States of America
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, Florida, 33612, United States of America
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, Florida, 33612, United States of America
- Department of Cancer Epidemiology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, Florida, 33612, United States of America
| | - Shari Pilon-Thomas
- Department of Immunology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, United States of America
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, Florida, 33612, United States of America
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Owusu-Boaitey N, Russell TW, Meyerowitz-Katz G, Levin AT, Herrera-Esposito D. Dynamics of SARS-CoV-2 seroassay sensitivity: a systematic review and modelling study. Euro Surveill 2023; 28:2200809. [PMID: 37227301 PMCID: PMC10283460 DOI: 10.2807/1560-7917.es.2023.28.21.2200809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 03/10/2023] [Indexed: 05/26/2023] Open
Abstract
BackgroundSerological surveys have been the gold standard to estimate numbers of SARS-CoV-2 infections, the dynamics of the epidemic, and disease severity. Serological assays have decaying sensitivity with time that can bias their results, but there is a lack of guidelines to account for this phenomenon for SARS-CoV-2.AimOur goal was to assess the sensitivity decay of seroassays for detecting SARS-CoV-2 infections, the dependence of this decay on assay characteristics, and to provide a simple method to correct for this phenomenon.MethodsWe performed a systematic review and meta-analysis of SARS-CoV-2 serology studies. We included studies testing previously diagnosed, unvaccinated individuals, and excluded studies of cohorts highly unrepresentative of the general population (e.g. hospitalised patients).ResultsOf the 488 screened studies, 76 studies reporting on 50 different seroassays were included in the analysis. Sensitivity decay depended strongly on the antigen and the analytic technique used by the assay, with average sensitivities ranging between 26% and 98% at 6 months after infection, depending on assay characteristics. We found that a third of the included assays departed considerably from manufacturer specifications after 6 months.ConclusionsSeroassay sensitivity decay depends on assay characteristics, and for some types of assays, it can make manufacturer specifications highly unreliable. We provide a tool to correct for this phenomenon and to assess the risk of decay for a given assay. Our analysis can guide the design and interpretation of serosurveys for SARS-CoV-2 and other pathogens and quantify systematic biases in the existing serology literature.
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Affiliation(s)
- Nana Owusu-Boaitey
- Case Western Reserve University School of Medicine, Cleveland, United States
- These authors contributed equally to this work
| | - Timothy W Russell
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Andrew T Levin
- Dartmouth College, Hanover, United States
- National Bureau for Economic Research, Cambridge, United States
- Centre for Economic Policy Research, London, United Kingdom
| | - Daniel Herrera-Esposito
- These authors contributed equally to this work
- Department of Psychology, University of Pennsylvania, Philadelphia, United States
- Laboratorio de Neurociencias, Universidad de la República, Montevideo, Uruguay
- Centro Interdisciplinario en Ciencia de Datos y Aprendizaje Automático, Universidad de la República, Montevideo, Uruguay
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Darling AM, Shephard H, Nestoridi E, Manning SE, Yazdy MM. SARS-CoV-2 infection during pregnancy and preterm birth in Massachusetts from March 2020 through March 2021. Paediatr Perinat Epidemiol 2022; 37:93-103. [PMID: 36512318 PMCID: PMC9877646 DOI: 10.1111/ppe.12944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 11/18/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND SARS-CoV-2 infection during pregnancy has been linked to preterm birth, but this association is not well understood. OBJECTIVES To examine the association between SARS-CoV-2 infection and spontaneous and provider-initiated preterm birth (PTB), and how timing of infection, and race/ethnicity as a marker of structural inequality, may modify this association. METHODS We conducted a retrospective cohort study among pregnant people who delivered singleton, liveborn infants (22-44 weeks gestation) from 1 March 2020 to 31 March 2021 (n = 68,288). We used Cox proportional hazards models to compare the hazard of PTB between pregnant people with and without laboratory-confirmed SARS-CoV-2 infection during pregnancy. We evaluated this association according to the trimester of infection, timing from infection to birth, and timing of PTB. We also examined the joint associations of SARS-CoV-2 infection and race/ethnicity with PTB using the relative excess risk due to interaction (RERI). RESULTS Positive SARS-CoV-2 tests were identified for 2195 pregnant people (3.2%). The prevalence of PTB was 7.2% (3.8% spontaneous, 3.6% provider-initiated). SARS-CoV-2 infection during pregnancy was associated with an increased risk of PTB overall (adjusted hazard ratio [HR] 1.53, 95% confidence interval [CI] 1.34, 1.74), and provider-initiated PTB (HR 1.79, 95% CI 1.50, 2.12) but not spontaneous PTB (HR 1.09, 95% CI 0.89, 1.36). Second trimester infections were associated with an increased risk of provider-initiated PTB, and third trimester infections were associated with an increased risk of both PTB subtypes. A joint inverse association between White non-Hispanic race/ethnicity and SARS-CoV-2 infection and spontaneous PTB (HR 0.56, 95% CI 0.34, 0.94; RERI -0.6, 95% CI -1.0, -0.2) was also observed. CONCLUSIONS SARS-CoV-2 infections were primarily associated with an increased risk for provider-initiated PTB in this study. These findings highlight the importance of promoting infection-prevention strategies among pregnant people.
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Affiliation(s)
- Anne Marie Darling
- Massachusetts Center for Birth Defects Research and Prevention, Bureau of Family Health and NutritionMassachusetts Department of Public HealthBostonMassachusettsUSA
| | - Hanna Shephard
- Massachusetts Center for Birth Defects Research and Prevention, Bureau of Family Health and NutritionMassachusetts Department of Public HealthBostonMassachusettsUSA,Council of State and Territorial Epidemiologists Applied Epidemiology FellowshipAtlantaGeorgiaUSA
| | - Eirini Nestoridi
- Massachusetts Center for Birth Defects Research and Prevention, Bureau of Family Health and NutritionMassachusetts Department of Public HealthBostonMassachusettsUSA
| | - Susan E. Manning
- Bureau of Family Health and NutritionMassachusetts Department of Public HealthBostonMassachusettsUSA,COVID‐19 ResponseCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Mahsa M. Yazdy
- Massachusetts Center for Birth Defects Research and Prevention, Bureau of Family Health and NutritionMassachusetts Department of Public HealthBostonMassachusettsUSA
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Gallen C, Dukes CW, Aldrich A, Macaisa L, Mo Q, Cubitt CL, Pilon-Thomas S, Giuliano AR, Czerniecki BJ, Costa RLB. Long-Term CD4 + T-Cell and Immunoglobulin G Immune Responses in Oncology Workers following COVID-19 Vaccination: An Interim Analysis of a Prospective Cohort Study. Vaccines (Basel) 2022; 10:1931. [PMID: 36423026 PMCID: PMC9696551 DOI: 10.3390/vaccines10111931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 09/08/2023] Open
Abstract
We conducted a prospective study to evaluate immune responses to SARS-CoV-2 in oncology workers in which we collected blood and clinical data every 6 months. Spike-specific CD4+ T-cells and immunoglobulin G responses were measured using interferon-gamma enzyme-linked immunosorbent spot and enzyme-linked immunosorbent assay, respectively. Sixty (81%) vaccinated and 14 (19%) unvaccinated individuals were enrolled. CD4+ T-cell responses of those individuals currently naturally infected were comparable to those who were 6 months from receiving their last dose of the vaccine; both responses were significantly higher than among those who were unvaccinated. Unvaccinated participants who became vaccinated while in the study showed a significant increase in both types of spike-specific immune responses. Previously vaccinated individuals who received a third dose (booster) showed a similar response to the spike protein. However, this response decreases as soon as 3 months but does not dip below the established response following two doses. Response to variants of concern B.1.617.2 (Delta) and B.1.1.529 (Omicron) also increased, with the Omicron variant having a significantly lower response when compared to Delta and the wild type. We conclude that antibody and T-cell responses increase in oncology workers after serial vaccination but can wane over time.
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Affiliation(s)
- Corey Gallen
- Department of Clinical Science, Moffitt Cancer Center, Tampa, FL 33612, USA
| | | | - Amy Aldrich
- Department of Clinical Science, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Lauren Macaisa
- Department of Clinical Science, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Qianxing Mo
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL 33612, USA
| | | | - Shari Pilon-Thomas
- Department of Immunology, Moffitt Cancer Center, Tampa, FL 33612, USA
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Anna R. Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL 33612, USA
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Brian J. Czerniecki
- Department of Clinical Science, Moffitt Cancer Center, Tampa, FL 33612, USA
- Department of Immunology, Moffitt Cancer Center, Tampa, FL 33612, USA
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA
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Giuliano AR, Lancet JE, Pilon-Thomas S, Dong N, Jain AG, Tan E, Ball S, Tworoger SS, Siegel EM, Whiting J, Mo Q, Cubitt CL, Dukes CW, Hensel JA, Keenan RJ, Hwu P. Evaluation of Antibody Response to SARS-CoV-2 mRNA-1273 Vaccination in Patients With Cancer in Florida. JAMA Oncol 2022; 8:748-754. [PMID: 35266953 PMCID: PMC8914884 DOI: 10.1001/jamaoncol.2022.0001] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Importance Patients with cancer experience high rates of morbidity and mortality after SARS-CoV-2 infection. Immune response to mRNA-1273 vaccination across multiple cancer types and treatments remains to be established. Objective To quantitate antibody responses after mRNA-1273 vaccination among patients with solid tumors and hematologic cancer and to assess clinical and treatment factors associated with vaccine response. Design, Setting, and Participants This cohort study included patients with cancer who were aged 18 years or older, spoke English or Spanish, had received their first mRNA-1273 dose between January 12 and 25, 2021, and agreed to blood tests before and after vaccination. Exposures Receipt of 1 and 2 mRNA-1273 SARS-CoV-2 vaccine doses. Main Outcomes and Measures Seroconversion after each vaccine dose and IgG levels against SARS-CoV-2 spike protein obtained immediately before the first and second vaccine doses and 57 days (plus or minus 14 days) after the first vaccine dose. Cancer diagnoses and treatments were ascertained by medical record review. Serostatus was assessed via enzyme-linked immunosorbent assay. Paired t tests were applied to examine days 1, 29, and 57 SARS-CoV-2 antibody levels. Binding antibody IgG geometric mean titers were calculated based on log10-transformed values. Results The 515 participants were a mean (SD) age of 64.5 (11.4) years; 262 (50.9%) were women; and 32 (6.2%) were Hispanic individuals and 479 (93.0%) White individuals; race and ethnicity data on 4 (0.7%) participants were missing. Seropositivity after vaccine dose 2 was 90.3% (465; 95% CI, 87.4%-92.7%) among patients with cancer, was significantly lower among patients with hematologic cancer (84.7% [255]; 95% CI, 80.1%-88.6%) vs solid tumors (98.1% [210]; 95% CI, 95.3%-99.5%), and was lowest among patients with lymphoid cancer (70.0% [77]; 95% CI, 60.5%-78.4%). Patients receiving a vaccination within 6 months after anti-CD20 monoclonal antibody treatment had a significantly lower seroconversion (6.3% [1]; 95% CI, 0.2%-30.2%) compared with those treated 6 to 24 months earlier (53.3% [8]; 95% CI, 26.6%-78.7%) or those who never received anti-CD20 treatment (94.2% [456]; 95% CI, 91.7%-96.1%). Low antibody levels after vaccination were observed among patients treated with anti-CD20 within 6 months before vaccination (GM, 15.5 AU/mL; 95% CI, 9.8-24.5 AU/mL), patients treated with small molecules (GM, 646.7 AU/mL; 95% CI, 441.9-946.5 AU/mL), and patients with low lymphocyte (GM, 547.4 AU/mL; 95% CI, 375.5-797.7 AU/mL) and IgG (GM, 494.7 AU/mL; 95% CI, 304.9-802.7 AU/mL) levels. Conclusions and Relevance This cohort study found that the mRNA-1273 SARS-CoV-2 vaccine induced variable antibody responses that differed by cancer diagnosis and treatment received. These findings suggest that patients with hematologic cancer and those who are receiving immunosuppressive treatments may need additional vaccination doses.
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Affiliation(s)
| | | | | | - Ning Dong
- Moffitt Cancer Center, Tampa, Florida
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