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Thornton CS, Waddell BJ, Congly SE, Svishchuk J, Somayaji R, Fatovich L, Isaac D, Doucette K, Fonseca K, Drews SJ, Borlang J, Osiowy C, Parkins MD. Porcine-derived pancreatic enzyme replacement therapy may be linked to chronic hepatitis E virus infection in cystic fibrosis lung transplant recipients. Gut 2024:gutjnl-2023-330602. [PMID: 38621922 DOI: 10.1136/gutjnl-2023-330602] [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: 07/01/2023] [Accepted: 04/02/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES In high-income countries hepatitis E virus (HEV) is an uncommonly diagnosed porcine-derived zoonoses. After identifying disproportionate chronic HEV infections in persons with cystic fibrosis (pwCF) postlung transplant, we sought to understand its epidemiology and potential drivers. DESIGN All pwCF post-transplant attending our regional CF centre were screened for HEV. HEV prevalence was compared against non-transplanted pwCF and with all persons screened for suspected HEV infection from 2016 to 2022 in Alberta, Canada. Those with chronic HEV infection underwent genomic sequencing and phylogenetic analysis. Owing to their swine derivation, independently sourced pancreatic enzyme replacement therapy (PERT) capsules were screened for HEV. RESULTS HEV seropositivity was similar between transplanted and non-transplanted pwCF (6/29 (21%) vs 16/83 (19%); p=0.89). Relative to all other Albertans investigated for HEV as a cause of hepatitis (n=115/1079, 10.7%), pwCF had a twofold higher seropositivity relative risk and this was four times higher than the Canadian average. Only three chronic HEV infection cases were identified in all of Alberta, all in CF lung transplant recipients (n=3/29, 10.3%). Phylogenetics confirmed cases were unrelated porcine-derived HEV genotype 3a. Ninety-one per cent of pwCF were taking PERT (median 8760 capsules/person/year). HEV RNA was detected by RT-qPCR in 44% (47/107) of PERT capsules, and sequences clustered with chronic HEV cases. CONCLUSION PwCF had disproportionate rates of HEV seropositivity, regardless of transplant status. Chronic HEV infection was evident only in CF transplant recipients. HEV may represent a significant risk for pwCF, particularly post-transplant. Studies to assess HEV incidence and prevalence in pwCF, and potential role of PERT are required.
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Affiliation(s)
- Christina S Thornton
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Barbara J Waddell
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Stephen E Congly
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Julianna Svishchuk
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Ranjani Somayaji
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Linda Fatovich
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Debra Isaac
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Karen Doucette
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Kevin Fonseca
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Steven J Drews
- Canadian Blood Services, Edmonton, Alberta, Canada
- Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Jamie Borlang
- Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Carla Osiowy
- Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Michael D Parkins
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
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Renaud C, Lewin A, Gregoire Y, Simard N, Vallières É, Paquette M, Drews SJ, O'Brien SF, Di Germanio C, Busch MP, Germain M, Bazin R. SARS-CoV-2 immunoassays in a predominantly vaccinated population: Performances and qualitative agreements obtained with two analytical approaches and four immunoassays. Vox Sang 2024. [PMID: 38577957 DOI: 10.1111/vox.13625] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/18/2024] [Accepted: 03/15/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND AND OBJECTIVES Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serosurveys are typically analysed by applying a fixed threshold for seropositivity ('conventional approach'). However, this approach underestimates the seroprevalence of anti-nucleocapsid (N) in vaccinated individuals-who often exhibit a difficult-to-detect anti-N response. This limitation is compounded by delays between the onset of infection and sample collection. To address this issue, we compared the performance of four immunoassays using a new analytical approach ('ratio-based approach'), which determines seropositivity based on an increase in anti-N levels. MATERIALS AND METHODS Two groups of plasma donors and four immunoassays (Elecsys total anti-N, VITROS total anti-N, Architect anti-N Immunoglobulin G (IgG) and in-house total anti-N) were evaluated. First-group donors (N = 145) had one positive SARS-CoV-2 polymerase chain reaction (PCR) test result and had made two plasma donations, including one before and one after the PCR test (median = 27 days post-PCR). Second-group donors (N = 100) had made two plasma donations early in the Omicron wave. RESULTS Among first-group donors (97.9% vaccinated), sensitivity estimates ranged from 60.0% to 89.0% with the conventional approach, compared with 94.5% to 98.6% with the ratio-based approach. Among second-group donors, Fleiss's κ ranged from 0.56 to 0.83 with the conventional approach, compared with 0.90 to 1.00 with the ratio-based approach. CONCLUSION With the conventional approach, the sensitivity of four immunoassays-measured in a predominantly vaccinated population based on samples collected ~1 month after a positive test result-fell below regulatory agencies requirement of ≥95%. The ratio-based approach significantly improved the sensitivities and qualitative agreement among immunoassays, to the point where all would meet this requirement.
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Affiliation(s)
- Christian Renaud
- Medical Affairs and Innovation, Héma-Québec, Montréal, Quebec, Canada
| | - Antoine Lewin
- Medical Affairs and Innovation, Héma-Québec, Montréal, Quebec, Canada
| | - Yves Gregoire
- Medical Affairs and Innovation, Héma-Québec, Montréal, Quebec, Canada
| | - Nathalie Simard
- Medical Affairs and Innovation, Héma-Québec, Montréal, Quebec, Canada
| | - Émilie Vallières
- Division of Microbiology, Clinical Laboratory Medicine Department, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
- Division of Infectious Diseases, Pediatrics Department, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
| | - Maude Paquette
- Division of Microbiology, Clinical Laboratory Medicine Department, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
- Division of Infectious Diseases, Pediatrics Department, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
| | - Steven J Drews
- Canadian Blood Services, Microbiology, Edmonton, Alberta, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Sheila F O'Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
| | | | | | - Marc Germain
- Medical Affairs and Innovation, Héma-Québec, Montréal, Quebec, Canada
| | - Renée Bazin
- Medical Affairs and Innovation, Héma-Québec, Montréal, Quebec, Canada
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Lewin A, Goldman M, Busch MP, Davison K, van de Laar T, Tiberghien P, Shinar E, O'Brien SF, Lambert G, Field S, Hervig T, Tan DHS, Custer B, Drews SJ, Lanteri MC, Klochkov D, Widmer E, Domingue MP, Renaud C, Germain M. End of selection criteria based on sexual orientation: An international symposium on alternatives to donation deferral. Vox Sang 2024; 119:388-401. [PMID: 38270352 DOI: 10.1111/vox.13587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/07/2023] [Accepted: 12/21/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND AND OBJECTIVES Until recently, gay, bisexual and other men who have sex with men (MSM) were deferred from donating blood for 3-12 months since the last male-to-male sexual contact. This MSM deferral has been discontinued by several high-income countries (HIC) that now perform gender-neutral donor selection. MATERIALS AND METHODS An international symposium (held on 20-04-2023) gathered experts from seven HICs to (1) discuss how this paradigm shift might affect the mitigation strategies for transfusion-transmitted infections and (2) address the challenges related to gender-neutral donor selection. RESULTS Most countries employed a similar approach for implementing a gender-neutral donor selection policy: key stakeholders were consulted; the transition was bridged by time-limited deferrals; donor compliance was monitored; and questions or remarks on anal sex and the number and/or type of sexual partners were often added. Many countries have now adopted a gender-neutral approach in which questions on pre- and post-exposure prophylaxis for human immunodeficiency virus (HIV) have been added (or retained, when already in place). Other countries used mitigation strategies, such as plasma quarantine or pathogen reduction technologies for plasma and/or platelets. CONCLUSION The experience with gender-neutral donor selection has been largely positive among the countries covered herein and seems to be acceptable to stakeholders, donors and staff. The post-implementation surveillance data collected so far appear reassuring with regards to safety, although longer observation periods are necessary. The putative risks associated with HIV antiretrovirals should be further investigated.
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Affiliation(s)
- Antoine Lewin
- Medical Affairs and Innovation, Héma-Québec, Montréal and Québec, Quebec, Canada
| | - Mindy Goldman
- Donation Policy and Studies, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Michael P Busch
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, University of California in San Francisco, San Francisco, California, USA
| | - Katy Davison
- NHS Blood and Transplant/UK Health Security Agency (UKHSA) Epidemiology Unit, UKHSA, London, UK
| | - Thijs van de Laar
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
- Laboratory of Medical Microbiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Pierre Tiberghien
- Établissement Français du Sang, La Plaine Saint Denis, France
- UMR 1098, Inserm, Établissement Français du Sang, Université de Franche-Comté, Besançon, France
| | - Eilat Shinar
- National Blood Services, Magen David Adom, Tel Aviv, Israel
| | - Sheila F O'Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Gilles Lambert
- Direction régionale de santé publique - Montréal, Montréal, Québec, Canada
- Institut national de santé publique du Québec, Montréal, Québec, Canada
| | - Stephen Field
- Irish Blood Transfusion Service, Dublin, County Dublin, Ireland
| | - Tor Hervig
- Irish Blood Transfusion Service, Dublin, County Dublin, Ireland
| | - Darrell H S Tan
- Division of Infectious Diseases, Department of Medicine, St Michael's Hospital, Toronto, Ontario, Canada
| | - Brian Custer
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, University of California in San Francisco, San Francisco, California, USA
| | - Steven J Drews
- Donation Policy and Studies, Canadian Blood Services, Edmonton, Alberta, Canada
| | - Marion C Lanteri
- Department of Laboratory Medicine, University of California in San Francisco, San Francisco, California, USA
- Scientific Affairs, Creative Testing Solutions, Tempe, Arizona, USA
| | - Denis Klochkov
- Research and Development, CSL Behring, Bern, Switzerland
| | | | - Marie-Pier Domingue
- Medical Affairs and Innovation, Héma-Québec, Montréal and Québec, Quebec, Canada
- Faculté des Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Christian Renaud
- Medical Affairs and Innovation, Héma-Québec, Montréal and Québec, Quebec, Canada
| | - Marc Germain
- Medical Affairs and Innovation, Héma-Québec, Montréal and Québec, Quebec, Canada
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O’Brien SF, Deeks SL, Hatchette T, Pambrun C, Drews SJ. SARS-CoV-2 seroprevalence in Nova Scotia blood donors. J Assoc Med Microbiol Infect Dis Can 2024; 9:32-45. [PMID: 38567363 PMCID: PMC10984316 DOI: 10.3138/jammi-2023-0017] [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] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/20/2023] [Accepted: 11/09/2023] [Indexed: 04/04/2024]
Abstract
Background SARS-CoV-2 seroprevalence monitors cumulative infection rates irrespective of case testing protocols. We aimed to describe Nova Scotia blood donor seroprevalence in relation to public health policy and reported data over the course of the COVID-19 pandemic (May 2020 to August 2022). Methods Monthly random Nova Scotia blood donation samples (24,258 in total) were tested for SARS-CoV-2 infection antibodies (anti-nucleocapsid) from May 2020 to August 2022, and vaccination antibodies (anti-spike) from January 2021 to August 2022. Multivariable logistic regression for infection antibodies and vaccination antibodies separately with month, age, sex, and racialization identified independent predictors. The provincial nucleic acid amplification test (NAAT)-positive case rate over the pandemic was calculated from publicly available data. Results Anti-N seroprevalence was 3.8% in January 2022, increasing to 50.8% in August 2022. The general population COVID-19 case rate was 3.5% in January 2022, increasing to 12.5% in August 2022. The percentage of NAAT-positive samples in public health laboratories increased from 1% in November 2021 to a peak of 30.7% in April 2022 with decreasing numbers of tests performed. Higher proportions of younger donors as well as Black, Indigenous, and racialized blood donors were more likely to have infection antibodies (p < 0.01). Vaccination antibodies increased to 100% over 2021, initially in older donors (60+ years), and followed by progressively younger age groups. Conclusions SARS-CoV-2 infection rates were relatively low in Nova Scotia until the more contagious Omicron variant dominated, after which about half of Nova Scotia donors had been infected despite most adults being vaccinated (although severity was much lower in vaccinated individuals). Most COVID-19 cases were detected by NAAT until Omicron arrived. When NAAT testing priorities focused on high-risk individuals, infection rates were better reflected by seroprevalence.
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Affiliation(s)
- Sheila F O’Brien
- Epidemiology & Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology & Public Health, University of Ottawa, Ontario, Canada
| | - Shelley L Deeks
- Department of Health and Wellness, Government of Nova Scotia, Halifax, Nova Scotia, Canada
- Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Todd Hatchette
- Division of Microbiology, Nova Scotia Health, Central Zone, Halifax, Nova Scotia, Canada
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Chantale Pambrun
- Medical Affairs & Innovation, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Steven J Drews
- Microbiology, Canadian Blood Services, Edmonton, Alberta, Canada
- Department of Pathology & Laboratory Medicine, University of Alberta, Edmonton, Alberta, Canada
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Osiowy C, Giles E, Lowe CF, Matic N, Murphy DG, Uzicanin S, Drews SJ, O'Brien SF. Hepatitis B virus genotype surveillance in Canadian blood donors and a referred patient population, 2016-2021. Vox Sang 2024; 119:232-241. [PMID: 38141175 DOI: 10.1111/vox.13568] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/06/2023] [Accepted: 11/05/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND AND OBJECTIVES Hepatitis B virus (HBV) genotypes (A-H) have a distinct geographic distribution and are highly associated with the country of birth. Canada has experienced increased immigration over the past decade, primarily from regions where HBV is endemic. This study investigated the proportions and trends of HBV genotypes within blood donor and clinical populations of Canada over the period 2016-2021. MATERIALS AND METHODS Study samples involved two cohorts: (1) Canadian blood donors (n = 246) deferred from donation due to HBV test positivity and (2) chronic HBV patients from across Canada (clinically referred population, n = 3539). Plasma or serum was extracted, and the surface antigen and/or polymerase-coding region was amplified and sequenced to determine genotype by phylogenetic analysis. RESULTS Six (A-E, G) and eight (A-H) HBV genotypes were detected among deferred blood donors and the clinically referred population, respectively. Differences in HBV genotype proportions between the two cohorts were observed across Canada. Males comprised most of the referred population among genotypes A-E (p < 0.0001), except for genotypes B and C. The median age was younger among blood donors (36 years [range 17-72]) compared with the referred population (41 years [range 0-99]). Distinct trends of increasing (E, referred; B, blood donor) and decreasing genotype prevalence were observed over the study period. CONCLUSION HBV genotypes in Canada are highly diverse, suggesting a large immigrant population. Observed trends in genotype prevalence and proportional differences among cohorts imply shifts among the HBV-infected population of Canada, which warrants continued surveillance.
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Affiliation(s)
- Carla Osiowy
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Elizabeth Giles
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Christopher F Lowe
- St. Paul's Hospital, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nancy Matic
- St. Paul's Hospital, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Donald G Murphy
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Quebec, Canada
| | | | - Steven J Drews
- Canadian Blood Services, Edmonton, Alberta, Canada
- Division of Diagnostic and Applied Microbiology, Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Sheila F O'Brien
- Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, Canada
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Drews SJ. Commentary on "Inhibition of cellular activation induced by platelet factor 4 via the CXCR3 pathway ameliorates Japanese encephalitis and dengue viral infections". J Thromb Haemost 2024; 22:609-612. [PMID: 38417982 DOI: 10.1016/j.jtha.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 03/01/2024]
Affiliation(s)
- Steven J Drews
- Canadian Blood Services, Microbiology Department, Donor Policy and Studies, Edmonton, Alberta, Canada; Division of Diagnostic and Applied Microbiology, Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, Alberta, Canada.
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O'Brien SF, Ehsani-Moghaddam B, Goldman M, Drews SJ. Prevalence of Hepatitis B in Canadian First-Time Blood Donors: Association with Social Determinants of Health. Viruses 2024; 16:117. [PMID: 38257817 DOI: 10.3390/v16010117] [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: 12/08/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Hepatitis B is transmitted sexually, by blood contact, and vertically from mother to child. Chronic hepatitis B is often seen in immigrants from higher-prevalence countries and their Canadian-born children. We assessed the relationship between hepatitis B and social determinants of health. Included were 1,539,869 first-time Canadian blood donors from April 2005 to December 2022. All donations were tested for hepatitis B markers. Logistic regression was fit with chronic hepatitis B as the dependent variable and age, sex, year, and ethnocultural composition and material deprivation quintiles as independent variables. Chronic hepatitis B prevalence was 47.5/100,000 (95% CI 41.5-53.5, years 2017-2022). Chronic hepatitis B prevalence was elevated in males, older age groups, and those living in more materially deprived and higher ethnocultural neighbourhoods. Of 212,518 donors from 2020 to 2022 with race/ethnicity data, chronic hepatitis B prevalence was highest in East Asians. The findings are consistent with infections in immigrants, acquired in their country of origin, in their Canadian-born children and in those with other risks. As blood donors are a low-risk population unaware of their infection and unlikely to seek testing, our results highlight the ongoing public health challenges of diagnosing chronic hepatitis B and treating it when appropriate.
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Affiliation(s)
- Sheila F O'Brien
- Epidemiology & Surveillance, Canadian Blood Services, Ottawa, ON K1G 4J5, Canada
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, ON K1G 192, Canada
| | - Behrouz Ehsani-Moghaddam
- Epidemiology & Surveillance, Canadian Blood Services, Ottawa, ON K1G 4J5, Canada
- Centre for Studies in Primary Care, Department of Family Medicine, Queens University, Kingston, ON K7L 3N6, Canada
| | - Mindy Goldman
- Donation and Policy Studies, Canadian Blood Services, Ottawa, ON K1G 4J5, Canada
- Department of Pathology & Laboratory Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON K1G 192, Canada
| | - Steven J Drews
- Microbiology, Canadian Blood Services, Edmonton, AB T6G 2R8, Canada
- Department of Laboratory Medicine & Pathology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2E1, Canada
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Drews SJ, Kjemtrup AM, Krause PJ, Lambert G, Leiby DA, Lewin A, O'Brien SF, Renaud C, Tonnetti L, Bloch EM. Transfusion-transmitted Babesia spp.: a changing landscape of epidemiology, regulation, and risk mitigation. J Clin Microbiol 2023; 61:e0126822. [PMID: 37750699 PMCID: PMC10595070 DOI: 10.1128/jcm.01268-22] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023] Open
Abstract
Babesia spp. are tick-borne parasites with a global distribution and diversity of vertebrate hosts. Over the next several decades, climate change is expected to impact humans, vectors, and vertebrate hosts and change the epidemiology of Babesia. Although humans are dead-end hosts for tick-transmitted Babesia, human-to-human transmission of Babesia spp. from transfusion of red blood cells and whole blood-derived platelet concentrates has been reported. In most patients, transfusion-transmitted Babesia (TTB) results in a moderate-to-severe illness. Currently, in North America, most cases of TTB have been described in the United States. TTB cases outside North America are rare, but case numbers may change over time with increased recognition of babesiosis and as the epidemiology of Babesia is impacted by climate change. Therefore, TTB is a concern of microbiologists working in blood operator settings, as well as in clinical settings where transfusion occurs. Microbiologists play an important role in deploying blood donor screening assays in Babesia endemic regions, identifying changing risks for Babesia in non-endemic areas, investigating recipients of blood products for TTB, and drafting TTB policies and guidelines. In this review, we provide an overview of the clinical presentation and epidemiology of TTB. We identify approaches and technologies to reduce the risk of collecting blood products from Babesia-infected donors and describe how investigations of TTB are undertaken. We also describe how microbiologists in Babesia non-endemic regions can assess for changing risks of TTB and decide when to focus on laboratory-test-based approaches or pathogen reduction to reduce TTB risk.
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Affiliation(s)
- Steven J. Drews
- Microbiology, Donation Policy and Studies, Canadian Blood Services, Edmonton, Alberta, Canada
- Department of Laboratory Medicine and Pathology, Division of Diagnostic and Applied Microbiology, University of Alberta, Edmonton, Alberta, Canada
| | - Anne M. Kjemtrup
- California Department of Public Health, Vector-Borne Disease Section, Sacramento, California, USA
| | - Peter J. Krause
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health and Yale School of Medicine, New Haven, Connecticut, USA
| | - Grayson Lambert
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health and Yale School of Medicine, New Haven, Connecticut, USA
| | - David A. Leiby
- Department of Microbiology, Immunology, and Tropical Medicine, George Washington University, Washington, USA
| | - Antoine Lewin
- Epidemiology, Surveillance and Biological Risk Assessment, Medical Affairs and Innovation, Héma-Québec, Montréal, Quebec, Canada
- Département d'Obstétrique et de Gynécologie, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Sheila F. O'Brien
- Epidemiology and Surveillance, Canadian Blood Services, Donation Policy and Studies, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Christian Renaud
- Department of Microbiology, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Laura Tonnetti
- American Red Cross, Scientific Affairs, Holland Laboratories for the Biomedical Sciences, Rockville, Maryland, USA
| | - Evan M. Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Tordon B, Drews SJ, Flahr F, Bennett K, Gaziano T, Anderson D, Nahirniak S, Gerges H, Tyrrell GJ, Mah J, Ndao M, Bigham M, Seftel M. Canadian Blood Services traceback investigation of a suspected case of transfusion-transmitted malaria. Transfusion 2023; 63:2001-2006. [PMID: 37715564 DOI: 10.1111/trf.17549] [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: 04/10/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND A 4-month-old infant hospitalized since birth received multiple blood transfusions. In March 2022, Plasmodium falciparum was confirmed with nucleic acid testing. As the mother was assessed as unlikely to be the source of infection, the blood operator initiated a traceback investigation for a potential blood donor source. The patient had received 13 red blood cell (RBC) transfusions (aliquoted from 11 donors), 4 apheresis platelet (PLT) transfusions and 16 buffy coat pooled PLT transfusions. The blood operator medical team developed a supplementary malaria infection risk questionnaire to identify donors at highest risk of life-time malaria infection, based on birthplace, residence, or travel in malaria-endemic regions. RESULTS With 79 donors initially implicated, initial focus was on donors of RBC components. The 11 RBC donors were contacted and assessed using the supplementary questionnaire. Three donors, all of whom met current malaria-related donor eligibility criteria, were deemed high risk of prior malaria infection. These donors consented to P. falciparum serology and nucleic acid testing (NAT). One donor who was born and had resided in an endemic West African country for 14 years, was positive for P. falciparum by serology (indirect fluorescent antibody test) and NAT-(Ct ≥32). Lookback of this donor's transfused fresh co-components and prior donation identified no other malaria cases. CONCLUSION This was a probable transfusion-transmitted malaria (TTM) case from an eligible donor who in retrospect was found to have unrecognized, asymptomatic, semi-immune malaria infection, and who was potentially infectious. Blood donor lack of recall of prior malaria infection does not negate the risk of TTM from those who have lived in malaria-endemic countries.
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Affiliation(s)
- Bryan Tordon
- Alberta Precision Laboratories (APL), Calgary, Alberta, Canada
| | - Steven J Drews
- Microbiology, Donation Policy & Studies, Canadian Blood Services, Edmonton, Alberta, Canada
- University of Alberta, Edmonton, Alberta, Canada
| | | | | | | | | | - Susan Nahirniak
- University of Alberta, Edmonton, Alberta, Canada
- Alberta Precision Laboratories (APL), Edmonton, Alberta, Canada
| | - Hanan Gerges
- University of Alberta, Edmonton, Alberta, Canada
| | - Gregory J Tyrrell
- University of Alberta, Edmonton, Alberta, Canada
- Alberta Health Services, Edmonton, Alberta, Canada
- APL Public Health, Edmonton, Alberta, Canada
| | - Jordan Mah
- University of Alberta, Edmonton, Alberta, Canada
| | - Momar Ndao
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Medicine, Division of Infectious Diseases, McGill University, Montreal, Quebec, Canada
| | - Mark Bigham
- Canadian Blood Services, Vancouver, British Columbia, Canada
| | - Matthew Seftel
- Canadian Blood Services, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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10
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Lin YCJ, Evans DH, Robbins NF, Orjuela G, Abe KT, Rathod B, Colwill K, Gingras AC, Tuite A, Yi QL, O’Brien SF, Drews SJ. Diminished Neutralization Capacity of SARS-CoV-2 Omicron BA.1 in Donor Plasma Collected from January to March 2021. Microbiol Spectr 2023; 11:e0525622. [PMID: 37289096 PMCID: PMC10434250 DOI: 10.1128/spectrum.05256-22] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/25/2023] [Indexed: 06/09/2023] Open
Abstract
The 50% plaque reduction neutralization assay (PRNT50) has been previously used to assess the neutralization capacity of donor plasma against wild-type and variant of concern (VOC) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Emerging data suggest that plasma with an anti-SARS-CoV-2 level of ≥2 × 104 binding antibody units/mL (BAU/mL) protects against SARS-CoV-2 Omicron BA.1 infection. Specimens were collected using a cross-sectional random sampling approach. For PRNT50 studies, 63 previously analyzed specimens by PRNT50 versus SARS-CoV-2 wild-type, Alpha, Beta, Gamma, and Delta were analyzed by PRNT50 versus Omicron BA.1. The 63 specimens plus 4,390 specimens (randomly sampled regardless of serological evidence of infection) were also tested using the Abbott SARS-CoV-2 IgG II Quant assay (anti-spike [S]; Abbott, Chicago, IL, USA; Abbott Quant assay). In the vaccinated group, the percentages of specimens with any measurable PRNT50 versus wild-type or VOC were wild type (21/25 [84%]), Alpha (19/25 [76%]), Beta (18/25 [72%]), Gamma (13/25 [52%]), Delta (19/25 [76%]), and Omicron BA.1 (9/25 [36%]). In the unvaccinated group, the percentages of specimens with any measurable PRNT50 versus wild type or VOC were wild-type SARS-CoV-2 (16/39 [41%]), Alpha (16/39 [41%]), Beta (10/39 [26%]), Gamma (9/39 [23%]), Delta (16/39 [41%]), and Omicron BA.1 (0/39) (Fisher's exact tests, vaccinated versus unvaccinated for each variant, P < 0.05). None of the 4,453 specimens tested by the Abbott Quant assay had a binding capacity of ≥2 × 104 BAU/mL. Vaccinated donors were more likely than unvaccinated donors to neutralize Omicron when assessed by a PRNT50 assay. IMPORTANCE SARS-CoV-2 Omicron emergence occurred in Canada during the period from November 2021 to January 2022. This study assessed the ability of donor plasma collected earlier (January to March 2021) to generate any neutralizing capacity against Omicron BA.1 SARS-CoV-2. Vaccinated individuals, regardless of infection status, were more likely to neutralize Omicron BA.1 than unvaccinated individuals. This study then used a semiquantitative binding antibody assay to screen a larger number of specimens (4,453) for individual specimens that might have high-titer neutralizing capacity against Omicron BA.1. None of the 4,453 specimens tested by the semiquantitative SARS-CoV-2 assay had a binding capacity suggestive of a high-titer neutralizing capacity against Omicron BA.1. These data do not imply that Canadians lacked immunity to Omicron BA.1 during the study period. Immunity to SARS-CoV-2 is complex, and there is still no wide consensus on correlation of protection to SARS-CoV-2.
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Affiliation(s)
- Yi-Chan J. Lin
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, Canada
| | - David H. Evans
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, Canada
| | | | | | - Kento T. Abe
- Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Bhavisha Rathod
- Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Karen Colwill
- Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Ashleigh Tuite
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Qi-Long Yi
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Sheila F. O’Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Steven J. Drews
- Canadian Blood Services, Microbiology, Edmonton, Alberta, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
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11
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Murphy TJ, Swail H, Jain J, Anderson M, Awadalla P, Behl L, Brown PE, Charlton CL, Colwill K, Drews SJ, Gingras AC, Hinshaw D, Jha P, Kanji JN, Kirsh VA, Lang ALS, Langlois MA, Lee S, Lewin A, O'Brien SF, Pambrun C, Skead K, Stephens DA, Stein DR, Tipples G, Van Caeseele PG, Evans TG, Oxlade O, Mazer BD, Buckeridge DL. The evolution of SARS-CoV-2 seroprevalence in Canada: a time-series study, 2020-2023. CMAJ 2023; 195:E1030-E1037. [PMID: 37580072 PMCID: PMC10426348 DOI: 10.1503/cmaj.230249] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND During the first year of the COVID-19 pandemic, the proportion of reported cases of COVID-19 among Canadians was under 6%. Although high vaccine coverage was achieved in Canada by fall 2021, the Omicron variant caused unprecedented numbers of infections, overwhelming testing capacity and making it difficult to quantify the trajectory of population immunity. METHODS Using a time-series approach and data from more than 900 000 samples collected by 7 research studies collaborating with the COVID-19 Immunity Task Force (CITF), we estimated trends in SARS-CoV-2 seroprevalence owing to infection and vaccination for the Canadian population over 3 intervals: prevaccination (March to November 2020), vaccine roll-out (December 2020 to November 2021), and the arrival of the Omicron variant (December 2021 to March 2023). We also estimated seroprevalence by geographical region and age. RESULTS By November 2021, 9.0% (95% credible interval [CrI] 7.3%-11%) of people in Canada had humoral immunity to SARS-CoV-2 from an infection. Seroprevalence increased rapidly after the arrival of the Omicron variant - by Mar. 15, 2023, 76% (95% CrI 74%-79%) of the population had detectable antibodies from infections. The rapid rise in infection-induced antibodies occurred across Canada and was most pronounced in younger age groups and in the Western provinces: Manitoba, Saskatchewan, Alberta and British Columbia. INTERPRETATION Data up to March 2023 indicate that most people in Canada had acquired antibodies against SARS-CoV-2 through natural infection and vaccination. However, given variations in population seropositivity by age and geography, the potential for waning antibody levels, and new variants that may escape immunity, public health policy and clinical decisions should be tailored to local patterns of population immunity.
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Affiliation(s)
- Tanya J Murphy
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Hanna Swail
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Jaspreet Jain
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Maureen Anderson
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Philip Awadalla
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Lesley Behl
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Patrick E Brown
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Carmen L Charlton
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Karen Colwill
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Steven J Drews
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Anne-Claude Gingras
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Deena Hinshaw
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Prabhat Jha
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Jamil N Kanji
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Victoria A Kirsh
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Amanda L S Lang
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Marc-André Langlois
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Stephen Lee
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Antoine Lewin
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Sheila F O'Brien
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Chantale Pambrun
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Kimberly Skead
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - David A Stephens
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que.
| | - Derek R Stein
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Graham Tipples
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Paul G Van Caeseele
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Timothy G Evans
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Olivia Oxlade
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - Bruce D Mazer
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
| | - David L Buckeridge
- COVID-19 Immunity Task Force (Murphy, Swail, Jain, Evans, Oxlade, Mazer, Buckeridge), School of Population and Global Health, McGill University, Montréal, Que.; Department of Community Health and Epidemiology (Anderson, Behl), University of Saskatchewan; Saskatchewan Health Authority (Anderson), Population Health, Saskatoon, Sask.; Department of Molecular Genetics (Awadalla), University of Toronto; Department of Computational Biology (Awadalla), Ontario Institute for Cancer Research; Centre for Global Health Research (Brown), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Charlton, Hinshaw, Tipples), Alberta Precision Laboratories, University of Alberta Hospital; Department of Laboratory Medicine and Pathology (Charlton, Tipples), and Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alta.; Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital (Colwill, Gingras), Sinai Health System, Toronto, Ont.; Canadian Blood Services (Drews); Department of Laboratory Medicine and Pathology (O'Brien, Pambrun, Drews), University of Alberta, Edmonton, Alta.; Department of Molecular Genetics (Gingras, Skead), University of Toronto; Centre for Global Health Research (Jha), Unity Health Toronto and University of Toronto, Toronto, Ont.; Public Health Laboratory (Kanji), Alberta Precision Laboratories, Foothills Medical Centre, and Section of Medical Microbiology (Kanji), Department of Pathology and Laboratory Medicine, and Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alta.; Ontario Health Study (Kirsh, Skead), Ontario Institute for Cancer Research; Department of Molecular Genetics (Kirsh, Skead), and Dalla Lana School of Public Health (Kirsh), University of Toronto, Toronto, Ont.; Roy Romanow Provincial Lab (Lang), Saskatchewan Health Authority; College of Medicine (Lang), University of Saskatchewan, Saskatoon, Sask.; Department of Biochemistry, Microbiology and Immunology (Langlois), and Centre for Infection, Immunity and Inflammation (Langlois), University of Ottawa, Ottawa, Ont.; Division of Infectious Diseases-Regina (Lee), University of Saskatchewan; Saskatchewan Health Authority (Lee), Saskatoon, Sask.; Medical Affair and Innovation (Lewin), Héma-Québec, Montréal, Que.; Departments of Epidemiology and Community Medicine (O'Brien), and Pathology and Laboratory Medicine (Pambrun), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; Department of Mathematics & Statistics (Stephens), McGill University, Montréal, Que.; Department of Medical Microbiology (Stein, Van Caeseele), University of Manitoba, and Cadham Provincial Laboratory, Winnipeg, Man.; School of Population and Global Health (Evans), McGill University; The Research Institute of the McGill University Health Centre (Mazer, Buckeridge), Montréal, Que
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Bloch EM, Siller A, Tonnetti L, Drews SJ, Spencer BR, Hedges D, Mergenthal T, Weber-Schehl M, Astl M, Patel EU, Gaber M, Schennach H. Molecular Screening of Blood Donors for Babesia in Tyrol, Austria. Transfus Med Hemother 2023; 50:330-333. [PMID: 37767285 PMCID: PMC10521223 DOI: 10.1159/000528793] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 12/19/2022] [Indexed: 09/29/2023] Open
Abstract
Introduction Babesia is a tick-borne intraerythrocytic parasite that is globally ubiquitous, yet understudied. Several species of Babesia have been shown to be transfusion-transmissible. Babesia has been reported in blood donors, animals, and ticks in the Tyrol (Western Austria), and regional cases of human babesiosis have been described. We sought to characterize the risk of Babesia to the local blood supply. Methods Prospective molecular testing was performed on blood donors who presented to regional, mobile blood collection drives in the Tyrol, Austria (27 May to October 4, 2021). Testing was conducted using the cobas® Babesia assay (Roche Molecular Systems, Inc.), a commercial PCR assay approved for blood donor screening that is capable of detecting the 4 primary species causing human babesiosis (i.e., B. microti, B. divergens, B. duncani, and B. venatorum). A confirmatory algorithm to manage initial PCR-reactive samples was developed, as were procedures for donor and product management. Results A total of 7,972 donors were enrolled and screened; 4,311 (54.1%) were male, with a median age of 47 years (IQR = 34-55). No positive cases of Babesia were detected, corresponding with an overall prevalence of 0.00% (95% CI: 0.00%, 0.05%). Discussion The findings suggest that the prevalence of Babesia is low in Austrian blood donors residing in the Tyrol, even during months of peak tick exposure. Although one cannot conclude the absence of Babesia in this population given the limited sample size, the findings suggest that the regional risk of transfusion-transmitted babesiosis is low.
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Affiliation(s)
- Evan M. Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Anita Siller
- Central Institute for Blood Transfusion and Immunology, Innsbruck, Austria
| | - Laura Tonnetti
- Holland Laboratories for the Biomedical Sciences, American Red Cross, Rockville, Maryland, USA
| | - Steven J. Drews
- Microbiology, Canadian Blood Services, Edmonton, Alberta, Canada
| | - Bryan R. Spencer
- Scientific Affairs, American Red Cross, Dedham, Massachusetts, USA
| | - Doris Hedges
- Blood donor service, Bavarian Red Cross, Wiesentheid, Germany
| | | | | | - Manfred Astl
- Central Institute for Blood Transfusion and Immunology, Innsbruck, Austria
| | - Eshan U. Patel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Manfred Gaber
- Blood donor service Tyrol, Austrian Red Cross, Rum, Austria
| | - Harald Schennach
- Central Institute for Blood Transfusion and Immunology, Innsbruck, Austria
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Leblanc JF, Custer B, Van de Laar T, Drews SJ, Germain M, Lewin A. HIV Pre-Exposure Prophylaxis, Blood Donor Deferral, Occult Infection, and Risk of HIV Transmission by Transfusion: A Fine Balance Between Evidence-Based Donor Selection Criteria and Transfusion Safety. Transfus Med Rev 2023; 37:150754. [PMID: 37741792 DOI: 10.1016/j.tmrv.2023.150754] [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] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 09/25/2023]
Abstract
Pre- and postexposure prophylaxis for human immunodeficiency virus (HIV) are key to reducing the transmission of this virus. Furthermore, low-toxicity, long-acting formulations provide additional clinical benefits, in particular easier adherence to treatment and prevention. However, breakthrough HIV infections can occur despite the use of pre-exposure prophylaxis (PrEP), mainly due to suboptimal adherence or multi-drug resistant HIV strains. Albeit rare, PrEP breakthrough infections have also been reported in fully adherent patients. Should such breakthrough infection occur in an eligible blood donor, PrEP might suppress viremia and delay antibody seroconversion, thereby masking the infection and increasing the risk of transfusion transmission. This possibility has raised concerns in the blood transfusion community but remains little documented. Therefore, a literature search was performed to assess the state of knowledge on the risk of PrEP breakthrough infection, with a particular focus on the risk of HIV entering the blood supply. Evidently, PrEP breakthrough infections are rare, although the risk is not zero. Moreover, a fraction of individuals - including blood donors - do not disclose PrEP use according to various surveys and measurements of HIV PrEP analytes. Additionally, viremia and seroconversion may remain undetectable or close to the limit of detection for a long time after cessation of PrEP, particularly with long-acting antiretrovirals. Therefore, current recommendations to defer donors for at least 3 months after the last dose of oral PrEP or 2 years for long-acting PrEP appear justified, as they safeguard the blood supply and public trust toward the system. These recommendations help to safeguard blood safety and public trust in the blood supply.
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Affiliation(s)
| | - Brian Custer
- Vitalant Research Institute, San Francisco, CA, USA; Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Thijs Van de Laar
- Sanquin Research, Department of Donor Medicine Research, Amsterdam, The Netherlands; Onze Lieve Vrouwe Gasthuis, Laboratory of Medical Microbiology, Amsterdam, The Netherlands
| | - Steven J Drews
- Microbiology, Donation Policy and Studies, Canadian Blood Services, Edmonton, Alberta, Canada; Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Marc Germain
- Hema-Québec, Medical Affairs and Innovation, Montréal and Québec, Québec, Canada
| | - Antoine Lewin
- Hema-Québec, Medical Affairs and Innovation, Montréal and Québec, Québec, Canada; Université de Sherbrooke, Faculty of Medicine and Health Sciences, Sherbrooke, Québec, Canada.
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14
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Candotti D, Drews SJ, Faddy HM. Monitoring viral genomic sequences in transfusion-transmitted viruses. Vox Sang 2023. [PMID: 37259832 DOI: 10.1111/vox.13444] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/23/2023] [Accepted: 04/28/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND AND OBJECTIVES Monitoring genomic sequences of blood-borne viruses infecting blood donors enables blood operators to undertake molecular epidemiology, confirm transfusion transmission and assess and characterize molecular and serological screening assays. The purpose of the study was to determine how blood operators globally value viral diversity surveillance and to assess its impact. MATERIALS AND METHODS An electronic questionnaire was developed and circulated to members of the International Society of Blood Transfusion-transmitted infectious diseases working party. Responses were compiled and complete data sets were analysed. RESULTS Ninety-seven percent of respondents agreed that monitoring viral genomic sequences was important to blood operators and the transfusion community. However, only 47% of respondents are currently doing this monitoring. The main limitations reported were a lack of financial resources and expertise. Sequencing techniques, primarily next-generation sequencing and also Sanger sequencing, were considered most appropriate, with the preferred option for testing being regional or national reference centres. Respondents agreed that engagement with public health authorities needs to be enhanced. CONCLUSION Monitoring genomic sequences of blood-borne viruses is widely considered important by the transfusion community because of its direct applications for transfusion safety, and beyond for public health in general. Therefore, there is a need to strengthen collaboration between blood operators and public health authorities. While national and regional reference centres may be the most appropriate structure for such testing, international collaborations should not be overlooked. Overcoming financial barriers will be an important hurdle for many.
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Affiliation(s)
- Daniel Candotti
- Department of Blood Transmitted Agents, National Institute of Blood Transfusion, Paris, France
- Department of Virology, Henri Mondor Hospital, Paris-Est University, Inserm U955-IMRB-Team 18, Créteil, France
| | - Steven J Drews
- Department of Microbiology, Canadian Blood Services, Edmonton, Alberta, Canada
- Division of Diagnostic and Applied Microbiology, Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Helen M Faddy
- School of Health, University of the Sunshine Coast, Petrie, Queensland, Australia
- Research and Development, Australian Red Cross Lifeblood, Kelvin Grove, Australia
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15
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O'Brien SF, Drews SJ, Yi QL, Osmond L, Tran V, Zhou HY, Goldman M. Monitoring syphilis serology in blood donors: Is there utility as a surrogate marker of early transfusion transmissible infection behavioral risk? Transfusion 2023. [PMID: 37158235 DOI: 10.1111/trf.17393] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/05/2023] [Accepted: 04/10/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND In Canada the time deferral for gay, bisexual, and other men who have sex with men (gbMSM) was progressively shortened (lifetime, 5 years, 1 year, 3 months). Here we describe trends in syphilis rates (a potential sexual risk marker) and risk behaviors from blood donors in the past 12 years. STUDY DESIGN AND METHODS Syphilis positivity in 10,288,322 whole blood donations (January 1, 2010-September 10, 2022) and gbMSM deferral time periods, donation status, age, and sex were analyzed with logistic regression. Overall, 26.9% syphilis positive and 42.2% controls (matched 1:4) participated in risk factor interviews analyzed by logistic regression. RESULTS Syphilis rates were higher in first-time donors (OR 27.0, 95% CI 22.1-33.0), in males (OR 2.3, 1.9-2.8) and with the 3-month deferral (OR 3.4, 2.6-4.3) during which the increase was greater for first-time males (p < .001) but similar for male and female repeat donors (p > .05). Among first-time donors, histories of intravenous drug use (OR 11.7, 2.0-69.5), male-to-male sex 7.8 (2.0-30.2) and birth in a high prevalence country (OR 7.6, 4.4-13.0) predicted syphilis positivity; among repeat donors, history of male-to-male sex (OR 33.5, CI 3.5-317.0). All but 1 gbMSM syphilis-positive donors were noncompliant with the gbMSM deferral. About a quarter of first-time interviewed case donors had history of syphilis; 44% were born in a high-prevalence country. CONCLUSION Rising syphilis rates in donors correlates with the general population epidemic. Recent infection rates rose similarly in males and females. GbMSM history may contribute to donor syphilis rates but shortening time deferrals appears unrelated.
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Affiliation(s)
- Sheila F O'Brien
- Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Steven J Drews
- Canadian Blood Services, Edmonton, Alberta, Canada
- Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Qi-Long Yi
- Canadian Blood Services, Ottawa, Ontario, Canada
| | - Lori Osmond
- Canadian Blood Services, Ottawa, Ontario, Canada
| | - Vanessa Tran
- Microbiology, Public Health Ontario, Toronto, Ontario, Canada
- Department of Laboratory Medicine & Pathology, University of Toronto, Toronto, Ontario, Canada
| | - Hong Yuan Zhou
- Microbiology, ProvLab Alberta, Calgary, Alberta, Canada
- Department of Pathology & Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Mindy Goldman
- Canadian Blood Services, Ottawa, Ontario, Canada
- Department of Pathology & Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
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16
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Drews SJ, Wendel S, Leiby DA, Tonnetti L, Ushiro-Lumb I, O'Brien SF, Lieshout-Krikke RW, Bloch EM. Climate change and parasitic risk to the blood supply. Transfusion 2023; 63:638-645. [PMID: 36565251 DOI: 10.1111/trf.17234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/02/2022] [Accepted: 12/04/2022] [Indexed: 12/25/2022]
Affiliation(s)
- Steven J Drews
- Canadian Blood Services, Microbiology, Donation Policy and Studies, Edmonton, Alberta, Canada
- Division of Diagnostic and Applied Microbiology, Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Silvano Wendel
- Blood Bank, Hospital Sírio-Libanês Blood Bank, São Paulo, Brazil
| | - David A Leiby
- Department of Microbiology, Immunology, & Tropical Medicine, George Washington University, Washington, DC, USA
| | - Laura Tonnetti
- American Red Cross, Scientific Affairs, Holland Laboratories for the Biomedical Sciences, Rockville, Maryland, USA
| | | | - Sheila F O'Brien
- Canadian Blood Services, Epidemiology and Surveillance, Microbiology, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Ryanne W Lieshout-Krikke
- Department of Medical Affairs, Corporate Staff, Sanquin Blood Supply Foundation, Amsterdam, the Netherlands
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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17
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O’Brien SF, Caffrey N, Yi QL, Bolotin S, Janjua NZ, Binka M, Thanh CQ, Stein DR, Lang A, Colquhoun A, Pambrun C, Reedman CN, Drews SJ. Cross-Canada Variability in Blood Donor SARS-CoV-2 Seroprevalence by Social Determinants of Health. Microbiol Spectr 2023; 11:e0335622. [PMID: 36625634 PMCID: PMC9927354 DOI: 10.1128/spectrum.03356-22] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/07/2022] [Indexed: 01/11/2023] Open
Abstract
We compared the seroprevalence of SARS-CoV-2 anti-nucleocapsid antibodies in blood donors across Canadian regions in 2021. The seroprevalence was the highest in Alberta and the Prairies, and it was so low in Atlantic Canada that few correlates were observed. Being male and of young age were predictive of seropositivity. Racialization was associated with higher seroprevalence in British Columbia and Ontario but not in Alberta and the Prairies. Living in a materially deprived neighborhood predicted higher seroprevalence, but it was more linear across quintiles in Alberta and the Prairies, whereas in British Columbia and Ontario, the most affluent 60% were similarly low and the most deprived 40% similarly elevated. Living in a more socially deprived neighborhood (more single individuals and one parent families) was associated with lower seroprevalence in British Columbia and Ontario but not in Alberta and the Prairies. These data show striking variability in SARS-CoV-2 seroprevalence across regions by social determinants of health. IMPORTANCE Canadian blood donors are a healthy adult population that shows clear disparities associated with racialization and material deprivation. This underscores the pervasiveness of the socioeconomic gradient on SARS-CoV-2 infections in Canada. We identify regional differences in the relationship between SARS-CoV-2 seroprevalence and social determinants of health. Cross-Canada studies, such as ours, are rare because health information is under provincial jurisdiction and is not available in sufficient detail in national data sets, whereas other national seroprevalence studies have insufficient sample sizes for regional comparisons. Ours is the largest seroprevalence study in Canada. An important strength of our study is the interpretation input from a public health team that represented multiple Canadian provinces. Our blood donor seroprevalence study has informed Canadian public health policy at national and provincial levels since the start of the SARS-CoV-2 pandemic.
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Affiliation(s)
- Sheila F. O’Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Niamh Caffrey
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Qi-Long Yi
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Shelly Bolotin
- Center for Vaccine Preventable Disease, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
| | - Naveed Z. Janjua
- BC Centre for Disease Control, British Columbia, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, British Columbia, Vancouver, Canada
| | - Mawuena Binka
- BC Centre for Disease Control, British Columbia, Vancouver, Canada
| | - Caroline Quach Thanh
- Department of Microbiology, Infectious Diseases & Immunology, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- Infection Prevention & Control, Clinical Department of Laboratory Medicine, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Derek R. Stein
- Cadham Provincial Laboratory, Winnipeg, Manitoba, Canada
- Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amanda Lang
- Roy Romanow Provincial laboratory, Saskatchewan Health Authority, Regina, Saskatchewan, Canada
| | - Amy Colquhoun
- Population Health Assessment, Alberta Health, Edmonton, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Chantale Pambrun
- Medical Affairs & Innovation, Canadian Blood Services, Ottawa, Ontario, Canada
- Department of Pathology & Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Cassandra N. Reedman
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Steven J. Drews
- Medical Microbiology Department, Canadian Blood Services, Edmonton, Alberta, Canada
- Department of Laboratory Medicine & Pathology, Division of Diagnostic and Applied Microbiology, University of Alberta, Edmonton, Alberta, Canada
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18
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O’Brien SF, Reedman CN, Osiowy C, Bolotin S, Yi QL, Lourenço L, Lewin A, Binka M, Caffrey N, Drews SJ. Hepatitis B Blood Donor Screening Data: An Under-Recognized Resource for Canadian Public Health Surveillance. Viruses 2023; 15:v15020409. [PMID: 36851623 PMCID: PMC9966614 DOI: 10.3390/v15020409] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
Hepatitis B surveillance is essential to achieving Canada's goal of eliminating hepatitis B by 2030. Hepatitis B rates, association of infection with vaccine age-eligibility, and risk factors were analyzed among 1,401,603 first-time Canadian blood donors from 2005 to 2020. Donors were classified as having likely chronic or likely resolved/occult infections based on hepatitis B surface antigen, anti-hepatitis B core antigen, and hepatitis B nucleic acid test results. Likely chronically infected and control donors (ratio 1:4) participated in risk-factor interviews. The 2019 rate of likely chronic infection was 61.9 per 100,000 (95% CI 46.5-80.86) and 1449.5 per 100,000 for likely resolved/occult infections (95% CI 1370.7-1531.7). Likely chronic infections were higher in males (OR 3.2; 95% CI 2.7-3.7) and the vaccine-ineligible birth cohort (OR 1.9; 95% CI 1.6-2.2). The main risk factors were living with someone who had hepatitis (OR 12.5; 95% CI 5.2-30.0) and ethnic origin from a high-prevalence country (OR 8.4; 95% CI 5.9-11.9). Undiagnosed chronic hepatitis B may be more prevalent in Canada than currently determined by traditional passive hepatitis B reporting. Blood donor data can be useful in informing hepatitis B rates and evaluating vaccination programs in Canada.
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Affiliation(s)
- Sheila F. O’Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, ON K1G 4J5, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Correspondence: ; Tel.: +1-613-739-2144
| | - Cassandra N. Reedman
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, ON K1G 4J5, Canada
- Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada
| | - Carla Osiowy
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E 3P6, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Shelly Bolotin
- Center for Vaccine Preventable Disease, University of Toronto, Toronto, ON M5S, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S, Canada
- Public Health Ontario, Toronto, ON M5G 1V2, Canada
| | - Qi-Long Yi
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, ON K1G 4J5, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | | | - Antoine Lewin
- Héma-Québec, Montreal, QC H4R 2W7, Canada
- Faculty of Medicine & Health Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
| | - Mawuena Binka
- BC Centre for Disease Control, Vancouver, BC V5Z 4R4, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Niamh Caffrey
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, ON K1G 4J5, Canada
| | - Steven J. Drews
- Medical Microbiology Department, Canadian Blood Services, Edmonton, AB T6G 2R3, Canada
- Department of Laboratory Medicine & Pathology, Division of Diagnostic and Applied Microbiology, University of Alberta, Edmonton, AB T6G 2R3, Canada
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19
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O’Brien SF, Goldman M, Drews SJ. An expanded role for blood donor emerging pathogens surveillance. CMAJ 2023; 195:E16. [PMID: 36623858 PMCID: PMC9829065 DOI: 10.1503/cmaj.147635-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
| | - Mindy Goldman
- Medical director, Donation Policy and Studies, Canadian Blood Services, Ottawa, Ont
| | - Steven J Drews
- Associate director, Microbiology, Donation Policy and Studies, Canadian Blood Services, Edmonton, Alta
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20
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O'Brien SF, Drews SJ, Lewin A, Russell A, Davison K, Goldman M. How do we decide how representative our donors are for public health surveillance? Transfusion 2022; 62:2431-2437. [PMID: 36193865 DOI: 10.1111/trf.17140] [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] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Surveillance of blood donors is fundamental to safety of the blood supply. Such data can also be useful for public health policy but tend to be underutilized. When the COVID-19 pandemic arrived, blood centers around the world measured blood donor SARS-CoV-2 seroprevalence to inform public health policy. There is now a movement toward blood centers becoming more involved in public health research and surveillance post-pandemic. However, blood donors are a healthy population and not representative of all segments of the general population. In this article, we explain how blood centers can evaluate their donor base to understand which part of the general population they are representative of. STUDY DESIGN AND METHODS Methodologic approaches for evaluating samples relative to the target population were reviewed. Blood donor data that are available to most blood centers were identified and application to assess representativeness of blood donors was evaluated. RESULTS Key aspects of blood donor data to compare with general population data include donor selection criteria, health indicators, geography, and demographics. In some cases, statistical adjustment can improve representativeness. DISCUSSION Comparing key blood donor data with corresponding general population data can define the subset of the general population for which a particular blood center's donors may be representative of. We suggest that donors are an ideal convenience population for surveillance of infectious agents which are frequently asymptomatic and main routes of transmission are not deferrable, for studying the natural history of disease in an initially well population, and for vaccination serology surveillance.
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Affiliation(s)
- Sheila F O'Brien
- Canadian Blood Services, Ottawa, Ontario, Canada.,School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Steven J Drews
- Canadian Blood Services, Edmonton, Alberta, Canada.,Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Antoine Lewin
- Héma-Québec, Montreal, Quebec, Canada.,Faculty of Medicine & Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Alton Russell
- School of Population and Global Health, McGill University, Montreal, Quebec, Canada
| | | | - Mindy Goldman
- Canadian Blood Services, Ottawa, Ontario, Canada.,Department of Pathology & Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
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21
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Asamoah-Boaheng M, Goldfarb DM, Karim ME, O’Brien SF, Wall N, Drews SJ, Barakauskas V, Jassem AN, Grunau B. The Relationship Between Anti-Spike SARS-CoV-2 Antibody Levels and Risk of Breakthrough COVID-19 Among Fully Vaccinated Adults. J Infect Dis 2022; 227:339-343. [PMID: 36197948 PMCID: PMC9619727 DOI: 10.1093/infdis/jiac403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/26/2022] [Accepted: 10/03/2022] [Indexed: 02/04/2023] Open
Abstract
The relationship between antibodies to wild-type severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigens and the risk of breakthrough infections is unclear, especially during circulation of the Omicron strain. We investigated the association of anti-spike and anti-receptor binding domain antibody levels and the risk of subsequent breakthrough coronavirus disease 2019 (COVID-19). We included adult paramedics from an observational cohort study who received 2 mRNA vaccines but did not have COVID-19 before the blood collection. Higher postvaccination antibody levels to wild-type SARS-CoV-2 antigens were associated with a reduced risk of COVID-19. Further research into clinical utility of antibody levels, to inform a threshold for protection and timing of boosters, should be prioritized.
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Affiliation(s)
- Michael Asamoah-Boaheng
- Correspondence: Dr Michael Asamoah-Boaheng, Department of Emergency Medicine, University of British Columbia, 1190 Horby Street, Vancouver, British Columbia V6Z 2K5, Canada ()
| | - David M Goldfarb
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mohammad Ehsanul Karim
- Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, British Columbia, Canada,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sheila F O’Brien
- Canadian Blood Services, Vancouver, British Columbia, Canada,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Nechelle Wall
- British Columbia Emergency Health Services, Vancouver, British Columbia, Canada
| | - Steven J Drews
- Canadian Blood Services, Vancouver, British Columbia, Canada,Division of Diagnostic and Applied Microbiology, Laboratory Medicine and Pathology, University of Alberta, Alberta, Canada
| | - Vilte Barakauskas
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Agatha N Jassem
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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22
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Bhullar KS, Nael MA, Elokely KM, Drews SJ, Wu J. Structurally Modified Bioactive Peptide Inhibits SARS-CoV-2 Lentiviral Particles Expression. Pharmaceutics 2022; 14:pharmaceutics14102045. [PMID: 36297481 PMCID: PMC9607082 DOI: 10.3390/pharmaceutics14102045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/15/2022] [Accepted: 09/23/2022] [Indexed: 11/17/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), the current global pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Various pharmaceuticals are being developed to counter the spread of the virus. The strategy of repurposing known drugs and bioactive molecules is a rational approach. A previously described molecule, Ile-Arg-Trp (IRW), is a bioactive tripeptide that exhibits an ability to boost angiotensin converting enzyme-2 (ACE2) expression in animals and cells. Given the importance of SARS-CoV-2 S receptor binding domain (RBD)-ACE2 interaction in SARS-CoV-2 pathophysiology, we synthesized various IRW analogs intending to mitigate the RBD-ACE-2 interaction. Herein, we describe two analogs of IRW, A9 (Acetyl-Ile-Arg-Trp-Amide) and A14 (Formyl-Ile-Arg-Trp-Amide) which lowered the SARS-CoV-2 S RBD-ACE2 (at 50 µM) in vitro. The free energy of binding suggested that A9 and A14 interacted with the SARS-CoV-2 S RBD more favorably than ACE2. The calculated MMGBSA ΔG of spike binding for A9 was −57.22 kcal/mol, while that of A14 was −52.44 kcal/mol. A14 also inhibited furin enzymatic activity at various tested concentrations (25, 50, and 100 µM). We confirmed the effect of the two potent analogs using SARS-CoV-2 spike protein overexpressing cells. Both peptides lowered the protein expression of SARS-CoV-2 spike protein at the tested concentration (50 µM). Similarly, both peptides, A9 and A14 (50 µM), also inhibited pseudotyped lentiviral particles with SARS-CoV-2 Spike in ACE2 overexpressing cells. Further, the molecular dynamics (MD) calculations showed the interaction of A9 and A14 with multiple residues in spike S1 RBD. In conclusion, novel peptide analogs of ACE2 boosting IRW were prepared and confirmed through in vitro, cellular, and computational evaluations to be potential seed candidates for SARS-CoV-2 host cell binding inhibition.
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Affiliation(s)
- Khushwant S. Bhullar
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, AB T6G 2P5, Canada
- Department of Pharmacology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2H7, Canada
| | - Manal A. Nael
- Institute for Computational Molecular Science and Department of Chemistry, Temple University, Philadelphia, PA 19122, USA
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Tanta 31527, Egypt
| | - Khaled M. Elokely
- Institute for Computational Molecular Science and Department of Chemistry, Temple University, Philadelphia, PA 19122, USA
| | - Steven J. Drews
- Canadian Blood Services, Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, AB T6G 2P5, Canada
| | - Jianping Wu
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, AB T6G 2P5, Canada
- Cardiovascular Research Centre, University of Alberta, Edmonton, AB T6G 2R7, Canada
- Correspondence:
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23
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Dibernardo A, Toledo NPL, Robinson A, Osiowy C, Giles E, Day J, Robbin Lindsay L, Drebot MA, Booth TF, Pidduck T, Baily A, Charlton CL, Tipples G, Kanji JN, Brochu G, Lang A, Therrien C, Bélanger-Collard M, Beaulac SN, Gilfix BM, Boivin G, Hamelin MÈ, Carbonneau J, Lévesque S, Martin P, Finzi A, Gendron-Lepage G, Goyette G, Benlarbi M, Gasser R, Fortin C, Martel-Lafferrière V, Lavoie M, Guérin R, Haraoui LP, Renaud C, Jenkins C, O'Brien SF, Drews SJ, Conrod V, Tran V, Awrey B, Scheuermann R, DuPuis A, Payne A, Warszycki C, Girardin R, Lee W, Zahariadis G, Jiao L, Needle R, Cordenbach J, Zaharatos J, Taylor K, Teltscher M, Miller M, Elsherif M, Robertson P, Robinson JL. Evaluation of the performance of multiple immunoassay diagnostic platforms on the National Microbiology Laboratory SARS-CoV-2 National Serology Panel. J Assoc Med Microbiol Infect Dis Can 2022; 7:186-195. [PMID: 36337598 PMCID: PMC9629736 DOI: 10.3138/jammi-2021-0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/05/2021] [Accepted: 03/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Serological assays designed to detect SARS-CoV-2 antibodies are being used in serological surveys and other specialized applications. As a result, and to ensure that the outcomes of serological testing meet high quality standards, evaluations are required to assess the performance of these assays and the proficiency of laboratories performing them. METHODS A panel of 60 plasma/serum samples from blood donors who had reverse transcriptase-polymerase chain reaction (RT-PCR) confirmed SARS-CoV-2 infections and 21 SARS-CoV-2 negative samples were secured and distributed to interested laboratories within Canada (n = 30) and the United States (n = 1). Participating laboratories were asked to provide details on the diagnostic assays used, the platforms the assays were performed on, and the results obtained for each panel sample. Laboratories were blinded with respect to the expected outcomes. RESULTS The performance of the different assays evaluated was excellent, with the high-throughput platforms of Roche, Ortho, and Siemens demonstrating 100% sensitivity. Most other high-throughput platforms had sensitivities of >93%, with the exception of the IgG assay using the Abbott ARCHITECT which had an average sensitivity of only 87%. The majority of the high-throughput platforms also demonstrated very good specificities (>97%). CONCLUSION This proficiency study demonstrates that most of the SARS-CoV-2 serological assays utilized by provincial public health or hospital laboratories in Canada have acceptable sensitivity and excellent specificity.
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Affiliation(s)
- Antonia Dibernardo
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Nikki PL Toledo
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Alyssia Robinson
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Carla Osiowy
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Elizabeth Giles
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Jacqueline Day
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - L Robbin Lindsay
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Michael A Drebot
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Timothy F Booth
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Tamara Pidduck
- BCCDC Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Ashley Baily
- Public Health Laboratory, Alberta Precision Laboratories, University of Alberta Hospital, Edmonton, Alberta, Canada
| | - Carmen L Charlton
- Department of Laboratory Medicine and Pathology, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
| | - Graham Tipples
- Department of Medical Microbiology & Immunology, University of Alberta, Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
- Li Ka Shing Institute for Virology, Edmonton, Alberta, Canada
| | - Jamil N Kanji
- Department of Laboratory Medicine and Pathology, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
- Division of Infectious Diseases, Department of Medicine, University of Alberta, Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gino Brochu
- CIUSSS Mauricie—Centre du Québec, Trois-Rivières, Québec, Canada
| | - Amanda Lang
- Roy Romanow Provincial Laboratory, Saskatchewan Health Authority, Regina, Saskatchewan, Canada
| | - Christian Therrien
- Laboratoire de santé publique du Québec, Institut de santé publique du Québec, Saint-Anne-de-Bellevue, Québec, Canada
| | - Mélina Bélanger-Collard
- Laboratoire de santé publique du Québec, Institut de santé publique du Québec, Saint-Anne-de-Bellevue, Québec, Canada
| | - Sylvie-Nancy Beaulac
- Laboratoire de santé publique du Québec, Institut de santé publique du Québec, Saint-Anne-de-Bellevue, Québec, Canada
| | - Brian M Gilfix
- McGill University Health Centre, Department of Medicine, Montreal, Québec, Canada
| | - Guy Boivin
- Université Laval and CHU de Québec, Québec City, Québec, Canada
| | | | | | - Simon Lévesque
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- CIUSSSE de l'Estrie—CHUS, Sherbrooke, Québec, Canada
- Département de microbiologie et infectiologie, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Philippe Martin
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- CIUSSSE de l'Estrie—CHUS, Sherbrooke, Québec, Canada
- Département de microbiologie et infectiologie, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Andrés Finzi
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada
- Canada Department of Microbiology and Immunology, McGill University, Montreal, Québec, Canada
| | | | | | | | - Romain Gasser
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada
| | - Claude Fortin
- CHUM: Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | | | - Myriam Lavoie
- CIUSSS du Saguenay Lac-St-Jean, Hôpital de Chicoutimi, Chicoutimi, Québec, Canada
| | - Renée Guérin
- Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Louis-Patrick Haraoui
- Department of Microbiology and Infectious Diseases, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Christian Renaud
- Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
| | | | | | | | | | - Vanessa Tran
- BCCDC Public Health Laboratory, Vancouver, British Columbia, Canada
- Public Health Ontario, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Bill Awrey
- Alpha Laboratories Inc., Toronto, Ontario, Canada
| | | | - Alan DuPuis
- Wadsworth Center, New York State Department of Health (NYSDOH), Albany, New York, United States
| | - Anne Payne
- Wadsworth Center, New York State Department of Health (NYSDOH), Albany, New York, United States
| | - Casey Warszycki
- Wadsworth Center, New York State Department of Health (NYSDOH), Albany, New York, United States
| | - Roxie Girardin
- Wadsworth Center, New York State Department of Health (NYSDOH), Albany, New York, United States
| | - William Lee
- BCCDC Public Health Laboratory, Vancouver, British Columbia, Canada
- Wadsworth Center, New York State Department of Health (NYSDOH), Albany, New York, United States
- Department of Biomedical Sciences, School of Public Health, University at Albany, Albany, New York, United States
| | - George Zahariadis
- Newfoundland and Labrador Public Health Microbiology Laboratory, St. Johns, Newfoundland, Canada
| | - Lei Jiao
- Newfoundland and Labrador Public Health Microbiology Laboratory, St. Johns, Newfoundland, Canada
| | - Robert Needle
- Newfoundland and Labrador Public Health Microbiology Laboratory, St. Johns, Newfoundland, Canada
| | | | | | | | | | - Matthew Miller
- Canadian Centre for Vaccinology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - May Elsherif
- Canadian Centre for Vaccinology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Peter Robertson
- Canadian Centre for Vaccinology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jason L Robinson
- Division of Clinical Chemistry, Provincial Laboratory Services, Health PEI, Charlottetown, Prince Edward Island, Canada
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24
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Grunau B, Asamoah-Boaheng M, Lavoie PM, Karim ME, Kirkham TL, Demers PA, Barakauskas V, Marquez AC, Jassem AN, O’Brien SF, Drews SJ, Haig S, Cheskes S, Goldfarb DM. A Higher Antibody Response Is Generated With a 6- to 7-Week (vs Standard) Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccine Dosing Interval. Clin Infect Dis 2022; 75:e888-e891. [PMID: 34849655 PMCID: PMC8690265 DOI: 10.1093/cid/ciab938] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Indexed: 01/19/2023] Open
Abstract
The optimal dosing interval for severe acute respiratory syndrome coronavirus 2 vaccines remains controversial. In this prospective study, we compared serology results of paramedics vaccinated with mRNA vaccines at the recommended short (17-28 days) vs long (42-49 days) interval. We found that a long dosing interval resulted in higher spike, receptor binding domain, and spike N terminal domain antibody concentrations.
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Affiliation(s)
- Brian Grunau
- Centre for Health Evaluation & Outcome Sciences, University of British Columbia, Canada
- Department of Emergency Medicine, University of British Columbia, Canada
- British Columbia Emergency Health Services, British Columbia, Canada
| | - Michael Asamoah-Boaheng
- Department of Emergency Medicine, University of British Columbia, Canada
- Faculty of Medicine, Clinical Epidemiology, Memorial University of Newfoundland, Canada
| | - Pascal M Lavoie
- Department of Pediatrics, University of British Columbia, Canada
| | - Mohammad Ehsanul Karim
- Centre for Health Evaluation & Outcome Sciences, University of British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Canada
| | - Tracy L Kirkham
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Ontario Occupational Cancer Research Centre, Ontario, Canada
| | - Paul A Demers
- School of Population and Public Health, University of British Columbia, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Ontario Occupational Cancer Research Centre, Ontario, Canada
| | - Vilte Barakauskas
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
| | - Ana Citlali Marquez
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
- Public Health Laboratory, British Columbia Centre for Disease Control, British Columbia, Canada
| | - Agatha N Jassem
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
- Public Health Laboratory, British Columbia Centre for Disease Control, British Columbia, Canada
| | | | - Steven J Drews
- Canadian, Blood Services Canada
- Laboratory Medicine and Pathology, University of Alberta, Alberta, Canadaand
| | - Scott Haig
- British Columbia Emergency Health Services, British Columbia, Canada
| | - Sheldon Cheskes
- Li Ka Shing Knowledge Institute and Division of Emergency Medicine, Department of Family and Community Medicine, University of Toronto, Ontario, Canada
| | - David M Goldfarb
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
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25
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Grunau B, Tom J, Asamoah-Boaheng M, O’Brien SF, Drews SJ, Sediqi S, Lavoie PM, Barakauskas V, Goldfarb DM. Sensitivity of the Elecsys Nucleocapsid Assay for the Detection of Preceding SARS-CoV-2 Infections. Open Forum Infect Dis 2022; 9:ofac349. [PMID: 35937649 PMCID: PMC9350617 DOI: 10.1093/ofid/ofac349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/24/2022] [Indexed: 11/26/2022] Open
Abstract
Nucleocapsid serological assay sensitivity to identify severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among vaccinees and for Omicron cases is unclear. In this prospective study, the Elecsys nucleocapsid assay was 89% sensitive in identifying SARS-CoV-2 infections 14–607 days pre–blood collection. Sensitivity was similar when comparing by vaccination status, and in Omicron (vs pre-Omicron) cases.
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Affiliation(s)
- Brian Grunau
- Centre for Health Evaluation & Outcome Sciences, St. Paul’s Hospital , Vancouver , Canada
- Department of Emergency Medicine, University of British Columbia , Vancouver , Canada
- British Columbia Emergency Health Services , Vancouver, British Columbia , Canada
| | - Janessa Tom
- British Columbia Emergency Health Services , Vancouver, British Columbia , Canada
| | - Michael Asamoah-Boaheng
- Department of Emergency Medicine, University of British Columbia , Vancouver , Canada
- Faculty of Medicine, Memorial University of Newfoundland , St. John’s , Canada
| | | | - Steven J Drews
- Canadian Blood Services , Ottawa , Canada
- Laboratory Medicine and Pathology, University of Alberta , Edmonton , Canada
| | - Sadaf Sediqi
- Department of Pathology and Laboratory Medicine, University of British Columbia , Vancouver , Canada
| | - Pascal M Lavoie
- Department of Pediatrics, University of British Columbia , Vancouver , Canada
| | - Vilte Barakauskas
- Department of Pathology and Laboratory Medicine, University of British Columbia , Vancouver , Canada
| | - David M Goldfarb
- Department of Pathology and Laboratory Medicine, University of British Columbia , Vancouver , Canada
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26
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Abe KT, Rathod B, Colwill K, Gingras AC, Tuite A, Robbins NF, Orjuela G, Jenkins C, Conrod V, Yi QL, O’Brien SF, Drews SJ. A Qualitative Comparison of the Abbott SARS-CoV-2 IgG II Quant Assay against Commonly Used Canadian SARS-CoV-2 Enzyme Immunoassays in Blood Donor Retention Specimens, April 2020 to March 2021. Microbiol Spectr 2022; 10:e0113422. [PMID: 35652636 PMCID: PMC9241784 DOI: 10.1128/spectrum.01134-22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/14/2022] [Indexed: 01/11/2023] Open
Abstract
Our group has previously used laboratory and commercially developed assays to understand the IgG responses to SARS-CoV-2 antigens, including nucleocapsid (N), spike (S), and receptor binding domain (RBD), in Canadian blood donors. In this current study, we analyzed 17,428 available and previously characterized retention samples collected from April 2020 to March 2021. The analysis compared the characteristics of the Abbott SARS-CoV-2 IgG II Quant assay (Abbott anti-spike [S], Abbott, Chicago, IL) against four other IgG assays. The Abbott anti-S assay has a qualitative threshold of 50 AU/mL. The four comparator assays were the Abbott anti-nucleocapsid (N) assay and three commonly used Canadian in-house IgG enzyme-linked immunosorbent assays (ELISAs) recognizing distinct recombinant viral antigens, full-length spike glycoprotein, glycoprotein RBD, and nucleocapsid. The strongest qualitative relationship was between Sinai RBD and the Abbott anti-S assay (kappa, 0.707; standard error [SE] of kappa, 0.018; 95% confidence interval, 0.671 to 0.743). We then scored each previously characterized specimen as positive when two anti-SARS-COV-2 assays identified anti-SARS-CoV-2 IgG in the specimen. Using this composite reference standard approach, the sensitivity of the Abbott anti-S assay was 95.96% (95% confidence interval [CI], 93.27 to 97.63%). The specificity of the Abbott anti-S assay was 99.35% (95% CI, 99.21 to 99.46%). Our study provides context on the use of commonly used SARS-CoV-2 serologies in Canada and identifies how these assays qualitatively compare to newer commercial assays. Our next steps are to assess how well the Abbott anti-S assays quantitatively detect wild-type and SARS-CoV-2 variants of concern. IMPORTANCE We describe the qualitative test characteristics of the Abbott SARS-CoV-2 IgG II Quant assay against four other anti-SARS-CoV-2 IgG assays commonly used in Canada. Although there is no gold standard for identifying anti-SARS-CoV-2 seropositivity, aggregate standards can be used to assess seropositivity. In this study, we used a specimen bank of previously well-characterized specimens collected between April 2020 and March 2021. The Abbott anti-S assay showed the strongest qualitative relationship with a widely used laboratory-developed IgG assay for the SARS-CoV-2 receptor binding domain. Using the composite reference standard approach, we also showed that the Abbott anti-S assay was highly sensitive and specific. As new anti-SARS-CoV-2 assays are developed, it is important to compare their test characteristics against other assays that have been extensively used in prior research.
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Affiliation(s)
- Kento T. Abe
- Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Bhavisha Rathod
- Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Karen Colwill
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Treadwell Therapeutics, Toronto, Ontario, Canada
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Ashleigh Tuite
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Craig Jenkins
- COVID-19 Serological Screening Laboratory, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Valerie Conrod
- COVID-19 Serological Screening Laboratory, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Qi-Long Yi
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Sheila F. O’Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Steven J. Drews
- Canadian Blood Services, Microbiology, Edmonton, Alberta, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
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27
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Colwill K, Galipeau Y, Stuible M, Gervais C, Arnold C, Rathod B, Abe KT, Wang JH, Pasculescu A, Maltseva M, Rocheleau L, Pelchat M, Fazel-Zarandi M, Iskilova M, Barrios-Rodiles M, Bennett L, Yau K, Cholette F, Mesa C, Li AX, Paterson A, Hladunewich MA, Goodwin PJ, Wrana JL, Drews SJ, Mubareka S, McGeer AJ, Kim J, Langlois MA, Gingras AC, Durocher Y. A scalable serology solution for profiling humoral immune responses to SARS-CoV-2 infection and vaccination. Clin Transl Immunology 2022; 11:e1380. [PMID: 35356067 PMCID: PMC8942165 DOI: 10.1002/cti2.1380] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 12/14/2022] Open
Abstract
Objectives Antibody testing against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has been instrumental in detecting previous exposures and analyzing vaccine‐elicited immune responses. Here, we describe a scalable solution to detect and quantify SARS‐CoV‐2 antibodies, discriminate between natural infection‐ and vaccination‐induced responses, and assess antibody‐mediated inhibition of the spike‐angiotensin converting enzyme 2 (ACE2) interaction. Methods We developed methods and reagents to detect SARS‐CoV‐2 antibodies by enzyme‐linked immunosorbent assay (ELISA). The main assays focus on the parallel detection of immunoglobulin (Ig)Gs against the spike trimer, its receptor binding domain (RBD) and nucleocapsid (N). We automated a surrogate neutralisation (sn)ELISA that measures inhibition of ACE2‐spike or ‐RBD interactions by antibodies. The assays were calibrated to a World Health Organization reference standard. Results Our single‐point IgG‐based ELISAs accurately distinguished non‐infected and infected individuals. For seroprevalence assessment (in a non‐vaccinated cohort), classifying a sample as positive if antibodies were detected for ≥ 2 of the 3 antigens provided the highest specificity. In vaccinated cohorts, increases in anti‐spike and ‐RBD (but not ‐N) antibodies are observed. We present detailed protocols for serum/plasma or dried blood spots analysis performed manually and on automated platforms. The snELISA can be performed automatically at single points, increasing its scalability. Conclusions Measuring antibodies to three viral antigens and identify neutralising antibodies capable of disrupting spike‐ACE2 interactions in high‐throughput enables large‐scale analyses of humoral immune responses to SARS‐CoV‐2 infection and vaccination. The reagents are available to enable scaling up of standardised serological assays, permitting inter‐laboratory data comparison and aggregation.
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Affiliation(s)
- Karen Colwill
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Yannick Galipeau
- Department of Biochemistry, Microbiology, and Immunology University of Ottawa Ottawa ON Canada
| | - Matthew Stuible
- Mammalian Cell Expression, Human Health Therapeutics Research Centre National Research Council Canada Montréal QC Canada
| | - Christian Gervais
- Mammalian Cell Expression, Human Health Therapeutics Research Centre National Research Council Canada Montréal QC Canada
| | - Corey Arnold
- Department of Biochemistry, Microbiology, and Immunology University of Ottawa Ottawa ON Canada
| | - Bhavisha Rathod
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Present address: Treadwell Therapeutics Toronto ON Canada
| | - Kento T Abe
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Department of Molecular Genetics University of Toronto Toronto ON Canada
| | - Jenny H Wang
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Adrian Pasculescu
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Mariam Maltseva
- Department of Biochemistry, Microbiology, and Immunology University of Ottawa Ottawa ON Canada
| | - Lynda Rocheleau
- Department of Biochemistry, Microbiology, and Immunology University of Ottawa Ottawa ON Canada
| | - Martin Pelchat
- Department of Biochemistry, Microbiology, and Immunology University of Ottawa Ottawa ON Canada.,The Centre for Infection, Immunity, and Inflammation University of Ottawa Ottawa ON Canada
| | - Mahya Fazel-Zarandi
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Mariam Iskilova
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Miriam Barrios-Rodiles
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Linda Bennett
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Kevin Yau
- Division of Nephrology Department of Medicine Sunnybrook Health Sciences Centre Toronto ON Canada
| | - François Cholette
- National Microbiology Laboratory Public Health Agency of Canada Winnipeg MB Canada.,Department of Medical Microbiology and Infectious Diseases University of Manitoba Winnipeg MB Canada
| | - Christine Mesa
- National Microbiology Laboratory Public Health Agency of Canada Winnipeg MB Canada
| | - Angel X Li
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Department of Microbiology, at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Aimee Paterson
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Department of Microbiology, at Mount Sinai Hospital Sinai Health Toronto ON Canada
| | - Michelle A Hladunewich
- Division of Nephrology Department of Medicine Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Pamela J Goodwin
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Department of Medicine University of Toronto Toronto ON Canada
| | - Jeffrey L Wrana
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Department of Molecular Genetics University of Toronto Toronto ON Canada
| | - Steven J Drews
- Microbiology, Donation Policy and Studies Canadian Blood Services Edmonton AB Canada.,Division of Diagnostic and Applied Microbiology Department of Laboratory Medicine and Pathology University of Alberta Edmonton AB Canada
| | - Samira Mubareka
- Division of Microbiology Department of Laboratory Medicine and Molecular Diagnostics Sunnybrook Health Sciences Centre Toronto ON Canada.,Biological Sciences Sunnybrook Research Institute Toronto ON Canada.,Division of Infectious Diseases Sunnybrook Health Sciences Centre Toronto ON Canada.,Department of Laboratory Medicine and Pathology University of Toronto Toronto ON Canada
| | - Allison J McGeer
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Department of Microbiology, at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Institute of Health Policy, Management and Evaluation University of Toronto Toronto ON Canada
| | - John Kim
- National Microbiology Laboratory Public Health Agency of Canada Winnipeg MB Canada
| | - Marc-André Langlois
- Department of Biochemistry, Microbiology, and Immunology University of Ottawa Ottawa ON Canada.,The Centre for Infection, Immunity, and Inflammation University of Ottawa Ottawa ON Canada
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital Sinai Health Toronto ON Canada.,Department of Molecular Genetics University of Toronto Toronto ON Canada
| | - Yves Durocher
- Mammalian Cell Expression, Human Health Therapeutics Research Centre National Research Council Canada Montréal QC Canada
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28
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Tuite AR, Fisman D, Abe KT, Rathod B, Pasculescu A, Colwill K, Gingras AC, Yi QL, O’Brien SF, Drews SJ. Estimating SARS-CoV-2 Seroprevalence in Canadian Blood Donors, April 2020 to March 2021: Improving Accuracy with Multiple Assays. Microbiol Spectr 2022; 10:e0256321. [PMID: 35196819 PMCID: PMC8865569 DOI: 10.1128/spectrum.02563-21] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/14/2022] [Indexed: 01/30/2023] Open
Abstract
We have previously used composite reference standards and latent class analysis (LCA) to evaluate the performance of laboratory assays in the presence of tarnished gold standards. Here, we apply these techniques to repeated, cross-sectional study of Canadian blood donors, whose sera underwent parallel testing with four separate SARS-CoV-2 antibody assays. We designed a repeated cross-sectional design with random cross-sectional sampling of all available retention samples (n = 1500/month) for a 12 -month period from April 2020 until March 2021. Each sample was evaluated for SARS-CoV-2 IgG antibodies using four assays an Abbott Architect assay targeting the nucleocapsid antigen (Abbott-NP, Abbott, Chicago IL) and three in-house IgG ELISAs recognizing distinct recombinant viral antigens: full-length spike glycoprotein (Spike), spike glycoprotein receptor binding domain (RBD) and nucleocapsid (NP). We used two analytic approaches to estimate SAR-CoV-2 seroprevalence: a composite reference standard and LCA. Using LCA to estimate true seropositivity status based on the results of the four antibody tests, we estimated that seroprevalence increased from 0.8% (95% CI: 0.5-1.4%) in April 2020 to 6.3% (95% CI: 5.1-7.6%) in March 2021. Our study provides further support for the use of LCA in upcoming public health crises, epidemics, and pandemics when a gold standard assay may not be available or identifiable. IMPORTANCE Here, we describe an approach to estimating seroprevalence in a low prevalence setting when multiple assays are available and yet no known gold standard exists. Because serological studies identify cases through both diagnostic testing and surveillance, and otherwise silent, unrecognized infections, serological data can be used to estimate the true infection fatality ratio of a disease. However, seroprevalence studies rely on assays with imperfect sensitivity and specificity. Seroreversion (loss of antibody response) also occurs over time, and with the advent of vaccination, distinction of antibody response resulting from vaccination as opposed to antibody response due to infection has posed an additional challenge. Our approach indicates that seroprevalence on Canadian blood donors by the end of March 2021was less than 10%. Our study supports the use of latent class analysis in upcoming public health crises, epidemics, and pandemics when a gold standard assay may not be available or identifiable.
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Affiliation(s)
- Ashleigh R. Tuite
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Immunization Readiness, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - David Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Kento T. Abe
- Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Bhavisha Rathod
- Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Adrian Pasculescu
- Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Karen Colwill
- Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Qi-Long Yi
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Sheila F. O’Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Steven J. Drews
- Canadian Blood Services, Microbiology, Edmonton, Alberta, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
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29
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Drews SJ, Bodnar M, Gill B, Carson D, Hawes G, Yi QL, Tran V, Zhou HY, Bigham M, O'Brien SF. An uncertain association between influenza season, recent influenza vaccination campaigns, and unconfirmed repeat reactive syphilis serology assay results in Canadian blood donors. Transfusion 2022; 62:510-512. [PMID: 35146767 DOI: 10.1111/trf.16786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 12/07/2021] [Accepted: 12/10/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Steven J Drews
- Microbiology Department, Donation Policy & Studies, Canadian Blood Services, Edmonton, Alberta, Canada.,Department of Laboratory Medicine & Pathology, Division of Diagnostic and Applied Microbiology, University of Alberta, Edmonton, Alberta, Canada
| | - Melanie Bodnar
- Department of Laboratory Medicine & Pathology, Division of Diagnostic and Applied Microbiology, University of Alberta, Edmonton, Alberta, Canada.,Medical Laboratory and Stem Cell Services, Canadian Blood Services, Edmonton, Alberta, Canada
| | - Balkar Gill
- Testing Department, Canadian Blood Services, Calgary, Alberta, Canada
| | - David Carson
- Testing Department, Canadian Blood Services, Brampton, Ontario, Canada
| | - Gordon Hawes
- Testing Department, Canadian Blood Services, Brampton, Ontario, Canada
| | - Qi-Long Yi
- Epidemiology and Surveillance, Donation Policy & Studies, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Vanessa Tran
- Microbiology, Public Health Ontario, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Hong Yuan Zhou
- Microbiology, Provlab Alberta, Calgary, Alberta, Canada.,Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Mark Bigham
- Medical Laboratory and Stem Cell Services, Canadian Blood Services, Vancouver, British Columbia, Canada
| | - Sheila F O'Brien
- Epidemiology and Surveillance, Donation Policy & Studies, Canadian Blood Services, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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30
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Sheffield WP, Bhakta V, Howell A, Jenkins C, Serrano K, Johnson N, Lin YCJ, Colwill K, Rathod B, Greenberg B, Gingras AC, Evans DH, Flaumenhaft E, Beckett A, Drews SJ, Devine DV. Retention of hemostatic and immunological properties of frozen plasma and COVID-19 convalescent apheresis fresh-frozen plasma produced and freeze-dried in Canada. Transfusion 2021; 62:418-428. [PMID: 34907536 DOI: 10.1111/trf.16772] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/05/2021] [Accepted: 11/19/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Randomized clinical trial data show that early plasma transfusion may save lives among trauma patients. Supplying plasma in remote environments is logistically challenging. Freeze-dried plasma (FDP) offers a possible solution. STUDY DESIGN AND METHODS A Terumo BCT plasma freeze-drying system was evaluated. We compared pooled frozen plasma (FP) units with derived Terumo BCT FDP (TFDP) units and pooled COVID-19 convalescent apheresis fresh-frozen plasma (CC-AFFP) with derived CC-TFDP units. Parameters measured were: coagulation factors (F) II; V; VII; VIII; IX; XI; XIII; fibrinogen; Proteins C (PC) and S (PS); antithrombin (AT); α2 -antiplasmin (α2 AP); ADAMTS13; von Willebrand Factor (vWF); thrombin-antithrombin (TAT); D-dimer; activated complement factors 3 (C3a) and 5 (C5a); pH; osmolality; prothrombin time (PT); and activated partial thromboplastin time (aPTT). Antibodies to SARS-CoV-2 in CC-AFFP and CC-TFDP units were compared by plaque reduction assays and viral protein immunoassays. RESULTS Most parameters were unchanged in TFDP versus FP or differed ≤15%. Mean aPTT, PT, C3a, and pH were elevated 5.9%, 6.9%, 64%, and 0.28 units, respectively, versus FP. CC-TFDP showed no loss of SARS-CoV-2 neutralization titer versus CC-AFFP and no mean signal loss in most pools by viral protein immunoassays. CONCLUSION Changes in protein activities or clotting times arising from freeze-drying were <15%. Although C3a levels in TFDP were elevated, they were less than literature values for transfusable plasma. SARS-CoV-2-neutralizing antibody titers and viral protein binding levels were largely unaffected by freeze-drying. In vitro characteristics of TFDP or CC-TFDP were comparable to their originating plasma, making future clinical studies appropriate.
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Affiliation(s)
- William P Sheffield
- Centre for Innovation, Canadian Blood Services, Edmonton, Hamilton, Ottawa, and Vancouver, Canada.,Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada
| | - Varsha Bhakta
- Centre for Innovation, Canadian Blood Services, Edmonton, Hamilton, Ottawa, and Vancouver, Canada
| | - Anita Howell
- Centre for Innovation, Canadian Blood Services, Edmonton, Hamilton, Ottawa, and Vancouver, Canada
| | - Craig Jenkins
- Centre for Innovation, Canadian Blood Services, Edmonton, Hamilton, Ottawa, and Vancouver, Canada
| | - Katherine Serrano
- Centre for Innovation, Canadian Blood Services, Edmonton, Hamilton, Ottawa, and Vancouver, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | | | - Yi-Chan J Lin
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, Canada
| | - Karen Colwill
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada
| | - Bhavisha Rathod
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada
| | | | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - David H Evans
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, Canada
| | | | | | - Steven J Drews
- Microbiology, Canadian Blood Services, Edmonton, Canada.,Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada
| | - Dana V Devine
- Centre for Innovation, Canadian Blood Services, Edmonton, Hamilton, Ottawa, and Vancouver, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
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31
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Drews SJ, Abe KT, Hu Q, Samson R, Gingras AC, Colwill K, Rathod B, Wang J, Fazel-Zarandi M, Yi QL, Robinson A, Wood H, Tuite A, Fisman D, Evans DH, Lin YCJ, O'Brien SF. Resistance of SARS-CoV-2 beta and gamma variants to plasma collected from Canadian blood donors during the spring of 2020. Transfusion 2021; 62:37-43. [PMID: 34662434 PMCID: PMC8662190 DOI: 10.1111/trf.16713] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/11/2021] [Accepted: 10/11/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND This pilot study assesses the ability of plasma collected from Canadian blood donors in the first wave of the SARS-CoV-2 pandemic to neutralize later SARS-CoV-2 variants of concern (VOCs). STUDY DESIGN AND METHODS A repeated cross-sectional design was used, and a random cross-sectional sample of all available Canadian Blood Services retention samples (n = 1500/month) was drawn monthly for April and May of 2020. Qualitative IgG analysis was performed on aliquots of specimens using anti-spike, anti-receptor binding domain, and anti-nucleocapsid protein enzyme-linked immunosorbent assays as well as the Abbott Architect SARS CoV-2 IgG assay (Abbott Laboratories) against the anti-nucleocapsid protein. Selected plasma specimens were then assessed for neutralization against VOCs using pseudotyped lentivirus inhibition assays as well as plaque reduction neutralization test 50% (PRNT50 ). RESULTS Six specimens with a high neutralizing titer against wild-type SARS-CoV-2 and three specimens with a low neutralizing titer against wild-type SARS-CoV-2 were chosen for further analysis against VOCs. Four of six high neutralizing titer specimens had a reduced neutralizing capacity against beta VOCs by both neutralization methods. Three of six high neutralizing titer specimens had reduced neutralization capacity against gamma VOCs. CONCLUSIONS This preliminary data can be used as a justification for limiting the use of first wave plasma products in upcoming clinical trials but cannot be used to speculate on general trends in the immunity of Canadian blood donors to SARS-CoV-2.
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Affiliation(s)
- Steven J Drews
- Microbiology, Canadian Blood Services, Edmonton, Alberta, Canada.,Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Kento T Abe
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Queenie Hu
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Toronto, Ontario, Canada
| | - Reuben Samson
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Toronto, Ontario, Canada
| | - Anne-Claude Gingras
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Karen Colwill
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Toronto, Ontario, Canada
| | - Bhavisha Rathod
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Toronto, Ontario, Canada
| | - Jenny Wang
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Toronto, Ontario, Canada
| | - Mahya Fazel-Zarandi
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital, Toronto, Ontario, Canada
| | - Qi-Long Yi
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Alyssia Robinson
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Heidi Wood
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ashleigh Tuite
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - David Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - David H Evans
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, Alberta, Canada
| | - Yi-Chan J Lin
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, Alberta, Canada
| | - Sheila F O'Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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32
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Drews SJ. Prevention of transfusion-transmitted syphilis by blood operators: How much is enough when transfusion-transmission has not been identified for decades? Transfusion 2021; 61:3055-3060. [PMID: 34617282 DOI: 10.1111/trf.16696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Steven J Drews
- Microbiology Department, Donation Policy and Studies, Canadian Blood Services, Edmonton, Alberta, Canada.,Department of Laboratory Medicine & Pathology, Division of Diagnostic and Applied Microbiology, University of Alberta, Edmonton, Alberta, Canada
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33
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Abstract
BACKGROUND Despite expected initial universal susceptibility to a novel pandemic pathogen like SARS-CoV-2, the pandemic has been characterized by higher observed incidence in older persons and lower incidence in children and adolescents. OBJECTIVE To determine whether differential testing by age group explains observed variation in incidence. DESIGN Population-based cohort study. SETTING Ontario, Canada. PARTICIPANTS Persons diagnosed with SARS-CoV-2 and those tested for SARS-CoV-2. MEASUREMENTS Test volumes from the Ontario Laboratories Information System, number of laboratory-confirmed SARS-CoV-2 cases from the Integrated Public Health Information System, and population figures from Statistics Canada. Demographic and temporal patterns in incidence, testing rates, and test positivity were explored using negative binomial regression models and standardization. Sources of variation in standardized ratios were identified and test-adjusted standardized infection ratios (SIRs) were estimated by metaregression. RESULTS Observed disease incidence and testing rates were highest in the oldest age group and markedly lower in those younger than 20 years; no differences in incidence were seen by sex. After adjustment for testing frequency, SIRs were lowest in children and in adults aged 70 years or older and markedly higher in adolescents and in males aged 20 to 49 years compared with the overall population. Test-adjusted SIRs were highly correlated with standardized positivity ratios (Pearson correlation coefficient, 0.87 [95% CI, 0.68 to 0.95]; P < 0.001) and provided a case identification fraction similar to that estimated with serologic testing (26.7% vs. 17.2%). LIMITATIONS The novel methodology requires external validation. Case and testing data were not linkable at the individual level. CONCLUSION Adjustment for testing frequency provides a different picture of SARS-CoV-2 infection risk by age, suggesting that younger males are an underrecognized group at high risk for SARS-CoV-2 infection. PRIMARY FUNDING SOURCE Canadian Institutes of Health Research.
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Affiliation(s)
- David N Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (D.N.F., A.R.T.)
| | - Amy L Greer
- University of Guelph, Guelph, Ontario, Canada (A.L.G., G.B.)
| | | | - Michael Hillmer
- Dalla Lana School of Public Health, University of Toronto, and Ontario Ministry of Health, Toronto, Ontario, Canada (M.H.)
| | | | - Steven J Drews
- Canadian Blood Services, Edmonton, Alberta, Canada (S.J.D.)
| | - Ashleigh R Tuite
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (D.N.F., A.R.T.)
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34
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Bhavanam S, Rayat GR, Keelan M, Kunimoto D, Drews SJ. Evaluation of the effect of T regulatory cell depletion and donor BCG vaccination on Mycobacterium tuberculosis H37Ra infection using an in vitro model of human PBMC infection. Pathog Dis 2021; 78:5974523. [PMID: 33300047 DOI: 10.1093/femspd/ftaa068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 11/09/2020] [Indexed: 11/13/2022] Open
Abstract
This study evaluated the effect of T regulatory cells (Treg cells) and the impact of BCG vaccination history of donors using an in vitro model of Mycobacterium tuberculosis H37Ra infection of peripheral blood mononuclear cells (PBMCs). PBMCs from donors with or without prior BCG vaccination were depleted of Treg cells (PBMCs-Tregs) or not depleted with Treg cells (PBMCs + Tregs) were infected up to 8 days with Mtb H37Ra. Cell aggregates were smaller in PBMCs-Tregs compared to PBMCs + Tregs at day 8 post-infection. Mtb CFUs were higher in the PBMCs-Tregs compared to PBMCs + Tregs at days 3, 5 and 8. The levels of IL-17, IFN-γ (at days 3 and 5), and TNF-α and IL-6 (at day 3) were lower in PBMCs-Tregs compared to PBMCs + Tregs. In contrast, the levels of IL-10 and IL-4 cytokines were higher at day 3 in PBMCs-Tregs compared to PBMCs + Tregs. BCG vaccination status of donors had no impact on the mycobacterial culture, level of cytokines and immune cell populations. This study shows that depletion of Tregs in human PBMCs infected with Mtb H37Ra in vitro leads to a shift from a Th1 to a Th2 cytokine rich environment that supports the survival of Mtb in this model.
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Affiliation(s)
- Sudha Bhavanam
- Department of Laboratory Medicine and Pathology, University of Alberta, 4B1.19 Walter Mackenzie Centre, 8440-112 St, Edmonton, Alberta, Canada T6G 2B7
| | - Gina R Rayat
- Alberta Diabetes Institute, Ray Rajotte Surgical-Medical Research Institute, Department of Surgery, University of Alberta, 1-002 Li Ka Shing Centre for Health Research Innovation, Edmonton, Alberta, Canada T6G 2E1
| | - Monika Keelan
- Department of Laboratory Medicine and Pathology, University of Alberta, 4B1.19 Walter Mackenzie Centre, 8440-112 St, Edmonton, Alberta, Canada T6G 2B7
| | - Dennis Kunimoto
- Department of Medicine, University of Alberta, Edmonton, Alberta, 2J2.00 WC Mackenzie Centre, 8440-112 St, Edmonton, Alberta, Canada T6G 2R7
| | - Steven J Drews
- Department of Laboratory Medicine and Pathology, University of Alberta, 4B1.19 Walter Mackenzie Centre, 8440-112 St, Edmonton, Alberta, Canada T6G 2B7.,Canadian Blood Services, Department of Laboratory Medicine and Pathology, University of Alberta, 8249 114 St. NW, Edmonton, Alberta, Canada T6G 2R8
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35
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Drews SJ, Van Caeseele P, Bullard J, Lindsay LR, Gaziano T, Zeller MP, Lane D, Ndao M, Allen VG, Boggild AK, O'Brien SF, Marko D, Musuka C, Almiski M, Bigham M. Babesia microti in a Canadian blood donor and lookback in a red blood cell recipient. Vox Sang 2021; 117:438-441. [PMID: 34462920 DOI: 10.1111/vox.13198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/09/2021] [Accepted: 08/09/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND OBJECTIVES We describe the third documented case of autochthonous human babesiosis in Canada and the second in a Canadian blood donor. MATERIALS AND METHODS Multiple laboratory investigations were carried out on the donor and the immunocompromised recipient of an associated, potentially infectious red blood cell product. RESULTS The donor had not travelled except for outdoor exposure in south-eastern Manitoba, followed by illness and hospital admission. The donor had a notable parasitaemia, positive for Babesia microti using whole blood nucleic acid testing (NAT). The recipient was negative for B. microti by both serology and NAT. CONCLUSION There was no evidence of transfusion-transmitted babesiosis.
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Affiliation(s)
- Steven J Drews
- Microbiology, Donation Policy and Studies, Canadian Blood Services, Edmonton, Alberta, Canada.,Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | | | - Jared Bullard
- Cadham Provincial Laboratory, Winnipeg, Manitoba, Canada
| | - L Robbin Lindsay
- Zoonotic Diseases and Special Pathogens Section, National Microbiology Laboratory, Winnipeg, Manitoba, Canada
| | - Teresa Gaziano
- Medical Laboratory and Stem Cell Services, Canadian Blood Services, Brampton, Ontario, Canada
| | - Michelle P Zeller
- Medical Laboratory and Stem Cell Services, Canadian Blood Services, Ancaster, Ontario, Canada.,McMaster Centre for Transfusion Research, McMaster University, Hamilton, Ontario, Canada
| | - Debra Lane
- Medical Laboratory and Stem Cell Services, Canadian Blood Services, Winnipeg, Manitoba, Canada
| | - Momar Ndao
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Vanessa G Allen
- Public Health Ontario, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Andrea K Boggild
- Tropical Disease Unit, Division of Infectious Diseases, University Health Network, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sheila F O'Brien
- Epidemiology and Surveillance, Donation Policy and Studies, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Daniel Marko
- Department of Pathology, University of Manitoba, Winnipeg, Manitoba, Canada.,Shared Health, Winnipeg, Manitoba, Canada
| | - Charles Musuka
- Department of Pathology, University of Manitoba, Winnipeg, Manitoba, Canada.,Shared Health, Winnipeg, Manitoba, Canada
| | - Muhamad Almiski
- Department of Pathology, University of Manitoba, Winnipeg, Manitoba, Canada.,Shared Health, Winnipeg, Manitoba, Canada
| | - Mark Bigham
- Medical Laboratory and Stem Cell Services, Canadian Blood Services, Vancouver, British Columbia, Canada
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36
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Hughes SL, Kwong JC, Schwartz KL, Chen C, Johnson C, Li Y, Marchand-Austin A, Bolotin S, Jamieson FB, Drews SJ, Russell ML, Svenson LW, Mahmud SM, Crowcroft NS. Exploring the reasons for low pertussis vaccine effectiveness in Ontario, Canada, 2006-2008: a Canadian Immunization Research Network study. Can J Public Health 2021; 113:155-164. [PMID: 34424508 DOI: 10.17269/s41997-021-00536-1] [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] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/27/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Although pertussis vaccines have been widely used for many decades, a burden of illness persists. Resurgences in Ontario, Canada, have not been substantial in the past decade, but an outbreak of pertussis occurred in Toronto between 1 October 2005 and 31 March 2006. Previous Ontario studies found high vaccine effectiveness (VE) in the initial years post-immunization. In order to explore the impact of outbreaks and external factors on VE, we investigated pertussis VE during the period 2006-2008. METHODS We assessed pertussis VE using a frequency-matched case-control study for the period 1 March 2006 to 31 December 2008. We used logistic regression to estimate VE by age, time since last vaccination, and vaccination status according to the Ontario recommended schedule. We compared analyses including and excluding cases from Toronto, and to two recent Ontario pertussis VE studies. RESULTS We included 1797 confirmed cases and 7188 matched controls. Most cases were under 4 years of age during the study period. Pertussis VE was 3.8% (95% CI: - 21.0, 24.0) in the period 15-364 days following the last pertussis vaccine dose, and increased with increasing time since vaccination. Pertussis VE in the first 15-364 days excluding Toronto increased to 57.1% (95% CI: 26.0, 75.1), but the trend of increasing VE with time since vaccination persisted. Although VE was higher in older (6-11 years) than younger (0-5 years) children, it was lower at 12-13 years than after 14 years. CONCLUSION VE was lower in comparison with other studies conducted in Ontario, particularly in younger children. Various factors occurring during the study period may have influenced the results, including clinical testing of asymptomatic contacts, laboratory testing and methods and reporting practice, and a sensitive case definition. Further studies are needed to optimize methods for measuring VE to inform pertussis vaccine policy.
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Affiliation(s)
| | - Jeffrey C Kwong
- Public Health Ontario, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7, Canada.,Department of Family & Community Medicine, University of Toronto, Toronto, ON, Canada.,ICES, Toronto, ON, Canada
| | - Kevin L Schwartz
- Public Health Ontario, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7, Canada.,ICES, Toronto, ON, Canada
| | - Cynthia Chen
- Public Health Ontario, Toronto, ON, Canada.,ICES, Toronto, ON, Canada
| | | | - Ye Li
- Public Health Ontario, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7, Canada
| | | | - Shelly Bolotin
- Public Health Ontario, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Frances B Jamieson
- Public Health Ontario, Toronto, ON, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Steven J Drews
- Canadian Blood Services, Ottawa, ON, Canada.,Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - Margaret L Russell
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lawrence W Svenson
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Alberta Health, Edmonton, AB, Canada.,Division of Preventive Medicine, University of Alberta, Edmonton, AB, Canada.,School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Salaheddin M Mahmud
- Vaccine and Drug Evaluation Centre, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Natasha S Crowcroft
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7, Canada.
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37
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O'Brien SF, Drews SJ, Yi QL, Bloch EM, Ogden NH, Koffi JK, Lindsay LR, Gregoire Y, Delage G. Risk of transfusion-transmitted Babesia microti in Canada. Transfusion 2021; 61:2958-2968. [PMID: 34272882 DOI: 10.1111/trf.16595] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Babesia microti has gained a foothold in Canada as tick vectors become established in broader geographic areas. B. microti infection is associated with mild or no symptoms in healthy individuals but is transfusion-transmissible and can be fatal in immunocompromised individuals. This is the first estimate of clinically significant transfusion-transmitted babesiosis (TTB) risk in Canada. STUDY DESIGN AND METHODS The proportion of B. microti-antibody (AB)/nucleic acid amplification test (NAT)-positive whole blood donations was estimated at 5.5% of the proportion of the general population with reported Lyme Disease (also tick-borne) based on US data. Monte Carlo simulation estimated the number and proportion of infectious red cell units for three scenarios: base, localized incidence (risk in Manitoba only), and donor study informed (prevalence from donor data). The model simulated 1,029,800 donations repeated 100,000 times for each. RESULTS In the base scenario 0.5 (0.01, 1.75), B. microti-NAT-positive donations would be expected per year, with 0.08 (0, 0.38) recipients suffering clinically significant TTB (1 every 12.5 years). In the localized incidence scenario, there were 0.21(0, 0.7) B. microti-NAT-positive donations, with 0.04 (0, 0.14) recipient infections (about 1 every 25 years). In the donor study informed scenario, there were 4.6 (0.3, 15.8) B. microti-NAT-positive donations expected, and 0.81 (0.05, 3.14) clinically significant TTB cases per year. DISCUSSION The likelihood of clinically relevant TTB is low. Testing would have very little utility in Canada at this time. Ongoing pathogen surveillance in tick vectors is important as B. microti prevalence appears to be slowly increasing in Canada.
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Affiliation(s)
- Sheila F O'Brien
- Epidemiology & Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada.,School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Steven J Drews
- Department of Microbiology, Canadian Blood Services, Edmonton, Alberta, Canada.,Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Qi-Long Yi
- Epidemiology & Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nicholas H Ogden
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, Quebec, Canada
| | - Jules K Koffi
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, Quebec, Canada
| | - Leslie Robbin Lindsay
- Zoonotic Diseases & Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Yves Gregoire
- Epidemiology and Statistics, Héma-Québec, Quebec City, Quebec, Canada
| | - Gilles Delage
- Medical Microbiology, Héma-Québec, Montreal, Quebec, Canada
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38
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Crowcroft NS, Schwartz KL, Savage RD, Chen C, Johnson C, Li Y, Marchand-Austin A, Bolotin S, Deeks SL, Jamieson FB, Drews SJ, Russell ML, Svenson LW, Simmonds K, Righolt CH, Bell C, Mahmud SM, Kwong JC. A Call for Caution in Use of Pertussis Vaccine Effectiveness Studies to Estimate Waning Immunity: A Canadian Immunization Research Network Study. Clin Infect Dis 2021; 73:83-90. [PMID: 32384142 DOI: 10.1093/cid/ciaa518] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Vaccine effectiveness (VE) studies provide essential evidence on waning vaccine-derived immunity, a major threat to pertussis control. We evaluated how study design affects estimates by comparing 2 case-control studies conducted in Ontario, Canada. METHODS We compared results from a test-negative design (TND) with a frequency-matched design (FMD) case-control study using pertussis cases from 2005-2015. In the first study, we identified test-negative controls from the public health laboratory that diagnosed cases and, in the second, randomly selected controls from patients attending the same physicians that reported cases, frequency matched on age and year. We compared characteristics of cases and controls using standardized differences. RESULTS In both designs, VE estimates for the early years postimmunization were consistent with clinical trials (TND, 84%; FMD, 89% at 1-3 years postvaccination) but diverged as time since last vaccination increased (TND, 41%; FMD, 74% by 8 years postvaccination). Overall, we observed lower VE and faster waning in the TND than the FMD. In the TND but not FMD, controls differed from cases in important confounders, being younger, having more comorbidities, and higher healthcare use. Differences between the controls of each design were greater than differences between cases. TND controls were more likely to be unvaccinated or incompletely vaccinated than FMD controls (P < .001). CONCLUSIONS The FMD adjusted better for healthcare-seeking behavior than the TND. Duration of protection from pertussis vaccines is unclear because estimates vary by study design. Caution should be exercised by experts, researchers, and decision makers when evaluating evidence on optimal timing of boosters.
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Affiliation(s)
- Natasha S Crowcroft
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Centre for Vaccine Preventable Diseases, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Kevin L Schwartz
- Centre for Vaccine Preventable Diseases, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Public Health Ontario, Toronto, Ontario, Canada.,St Joseph's Health Centre, Toronto, Ontario, Canada
| | - Rachel D Savage
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | | | | | - Ye Li
- Centre for Vaccine Preventable Diseases, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Public Health Ontario, Toronto, Ontario, Canada
| | | | - Shelly Bolotin
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Centre for Vaccine Preventable Diseases, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Public Health Ontario, Toronto, Ontario, Canada
| | - Shelley L Deeks
- Centre for Vaccine Preventable Diseases, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Public Health Ontario, Toronto, Ontario, Canada
| | - Frances B Jamieson
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Public Health Ontario, Toronto, Ontario, Canada
| | - Steven J Drews
- Medical Microbiology, Canadian Blood Service, Edmonton, Alberta, Canada.,Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Margaret L Russell
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lawrence W Svenson
- Alberta Health, Edmonton, Alberta, Canada.,Division of Preventive Medicine, University of Alberta, Edmonton, Alberta, Canada.,School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Kimberley Simmonds
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Health, Edmonton, Alberta, Canada.,School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Christiaan H Righolt
- Vaccine and Drug Evaluation Centre, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christopher Bell
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Salaheddin M Mahmud
- Vaccine and Drug Evaluation Centre, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jeffrey C Kwong
- Centre for Vaccine Preventable Diseases, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Public Health Ontario, Toronto, Ontario, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
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39
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Gaussen A, Hornby L, Rockl G, O'Brien S, Delage G, Sapir-Pichhadze R, Drews SJ, Weiss MJ, Lewin A. Evidence of SARS-CoV-2 Infection in Cells, Tissues, and Organs and the Risk of Transmission Through Transplantation. Transplantation 2021; 105:1405-1422. [PMID: 33724248 DOI: 10.1097/tp.0000000000003744] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus responsible for the coronavirus disease 2019 (COVID-19) pandemic has raised concerns for programs overseeing donation and transplantation of cells, tissues, and organs (CTO) that this virus might be transmissible by transfusion or transplantation. Transplant recipients are considered particularly vulnerable to pathogens because of immunosuppression, and SARS-CoV-2 is likely to generate complications if contracted. Several signs and symptoms observed in COVID-19 positive patients reflect damage to multiple organs and tissues, raising the possibility of extrapulmonary SARS-CoV-2 infections and risk of transmission. At the beginning of the pandemic, a consensus has emerged not to consider COVID-19 positive patients as potential living or deceased donors, resulting in a global decrease in transplantation procedures. Medical decision-making at the time of organ allocation must consider safely alongside the survival advantages offered by transplantation. To address the risk of transmission by transplantation, this review summarizes the published cases of transplantation of cells or organs from donors infected with SARS-CoV-2 until January 2021 and assesses the current state of knowledge for the detection of this virus in different biologic specimens, cells, tissues, and organs. Evidence collected to date raises the possibility of SARS-CoV-2 infection and replication in some CTO, which makes it impossible to exclude transmission through transplantation. However, most studies focused on evaluating transmission under laboratory conditions with inconsistent findings, rendering the comparison of results difficult. Improved standardization of donors and CTO screening practices, along with a systematic follow-up of transplant recipients could facilitate the assessment of SARS-CoV-2 transmission risk by transplantation.
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Affiliation(s)
- Amaury Gaussen
- Medical Affairs and Innovation, Héma-Québec, Québec, QC, Canada
| | - Laura Hornby
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Canadian Blood Services, Ottawa, ON, Canada
| | - Gary Rockl
- Medical Affairs and Innovation, Héma-Québec, Québec, QC, Canada
| | | | - Gilles Delage
- Medical Affairs and Innovation, Héma-Québec, Saint-Laurent, QC, Canada
| | - Ruth Sapir-Pichhadze
- Centre for Outcomes Research and Evaluation (CORE), Research Institute of McGill University Health Centre, Montréal, QC, Canada
- Division of Nephrology and the Multi Organ Transplant Program, Royal Victoria Hospital, McGill University Health Centre, Montréal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | - Steven J Drews
- Canadian Blood Services, Edmonton, AB, Canada
- Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - Matthew J Weiss
- Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, CHU de Québec, Université Laval Research Center, Québec, QC, Canada
- Pediatrics Department, Intensive Care Division, Faculté de Médecine, Université Laval, Québec, QC, Canada
- Transplant Québec, Montréal, QC, Canada
| | - Antoine Lewin
- Medical Affairs and Innovation, Héma-Québec, Saint-Laurent, QC, Canada
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
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40
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Lewin A, Drews SJ, Lieshout-Krikke R, Erikstrup C, Saeed S, Fady H, Uzicanin S, Custer B, O'Brien SF. An international comparison of anti-SARS-COV-2 assays used for seroprevalence surveys from blood component providers. Vox Sang 2021; 116:946-954. [PMID: 33914918 PMCID: PMC8242559 DOI: 10.1111/vox.13100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/25/2021] [Accepted: 02/28/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVES Access to large pools of healthy adult donors advantageously positions blood component providers to undertake anti-SARS-CoV-2 seroprevalence studies. While numerous seroprevalence reports have been published by blood operators during the COVID-19 pandemic, details on the assay used has not been well documented. The objectives of this study were to evaluate the diversity of assays being used by blood operators and assess how this may affect seroprevalence estimates. MATERIALS AND METHODS We surveyed 49 blood component providers from 39 countries. Questionnaire included information on the number and identity of assays used, the detected immunoglobulin(s) and target antigen, and performance characteristics (sensitivity, specificity). RESULTS Thirty-eight of the 49 contacted blood suppliers provided at least partial responses. The results indicate that 19 commercial and five in-house serology assays have been used by surveyed blood operators. The Abbott SARS-CoV-2 IgG assay was the most commonly used kit and utilized by 15 blood suppliers. Two assays did not detect IgG, but detected either IgM/IgA or IgM. 68·2% of assays targeted the spike protein and 50% the nucleocapsid protein, while 18·2% targeted both viral proteins. The sensitivity and specificity of IgG-specific assays ranged from 71·9% to 100% and from 96·2% to 100%, respectively. As of 18 October 2020, the seroprevalence was below 5% in 10 of 14 countries reporting. CONCLUSION Our results highlight the diversity of assays being used. Analyses comparing blood donor seroprevalence across countries should consider assay characteristics with optimization of signal/cut-off ratios and consistent methodology to adjust for waning antibody.
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Affiliation(s)
- Antoine Lewin
- Medical Affairs & Innovation, Héma-Québec, Montreal, QC, Canada
| | - Steven J Drews
- Microbiology, Canadian Blood Services, Edmonton, AB, Canada
| | | | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Sahar Saeed
- Epidemiology & Surveillance, Canadian Blood Services, Ottawa, ON, Canada
| | - Helen Fady
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Petrie, QLD, Australia
| | - Samra Uzicanin
- Epidemiology & Surveillance, Canadian Blood Services, Ottawa, ON, Canada
| | - Brian Custer
- Research & Scientific Programs, Vitalant, San Francisco, CA, USA
| | - Sheila F O'Brien
- Epidemiology & Surveillance, Canadian Blood Services, Ottawa, ON, Canada
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41
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Yao Z, Drecun L, Aboualizadeh F, Kim SJ, Li Z, Wood H, Valcourt EJ, Manguiat K, Plenderleith S, Yip L, Li X, Zhong Z, Yue FY, Closas T, Snider J, Tomic J, Drews SJ, Drebot MA, McGeer A, Ostrowski M, Mubareka S, Rini JM, Owen S, Stagljar I. A homogeneous split-luciferase assay for rapid and sensitive detection of anti-SARS CoV-2 antibodies. Nat Commun 2021; 12:1806. [PMID: 33753733 PMCID: PMC7985487 DOI: 10.1038/s41467-021-22102-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/23/2021] [Indexed: 01/05/2023] Open
Abstract
Better diagnostic tools are needed to combat the ongoing COVID-19 pandemic. Here, to meet this urgent demand, we report a homogeneous immunoassay to detect IgG antibodies against SARS-CoV-2. This serological assay, called SATiN, is based on a tri-part Nanoluciferase (tNLuc) approach, in which the spike protein of SARS-CoV-2 and protein G, fused respectively to two different tNLuc tags, are used as antibody probes. Target engagement of the probes allows reconstitution of a functional luciferase in the presence of the third tNLuc component. The assay is performed directly in the liquid phase of patient sera and enables rapid, quantitative and low-cost detection. We show that SATiN has a similar sensitivity to ELISA, and its readouts are consistent with various neutralizing antibody assays. This proof-of-principle study suggests potential applications in diagnostics, as well as disease and vaccination management.
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Affiliation(s)
- Zhong Yao
- Donnelly Centre, University of Toronto, Toronto, ON, Canada
- Department of Biochemistry, University of Toronto, Toronto, ON, Canada
| | - Luka Drecun
- Donnelly Centre, University of Toronto, Toronto, ON, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Farzaneh Aboualizadeh
- Donnelly Centre, University of Toronto, Toronto, ON, Canada
- Department of Biochemistry, University of Toronto, Toronto, ON, Canada
| | - Sun Jin Kim
- Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah, Salt Lake City, UT, USA
| | - Zhijie Li
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Heidi Wood
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Emelissa J Valcourt
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Kathy Manguiat
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | | | - Lily Yip
- Biological Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Xinliu Li
- Department of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Zoe Zhong
- Department of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Feng Yun Yue
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | | | - Jamie Snider
- Donnelly Centre, University of Toronto, Toronto, ON, Canada
- Department of Biochemistry, University of Toronto, Toronto, ON, Canada
| | - Jelena Tomic
- Donnelly Centre, University of Toronto, Toronto, ON, Canada
- Department of Biochemistry, University of Toronto, Toronto, ON, Canada
| | - Steven J Drews
- Canadian Blood Services, Edmonton, AB, Canada
- Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, AB, Canada
| | - Michael A Drebot
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Allison McGeer
- Department of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Mario Ostrowski
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Samira Mubareka
- Biological Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - James M Rini
- Department of Biochemistry, University of Toronto, Toronto, ON, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Shawn Owen
- Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah, Salt Lake City, UT, USA.
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA.
- Department of Medicinal Chemistry, University of Utah, Salt Lake City, UT, USA.
| | - Igor Stagljar
- Donnelly Centre, University of Toronto, Toronto, ON, Canada.
- Department of Biochemistry, University of Toronto, Toronto, ON, Canada.
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada.
- Mediterranean Institute for Life Sciences, Split, Croatia.
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42
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Drews SJ, Devine DV, McManus J, Mendoza E, Manguiat K, Wood H, Girardin R, Dupuis A, McDonough K, Drebot M. A trend of dropping anti-SARS-CoV-2 plaque reduction neutralization test titers over time in Canadian convalescent plasma donors. Transfusion 2021; 61:1440-1446. [PMID: 33734448 DOI: 10.1111/trf.16364] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/19/2020] [Accepted: 01/27/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Convalescent plasma products are a potential passive immunotherapy for Coronavirus disease 2019 (COVID-19) disease. Various approaches have been utilized to determine the concentration of Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-neutralizing antibodies in plasma products. The Canadian Blood Services used Plaque Reduction Neutralization Test 50 (PRNT50) -generated values to qualify convalescent plasma donations supporting clinical trials in Canada. This manuscript describes changes in PRNT50 titers of repeat male plasma donations collected approximately 1-4 months after onset of COVID-19 signs and symptoms in donors. STUDY DESIGN AND METHODS Men were eligible to donate if they: met standard criteria, were < 67 years of age, reported a previous SARS-CoV-2-positive nucleic acid test, and recovered and were symptom free for at least 28 days prior to donation. Repeat donation analysis required at least one original and one repeat donation where a PRNT50 was performed. RESULTS From April 29, 2020 to July 25, 2020, 156 donors donated once, with 78 (50%) of the donated plasma having PRNT50 titers of ≥1:160. Thirty-seven (23.7%) of the donated plasma had a titer of 1:40 or 1:80 (individuals donating this plasma were asked to donate a second time only). A total of 30 donors (19.2%) had repeat donations. Of the repeat donors, 15 (50%) had at least an eightfold change from peak to trough PRNT50 titers within greater than 90 days after onset of COVID-19 symptoms. CONCLUSIONS Blood operators cannot infer that SARS-CoV-2 PRNT50 will remain high in repeat plasma donors 3-4 months after onset of COVID-19 symptoms.
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Affiliation(s)
- Steven J Drews
- Microbiology, Canadian Blood Services, Edmonton, Alberta, Canada.,Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Dana V Devine
- Canadian Blood Services, Vancouver, British Columbia, Canada.,Centre for Blood Research and Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Janet McManus
- Canadian Blood Services, Vancouver, British Columbia, Canada
| | - Emelissa Mendoza
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Kathy Manguiat
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Heidi Wood
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Roxie Girardin
- Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Alan Dupuis
- Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Kathleen McDonough
- Wadsworth Center, New York State Department of Health, Albany, New York, USA.,Department of Biomedical Sciences, School of Public Health, University at Albany, Albany, New York, USA
| | - Michael Drebot
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
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43
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Saeed S, Drews SJ, Pambrun C, Yi QL, Osmond L, O'Brien SF. SARS-CoV-2 seroprevalence among blood donors after the first COVID-19 wave in Canada. Transfusion 2021; 61:862-872. [PMID: 33527398 PMCID: PMC8013879 DOI: 10.1111/trf.16296] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/06/2021] [Accepted: 01/15/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Case detection underestimates the burden of the COVID-19 pandemic. Following the first COVID-19 wave, we estimated the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among blood donors across Canada. STUDY DESIGN AND METHODS This serial cross-sectional study was conducted between May 9 and July 21, 2020 from blood donors donating at all Canadian Blood Services locations. We used the Abbott Architect assay to detect SARS-CoV-2 IgG antibodies from retention plasma. Seroprevalence was standardized to population-level demographics and assay characteristics were adjusted using the Rogan-Gladen equation. Results were stratified by region, age, ethnicity, ABO groups, and quantiles of material and social deprivation indices. Temporal trends were evaluated at 2-week intervals. Univariate and multivariate logistic regression compared SARS-CoV-2 reactive to non-reactive donors by sociodemographic variables. RESULTS Overall 552/74642 donors, had detectable antibodies, adjusted seroprevalence was 7.0/1000 donors (95% CI; 6.3, 7.6). Prevalence was differential by geography, Ontario had the highest rate, 8.8/1000 donors (7.8, 9.8), compared to the Atlantic region 4.5/1000 donors (2.6, 6.4); adjusted odds ratio (aOR) 2.2 (1.5, 3.3). Donors that self-identified as an ethnic minority were more likely than white donors to be sero-reactive aOR 1.5 (1.2, 1.9). No temporal trends were observed. DISCUSSION Worldwide, blood services have leveraged their operational capacity to inform public health. While >99% of Canadians did not show humoral evidence of past infection, we found regional variability and disparities by ethnicity. Seroprevalence studies will continue to play a pivotal role in evaluating public health policies by identifying trends and monitor disparities.
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Affiliation(s)
- Sahar Saeed
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Steven J Drews
- Microbiology Department, Canadian Blood Services, Ottawa, Ontario, Canada.,Department of Laboratory Medicine & Pathology, Division of Diagnostic and Applied Microbiology, University of Alberta, Edmonton, Alberta, Canada
| | - Chantale Pambrun
- Center for Innovation, Canadian Blood Services, Ottawa, Ontario, Canada.,Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Qi-Long Yi
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Lori Osmond
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Sheila F O'Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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44
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Drews SJ, Spencer BR, Wendel S, Bloch EM. Filariasis and transfusion-associated risk: a literature review. Vox Sang 2021; 116:741-754. [PMID: 33491765 DOI: 10.1111/vox.13073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/19/2020] [Accepted: 12/28/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND OBJECTIVES Filariae are parasitic worms that include the pathogens Loa loa, Onchocerca volvulus, Wuchereria bancrofti, Brugia spp. and Mansonella spp. which are endemic in parts of Africa, Asia, Asia-Pacific, South and Central America. Filariae have a wide clinical spectrum spanning asymptomatic infection to chronic debilitating disease including blindness and lymphedema. Despite successful eradication programmes, filarial infections remain an important -albeit neglected - source of morbidity. We sought to characterize the risk of transfusion transmission of microfilaria with a view to guide mitigation practices in both endemic and non-endemic countries. MATERIALS AND METHODS A scoping review of scientific publications as well as grey literature was carried out by a group of domain experts in microbiology, transfusion medicine and infectious diseases, representing the parasite subgroup of the International Society of Blood Transfusion. RESULTS Cases of transfusion-transmitted filariasis are rare and confined to case reports of variable quality. Transfusion-associated adverse events related to microfilariae are confined to isolated reports of transfusion reactions. Serious outcomes have not been reported. No known strategies have been implemented, specifically, to mitigate transfusion-transmitted filariasis yet routine blood donor screening for other transfusion-transmissible infections (e.g. hepatitis B, malaria) may indirectly defer donors with microfilaremia in endemic areas. CONCLUSION Rare examples of transfusion-transmitted filariasis, without serious clinical effect, suggest that filariasis poses low transfusion risk. Dedicated mitigation strategies against filarial transfusion transmission are not recommended. Given endemicity in low-resource regions, priority should be on the control of filariasis with public health measures.
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Affiliation(s)
- Steven J Drews
- Canadian Blood Services, Microbiology, Donor and Clinical Services, Edmonton, AB, Canada.,Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | | | - Silvano Wendel
- Banco de Sangue Medical Director, Blood Bank, Hospital Sirio Libanês, São Paulo, Brasil
| | - Evan M Bloch
- Department of Pathology, Transfusion Medicine Division, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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45
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Abstract
COVID-19 (Coronavirus disease 2019) is a global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a positive-sense RNA virus. This virus has emerged as a threat to global health, social stability, and the global economy. This pandemic continues to cause rampant mortality worldwide with the dire urgency to develop novel therapeutic agents. To meet this task, this article discusses advances in the research and potential application of bioactive peptides for possible mitigation of infection by SARS-CoV-2. Growing insight into the molecular biology of SARS-CoV-2 has revealed potential druggable targets for bioactive peptides. Bioactive peptides with unique amino acid sequences can mitigate such targets including, type II transmembrane serine proteases (TMPRSS2) inhibition, furin cleavage, and renin-angiotensin-aldosterone system (RAAS) members. Based on current evidence and structure-function analysis, multiple bioactive peptides present potency to neutralize the virus. To date, no SARS-CoV-2-explicit drug has been reported, but we here introduce bioactive peptides in the perspective of their potential activity against SARS-CoV-2 infection.
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Affiliation(s)
- Khushwant S Bhullar
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Alberta, T6G 2P5, Canada; Department of Pharmacology, University of Alberta, Edmonton, Alberta, T6G 2P5, Canada
| | - Steven J Drews
- Canadian Blood Services, Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, Alberta, T6G 2P5, Canada
| | - Jianping Wu
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Alberta, T6G 2P5, Canada.
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46
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Skowronski DM, Zou M, Clarke Q, Chambers C, Dickinson JA, Sabaiduc S, Olsha R, Gubbay JB, Drews SJ, Charest H, Winter AL, Jassem A, Murti M, Krajden M, De Serres G. Influenza Vaccine Does Not Increase the Risk of Coronavirus or Other Noninfluenza Respiratory Viruses: Retrospective Analysis From Canada, 2010-2011 to 2016-2017. Clin Infect Dis 2020; 71:2285-2288. [PMID: 32442261 PMCID: PMC7314125 DOI: 10.1093/cid/ciaa626] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/20/2020] [Indexed: 11/30/2022] Open
Abstract
Influenza vaccine effectiveness against influenza and noninfluenza respiratory viruses (NIRVs) was assessed by test-negative design using historic datasets of the community-based Canadian Sentinel Practitioner Surveillance Network, spanning 2010-2011 to 2016-2017. Vaccine significantly reduced the risk of influenza illness by >40% with no effect on coronaviruses or other NIRV risk.
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Affiliation(s)
- Danuta M Skowronski
- British Columbia Centre for Disease Control, Vancouver, Canada
- University of British Columbia, Vancouver, Canada
| | - Macy Zou
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Quinten Clarke
- British Columbia Centre for Disease Control, Vancouver, Canada
| | | | | | - Suzana Sabaiduc
- British Columbia Centre for Disease Control, Vancouver, Canada
| | | | - Jonathan B Gubbay
- Public Health Ontario, Toronto, Canada
- University of Toronto, Toronto, Canada
| | - Steven J Drews
- Provincial Laboratory for Public Health, Edmonton, Canada
- University of Alberta, Edmonton, Canada
| | - Hugues Charest
- Institut National de Santé Publique du Québec, Quebec City, Canada
| | | | - Agatha Jassem
- British Columbia Centre for Disease Control, Vancouver, Canada
- University of British Columbia, Vancouver, Canada
| | - Michelle Murti
- Public Health Ontario, Toronto, Canada
- University of Toronto, Toronto, Canada
| | - Mel Krajden
- British Columbia Centre for Disease Control, Vancouver, Canada
- University of British Columbia, Vancouver, Canada
| | - Gaston De Serres
- Institut National de Santé Publique du Québec, Quebec City, Canada
- Laval University, Quebec City, Canada
- Centre Hospitalier Universitaire de Québec, Quebec City, Canada
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47
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Isho B, Abe KT, Zuo M, Jamal AJ, Rathod B, Wang JH, Li Z, Chao G, Rojas OL, Bang YM, Pu A, Christie-Holmes N, Gervais C, Ceccarelli D, Samavarchi-Tehrani P, Guvenc F, Budylowski P, Li A, Paterson A, Yue FY, Marin LM, Caldwell L, Wrana JL, Colwill K, Sicheri F, Mubareka S, Gray-Owen SD, Drews SJ, Siqueira WL, Barrios-Rodiles M, Ostrowski M, Rini JM, Durocher Y, McGeer AJ, Gommerman JL, Gingras AC. Persistence of serum and saliva antibody responses to SARS-CoV-2 spike antigens in COVID-19 patients. Sci Immunol 2020. [PMID: 33033173 DOI: 10.1101/2020.08.01.20166553] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
While the antibody response to SARS-CoV-2 has been extensively studied in blood, relatively little is known about the antibody response in saliva and its relationship to systemic antibody levels. Here, we profiled by enzyme-linked immunosorbent assays (ELISAs) IgG, IgA and IgM responses to the SARS-CoV-2 spike protein (full length trimer) and its receptor-binding domain (RBD) in serum and saliva of acute and convalescent patients with laboratory-diagnosed COVID-19 ranging from 3-115 days post-symptom onset (PSO), compared to negative controls. Anti-SARS-CoV-2 antibody responses were readily detected in serum and saliva, with peak IgG levels attained by 16-30 days PSO. Longitudinal analysis revealed that anti-SARS-CoV-2 IgA and IgM antibodies rapidly decayed, while IgG antibodies remained relatively stable up to 105 days PSO in both biofluids. Lastly, IgG, IgM and to a lesser extent IgA responses to spike and RBD in the serum positively correlated with matched saliva samples. This study confirms that serum and saliva IgG antibodies to SARS-CoV-2 are maintained in the majority of COVID-19 patients for at least 3 months PSO. IgG responses in saliva may serve as a surrogate measure of systemic immunity to SARS-CoV-2 based on their correlation with serum IgG responses.
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Affiliation(s)
- Baweleta Isho
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Kento T Abe
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Michelle Zuo
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Alainna J Jamal
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Department of Microbiology, at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Bhavisha Rathod
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Jenny H Wang
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Zhijie Li
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Gary Chao
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Olga L Rojas
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Yeo Myong Bang
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Annie Pu
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | | | - Christian Gervais
- Mammalian Cell Expression, Human Health Therapeutics Research Centre, National Research Council Canada, Montréal, QC, Canada
| | - Derek Ceccarelli
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Payman Samavarchi-Tehrani
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Furkan Guvenc
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Patrick Budylowski
- Combined Containment Level 3 Unit, University of Toronto, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Angel Li
- Department of Microbiology, at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Aimee Paterson
- Department of Microbiology, at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Feng Yun Yue
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Lina M Marin
- College of Dentistry, University of Saskatchewan, Saskatoon, SK, Canada
| | - Lauren Caldwell
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Jeffrey L Wrana
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Karen Colwill
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Frank Sicheri
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Samira Mubareka
- Department of Laboratory Medicine and Molecular Diagnostics, Division of Microbiology, Sunnybrook Health Sciences Centre; Biological Sciences, Sunnybrook Research Institute; and Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Laboratory Medicine and Pathology, University of Toronto, Toronto, ON, Canada
| | - Scott D Gray-Owen
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada.,Combined Containment Level 3 Unit, University of Toronto, Toronto, ON, Canada
| | - Steven J Drews
- Canadian Blood Services, Edmonton, AB & Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - Walter L Siqueira
- College of Dentistry, University of Saskatchewan, Saskatoon, SK, Canada
| | - Miriam Barrios-Rodiles
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Mario Ostrowski
- Department of Immunology, University of Toronto, Toronto, ON, Canada.,St. Michael's Hospital, Toronto, ON, Canada; Li Ka Shing Knowledge Institute.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - James M Rini
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada.,Department of Biochemistry, University of Toronto, Toronto, ON, Canada
| | - Yves Durocher
- Mammalian Cell Expression, Human Health Therapeutics Research Centre, National Research Council Canada, Montréal, QC, Canada
| | - Allison J McGeer
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Department of Microbiology, at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | | | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada. .,Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
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48
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Enok Bonong PR, Buteau C, Delage G, Tanner JE, Lacroix J, Duval M, Laporte L, Tucci M, Robitaille N, Spinella PC, Cuvelier G, Vercauteren S, Lewis V, Fearon M, Drews SJ, Alfieri C, Trottier H. Transfusion-related Epstein-Barr virus (EBV) infection: A multicenter prospective cohort study among pediatric recipients of hematopoietic stem cell transplants (TREASuRE study). Transfusion 2020; 61:144-158. [PMID: 33089891 DOI: 10.1111/trf.16149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 08/31/2020] [Accepted: 09/11/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Epstein-Barr virus (EBV) is carried in the blood of most adults, and transfusion-related infections have been reported. EBV is particularly deleterious in immunosuppressed transplant patients. The aim was to determine if EBV transmission occurred through leukodepleted blood product transfusion in pediatric recipients of hematopoietic stem cell transplants (HSCT). STUDY DESIGN AND METHODS This prospective Canadian multi-center cohort study includes 156 allogeneic HSCT pediatric recipients. The association between EBV and transfusion was analyzed using Cox regressions. EBV infection, defined by a PCR+ test in the blood of seronegative recipients of an EBV-negative graft, was monitored in order to correlate the recipient EBV strain with that of the blood donors. EBV genotypes were determined by PCR amplification followed by DNA sequencing at two loci (EBNA3b and LMP1). RESULTS No statistically significant associations were found between transfusions and EBV. One case of post-transplant EBV infection was identified among the 21 EBV-seronegative recipients receiving an EBV-negative graft. A total of 22 blood donors were retraced to determine whether the recipient's EBV strain matched that of a donor. One donor strain showed 100% sequence homology at the EBNA3b locus, but differed by one or two point mutations and by a 132-bp deletion at the LMP1 locus. The blood donor in question was alone among the 22 donors to show amplifiable virus in plasma. Blood from this donor readily produced an immortalized lymphoblastoid cell line in culture. CONCLUSION While considered a rare event, EBV transmission through transfusion may occur in the context of severe immunosuppression.
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Affiliation(s)
- Pascal R Enok Bonong
- Department of Social and Preventive Medicine, Université de Montréal, Sainte-Justine University Hospital, Montreal, Quebec, Canada
| | - Chantal Buteau
- Division of Infectious Diseases, Department of Pediatrics, Sainte-Justine University Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Gilles Delage
- Medical Affairs, Microbiology, Héma-Québec, Ville St-Laurent, Quebec, Canada
| | - Jerome E Tanner
- Sainte-Justine University Hospital, Montreal, Quebec, Canada
| | - Jacques Lacroix
- Division of Pediatric Intensive Care Medicine, Department of Pediatrics, Sainte-Justine University Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Michel Duval
- Division of Hematology-Oncology, Department of Pediatrics, Sainte-Justine University Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Louise Laporte
- Sainte-Justine University Hospital, Montreal, Quebec, Canada
| | - Marisa Tucci
- Division of Pediatric Intensive Care Medicine, Department of Pediatrics, Sainte-Justine University Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Nancy Robitaille
- Division of Hematology-Oncology, Department of Pediatrics, Sainte-Justine University Hospital, Université de Montréal and Medical Affairs, Transfusion Medicine, Héma-Québec, Ville Saint-Laurent, Quebec, Canada
| | - Philip C Spinella
- St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Geoffrey Cuvelier
- Department of Pediatrics and Child Health, CancerCare Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Suzanne Vercauteren
- Department of Pathology and Laboratory Medicine, BC Children's Hospital, University of British Colombia, Vancouver, British Columbia, Canada
| | - Victor Lewis
- Department of Pediatrics and Department of Oncology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Margaret Fearon
- Medical Microbiology, Canadian Blood Services, Toronto, Ontario, Canada
| | - Steven J Drews
- Medical Affairs and Innovation, Microbiology, Canadian Blood Services and University of Alberta, Laboratory Medicine and Pathology, Edmonton, Alberta, Canada
| | - Carolina Alfieri
- Department of Microbiology, Infectiology and Immunology, Université de Montréal, Sainte-Justine University Hospital Research Centre, Université de Montréal, Montreal, Quebec, Canada
| | - Helen Trottier
- Department of Social and Preventive Medicine, Université de Montréal, Sainte-Justine University Hospital, Montreal, Quebec, Canada
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49
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Isho B, Abe KT, Zuo M, Jamal AJ, Rathod B, Wang JH, Li Z, Chao G, Rojas OL, Bang YM, Pu A, Christie-Holmes N, Gervais C, Ceccarelli D, Samavarchi-Tehrani P, Guvenc F, Budylowski P, Li A, Paterson A, Yue FY, Marin LM, Caldwell L, Wrana JL, Colwill K, Sicheri F, Mubareka S, Gray-Owen SD, Drews SJ, Siqueira WL, Barrios-Rodiles M, Ostrowski M, Rini JM, Durocher Y, McGeer AJ, Gommerman JL, Gingras AC. Persistence of serum and saliva antibody responses to SARS-CoV-2 spike antigens in COVID-19 patients. Sci Immunol 2020; 5:5/52/eabe5511. [PMID: 33033173 PMCID: PMC8050884 DOI: 10.1126/sciimmunol.abe5511] [Citation(s) in RCA: 534] [Impact Index Per Article: 133.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/05/2020] [Indexed: 12/13/2022]
Abstract
While the antibody response to SARS-CoV-2 has been extensively studied in blood, relatively little is known about the antibody response in saliva and its relationship to systemic antibody levels. Here, we profiled by enzyme-linked immunosorbent assays (ELISAs) IgG, IgA and IgM responses to the SARS-CoV-2 spike protein (full length trimer) and its receptor-binding domain (RBD) in serum and saliva of acute and convalescent patients with laboratory-diagnosed COVID-19 ranging from 3-115 days post-symptom onset (PSO), compared to negative controls. Anti-SARS-CoV-2 antibody responses were readily detected in serum and saliva, with peak IgG levels attained by 16-30 days PSO. Longitudinal analysis revealed that anti-SARS-CoV-2 IgA and IgM antibodies rapidly decayed, while IgG antibodies remained relatively stable up to 105 days PSO in both biofluids. Lastly, IgG, IgM and to a lesser extent IgA responses to spike and RBD in the serum positively correlated with matched saliva samples. This study confirms that serum and saliva IgG antibodies to SARS-CoV-2 are maintained in the majority of COVID-19 patients for at least 3 months PSO. IgG responses in saliva may serve as a surrogate measure of systemic immunity to SARS-CoV-2 based on their correlation with serum IgG responses.
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Affiliation(s)
- Baweleta Isho
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Kento T Abe
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Michelle Zuo
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Alainna J Jamal
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Microbiology, at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Bhavisha Rathod
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Jenny H Wang
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Zhijie Li
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Gary Chao
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Olga L Rojas
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Yeo Myong Bang
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Annie Pu
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | | | - Christian Gervais
- Mammalian Cell Expression, Human Health Therapeutics Research Centre, National Research Council Canada, Montréal, QC, Canada
| | - Derek Ceccarelli
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Payman Samavarchi-Tehrani
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Furkan Guvenc
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Patrick Budylowski
- Combined Containment Level 3 Unit, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Angel Li
- Department of Microbiology, at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Aimee Paterson
- Department of Microbiology, at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Feng Yun Yue
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Lina M Marin
- College of Dentistry, University of Saskatchewan, Saskatoon, SK, Canada
| | - Lauren Caldwell
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Jeffrey L Wrana
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Karen Colwill
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Frank Sicheri
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Samira Mubareka
- Department of Laboratory Medicine and Molecular Diagnostics, Division of Microbiology, Sunnybrook Health Sciences Centre; Biological Sciences, Sunnybrook Research Institute; and Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Laboratory Medicine and Pathology, University of Toronto, Toronto, ON, Canada
| | - Scott D Gray-Owen
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
- Combined Containment Level 3 Unit, University of Toronto, Toronto, ON, Canada
| | - Steven J Drews
- Canadian Blood Services, Edmonton, AB & Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - Walter L Siqueira
- College of Dentistry, University of Saskatchewan, Saskatoon, SK, Canada
| | - Miriam Barrios-Rodiles
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Mario Ostrowski
- Department of Immunology, University of Toronto, Toronto, ON, Canada
- St. Michael's Hospital, Toronto, ON, Canada; Li Ka Shing Knowledge Institute
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - James M Rini
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
- Department of Biochemistry, University of Toronto, Toronto, ON, Canada
| | - Yves Durocher
- Mammalian Cell Expression, Human Health Therapeutics Research Centre, National Research Council Canada, Montréal, QC, Canada
| | - Allison J McGeer
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Microbiology, at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | | | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada.
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
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50
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Abe KT, Li Z, Samson R, Samavarchi-Tehrani P, Valcourt EJ, Wood H, Budylowski P, Dupuis AP, Girardin RC, Rathod B, Wang JH, Barrios-Rodiles M, Colwill K, McGeer AJ, Mubareka S, Gommerman JL, Durocher Y, Ostrowski M, McDonough KA, Drebot MA, Drews SJ, Rini JM, Gingras AC. A simple protein-based surrogate neutralization assay for SARS-CoV-2. JCI Insight 2020; 5:142362. [PMID: 32870820 PMCID: PMC7566699 DOI: 10.1172/jci.insight.142362] [Citation(s) in RCA: 138] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 08/31/2020] [Indexed: 12/22/2022] Open
Abstract
Most of the patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mount a humoral immune response to the virus within a few weeks of infection, but the duration of this response and how it correlates with clinical outcomes has not been completely characterized. Of particular importance is the identification of immune correlates of infection that would support public health decision-making on treatment approaches, vaccination strategies, and convalescent plasma therapy. While ELISA-based assays to detect and quantitate antibodies to SARS-CoV-2 in patient samples have been developed, the detection of neutralizing antibodies typically requires more demanding cell-based viral assays. Here, we present a safe and efficient protein-based assay for the detection of serum and plasma antibodies that block the interaction of the SARS-CoV-2 spike protein receptor binding domain (RBD) with its receptor, angiotensin-converting enzyme 2 (ACE2). The assay serves as a surrogate neutralization assay and is performed on the same platform and in parallel with an ELISA for the detection of antibodies against the RBD, enabling a direct comparison. The results obtained with our assay correlate with those of 2 viral-based assays, a plaque reduction neutralization test (PRNT) that uses live SARS-CoV-2 virus and a spike pseudotyped viral vector-based assay.
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Affiliation(s)
- Kento T. Abe
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, Ontario, Canada
| | - Zhijie Li
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Reuben Samson
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, Ontario, Canada
| | - Payman Samavarchi-Tehrani
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, Ontario, Canada
| | - Emelissa J. Valcourt
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory (NML), Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Heidi Wood
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory (NML), Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Patrick Budylowski
- Department of Immunology and
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Alan P. Dupuis
- Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Roxie C. Girardin
- Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Bhavisha Rathod
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, Ontario, Canada
| | - Jenny H. Wang
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, Ontario, Canada
| | - Miriam Barrios-Rodiles
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, Ontario, Canada
| | - Karen Colwill
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, Ontario, Canada
| | - Allison J. McGeer
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, Ontario, Canada
- Department of Microbiology, University Health Network and Sinai Health System, Toronto, Ontario, Canada
- Dalla Lana School of Public Health and
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Samira Mubareka
- Department of Laboratory Medicine and Molecular Diagnostics, Division of Microbiology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Biological Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | | | - Yves Durocher
- Mammalian Cell Expression, Human Health Therapeutics Research Centre, National Research Council Canada, Montréal, Quebec, Canada
| | - Mario Ostrowski
- Department of Immunology and
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Kathleen A. McDonough
- Wadsworth Center, New York State Department of Health, Albany, New York, USA
- Department of Biomedical Sciences, School of Public Health, University at Albany, SUNY, Albany, New York, USA
| | - Michael A. Drebot
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory (NML), Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology and Infectious Disease, University of Manitoba, Manitoba, Canada
| | - Steven J. Drews
- Canadian Blood Services, Edmonton, AB & Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - James M. Rini
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Department of Biochemistry, University of Toronto, Toronto, Ontario, Canada
| | - Anne-Claude Gingras
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health System, Toronto, Ontario, Canada
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