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El-Ghitany EM, Hashish MH, Farghaly AG, Omran EA, Osman NA, Fekry MM. Asymptomatic versus symptomatic SARS-CoV-2 infection: a cross-sectional seroprevalence study. Trop Med Health 2022; 50:98. [PMID: 36575501 PMCID: PMC9792933 DOI: 10.1186/s41182-022-00490-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/08/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Although symptomatic SARS-CoV-2 infection predisposes patients to develop complications, the asymptomatic SARS-CoV-2 infection state is of public health importance being a hidden source of infection. Moreover, the asymptomatic state may camouflage the actual burden of the disease. METHODS Data of 1434 seropositive participants for SARS-CoV-2 spike (anti-S) and/or nucleocapsid antibodies (anti-N) were retrieved from a larger cross-sectional survey on COVID-19. Relevant data were retrieved from records including socio-demographic, medical, and behavioral characteristics of seropositive participants as well as history of COVID-19 symptoms during the last 6 months. Symptomatic/asymptomatic SARS-CoV-2 infection was categorized based on the history of the presence or absence of COVID-19 symptoms. RESULTS The rate of asymptomatic SARS-CoV-2 infection was 34.9%. There was a statistically significant difference between symptomatic and asymptomatic participants regarding age, residence, medical conditions, habits, and infection control measures. The number of symptoms was positively correlated with anti-S titer and both were positively correlated with adult body mass index. Slum areas residence, client-facing occupation or being a healthcare worker, having lung disease, having blood group type A, never practicing exercise or social distancing, never using soap for hand washing, and minimal engagement in online working/studying were independent factors associated with the symptomatic state. Patients having less than three symptoms were less likely to be diagnosed by any means. CONCLUSIONS One-third of SARS-CoV-2 infections in our study were asymptomatic. This mandates applying proper measures to prevent transmission even from apparently healthy individuals. Modifiable factors associated with symptomatic infection should be controlled to reduce the risk of COVID-19 complications.
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Affiliation(s)
- Engy Mohamed El-Ghitany
- grid.7155.60000 0001 2260 6941Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Mona H. Hashish
- grid.7155.60000 0001 2260 6941Department of Microbiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Azza Galal Farghaly
- grid.7155.60000 0001 2260 6941Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Eman A. Omran
- grid.7155.60000 0001 2260 6941Department of Microbiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Nermin A. Osman
- grid.7155.60000 0001 2260 6941Biomedical Informatics and Medical Statistics Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Marwa M. Fekry
- grid.7155.60000 0001 2260 6941Department of Microbiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Navaratnam AMD, Shrotri M, Nguyen V, Braithwaite I, Beale S, Byrne TE, Fong WLE, Fragaszy E, Geismar C, Hoskins S, Kovar J, Patel P, Yavlinsky A, Aryee A, Rodger A, Hayward AC, Aldridge RW. Nucleocapsid and spike antibody responses following virologically confirmed SARS-CoV-2 infection: an observational analysis in the Virus Watch community cohort. Int J Infect Dis 2022; 123:104-111. [PMID: 35987470 PMCID: PMC9385348 DOI: 10.1016/j.ijid.2022.07.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 03/29/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Seroprevalence studies can provide a measure of SARS-CoV-2 cumulative incidence, but a better understanding of spike and nucleocapsid (anti-N) antibody dynamics following infection is needed to assess the longevity of detectability. METHODS Adults aged ≥18 years, from households enrolled in the Virus Watch prospective community cohort study in England and Wales, provided monthly capillary blood samples, which were tested for spike antibody and anti-N. Participants self-reported vaccination dates and past medical history. Previous polymerase chain reaction (PCR) swabs were obtained through Second Generation Surveillance System linkage data. The primary outcome variables were seropositivity and total anti-N and spike antibody levels after PCR-confirmed infection. RESULTS A total of 13,802 eligible individuals provided 58,770 capillary blood samples. A total of 537 of these had a previous positive PCR-confirmed SARS-CoV-2 infection within 0-269 days of antibody sample date, among them 432 (80.45%) having a positive anti-N result. Median anti-N levels peaked between days 90 and 119 after PCR results and then began to decline. There is evidence of anti-N waning from 120 days onwards, with earlier waning for females and younger age categories. CONCLUSION Our findings suggest that anti-N has around 80% sensitivity for identifying previous COVID-19 infection, and the duration of detectability is affected by sex and age.
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Affiliation(s)
| | - Madhumita Shrotri
- Institute of Health Informatics, University College London, United Kingdom
| | - Vincent Nguyen
- Institute of Health Informatics, University College London, United Kingdom
| | - Isobel Braithwaite
- Institute of Health Informatics, University College London, United Kingdom
| | - Sarah Beale
- Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Thomas E Byrne
- Institute of Health Informatics, University College London, United Kingdom
| | | | - Ellen Fragaszy
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom
| | - Cyril Geismar
- Institute of Health Informatics, University College London, United Kingdom
| | - Susan Hoskins
- Institute of Health Informatics, University College London, United Kingdom
| | - Jana Kovar
- Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Parth Patel
- Institute of Health Informatics, University College London, United Kingdom
| | - Alexei Yavlinsky
- Institute of Health Informatics, University College London, United Kingdom
| | - Anna Aryee
- Institute of Health Informatics, University College London, United Kingdom
| | - Alison Rodger
- Institute for Global Health, University College London, London, United Kingdom
| | - Andrew C Hayward
- Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Robert W Aldridge
- Institute of Health Informatics, University College London, United Kingdom.
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Wang W, Sun L, Li T, Ma Y, Li J, Liu Y, Li M, Wang L, Li C, Xie Y, Wen Y, Liang M, Chen L, Tong S. A human monoclonal antibody against small envelope protein of hepatitis B virus with potent neutralization effect. MAbs 2015; 8:468-77. [PMID: 26713590 DOI: 10.1080/19420862.2015.1134409] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Hepatitis B virus (HBV) produces large (L), middle (M), and small (S) envelope proteins, alternatively referred to as hepatitis B surface antigen (HBsAg). Currently, yeast-derived S protein serves as the preventive vaccine, while hepatitis B immune globulin (HBIG) concentrated from pooled plasma of vaccine recipients is employed for post-exposure prophylaxis. However, only a small proportion of the antibodies in HBIG are HBV specific. In the present study, a human monoclonal anti-S antibody (G12) was developed, produced under GLP conditions, and subjected to a panel of functional assays. In vitro results demonstrated high affinity of G12 for the S protein (KD = 7.56 nM). It reacted with envelope proteins of all 7 HBV genotypes tested (A-F, H) by immunofluorescent staining, and more than 97% of HBsAg-positive patient serum samples by enzyme-linked immunosorbent assay. G12 recognized a conformational epitope, although the exact sequence remains unknown. Strikingly, G12 was at least 1,000-fold more potent than HBIG in neutralizing HBV infectivity in both HepaRG cell line and HepG2 cells reconstituted with the HBV receptor. In a transgenic mouse model of HBV persistence, a single peritoneal injection of G12 markedly diminished serum HBsAg titers in all 7 mice, which was sustained for the observation period of 144 d in mice with low pre-treatment levels. While the therapeutic potential of G12 warrants further investigation using a large number of animals, G12 is a potent neutralizing human monoclonal antibody and a promising candidate to replace or supplement HBIG in the prevention of HBV infection.
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Affiliation(s)
- Wei Wang
- a Department of Pathobiology and Key Laboratory of Medical Molecular Virology , School of Basic Medical Sciences, Fudan University , Shanghai , China
| | - Lina Sun
- b Key Laboratory for Medical Virology, NHFPC, National Institute for Viral Disease Control and Prevention , China
| | - Tiansheng Li
- a Department of Pathobiology and Key Laboratory of Medical Molecular Virology , School of Basic Medical Sciences, Fudan University , Shanghai , China
| | - Yanchun Ma
- c Putuo District Center Hospital, Shanghai University of Traditional Chinese Medicine , Shanghai , China
| | - Jisu Li
- d Liver Research Center, The Warren Alpert School of Medicine, Brown University , Providence , Rhode Island , USA
| | - Yang Liu
- b Key Laboratory for Medical Virology, NHFPC, National Institute for Viral Disease Control and Prevention , China
| | - Meng Li
- a Department of Pathobiology and Key Laboratory of Medical Molecular Virology , School of Basic Medical Sciences, Fudan University , Shanghai , China
| | - Lei Wang
- a Department of Pathobiology and Key Laboratory of Medical Molecular Virology , School of Basic Medical Sciences, Fudan University , Shanghai , China
| | - Chuan Li
- b Key Laboratory for Medical Virology, NHFPC, National Institute for Viral Disease Control and Prevention , China
| | - Youhua Xie
- a Department of Pathobiology and Key Laboratory of Medical Molecular Virology , School of Basic Medical Sciences, Fudan University , Shanghai , China
| | - Yumei Wen
- a Department of Pathobiology and Key Laboratory of Medical Molecular Virology , School of Basic Medical Sciences, Fudan University , Shanghai , China
| | - Mifang Liang
- b Key Laboratory for Medical Virology, NHFPC, National Institute for Viral Disease Control and Prevention , China
| | - Li Chen
- a Department of Pathobiology and Key Laboratory of Medical Molecular Virology , School of Basic Medical Sciences, Fudan University , Shanghai , China
| | - Shuping Tong
- a Department of Pathobiology and Key Laboratory of Medical Molecular Virology , School of Basic Medical Sciences, Fudan University , Shanghai , China
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