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Fraser DD, Patel MA, Van Nynatten LR, Martin C, Seney SL, Miller MR, Daley M, Slessarev M, Cepinskas G, Juneja GK, Sabourin V, Fox-Robichaud A, Yeh CH, Kim PY, Badrnya S, Oehler S, Miholits M, Webb B. Cross-immunity against SARS-COV-2 variants of concern in naturally infected critically ill COVID-19 patients. Heliyon 2023; 9:e12704. [PMID: 36594041 PMCID: PMC9797417 DOI: 10.1016/j.heliyon.2022.e12704] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
Critically ill patients infected with SARS-CoV-2 display adaptive immunity, but it is unknown if they develop cross-reactivity to variants of concern (VOCs). We profiled cross-immunity against SARS-CoV-2 VOCs in naturally infected, non-vaccinated, critically ill COVID-19 patients. Wave-1 patients (wild-type infection) were similar in demographics to Wave-3 patients (wild-type/alpha infection), but Wave-3 patients had higher illness severity. Wave-1 patients developed increasing neutralizing antibodies to all variants, as did patients during Wave-3. Wave-3 patients, when compared to Wave-1, developed more robust antibody responses, particularly for wild-type, alpha, beta and delta variants. Within Wave-3, neutralizing antibodies were significantly less to beta and gamma VOCs, as compared to wild-type, alpha and delta. Patients previously diagnosed with cancer or chronic obstructive pulmonary disease had significantly fewer neutralizing antibodies. Naturally infected ICU patients developed adaptive responses to all VOCs, with greater responses in those patients more likely to be infected with the alpha variant, versus wild-type.
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Key Words
- ACE2, angiotensin-converting enzyme
- AUC, area-under-the-curve
- Adaptive immunity
- Antibodies
- COPD, chronic obstructive pulmonary disease
- COVID-19
- COVID-19, coronavirus disease 2019
- ICU, intensive care unit
- IQR, interquartile range
- Intensive care units
- MFI, median fluorescence intensity
- MODS, multi-organ dysfunction score
- Neutralizing
- P/F, arterial partial pressure to inspired oxygen
- RBD, receptor binding domain
- REB, research ethics board
- ROC, receiver operating characteristic
- SARS-CoV-2
- SARS-CoV-2 alpha variant
- SARS-CoV-2 beta variant
- SARS-CoV-2 delta variant
- SARS-CoV-2 gamma variant
- SOFA, sequential organ failure assessment
- VOC, variants of concern
- VTE, venous thromboembolism
- WT, wild-type
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Affiliation(s)
- Douglas D. Fraser
- Lawson Health Research Institute, London, ON, N6C 2R5, Canada,Pediatrics, Western University, London, ON, N6A 3K7, Canada,Clinical Neurological Sciences, Western University, London, ON, N6A 3K7, Canada,Physiology & Pharmacology, Western University, London, ON, N6A 3K7, Canada,Corresponding author. Lawson Health Research Institute, London, ON, N6C 2R5, Canada
| | | | | | - Claudio Martin
- Lawson Health Research Institute, London, ON, N6C 2R5, Canada,Medicine, Western University, London, ON, N6A 3K7, Canada
| | | | - Michael R. Miller
- Lawson Health Research Institute, London, ON, N6C 2R5, Canada,Pediatrics, Western University, London, ON, N6A 3K7, Canada
| | - Mark Daley
- Epidemiology, Western University, London, ON, N6A 3K7, Canada
| | - Marat Slessarev
- Lawson Health Research Institute, London, ON, N6C 2R5, Canada,Medicine, Western University, London, ON, N6A 3K7, Canada
| | - Gediminas Cepinskas
- Lawson Health Research Institute, London, ON, N6C 2R5, Canada,Medical Biophysics, Western University, London, ON, N6A 3K7, Canada
| | - Ganeem K. Juneja
- Medicine, McMaster University, Hamilton, ON, L8S 4L8, Canada,Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, L8L 2X2, Canada
| | - Vanessa Sabourin
- Medicine, McMaster University, Hamilton, ON, L8S 4L8, Canada,Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, L8L 2X2, Canada
| | - Alison Fox-Robichaud
- Medicine, McMaster University, Hamilton, ON, L8S 4L8, Canada,Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, L8L 2X2, Canada
| | - Calvin H. Yeh
- Medicine, McMaster University, Hamilton, ON, L8S 4L8, Canada,Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, L8L 2X2, Canada
| | - Paul Y. Kim
- Medicine, McMaster University, Hamilton, ON, L8S 4L8, Canada,Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, L8L 2X2, Canada
| | | | | | | | - Brian Webb
- Thermo Fisher Scientific, Rockford, IL, USA
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Shingleton J, Burton L, Williams HE, Finnie TJR, Bennett E, Birrell P, Kenny S, Watson-Koszel T, Viner R, Arditi M, DeAngelis D, Gent N, Ladhani SN. Risk of paediatric multisystem inflammatory syndrome (PIMS-TS) during the SARS-CoV-2 alpha and delta variant waves: National observational and modelling study, 2020-21, England. Front Pediatr 2022; 10:1034280. [PMID: 36545670 PMCID: PMC9762156 DOI: 10.3389/fped.2022.1034280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives Paediatric Multisystem Inflammatory Syndrome (PIMS-TS) is a rare life-threatening complication that typically occurs several weeks after SARS-CoV-2 infection in children and young people (CYP). We used national and regional-level data from the COVID-19 pandemic waves in England to develop a model to predict PIMS-TS cases. Methods SARS-CoV-2 infections in CYP aged 0-15 years in England were estimated using the PHE-Cambridge real-time model. PIMS-TS cases were identified through the British Paediatric Surveillance Unit during (March-June 2020) and through Secondary Uses Services (SUS) from November 2020. A predictive model was developed to estimate PIMS-TS risk and lag times after SARS-CoV-2 infections. Results During the Alpha wave, the model accurately predicted PIMS-TS cases (506 vs. 502 observed cases), with a median estimated risk of 0.038% (IQR, 0.037-0.041%) of paediatric SARS-CoV-2 infections. For the Delta wave, the median risk of PIMS-TS was significantly lower at 0.026% (IQR, 0.025-0.029%), with 212 observed PIMS-TS cases compared to 450 predicted by the model. Conclusions The model accurately predicted national and regional PIMS-TS cases in CYP during the Alpha wave. PIMS-TS cases were 53% lower than predicted during the Delta wave. Further studies are needed to understand the mechanisms of the observed lower risk with the Delta variant.
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Affiliation(s)
- Joseph Shingleton
- Emergency Preparedness Response and Resilience Directorate, UK Health Security Agency, Porton Down, London, United Kingdom
- Joint Modelling Team, UK Health Security Agency, London, United Kingdom
| | - Lucy Burton
- Emergency Preparedness Response and Resilience Directorate, UK Health Security Agency, Porton Down, London, United Kingdom
- Joint Modelling Team, UK Health Security Agency, London, United Kingdom
| | - Hannah E. Williams
- Emergency Preparedness Response and Resilience Directorate, UK Health Security Agency, Porton Down, London, United Kingdom
- Joint Modelling Team, UK Health Security Agency, London, United Kingdom
| | - Thomas J. R. Finnie
- Emergency Preparedness Response and Resilience Directorate, UK Health Security Agency, Porton Down, London, United Kingdom
- Joint Modelling Team, UK Health Security Agency, London, United Kingdom
| | - Emma Bennett
- Emergency Preparedness Response and Resilience Directorate, UK Health Security Agency, Porton Down, London, United Kingdom
- Joint Modelling Team, UK Health Security Agency, London, United Kingdom
| | - Paul Birrell
- Joint Modelling Team, UK Health Security Agency, London, United Kingdom
- MRC Biostatistics Unit, University of Cambridge, School of Clinical Medicine, Cambridge Institute of Public Health, Cambridge, United Kingdom
- Statistical Modelling and Economics, UK Health Security Agency, Colindale, United Kingdom
| | - Simon Kenny
- CYP Transformation Programme Team, Nursing Directorate, NHS England and NHS Improvement, Leeds, England
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
- Department of Paediatric Surgery, Alder Hey in the Park, Liverpool, United Kingdom
| | - Tiffany Watson-Koszel
- CYP Transformation Programme Team, Nursing Directorate, NHS England and NHS Improvement, Leeds, England
| | - Russell Viner
- Population, Policy and Practice, UCL Great Ormond St. Institute of Child Health, London, United Kingdom
| | - Moshe Arditi
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Daniela DeAngelis
- Statistical Modelling and Economics, UK Health Security Agency, Colindale, United Kingdom
| | - Nick Gent
- Emergency Preparedness Response and Resilience Directorate, UK Health Security Agency, Porton Down, London, United Kingdom
- Joint Modelling Team, UK Health Security Agency, London, United Kingdom
| | - Shamez N. Ladhani
- Immunisation and Countermeasures Division, UK Health Security Agency, London, United Kingdom
- Paediatric Infectious Diseases Research Group, St George’s University of London, London, United Kingdom
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Nakaya A, Ogura E, Katayama Y, Yoshii M, Yoshino E, Hozumi K, Tago S, Teranishi Y, Minamibashi Y, Harada M, Yoshioka M, Kawano Y, Arai Y, Yoshida K, Shimizu S, Ogura K, Iwashita K. Red face may be a specific sign of SARS-CoV-2 alpha variant. IDCases 2021; 25:e01214. [PMID: 34230877 PMCID: PMC8247189 DOI: 10.1016/j.idcr.2021.e01214] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 11/29/2022] Open
Abstract
Red face was seen in three patients with COVID-19. Red face may reflect a cytokine storm. Red face may be predictive of a sudden deterioration.
Japan is currently suffering the fourth wave of the COVID-19 pandemic, with the dominant type being SARS-CoV-2 alpha variant. Patients with COVID-19 variant types show more aggressive symptoms. In the present study, three patients developed a red face during treatment. Two of them suddenly worsened shortly after. We assumed that the red face reflected a cytokine storm and conjectured that it may be a specific sign of variant type COVID-19, because we have never seen it in patients with non-variant type. Moreover, we believe that red face may be predictive of a sudden deterioration.
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Affiliation(s)
- Aya Nakaya
- Internal Medicine, Biwako Ohashi Hospital, 5-1-29 Mano, Otsu city, Shiga, 520-0232, Japan
| | - Eiji Ogura
- Internal Medicine, Biwako Ohashi Hospital, 5-1-29 Mano, Otsu city, Shiga, 520-0232, Japan
| | - Yuki Katayama
- Internal Medicine, Biwako Ohashi Hospital, 5-1-29 Mano, Otsu city, Shiga, 520-0232, Japan
| | - Masami Yoshii
- Internal Medicine, Biwako Ohashi Hospital, 5-1-29 Mano, Otsu city, Shiga, 520-0232, Japan
| | - Eiko Yoshino
- Internal Medicine, Biwako Ohashi Hospital, 5-1-29 Mano, Otsu city, Shiga, 520-0232, Japan
| | - Kazuya Hozumi
- Internal Medicine, Biwako Ohashi Hospital, 5-1-29 Mano, Otsu city, Shiga, 520-0232, Japan
| | - Saori Tago
- Internal Medicine, Biwako Ohashi Hospital, 5-1-29 Mano, Otsu city, Shiga, 520-0232, Japan
| | - Yuko Teranishi
- Internal Medicine, Biwako Ohashi Hospital, 5-1-29 Mano, Otsu city, Shiga, 520-0232, Japan
| | - Yuki Minamibashi
- Internal Medicine, Biwako Ohashi Hospital, 5-1-29 Mano, Otsu city, Shiga, 520-0232, Japan
| | - Makiko Harada
- Internal Medicine, Biwako Ohashi Hospital, 5-1-29 Mano, Otsu city, Shiga, 520-0232, Japan
| | - Mami Yoshioka
- Internal Medicine, Biwako Ohashi Hospital, 5-1-29 Mano, Otsu city, Shiga, 520-0232, Japan
| | - Yuri Kawano
- Internal Medicine, Biwako Ohashi Hospital, 5-1-29 Mano, Otsu city, Shiga, 520-0232, Japan
| | - Yuka Arai
- Internal Medicine, Biwako Ohashi Hospital, 5-1-29 Mano, Otsu city, Shiga, 520-0232, Japan
| | - Keno Yoshida
- Internal Medicine, Biwako Ohashi Hospital, 5-1-29 Mano, Otsu city, Shiga, 520-0232, Japan
| | - Shozo Shimizu
- Internal Medicine, Biwako Ohashi Hospital, 5-1-29 Mano, Otsu city, Shiga, 520-0232, Japan
| | - Kazuma Ogura
- Internal Medicine, Biwako Ohashi Hospital, 5-1-29 Mano, Otsu city, Shiga, 520-0232, Japan
| | - Katsuaki Iwashita
- Internal Medicine, Biwako Ohashi Hospital, 5-1-29 Mano, Otsu city, Shiga, 520-0232, Japan
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