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Ogata AF, Maley AM, Wu C, Gilboa T, Norman M, Lazarovits R, Mao CP, Newton G, Chang M, Nguyen K, Kamkaew M, Zhu Q, Gibson TE, Ryan ET, Charles RC, Marasco WA, Walt DR. Ultra-Sensitive Serial Profiling of SARS-CoV-2 Antigens and Antibodies in Plasma to Understand Disease Progression in COVID-19 Patients with Severe Disease. Clin Chem 2021; 66:1562-1572. [PMID: 32897389 DOI: 10.1093/clinchem/hvaa213] [Citation(s) in RCA: 115] [Impact Index Per Article: 38.3] [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: 08/16/2020] [Accepted: 09/01/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected over 21 million people worldwide since August 16, 2020. Compared to PCR and serology tests, SARS-CoV-2 antigen assays are underdeveloped, despite their potential to identify active infection and monitor disease progression. METHODS We used Single Molecule Array (Simoa) assays to quantitatively detect SARS-CoV-2 spike, S1 subunit, and nucleocapsid antigens in the plasma of patients with coronavirus disease (COVID-19). We studied plasma from 64 patients who were COVID-19 positive, 17 who were COVID-19 negative, and 34 prepandemic patients. Combined with Simoa anti-SARS-CoV-2 serological assays, we quantified changes in 31 SARS-CoV-2 biomarkers in 272 longitudinal plasma samples obtained for 39 patients with COVID-19. Data were analyzed by hierarchical clustering and were compared to longitudinal RT-PCR test results and clinical outcomes. RESULTS SARS-CoV-2 S1 and N antigens were detectable in 41 out of 64 COVID-19 positive patients. In these patients, full antigen clearance in plasma was observed a mean ± 95% CI of 5 ± 1 days after seroconversion and nasopharyngeal RT-PCR tests reported positive results for 15 ± 5 days after viral-antigen clearance. Correlation between patients with high concentrations of S1 antigen and ICU admission (77%) and time to intubation (within 1 day) was statistically significant. CONCLUSIONS The reported SARS-CoV-2 Simoa antigen assay is the first to detect viral antigens in the plasma of patients who were COVID-19 positive to date. These data show that SARS-CoV-2 viral antigens in the blood are associated with disease progression, such as respiratory failure, in COVID-19 cases with severe disease.
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Affiliation(s)
- Alana F Ogata
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA.,Harvard Medical School, Boston, MA
| | - Adam M Maley
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA.,Harvard Medical School, Boston, MA
| | - Connie Wu
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA.,Harvard Medical School, Boston, MA
| | - Tal Gilboa
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA.,Harvard Medical School, Boston, MA
| | - Maia Norman
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA.,Tufts University School of Medicine, Boston, MA
| | - Roey Lazarovits
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA
| | - Chih-Ping Mao
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
| | - Gail Newton
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
| | - Matthew Chang
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA
| | - Katrina Nguyen
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA
| | - Maliwan Kamkaew
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA
| | - Quan Zhu
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA.,Department of Medicine, Harvard Medical School, Boston, MA
| | - Travis E Gibson
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Edward T Ryan
- Department of Medicine, Harvard Medical School, Boston, MA.,Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA.,Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Richelle C Charles
- Department of Medicine, Harvard Medical School, Boston, MA.,Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA
| | - Wayne A Marasco
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA.,Department of Medicine, Harvard Medical School, Boston, MA
| | - David R Walt
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA.,Harvard Medical School, Boston, MA
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