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Background: Vaccination programs have been highly effective for curbing the spread of SARS-CoV-2 . In this context, serology surveillance of SARS-CoV-2 antibodies represents a useful tool for monitoring of potential protective immunity in the population but the long-term antibody response over time remains an open question. Method(s): We compared the performance of three SARS-CoV-2 antibody serological immunoassays in 600 vaccinated individuals after two and third BNT162b2 mRNA COVID-19 (Comirnaty) vaccine dose. Result(s): All three methods were able to detect a post-vaccine humoral immune response with good analytical performance obtained from a comparison with serum samples obtained in the pre-Covid-19 era. Median (IQR) anti-RBD IgG, Access SARS-CoV-2 IgG (1st IS) and Access SARS-CoV-2 IgG II levels of the subjects investigated were, respectively, 687 BAU/mL (131-2325), 419 IU/ mL (58-1091) and 104 AU/mL (14-274). The analysis of the comparison of the methods showed a correlation between the levels of antibodies of the three methods analized. We also considered the kinetics of subjects with multiple doses and observed that the differences between the absolute decreasing gradients were statistically significant (overall Friedman test p <0.001). Conclusion(s): All immunoassays considered in the study proved useful in evaluating the antibody response to the vaccine. Our results suggest that postvaccination testing of antibody response is an important and feasible tool for following people after vaccination and selecting individuals who might require a third / fourth dose of vaccine at an earlier time point or subjects who may not need to another dose of vaccine due to previous SARS-CoV-2 infection. Reference: Lo Sasso B. et al. Longitudinal analysis of anti-SARS-CoV-2 S-RBD IgG antibodies before and after the third dose of the BNT162b2 vaccine. Sci Rep. 2022;12: 8679. Published online 2022 May 23.
ABSTRACT
Background: Vaccines represent the most effective tool to contain SARS-CoV-2 infection as well as monitoring their effectiveness is essential to assess individual protection against the pathogen. Immunosurveillance by evaluating anti-spike protein receptor-binding domain (S-RBD) antibodies represents a useful tool to estimate the long immunity against Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) infection. The aim of this study was to evaluate the kinetics of antibody response in vaccine recipients. Method(s): We measured anti-S-RBD IgG levels by indirect chemiluminescence immunoassay on Maglumi 800 (SNIBE, California) in 1013 healthy individuals naive to SARS-CoV2 infection after two and three COVID-19 vaccine doses. Result(s): Median (IQR) anti-S-RBD IgG levels at the first measurement (baseline) were 1206 (522-2601) BAU/mL. Females displayed significantly higher median baseline anti-SRBD IgG levels than males (1407 vs 1091 BAU/mL, p=0.003). No association was found between age and baseline anti-S-RBD IgG levels. Antibody levels gradually decrease to a steady state after four months since the peak, and the decay is independent of age, sex, vaccine doses, and baseline antibodies titer. The third dose induces a high anti-S-RBD IgG reactivity in individuals with previous high response and trigger a moderate-high anti-S-RBD reactivity also in individuals with an initial low-moderate anti-S-RBD IgG response. Thus, a third SARS-CoV-2 vaccine dose is associated with a significant immunological response. Conclusion(s): Monitoring anti-SRBD IgG levels as a correlate of protection is helpful for answering important questions about virus neutralization and immunity against SARS-CoV-2. A third SARSCoV-2 vaccine dose is associated with a significant immunological response. Thus, our results support the efficacy of the vaccine programs and the usefulness of the third dose.
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Background: Coronavirus disease 2019 (COVID-19) is characterized by different manifestations, including an immune system imbalance. However, the specific mechanism that triggers a dysregulated immune response is not yet completely known. AntiNeutrophil Cytoplasmic Antibodies (ANCAs) are autoantibodies directed against various neutrophil antigens, including Myelo Per Oxidase (MPO) and PRoteinase 3 (PR3). In this study, we investigated the potential usefulness ofanti-MPO and anti-PR3 to elucidate whether the infection stimulates autoantibody production and contributes to autoimmunity activation in COVID-19 patients. Method(s): We assessedone hundred ten patients hospitalized for COVID-19, 62 (interquartile range [IQR], 52-72) years, admitted to COVID-19 Units at the University Hospital P. Giaccone of Palermo, Italy. Hematological, biochemical, and inflammatory parameters were evaluated. ANCA testing (anti-MPO and anti-PR3) was analyzed using a chemiluminescent assay (ACL AcuStar;Instrumentation Laboratory). Result(s): Laboratory results revealed a reduction in lymphocytes, higher levels of C Reactive Protein (CRP), and IL-6. In the great majority (76%) a moderate decrease in vitamin D levels was found. In addition, a weak increase in serum D-dimer and high-sensitive troponin T (hs-TnT) concentrations were observed in 37% and 51% of patients. Our analysis showed that anti-MPO and anti-PR3 antibodies were present in <2% and <5%, respectively, of study population. Conclusion(s): It has been known that SARS-CoV-2 can trigger a strong immune response in some individuals. Our results do not show greater activation of autoimmune response given the low rate of ANCAs positivity encountered. However, the study is ongoing for a long-term evaluation of patients.
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Background: Vaccines have been rapidly developed to control Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) diffusion among the population. The immune surveillance by assessing anti-spike protein receptor-binding domain (S-RBD) antibodies levels is fundamental to evaluate the individual protection against SARS-CoV-2 infection. Methods: We evaluated the anti S-RBD IgG levels on a large cohort consisting of recipients of COVID-19 mRNA BNT162b2 (Pfizer-BioNTech) vaccine, without or with previous SARS-CoV-2 infection (2872 and 149 subjects, respectively), and 318 recovered COVID-19 patients that did not receive the vaccination. Among vaccinated, 450 subjects performed a re-dosing after about 72 days from the first measurement. Anti S-RBD IgG levels were evaluated by chemiluminescence immunoassay on Maglumi 800 (SNIBE, China). Results: Anti S-RBD IgG levels were significantly lower in subjects with the previous infection than vaccinated subjects, both with and without previous infection (Bonferroni's correction, both p< 0.001). No difference was observed between vaccinated subjects with and without previous SARS-CoV-2 infection (p= 0.118). General linear model analysis revealed that age (p= 0.012), development of adverse effects after vaccination (p= 0.001), and sex (p= 0.003), but not the presence of previous infection (p= 0.660), were independent predictors of anti S-RBD IgG levels. Anti S-RBD IgG levels were significantly higher in women than men (2300 vs. 1462 BAU/mL;p< 0.001) as well as in subjects with one or more symptoms after vaccination than asymptomatic ones (2150 vs. 1374 BAU/mL;p= 0.001). Additionally, anti S-RBD IgG levels decreased with age (rho= -0.190;p< 0.001). Finally, a significant decrease in anti-RBD IgG levels was observed within a short period (median -1.1% day) not influenced by age and sex. Conclusions: This observational study has revealed a robust response to COVID-19 vaccine administration, characterized by a good antibody production with ageand sex-related differences. Additionally, we showed a rapid antibody decay rate within a short period after a completed two-dose vaccine cycle.
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Introduction: Monocyte Distribution Width (MDW), a measure of monocyte anisocytosis, has emerged as a reliable biomarker for screening sepsis in the acute setting, including the emergency department (ED) and intensive care unit (ICU). Noteworthy, Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCoV-2) infection can cause sepsis, representing the most common complication in Coronavirus Disease 19 (COVID-19), associated with high mortality. However, only a few studies examine the MDW in COVID-19. Therefore, this study aimed to investigate the role of MDW as a sepsis biomarker in patients with COVID-19. Materials and Methods: We enrolled one hundred ten COVID-19 patients hospitalized in the COVID-19 Units at the University Hospital P. Giaccone of Palermo, Italy, from September to October 2020. MDW was measured in samples collected in K3 EDTA tubes by a UniCel® DxH 900 hematology analyzer (Beckman Coulter's Inc, Brea, California). Statistical analysis was performed using MedCalc v12.1.4.0 statistical software (MedCalc Software, Mariakerke, Belgium). Results: COVID-19 patients showed elevated MDW values with a median of 25.3 (IQR 23 - 27). About 70% of patients on admission had MDW values higher than the cut-off of 23.5, which we established in previous studies. Conclusions: Our results support the clinical utility of the novel biomarker MDW in COVID-19 patients. Further studies are needed to explain better the mechanisms involved in the increase of MDW in COVID-19 patients and, in particular, its relation with the severity of the disease.
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The new Coronavirus Disease 2019 (COVID-19), caused by the virus SARS-CoV-2, is characterized by a broad spectrum of clinical manifestations and different degrees of severity, ranging from asymptomatic/mild symptoms to Acute Respiratory Distress Syndrome (ARDS) and Multiple Organ Failure (MOF), potentially life-threatening. The clinical course of COVID-19 includes usually three stages. The first stage, defined as “early infection”, occurs at the time of virus infiltration in the lung parenchyma, via the interaction of SARS-CoV-2 with the angiotensin-converting enzyme 2 (ACE2) in ciliated bronchial epithelial cells. The second step, the “pulmonary phase”, is characterized by viral pneumonia with localized inflammation within the lung. The third stage, the “hyperinflammation phase”, is the most severe because of the development of a systemic inflammation and cytokine overproduction leading to ARDS and MOF. In this complex contest, the laboratory can provide a strong support for the appropriate clinical management of COVID-19 for diagnosis, prognosis, and monitoring of the disease. Current research focuses on the potential role of immune and/or inflammatory biomarkers as useful tools in COVID-19 patients. In this narrative review, we will provide an overview about some of these biomarkers: procalcitonin, mid regional-pro adrenomedullin, presepsin, soluble fms-like tyrosine kinase 1/placental growth factor, ACE2, interleukin-6 and vitamin D. © 2020 Biomedia. All rights reserved.