ABSTRACT
Studies evaluating the levels of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) anti-spike protein receptor-binding domain (S-RBD) immunoglobulin G (IgG) antibodies in vaccinated healthcare workers in Indonesia are limited. Objectives: Evaluating time-dependent levels of anti-IgG S-RBD antibodies and monitoring the response of healthcare workers in a tertiary hospital in Indonesia after vaccination. Materials and methods: This prospective cohort observational study was conducted from January to December 2021. A total of 50 healthcare workers participated in the study. Blood samples were collected at five time points. Antibody levels were measured using a CL 1000i analyzer (Mindray Bio-Medical Electronics Co., Ltd., Shenzhen, China). Antibody levels between groups were analyzed using the Wilcoxon signed-rank test with P less than 0.05. Results: The median levels of SARS-CoV-2 anti-S-RBD IgG antibody on days 14, 28, 90, and 180 were significantly higher than the levels on day 0 (P<0.001). After the second dose, peak levels were observed on day 14; the levels decreased gradually after day 28. Despite receiving two doses of the vaccine, 10 out of 50 participants (20%) were infected with COVID-19 (coronavirus disease 2019). However, symptoms were mild, and antibody levels were significantly higher than in noninfected participants (P<0.001). Conclusion: SARS-CoV-2 anti-S-RBD IgG antibody levels increased significantly until day 14 after the second dose; the levels decreased gradually after day 28. Ten participants (20%) were infected with SARS-CoV-2, with mild symptoms.
ABSTRACT
Background: COVID-19 pandemic causes severe acute respiratory syndrome and requires rapid action. The development of effective safe vaccines become a global priority for achieving herd immunity. Vaccination is expected to form specific antibodies against the SARS-CoV-2 spike protein which can neutralize the virus, preventing the virus from binding with ACE 2 receptors. Objective: Evaluating and to know if there any differences of kinetics antibody levels from recipient's anti-IgG S-RBD and NAb with complete second dose CoronaVac Vaccine, to determine the antibody response in preventing SARS-CoV-2. Method: A prospective-cohort study using observational analytics was conducted from January-April 2021 at Dr. Soetomo Hospital, Surabaya. A total of 50 subjects are healthcare workers who received two doses of CoronaVac. The IgG S-RBD and NAb levels were measured on Maglumi 800 device (SNIBE, China). Differences in IgG S-RBD and NAb levels before vaccination and after second dose CoronaVac vaccination on 14th day, on 28th day, ware tested using Friedman and Wilcoxon tests. Result: Mean values of IgG S-RBD and NAb have fluctuated. There was a significant difference between IgG S-RBD and NAb levels on day-0 (0.090 vs 18.630; p < 0.001) and day-28 (141.266 vs 116.640; p = 0.037). The median value showed the IgG S-RBD level on day-28 was much better than NAb value (141,266 v 116,640). Conclusion: CoronaVac will form persistent antibodies. Despite antibody development, the acquired humoral immunity decreased at 28 days after full CoronaVac immunization. Kinetics of antibody NAb decreased more rapidly than IgG S-RBD.
ABSTRACT
The aim of the research is to analyze the differences in the subset of T lymphocytes and NK cells at various degrees of disease severity in order to be used in stratification of patients' management and to predict outcomes for optimal treatment. The study sample of 123 patients with confirmed COVID-19 was classified based on the degree of severity: 50 patients with mild severity, 34 patients with moderate severity and 39 patients with severe to critical severity who were subjected to complete blood count and T lymphocyte subsets (CD3, CD4, CD8) and NK cells with Flowcytometry. There were significant differences in the number of CD 3 cells (p=0.000), CD4 (p=0.000), CD8 (p=0.000), and NK cells (p=0.000) in the three groups. In the severe to critical group there was a decrease in lymphocytes accompanied by decrease of the number of CD3, CD4, CD8 and NK cells as well as an increase in WBC and neutrophils. Based on the outcome, there were significant differences in the number of CD 3 cells (p=0.000), CD4 (p=0.001), CD8 (p=0.000), and NK cells (p=0.001) between the Discharged and death groups. The decrease in the number of CD3, CD4, CD8 and NK cells indicates a relationship between changes in lymphocyte subsets and the pathogenesis of SARS-CoV-2, namely immune system disorders such as SARS infection. Increased of WBC with a decrease in CD3, CD4, CD8 and NK cell counts are associated with poor patient outcome. A significant decrease in the number of CD3, CD4, CD8 and NK cells in COVID-19 patients with severe to critical and moderate symptoms compared to mild groups and associated with poor patient clinical outcome.