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1.
medrxiv; 2020.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2020.08.10.20171561

ABSTRACT

Background The coronavirus disease 2019 (COVID-19) pandemic challenges governments worldwide to balance appropriate virus control measures and their societal and economic consequences. These control measures include the identification, isolation and testing of potentially infected individuals. As this relies on an individual's awareness of infection, we investigated the extent to which healthy adults suspected having had COVID-19, and how COVID-19 suspicion and symptoms relate to antibodies indicative of a past infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods and findings Individuals donating plasma anywhere in the Netherlands between May 11th and 18th were screened for total SARS-CoV-2 antibodies using ELISA and invited to participate in an online questionnaire about COVID-19-related symptoms and awareness. Antibody and questionnaire data were complete for 3,676 individuals, including 239 (6.5%) that tested positive for SARS-CoV-2 antibodies. Here, we show that a 38% of the individuals that tested positive for SARS-CoV-2 antibodies reported having had no or only very mild symptoms at any time during the peak of the epidemic. The loss of taste and/or smell in particular was significantly associated with seropositivity, independent of age and sex. Forty-eight percent of antibody-positive persons did not suspect having had COVID-19, in spite of most of them reporting symptoms. Conclusions Awareness of infection was low among individuals that tested positive for SARS-CoV-2 antibodies, even at the peak of the epidemic. Improved awareness and recognition of COVID-19 symptoms and tracing of asymptomatic contacts is crucial to halting SARS-CoV-2 transmission.

2.
biorxiv; 2020.
Preprint in English | bioRxiv | ID: ppzbmed-10.1101.2020.06.18.159202

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the current coronavirus disease 2019 (COVID-19) pandemic. Understanding both the immunological processes providing specific immunity and potential immunopathology underlying the pathogenesis of this disease may provide valuable insights for potential therapeutic interventions. Here, we quantified SARS-CoV-2 specific immune responses in patients with different clinical courses. Compared to individuals with a mild clinical presentation, CD4+ T cell responses were qualitatively impaired in critically ill patients. Strikingly, however, in these patients the specific IgG antibody response was remarkably strong. The observed disparate T and B cell responses could be indicative of a deregulated immune response in critically ill COVID-19 patients.

3.
researchsquare; 2020.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-25862.v1

ABSTRACT

The world is combating an ongoing COVID-19 pandemic1-4. Health-care systems, society and the economy are impacted in an unprecedented way. It is unclear how many people have contracted the causative coronavirus (SARS-CoV-2) unknowingly. Therefore, reported COVID-19 cases do not reflect the true scale of outbreak5-9. Natural herd immunity has been suggested as a potential exit strategy during COVID-19 outbreaks, which may arise when 50-67% of a community has been infected10. Here we present the prevalence and distribution of antibodies to SARS-CoV-2 in a healthy adult population of a highly affected country using a novel immunoassay, indicating that one month into the outbreak (i) the seroprevalence in the Netherlands is 2.7% with substantial regional variation, (ii) the hardest-hit areas show a seroprevalence of up to 9.5%, (iii) the seroprevalence is sex-independent throughout age groups (18-72 years), (iv) antibodies are significantly more often detected in younger people (18-30 years), and (v) the number of immune individuals in the current epidemic stage is far below the herd immunity threshold. This study provides vital information on the extent of virus spread in a country where social distancing is in place, concluding that herd immunity to SARS-CoV-2 is not a realistic short-term exit strategy option.

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