Mother's Pregnancy Trimester Does Not Affect the Differences of IgG SARS-COV-2 Antibody Levels in Pregnant Women after mRNA and Inactivated Coronavirus Disease 2019 Vaccination

BACKGROUND: Since pregnancy increases the risk of coronavirus disease 2019 (COVID-19) and its morbidity in pregnant women, it is necessary and recommended to prevent COVID-19 in pregnant women by vaccination such as by messenger RNA (mRNA) and inactivated vaccines. SARS-CoV-2 antibodies produced from vaccination have different results according to the type of vaccine given. The previous studies showed that IgG SARS-CoV-2 antibody levels were influenced by various factors such as gestational weeks at the time when vaccines were given. Moreover, there have been no previous studies on the effect of gestational age on quantitative IgG levels after the second dose of the vaccine especially in Indonesia during this pandemic due to some restrictions on daily activities. AIM: The aim of this study is to see the effect of giving the COVID-19 vaccine based on maternal gestational age (in trimester units) on maternal immunity (IgG SARS-CoV-2) in Dr. Hasan Sadikin General Hospital Bandung, Bandung Kiwari Hospital and Dr. Slamet Hospital, Garut. METHOD(S): This was a retrospective and cohort study by taking secondary data using consecutive sampling from the previous tests on the levels of SARS-CoV-2 IgG antibodies after two doses of inactivated vaccine and mRNA. Healthy pregnant women 14-34 weeks at the Department of Obstetrics and Gynecology, Dr. Hasan Sadikin (RSHS) Bandung, Bandung Kiwari Hospital, and Dr. Slamet Hospital for the period October 2021 to January 2022 were the target population of this study. Based on inclusion and exclusion criteria, 103 samples met the criteria. Examination of Maternal SARS-CoV-2 IgG Antibody Levels procedures was carried out using Chemiluminescent Microparticle Immunoassay. Statistical analysis was done using IBM SPSS 28.00 and p < 0.05 was considered statistically significant. RESULT(S): There was no significant difference (p = 0.236, p > 0.05) between the mean maternal age in the mRNA and inactivated vaccine groups. The mRNA and inactivated vaccine groups also had no significant difference in the gestational age category (0.70). There was a significant difference (p = 0.0001) between the levels of SARS-CoV-2 IgG antibodies after the vaccine in the mRNA and inactivated vaccine groups. There was no significant difference in the levels of SARS-CoV-2 IgG antibodies in the gestational age group after the mRNA vaccine (p = 0.426) and after the inactivated vaccine (p = 0.293). There was a significant difference (p < 0.05) in the subgroup analysis in each gestational age group (second trimester and third trimester) between SARS-CoV-2 IgG antibody levels after the mRNA vaccine compared to inactivated vaccine. DISCUSSIONS: The mRNA vaccine is based on the principle that mRNA is an intermediate messenger to be translated to an antigen after delivery to the host cell via various routes. However, inactivated vaccines contain viruses whose genetic material has been destroyed by heat, chemicals, or radiation, so they cannot infect cells and replicate but can still trigger an immune response. The administration of the vaccine in the second and third trimesters of pregnancy has the same results in increasing levels of SARS-CoV-2 IgG antibodies after mRNA and inactivated vaccination in this study. CONCLUSION(S): mRNA vaccination in pregnant women is better than inactivated vaccines based on the levels of IgG SARS-CoV-2 antibodies after vaccination. The maternal trimester of pregnancy was not a factor influencing the levels of SARS-CoV-2 IgG antibodies after either mRNA or inactivated COVID-19 vaccinations in this study.Copyright © 2023 Anita Deborah Anwar, Putri Nadhira Adinda Adriansyah, Ivan Christian Channel, Annisa Dewi Nugrahani, Febriani Febriani, Asep Surachman, Dhanny Primantara Johari Santoso, Akhmad Yogi Pramatirta, Budi Handono.

Maternal COVID-19 Infection: A Cause of Neonatal Stroke?

Perinatal arterial ischemic stroke (PAIS) is a rare cause of neonatal seizures, with an incidence of 1 in 2500 to 4000 live births, globally. This is a case of a neonate with PAIS due to transpla-cental passage of COVID-19 IgG antibodies from the mother. A term, male neonate, born to a primigravida with an unevent-ful antenatal history was presented on the second day of life with multiple episodes of focal clonic seizures involving the right upper and lower limbs. Magnetic resonance imaging revealed an acute infarct in the left frontal lobe, extending into the parietal region, anterior limb, and genu of internal capsule suggestive of arterial ischemic stroke. The known causes of PAIS were evaluated and ruled out. The result of reverse transcription polymerase chain reaction analysis for SARS-CoV-2 antigen was negative for both the mother and the neonate. COVID-19 IgG antibodies in the mother and neonate were elevated. Seizures were controlled with antiepileptics. The neonate had no further seizure episodes and was discharged on oral levetiracetam. The infant was developmentally and neurologically normal at 3 months of age. PAIS is a rare cause of neonatal seizures, and maternal COVID-19 infection may be associated with neonatal stroke.Copyright © 2022, Himalaya Wellness Company. All rights reserved.

Statistical analysis for COVID-19 infections including several association factors: Age, gender and blood parameters

Clinical manifestations of COVID-19 caused by the new coronavirus SARS-CoV-2 are associated with several blood parameters. In this report we investigate the relation between COVID-19 susceptibility to the gender, ABO blood, patient's age and blood parameters. Blood samples of 50 patients were analysed for five months to detect ferritin, D-dimer, CR Protein, W. BCs count, COVID-19 IgM and COVID-19 IgG. According to the gender of the cases. The results showed that number of male's incidence is higher than in females (31case-62% male) (19 case-38%) respectively. The incidence of COVID-19 in.age period 30-42 years showed the highest number for both genders. The ABO blood group investigations showed that cases with blood group A+ were the highest percentage and the lowest was in the AB+ blood group for both genders. The blood parameters were significant elevated;ferritin (95% Confidence Interval CI: 304.7-540.2, Median 198.3, Range (IQR) 1163.11), the reactive protein (CRP) titre significant elevated (95% CI, 62.11-93.73 mg/L, median of CRP titre 59) and D-Dimer (95% CI, 0.5647-1.039mg/L, median of D-Dimer titre 0.4 while Range (IQR) 3. Higher levels of white blood cell (95% CI, 10.55-12, median of WBC 10.94). Finally, elevated titre of IgG, CI 95% 2. 926-4.966, Median 2.405, Range (IQR) 17.03. Whereas, IgM CI 95% 6.905-12.04 Median 6.14, Range (IQR) 44.53). In summary, our results showed that COVID-19 impact significantly on ferritin, D-dimer, CR Protein, W. BCs count, IgM and IgG. Additionally, there was a significant association between COVID-19 predisposition and the ABO blood group. Persons with blood group A have a higher risk comparing with blood group AB individuals, how have a lower risk for COVID-19 infection. Based on the results of the study, it demonstrated a correlation between older age and change in blood parameters post Covid-19 infection. Current study suggest that aged people and blood group A might need particularly more awareness to protect and reduce the possibility of infection. © 2022 Author(s).

Efficient and Sustainable Platform for Preparation of a High-Quality Immunoglobulin G as an Urgent Treatment Option During Emerging Virus Outbreaks.

During the pre-vaccine era of the COVID-19 pandemic convalescent plasma has once again emerged as a major potential therapeutic form of passive immunization that in specific cases still represents irreplaceable treatment option. There is a growing concern that variable concentration of neutralizing antibodies, present in convalescent plasma which originates from different donors, apparently affects its effectiveness. The drawback can be overcome through the downstream process of immunoglobulin fraction purification into a standardized product of improved safety and efficacy. All modern procedures are quite lengthy processes. They are also based on fractionation of large plasma quantities whose collection is not attainable during an epidemic. When outbreaks of infectious diseases are occurring more frequently, there is a great need for a more sustainable production approach that would be goal-oriented towards assuring easily and readily available immunoglobulin of therapeutic relevance. We propose a refinement strategy for the IgG preparation achieved through simplification and reduction of the processing steps. It was designed as a small but scalable process to offer an immediately available treatment option that would simultaneously be harmonized with an increased availability of convalescent plasma over the viral outbreak time-course. Concerning the ongoing pandemic status of the COVID-19, the proof of concept was demonstrated on anti-SARS-CoV-2 convalescent plasma but is likely applicable to any other type depending on the current needs. It was guided by the idea of persistent keeping of IgG molecules in the solution, so that protection of their native structure could be assured. Our manufacturing procedure provided a high-quality IgG product of above the average recovery whose composition profile was analyzed by mass spectrometry as quality control check. It was proved free from IgA and IgM as mediators of adverse transfusion reactions, as well as of any other residual impurities, since only IgG fragments were identified. The proportion of S protein-specific IgGs remained unchanged relative to the convalescent plasma. Undisturbed IgG subclass composition was accomplished as well. However, the fractionation principle affected the final product's capacity to neutralize wild-type SARS-CoV-2 infectivity, reducing it by half. Decrease in neutralization potency significantly correlated with the amount of IgM in the starting material.

Single-step, wash-free digital immunoassay for rapid quantitative analysis of serological antibody against SARS-CoV-2 by photonic resonator absorption microscopy.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the cause of Coronavirus Disease 2019 (COVID-19), poses extraordinary threats and complex challenges to global public health. Quantitative measurement of SARS-CoV-2 antibody titer plays an important role in understanding the patient-to-patient variability of immune response, assessing the efficacy of vaccines, and identifying donors for blood transfusion therapy. There is an urgent and ever-increasing demand for serological COVID-19 antibody tests that are highly sensitive, quantitative, rapid, simple, minimally invasive, and inexpensive. In this work, we developed a single-step, wash-free immunoassay for rapid and highly sensitive quantitative analysis of serological human IgG against SARS-CoV-2 which requires only a single droplet of serum. By simply incubating 4 µL human serum samples with antibody-functionalized gold nanoparticles, a photonic crystal optical biosensor coated with the recombinant spike protein serves as a sensing platform for the formation of sandwich immunocomplex through specific antigen-antibody interactions, upon which the detected IgG molecules can be counted with digital precision. We demonstrated a single-step 15-min assay capable of detecting as low as 100 pg mL-1 human COVID-19 IgG in serum samples. The calculated limit of detecting (LOD) and limit of quantification (LOQ) is 26.7 ± 7.7 and 32.0 ± 8.9 pg mL-1, respectively. This work represents the first utilization of the Activate Capture + Digital Counting (AC + DC)-based immunoassay for rapid and quantitative analysis of serological COVID-19 antibody, demonstrating a route toward point-of-care testing, using a portable detection instrument. On the basis of the sandwich immunoassay principle, the biosensing platform can be extended for the multiplexed detection of antigens, additional IgGs, cytokines, and other protein biomarkers.