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High prevalence of SARS-CoV-2 antibodies in care homes affected by COVID-19: Prospective cohort study, England.
Ladhani, Shamez N; Jeffery-Smith, Anna; Patel, Monika; Janarthanan, Roshni; Fok, Jonathan; Crawley-Boevey, Emma; Vusirikala, Amoolya; Fernandez Ruiz De Olano, Elena; Perez, Marina Sanchez; Tang, Suzanne; Dun-Campbell, Kate; Evans, Edward Wynne-; Bell, Anita; Patel, Bharat; Amin-Chowdhury, Zahin; Aiano, Felicity; Paranthaman, Karthik; Ma, Thomas; Saavedra-Campos, Maria; Ellis, Joanna; Chand, Meera; Brown, Kevin; Ramsay, Mary E; Hopkins, Susan; Shetty, Nandini; Chow, J Yimmy; Gopal, Robin; Zambon, Maria.
  • Ladhani SN; Immunisation and Countermeasures Division, Public Health England, London, UK.
  • Jeffery-Smith A; Paediatric Infectious Diseases Research Group, St. George's University of London, UK.
  • Patel M; Virus Reference Department, Public Health England, London, UK.
  • Janarthanan R; Virus Reference Department, Public Health England, London, UK.
  • Fok J; London Health Protection Team, National Infection Service, Public Health England, London, UK.
  • Crawley-Boevey E; London Health Protection Team, National Infection Service, Public Health England, London, UK.
  • Vusirikala A; London Health Protection Team, National Infection Service, Public Health England, London, UK.
  • Fernandez Ruiz De Olano E; London Health Protection Team, National Infection Service, Public Health England, London, UK.
  • Perez MS; London Health Protection Team, National Infection Service, Public Health England, London, UK.
  • Tang S; London Health Protection Team, National Infection Service, Public Health England, London, UK.
  • Dun-Campbell K; London Health Protection Team, National Infection Service, Public Health England, London, UK.
  • Evans EW; London Health Protection Team, National Infection Service, Public Health England, London, UK.
  • Bell A; London Health Protection Team, National Infection Service, Public Health England, London, UK.
  • Patel B; London Health Protection Team, National Infection Service, Public Health England, London, UK.
  • Amin-Chowdhury Z; London Health Protection Team, National Infection Service, Public Health England, London, UK.
  • Aiano F; Immunisation and Countermeasures Division, Public Health England, London, UK.
  • Paranthaman K; Immunisation and Countermeasures Division, Public Health England, London, UK.
  • Ma T; Field Service, National Infection Service, Public Health England, UK.
  • Saavedra-Campos M; Field Service, National Infection Service, Public Health England, UK.
  • Ellis J; Field Service, National Infection Service, Public Health England, UK.
  • Chand M; Virus Reference Department, Public Health England, London, UK.
  • Brown K; Antimicrobial Resistance and Hospital Acquired Infection Department, Public Health England, London, UK.
  • Ramsay ME; Virus Reference Department, Public Health England, London, UK.
  • Hopkins S; Immunisation and Countermeasures Division, Public Health England, London, UK.
  • Shetty N; Antimicrobial Resistance and Hospital Acquired Infection Department, Public Health England, London, UK.
  • Chow JY; Virus Reference Department, Public Health England, London, UK.
  • Gopal R; London Health Protection Team, National Infection Service, Public Health England, London, UK.
  • Zambon M; Virus Reference Department, Public Health England, London, UK.
EClinicalMedicine ; 28: 100597, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-912161
Semantic information from SemMedBD (by NLM)
1. Antibodies PART_OF 2019 novel coronavirus
Subject
Antibodies
Predicate
PART_OF
Object
2019 novel coronavirus
2. Antigens PART_OF 2019 novel coronavirus
Subject
Antigens
Predicate
PART_OF
Object
2019 novel coronavirus
3. Reverse Transcriptase Polymerase Chain Reaction USES Nasal Swabs
Subject
Reverse Transcriptase Polymerase Chain Reaction
Predicate
USES
Object
Nasal Swabs
4. Hematologic Tests USES Enzyme-Linked Immunosorbent Assay
Subject
Hematologic Tests
Predicate
USES
Object
Enzyme-Linked Immunosorbent Assay
5. Negative PROCESS_OF Persons
Subject
Negative
Predicate
PROCESS_OF
Object
Persons
6. Antibodies PART_OF 2019 novel coronavirus
Subject
Antibodies
Predicate
PART_OF
Object
2019 novel coronavirus
7. Antigens PART_OF 2019 novel coronavirus
Subject
Antigens
Predicate
PART_OF
Object
2019 novel coronavirus
8. Reverse Transcriptase Polymerase Chain Reaction USES Nasal Swabs
Subject
Reverse Transcriptase Polymerase Chain Reaction
Predicate
USES
Object
Nasal Swabs
9. Hematologic Tests USES Enzyme-Linked Immunosorbent Assay
Subject
Hematologic Tests
Predicate
USES
Object
Enzyme-Linked Immunosorbent Assay
10. Negative PROCESS_OF Persons
Subject
Negative
Predicate
PROCESS_OF
Object
Persons
ABSTRACT

BACKGROUND:

We investigated six London care homes experiencing a COVID-19 outbreak and found high rates of SARS-CoV-2 infection among residents and staff. Here we report follow-up investigations including antibody testing in the same care homes five weeks later.

METHODS:

Residents and staff in the initial investigation had a repeat nasal swab for SARS-CoV-2 RT-PCR and a blood test for SARS CoV-2 antibodies using ELISA based on SARS-CoV-2 native viral antigens derived from infected cells and virus neutralisation.

FINDINGS:

Of the 518 residents and staff in the initial investigation, 186/241 (77.2%) surviving residents and 208/254 (81.9%) staff underwent serological testing. Almost all SARS-CoV-2 RT-PCR positive residents and staff were seropositive five weeks later, whether symptomatic (residents 35/35, 100%; staff, 22/22, 100%) or asymptomatic (residents 32/33, 97.0%; staff 21/22, 95.5%). Symptomatic but SARS-CoV-2 RT-PCR negative residents and staff also had high seropositivity rates (residents 23/27, 85.2%; staff 18/21, 85.7%), as did asymptomatic RT-PCR negative individuals (residents 61/91, 67.0%; staff 95/143, 66.4%). Neutralising antibody was detected in 118/132 (89.4%) seropositive individuals and was not associated with age or symptoms. Ten residents (10/79 re-tested, 12.7%) remained RT-PCR positive but with higher RT-PCR cycle threshold values; 7/10 had serological testing and all were seropositive. New infections were detected in three residents and one staff.

INTERPRETATION:

RT-PCR provides a point prevalence of SARS-CoV-2 infection but significantly underestimates total exposure in outbreak settings. In care homes experiencing large COVID-19 outbreaks, most residents and staff had neutralising SARS-CoV-2 antibodies, which was not associated with age or symptoms.

FUNDING:

PHE.

Full text: Available Collection: International databases Database: MEDLINE Type of study: Etiology study / Observational study / Prevalence study / Risk factors Language: English Journal: EClinicalMedicine Year: 2020 Document Type: Article Affiliation country: J.eclinm.2020.100597

Full text: Available Collection: International databases Database: MEDLINE Type of study: Etiology study / Observational study / Prevalence study / Risk factors Language: English Journal: EClinicalMedicine Year: 2020 Document Type: Article Affiliation country: J.eclinm.2020.100597