Serological responses to SARS-CoV-2 following non-hospitalised infection: clinical and ethnodemographic features associated with the magnitude of the antibody response

Objective To determine clinical and ethnodemographic correlates of serological responses against the SARS-CoV-2 spike glycoprotein following mild-to-moderate COVID-19.Design A retrospective cohort study of healthcare workers who had self-isolated due to COVID-19.Setting University Hospitals Birmingh...

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Main Authors: Saly Al-Taei, Sian E Faustini, Marisol Perez-Toledo, Sian Jossi, Joel D Allen, Claire Backhouse, Daniel Ebanks, Beena Emmanuel, Mark Garvey, Golaleh McGinnell, Yasunori Watanabe, Max Crispin, David C Wraith, Adam F Cunningham, Mark T Drayson, Alex G Richter, Adrian M Shields, Lynsey A Dunbar, Aduragbemi A Faniyi, Annabel Grinbergs, Joanne O'Neill
Format: Article
Language:English
Published: BMJ Publishing Group 2021-01-01
Series:BMJ Open Respiratory Research
Online Access:https://bmjopenrespres.bmj.com/content/8/1/e000872.full
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author Saly Al-Taei
Sian E Faustini
Marisol Perez-Toledo
Sian Jossi
Joel D Allen
Claire Backhouse
Daniel Ebanks
Beena Emmanuel
Mark Garvey
Golaleh McGinnell
Yasunori Watanabe
Max Crispin
David C Wraith
Adam F Cunningham
Mark T Drayson
Alex G Richter
Adrian M Shields
Lynsey A Dunbar
Aduragbemi A Faniyi
Annabel Grinbergs
Joanne O'Neill
author_facet Saly Al-Taei
Sian E Faustini
Marisol Perez-Toledo
Sian Jossi
Joel D Allen
Claire Backhouse
Daniel Ebanks
Beena Emmanuel
Mark Garvey
Golaleh McGinnell
Yasunori Watanabe
Max Crispin
David C Wraith
Adam F Cunningham
Mark T Drayson
Alex G Richter
Adrian M Shields
Lynsey A Dunbar
Aduragbemi A Faniyi
Annabel Grinbergs
Joanne O'Neill
author_sort Saly Al-Taei
collection DOAJ
description Objective To determine clinical and ethnodemographic correlates of serological responses against the SARS-CoV-2 spike glycoprotein following mild-to-moderate COVID-19.Design A retrospective cohort study of healthcare workers who had self-isolated due to COVID-19.Setting University Hospitals Birmingham NHS Foundation Trust, UK (UHBFT).Participants 956 healthcare workers were recruited by open invitation via UHBFT trust email and social media between 27 April 2020 and the 8 June 2020.Intervention Participants volunteered a venous blood sample that was tested for the presence of anti-SARS-CoV-2 spike glycoprotein antibodies. Results were interpreted in the context of the symptoms of their original illness and ethnodemographic variables.Results Using an assay that simultaneously measures the combined IgG, IgA and IgM response against the spike glycoprotein (IgGAM), the overall seroprevalence within this cohort was 46.2% (n=442/956). The seroprevalence of immunoglobulin isotypes was 36.3%, 18.7% and 8.1% for IgG, IgA and IgM, respectively. IgGAM identified serological responses in 40.6% (n=52/128) of symptomatic individuals who reported a negative SARS-CoV-2 PCR test. Increasing age, non-white ethnicity and obesity were independently associated with greater IgG antibody response against the spike glycoprotein. Self-reported fever and fatigue were associated with greater IgG and IgA responses against the spike glycoprotein. The combination of fever and/or cough and/or anosmia had a positive predictive value of 92.3% for seropositivity in self-isolating individuals a time when Wuhan strain SARS-CoV-2 was predominant.Conclusions and relevance Assays employing combined antibody detection demonstrate enhanced seroepidemiological sensitivity and can detect prior viral exposure even when PCR swabs have been negative. We demonstrate an association between known ethnodemographic risk factors associated with mortality from COVID-19 and the magnitude of serological responses in mild-to-moderate disease.
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spelling doaj-art-e0200576b9bb42ee8e2962a819f963642025-08-20T02:32:59ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392021-01-018110.1136/bmjresp-2020-000872Serological responses to SARS-CoV-2 following non-hospitalised infection: clinical and ethnodemographic features associated with the magnitude of the antibody responseSaly Al-Taei0Sian E Faustini1Marisol Perez-Toledo2Sian Jossi3Joel D Allen4Claire Backhouse5Daniel Ebanks6Beena Emmanuel7Mark Garvey8Golaleh McGinnell9Yasunori Watanabe10Max Crispin11David C Wraith12Adam F Cunningham13Mark T Drayson14Alex G Richter15Adrian M Shields16Lynsey A Dunbar17Aduragbemi A Faniyi18Annabel Grinbergs19Joanne O'Neill20Department of Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham, UKInstitute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UKInstitute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UKInstitute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UKSchool of Biological Sciences, University of Southampton, Southampton, UKDepartment of Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham, UKDepartment of Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham, UKDepartment of Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham, UKUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, UKUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, UKSchool of Biological Sciences, University of Southampton, Southampton, UKSchool of Biological Sciences, University of Southampton, Southampton, UKInstitute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UKMRC Centre for Immune Regulation, University of Birmingham, Birmingham, UKDepartment of Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham, UKDepartment of Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham, UKInstitute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UKDepartment of Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham, UKBirmingham Acute Care Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UKUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, UKUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, UKObjective To determine clinical and ethnodemographic correlates of serological responses against the SARS-CoV-2 spike glycoprotein following mild-to-moderate COVID-19.Design A retrospective cohort study of healthcare workers who had self-isolated due to COVID-19.Setting University Hospitals Birmingham NHS Foundation Trust, UK (UHBFT).Participants 956 healthcare workers were recruited by open invitation via UHBFT trust email and social media between 27 April 2020 and the 8 June 2020.Intervention Participants volunteered a venous blood sample that was tested for the presence of anti-SARS-CoV-2 spike glycoprotein antibodies. Results were interpreted in the context of the symptoms of their original illness and ethnodemographic variables.Results Using an assay that simultaneously measures the combined IgG, IgA and IgM response against the spike glycoprotein (IgGAM), the overall seroprevalence within this cohort was 46.2% (n=442/956). The seroprevalence of immunoglobulin isotypes was 36.3%, 18.7% and 8.1% for IgG, IgA and IgM, respectively. IgGAM identified serological responses in 40.6% (n=52/128) of symptomatic individuals who reported a negative SARS-CoV-2 PCR test. Increasing age, non-white ethnicity and obesity were independently associated with greater IgG antibody response against the spike glycoprotein. Self-reported fever and fatigue were associated with greater IgG and IgA responses against the spike glycoprotein. The combination of fever and/or cough and/or anosmia had a positive predictive value of 92.3% for seropositivity in self-isolating individuals a time when Wuhan strain SARS-CoV-2 was predominant.Conclusions and relevance Assays employing combined antibody detection demonstrate enhanced seroepidemiological sensitivity and can detect prior viral exposure even when PCR swabs have been negative. We demonstrate an association between known ethnodemographic risk factors associated with mortality from COVID-19 and the magnitude of serological responses in mild-to-moderate disease.https://bmjopenrespres.bmj.com/content/8/1/e000872.full
spellingShingle Saly Al-Taei
Sian E Faustini
Marisol Perez-Toledo
Sian Jossi
Joel D Allen
Claire Backhouse
Daniel Ebanks
Beena Emmanuel
Mark Garvey
Golaleh McGinnell
Yasunori Watanabe
Max Crispin
David C Wraith
Adam F Cunningham
Mark T Drayson
Alex G Richter
Adrian M Shields
Lynsey A Dunbar
Aduragbemi A Faniyi
Annabel Grinbergs
Joanne O'Neill
Serological responses to SARS-CoV-2 following non-hospitalised infection: clinical and ethnodemographic features associated with the magnitude of the antibody response
BMJ Open Respiratory Research
title Serological responses to SARS-CoV-2 following non-hospitalised infection: clinical and ethnodemographic features associated with the magnitude of the antibody response
title_full Serological responses to SARS-CoV-2 following non-hospitalised infection: clinical and ethnodemographic features associated with the magnitude of the antibody response
title_fullStr Serological responses to SARS-CoV-2 following non-hospitalised infection: clinical and ethnodemographic features associated with the magnitude of the antibody response
title_full_unstemmed Serological responses to SARS-CoV-2 following non-hospitalised infection: clinical and ethnodemographic features associated with the magnitude of the antibody response
title_short Serological responses to SARS-CoV-2 following non-hospitalised infection: clinical and ethnodemographic features associated with the magnitude of the antibody response
title_sort serological responses to sars cov 2 following non hospitalised infection clinical and ethnodemographic features associated with the magnitude of the antibody response
url https://bmjopenrespres.bmj.com/content/8/1/e000872.full
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