1887
Research Open Access
Like 0

Abstract

Introduction

The COVID-19 pandemic has put healthcare workers (HCW) at significant risk. Presence of antibodies can confirm prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Aim

This study investigates the prevalence of IgA and IgG antibodies against SARS-CoV-2 in HCW.

Methods

Performance of IgA and IgG antibody ELISA assays were initially evaluated in positive and negative SARS-CoV-2 serum samples. IgA and IgG antibodies against SARS-CoV-2 were measured in 428 asymptomatic HCW. We assessed the risk of two groups: HCW with high exposure risk outside work (HROW) residing in areas where COVID-19 was endemic (n = 162) and HCW with high exposure risk at work (HRAW) in a COVID-19 intensive care unit (ICU) (n = 97).

Results

Sensitivities of 80% and 81.2% and specificities of 97.2% and 98% were observed for IgA and IgG antibodies, respectively. Of the 428 HCW, three were positive for IgG and 27 for IgA. Only 3/27 (11%) IgA-positive HCW had IgG antibodies compared with 50/62 (81%) in a group of previous SARS-CoV-2-PCR-positive individuals. Consecutive samples from IgA-positive HCW demonstrated IgA persistence 18–83 days in 12/20 samples and IgG seroconversion in 1/20 samples. IgA antibodies were present in 8.6% of HROW and 2% of HRAW.

Conclusions

SARS-CoV-2 exposure may lead to asymptomatic transient IgA response without IgG seroconversion. The significance of these findings needs further study. Out of work exposure is a possible risk of SARS-CoV-2 infection in HCW and infection in HCW can be controlled if adequate protective equipment is implemented.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2021.26.48.2001690
2021-12-02
2024-11-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2021.26.48.2001690
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/26/48/eurosurv-26-48-4.html?itemId=/content/10.2807/1560-7917.ES.2021.26.48.2001690&mimeType=html&fmt=ahah

References

  1. Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020;579(7798):265-9.  https://doi.org/10.1038/s41586-020-2008-3  PMID: 32015508 
  2. Rafiq D, Batool A, Bazaz MA. Three months of COVID-19: A systematic review and meta-analysis. Rev Med Virol. 2020;30(4):e2113.  https://doi.org/10.1002/rmv.2113  PMID: 32420674 
  3. Singh S, McNab C, Olson RM, Bristol N, Nolan C, Bergstrøm E, et al. How an outbreak became a pandemic: a chronological analysis of crucial junctures and international obligations in the early months of the COVID-19 pandemic. Lancet. 2021;8:S0140-6736(21)01897-3.  https://doi.org/10.1016/S0140-6736(21)01897-3 .  PMID: 34762857 
  4. Corman VM, Landt O, Kaiser M, Molenkamp R, Meijer A, Chu DKW, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill. 2020;25(3).  https://doi.org/10.2807/1560-7917.ES.2020.25.3.2000045  PMID: 31992387 
  5. Özçürümez MK, Ambrosch A, Frey O, Haselmann V, Holdenrieder S, Kiehntopf M, et al. SARS-CoV-2 antibody testing-questions to be asked. J Allergy Clin Immunol. 2020;146(1):35-43.  https://doi.org/10.1016/j.jaci.2020.05.020  PMID: 32479758 
  6. Long QX, Liu BZ, Deng HJ, Wu GC, Deng K, Chen YK, et al. Antibody responses to SARS-CoV-2 in patients with COVID-19. Nat Med. 2020;26(6):845-8.  https://doi.org/10.1038/s41591-020-0897-1  PMID: 32350462 
  7. Wang Y, Zhang L, Sang L, Ye F, Ruan S, Zhong B, et al. Kinetics of viral load and antibody response in relation to COVID-19 severity. J Clin Invest. 2020;130(10):5235-44.  https://doi.org/10.1172/JCI138759  PMID: 32634129 
  8. Indenbaum V, Koren R, Katz-Likvornik S, Yitzchaki M, Halpern O, Regev-Yochay G, et al. Testing IgG antibodies against the RBD of SARS-CoV-2 is sufficient and necessary for COVID-19 diagnosis. PLoS One. 2020;15(11):e0241164.  https://doi.org/10.1371/journal.pone.0241164  PMID: 33227020 
  9. Long QX, Tang XJ, Shi QL, Li Q, Deng HJ, Yuan J, et al. Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections. Nat Med. 2020;26(8):1200-4.  https://doi.org/10.1038/s41591-020-0965-6  PMID: 32555424 
  10. Ripperger TJ, Uhrlaub JL, Watanabe M, Wong R, Castaneda Y, Pizzato HA, et al. Orthogonal SARS-CoV-2 Serological Assays Enable Surveillance of Low-Prevalence Communities and Reveal Durable Humoral Immunity. Immunity. 2020;53(5):925-33 e4.
  11. Tang J, Ravichandran S, Lee Y, Grubbs G, Coyle EM, Klenow L, et al. Antibody affinity maturation and plasma IgA associate with clinical outcome in hospitalized COVID-19 patients. Nat Commun. 2021;12(1):1221.  https://doi.org/10.1038/s41467-021-21463-2  PMID: 33619281 
  12. Chao YX, Rötzschke O, Tan EK. The role of IgA in COVID-19. Brain Behav Immun. 2020;87:182-3.  https://doi.org/10.1016/j.bbi.2020.05.057  PMID: 32454136 
  13. Russell MW, Moldoveanu Z, Ogra PL, Mestecky J. Mucosal Immunity in COVID-19: A Neglected but Critical Aspect of SARS-CoV-2 Infection. Front Immunol. 2020;11:611337.  https://doi.org/10.3389/fimmu.2020.611337  PMID: 33329607 
  14. Huff HV, Singh A. Asymptomatic transmission during the COVID-19 pandemic and implications for public health strategies. Clin Infect Dis. 2020.
  15. Peeling RW, Wedderburn CJ, Garcia PJ, Boeras D, Fongwen N, Nkengasong J, et al. Serology testing in the COVID-19 pandemic response. Lancet Infect Dis. 2020;20(9):e245-9.  https://doi.org/10.1016/S1473-3099(20)30517-X  PMID: 32687805 
  16. Chou R, Dana T, Buckley DI, Selph S, Fu R, Totten AM. Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers: A Living Rapid Review. Ann Intern Med. 2020;173(2):120-36.  https://doi.org/10.7326/M20-1632  PMID: 32369541 
  17. Oved K, Olmer L, Shemer-Avni Y, Wolf T, Supino-Rosin L, Prajgrod G, et al. Multi-center nationwide comparison of seven serology assays reveals a SARS-CoV-2 non-responding seronegative subpopulation. EClinicalMedicine. 2020;29-30:100651. PMID: 33235985 
  18. Huang AT, Garcia-Carreras B, Hitchings MDT, Yang B, Katzelnick LC, Rattigan SM, et al. A systematic review of antibody mediated immunity to coronaviruses: kinetics, correlates of protection, and association with severity. Nat Commun. 2020;11(1):4704.  https://doi.org/10.1038/s41467-020-18450-4  PMID: 32943637 
  19. Charlton CL, Kanji JN, Johal K, Bailey A, Plitt SS, MacDonald C, et al. Evaluation of six commercial mid to high volume antibody and six point of care lateral flow assays for detection of SARS-CoV-2 antibodies. J Clin Microbiol. 2020;58(10):e01361-20.  https://doi.org/10.1128/JCM.01361-20  PMID: 32665420 
  20. Montesinos I, Gruson D, Kabamba B, Dahma H, Van den Wijngaert S, Reza S, et al. Evaluation of two automated and three rapid lateral flow immunoassays for the detection of anti-SARS-CoV-2 antibodies. J Clin Virol. 2020;128:104413.  https://doi.org/10.1016/j.jcv.2020.104413  PMID: 32403010 
  21. Needle R, Gilbert L, Zahariadis G, Yu Y, Dalton-Kenny H, Russell RS, et al. Serological Evaluation of Human Antibodies of the Immunoglobulin Class A and G Against SARS-CoV-2 in Serum Collected in Newfoundland and Labrador. Viral Immunol. 2021;34(3):182-9.  https://doi.org/10.1089/vim.2020.0199  PMID: 33739895 
  22. Behrens GMN, Cossmann A, Stankov MV, Witte T, Ernst D, Happle C, et al. Perceived versus proven SARS-CoV-2-specific immune responses in health-care professionals. Infection. 2020;48(4):631-4.  https://doi.org/10.1007/s15010-020-01461-0  PMID: 32524515 
  23. Gudbjartsson DF, Norddahl GL, Melsted P, Gunnarsdottir K, Holm H, Eythorsson E, et al. Humoral Immune Response to SARS-CoV-2 in Iceland. N Engl J Med. 2020;383(18):1724-34.  https://doi.org/10.1056/NEJMoa2026116  PMID: 32871063 
  24. de Sousa-Pereira P, Woof JM. IgA: Structure, Function, and Developability. Antibodies (Basel). 2019;8(4):E57.  https://doi.org/10.3390/antib8040057  PMID: 31817406 
  25. Hansen IS, Baeten DLP, den Dunnen J. The inflammatory function of human IgA. Cell Mol Life Sci. 2019;76(6):1041-55.  https://doi.org/10.1007/s00018-018-2976-8  PMID: 30498997 
  26. Huang AT, Garcia-Carreras B, Hitchings MDT, Yang B, Katzelnick LC, Rattigan SM, et al. A systematic review of antibody mediated immunity to coronaviruses: kinetics, correlates of protection, and association with severity. Nat Commun. 2020;11(1):4704.  https://doi.org/10.1038/s41467-020-18450-4  PMID: 32943637 
  27. Davis SK, Selva KJ, Kent SJ, Chung AW. Serum IgA Fc effector functions in infectious disease and cancer. Immunol Cell Biol. 2020;98(4):276-86.  https://doi.org/10.1111/imcb.12306  PMID: 31785006 
/content/10.2807/1560-7917.ES.2021.26.48.2001690
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error