Longitudinal serology in SARS-CoV-2 infected individuals in India – a prospective cohort study

Thiruvengadam, Ramachandran; Chattopadhyay, Souvick; Mehdi, Farha; Desiraju, Bapu Koundinya; Chaudhuri, Susmita; Singh, Sandeep; Bhartia, Vandita; Kshetrapal, Pallavi; Natchu, Uma Chandra Mouli; Wadhwa, Nitya; Sopory, Shailaja; Gosain, Mudita; Pandey, Anil; Das, Asim Bikas; Anand, Nidhi; Sharma, Nandini; Sharma, Pragya; Saxena, Sonal; Sindhu, Deepa; Sindhu, Brahmdeep; Sharma, Dharmendra; Dang, Navin; Batra, Gaurav; Kang, Gagandeep; Bhatnagar, Shinjini

doi:10.1101/2021.02.04.21251140

Cited by 8 publications

(9 citation statements)

References 25 publications

(25 reference statements)

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“…In this study nearly one in four participants with a past history of COVID-19 disease were seronegative, a finding consistent with previous rounds where antibodies to COVID-19 were lacking in a substantial proportion of the participants [2]. These findings could be attributed to the growing evidence suggestive of the waning of IgG antibodies especially during asymptomatic and mild illness, although the risk of Covid-19 reinfection in previously infected patients remains low [9,10].…”

Section: Discussionsupporting

confidence: 87%

Second wave of the Covid-19 pandemic in Delhi, India: high seroprevalence not a deterrent?

Sharma

Basu

et al. 2021

Preprint

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Background We report the findings of a large follow-up community-based serosurvey and correlating it with the COVID-19 test-positivity rate and the case load observed during the peak of the second wave of the Covid-19 pandemic in Delhi, India. Methods Individuals of age more than or equal to 5 years were recruited from 274 wards of the state (population ~ 19.6 million) during January 11 to January 22, 2021. A total of 100 participants each were included from all the wards for a net sample size of ~28,000. A multi-stage sampling technique was applied for selection of participants for the household serosurvey. Anti SARS CoV-2 IgG antibodies were detected by using the VITROS assay (90% Sn, 100% Sp). Results Antibody positivity was observed in 14,298 (50.76%) of the 28,169 samples. The age, sex and district population weighted seroprevalence of the IgG SARS-CoV-2 was 50.52% (95% C.I. 49.94-51.10) and after adjustment for assay characteristics was 56.13% (95% C.I. 55.49- 56.77). On adjusted analysis, participants aged more than or equal to 50 years, of female gender, housewives, having ever lived in containment zones, urban slum dwellers, and diabetes or hypertensive patients had significantly higher odds of SARS-CoV-2 antibody positivity. The peak infection rate and the test positivity rate since October 2020 were initially observed in mid-November 2020 with a subsequent steep declining trend, followed by a period of persistently low case burden lasting until the first week of March 2021. This was followed by a steady increase followed by an exponential surge in infections from April 2021 onwards culminating in the second wave of the pandemic. Conclusions The presence of infection induced immunity from SARS-CoV-2 even in more than one in two people can be ineffective in protecting the population. Keywords: Covid-19; Serosurvey; Delhi; Pandemic wave

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Section: Discussionsupporting

confidence: 87%

Second wave of the Covid-19 pandemic in Delhi, India: high seroprevalence not a deterrent?

Sharma

Basu

et al. 2021

Preprint

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“…The proportion of adults who did not seroconvert were similar to that observed in our study. Other studies in adults have reported variable seroconversion rates between 5 and 25% 30,[37][38][39] . Viral load was similar between children and adults in our cohort, which does not explain why fewer children seroconverted compared with adults.…”

Section: Discussionmentioning

confidence: 89%

“…Results: Among 108 SARS-CoV-2 PCR-positive participants, 57 were children (median age: 4, IQR 2-10) and 51 were adults (median age: 37, IQR [34][35][36][37][38][39][40][41][42][43][44][45]. Using three established serological assays, a lower proportion of children seroconverted compared with adults [20/54 (37.0%) vs 32/42 (76.2%); (p<0.001)].…”

Section: Main Outcomes and Measures: Sars-cov-2 Antibody And Cellular Responses In Children Andmentioning

confidence: 99%

Reduced seroconversion in children compared to adults with mild COVID-19

Toh

Anderson

Mazarakis

et al. 2021

Preprint

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Importance: The immune response in children with SARS-CoV-2 infection is not well understood. Objective: To compare seroconversion in children and adults with non-hospitalized (mild) SARS-CoV-2 infection and to understand the factors that influence this. Design: Participants were part of a household cohort study of SARS-CoV-2 infection. Weekly nasopharyngeal/throat swabs and blood samples were collected during the acute and convalescent period following PCR diagnosis for analysis. Setting: Participants were recruited at the Royal Childrens Hospital, Melbourne, Australia between May and October 2020. Participants: Those who had a SARS-CoV-2 PCR-positive nasal/throat swab. Main outcomes and measures: SARS-CoV-2 antibody and cellular responses in children and adults. Seroconversion was defined by seropositivity in all three serological assays. Results: Among 108 SARS-CoV-2 PCR-positive participants, 57 were children (median age: 4, IQR 2-10) and 51 were adults (median age: 37, IQR 34-45). Using three established serological assays, a lower proportion of children seroconverted compared with adults [20/54 69 (37.0%) vs 32/42 (76.2%); (p<0.001)]. This was not related to viral load, which was similar in children and adults [mean Ct 28.58 (SD: 6.83) vs 24.14 (SD: 8.47)]. Age and sex also did not influence seroconversion or the magnitude of antibody response within children or adults. Notably, in adults (but not children) symptomatic adults had three-fold higher antibody levels than asymptomatic adults (median 227.5 IU/mL, IQR 133.7-521.6 vs median 75.3 IU/mL, IQR 36.9-113.6). Evidence of cellular immunity was observed in adults who seroconverted but not in children who seroconverted. Conclusion and Relevance: In this non-hospitalized cohort with mild COVID-19, children were less likely to seroconvert than adults despite similar viral loads. This has implications for future protection following COVID-19 infection in children and for interpretation of serosurveys that involve children. Further research to understand why children are less likely to seroconvert and develop symptoms following SARS-CoV-2 infection, and comparison with vaccine responses may be of clinical and scientific importance.

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“…In this study, nearly one in four participants with a history of COVID-19 disease were seronegative, a finding consistent with previous serosurveys where antibodies to COVID-19 were lacking in a substantial proportion of the participants [ 8 ]. These findings could be attributed to the growing evidence, suggestive of the waning of IgG antibodies, especially during asymptomatic and mild illness, although the risk of COVID-19 reinfection in previously infected patients remains low [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Second Wave of the COVID-19 Pandemic in Delhi, India: High Seroprevalence Not a Deterrent?

Sharma¹,

Sharma²,

Basu³

et al. 2021

Cureus

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BackgroundWe report the findings of a large follow-up, community-based, cross-sectional serosurvey and correlate it with the coronavirus disease (COVID-19) test-positivity rate and the caseload observed between the peaks of the first and the second wave of the COVID-19 pandemic in Delhi, India. MethodologyIndividuals aged five and above were recruited from 274 wards of the state (population approximately 19.6 million) from January 11 to January 22, 2021. A total of 100 participants each were included from all wards for a net sample size of approximately 28,000. A multistage sampling technique was employed to select participants for the household serosurvey. Anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin (IgG) antibodies were detected by using the VITROS® (Ortho Clinical Diagnostics, Raritan, NJ, USA) assay (90% sensitivity, 100% specificity). ResultsAntibody positivity was observed in 14,298 (50.76%) of 28,169 samples. The age, sex, and district population-weighted seroprevalence of the SARS-CoV-2 IgG was 50.52% (95% confidence interval [CI] = 49.94-51.10), and after adjustment for assay characteristics, it was 56.13% (95% CI = 55.49-56.77). On adjusted analysis, participants aged ≥50 years, of female gender, housewives, having ever lived in containment zones, urban slum dwellers, and diabetes or hypertensive patients had significantly higher odds of SARS-CoV-2 antibody positivity.The peak infection rate and the test-positivity rate since October 2020 were initially observed in mid-November 2020, with a subsequent steep declining trend, followed by a period of persistently low case burden lasting until the first week of March 2021. This was followed by a steady increase followed by an exponential surge in infections from April 2021 onward culminating in the second wave of the pandemic. ConclusionsThe presence of infection-induced immunity from SARS-CoV-2 even in more than one in two people can be ineffective in protecting the population. Despite such high seroprevalence, population susceptibility to COVID-19 can be accentuated by variants of concern having the ability for rapid transmission and depletion of antibody levels with the threat of recurrent infections, signifying the need for mass vaccination.

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Longitudinal serology in SARS-CoV-2 infected individuals in India – a prospective cohort study

Cited by 8 publications

References 25 publications

Second wave of the Covid-19 pandemic in Delhi, India: high seroprevalence not a deterrent?

Second wave of the Covid-19 pandemic in Delhi, India: high seroprevalence not a deterrent?

Reduced seroconversion in children compared to adults with mild COVID-19

Second Wave of the COVID-19 Pandemic in Delhi, India: High Seroprevalence Not a Deterrent?

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