Qualitative assessment of SARS‐CoV‐2‐specific antibody avidity by lateral flow immunochromatographic IgG/IgM antibody assay

Valdivia, Arantxa; Torres, Ignacio; Huntley, Dixie; Alcaráz, María Jesús; Albert, Eliseo; Colomina, Javier; Ferrer, Jaime; Carratalá, Arturo; Navarro, David

doi:10.1002/jmv.26344

Cited by 15 publications

(6 citation statements)

References 14 publications

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“…Antibody avidity is defined as the strength of bivalent or multivalent interaction between antibody and epitope 46 . It is well described that antibody avidity increase over duration of infection and remained elevated, as expected to SARS-CoV-2 the same is observed, once low antibody avidity is showed during early infection and it is detected strongly after 3 weeks of symptom onset in patients recovered from COVID-19 47 . Moreover, a study demonstrated that anti-spike avidity was directed correlated with higher neutralizing antibodies titers 45 .…”

Section: Introductionmentioning

confidence: 57%

Assessment of avidity related to IgG subclasses in SARS-CoV-2 Brazilian infected patients

Moura

Costa

Correa

et al. 2021

Sci Rep

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SARS-CoV-2 is considered a global emergency, resulting in an exacerbated crisis in the health public in the world. Although there are advances in vaccine development, it is still limited for many countries. On the other hand, an immunological response that mediates protective immunity or indicates that predict disease outcome in SARS-CoV-2 infection remains undefined. This work aimed to assess the antibody levels, avidity, and subclasses of IgG to RBD protein, in symptomatic patients with severe and mild forms of COVID-19 in Brazil using an adapted in-house RBD-IgG ELISA. The RBD IgG-ELISA showed 100% of specificity and 94.3% of sensibility on detecting antibodies in the sera of hospitalized patients. Patients who presented severe COVID-19 had higher anti-RBD IgG levels compared to patients with mild disease. Additionally, most patients analyzed displayed low antibody avidity, with 64.4% of the samples of patients who recovered from the disease and 84.6% of those who died in this avidity range. Our data also reveals an increase of IgG1 and IgG3 levels since the 8th day after symptoms onset, while IgG4 levels maintained less detectable during the study period. Surprisingly, patients who died during 8–14 and 15–21 days also showed higher anti-RBD IgG4 levels in comparison with the recovered (P < 0.05), suggesting that some life-threatening patients can elicit IgG4 to RBD antibody response in the first weeks of symptoms onset. Our findings constitute the effort to clarify IgG antibodies' kinetics, avidity, and subclasses against SARS-CoV-2 RBD in symptomatic patients with COVID-19 in Brazil, highlighting the importance of IgG antibody avidity in association with IgG4 detection as tool laboratory in the follow-up of hospitalized patients with more significant potential for life-threatening.

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Section: Introductionmentioning

confidence: 57%

Assessment of avidity related to IgG subclasses in SARS-CoV-2 Brazilian infected patients

Moura

Costa

Correa

et al. 2021

Sci Rep

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“…Since avidity maturation is time dependent, avidity testing has been suggested as a diagnostic tool to estimate the time of acquisition of infection [ 11 , 35 ]. In our study we found a considerable variation over time in the maturation of avidity and the majority did not reach >80% in avidity even after 6 months of follow-up.…”

Section: Discussionmentioning

confidence: 99%

Dynamics of IgG-avidity and antibody levels after Covid-19

Löfström¹,

Eringfält²,

Kötz³

et al. 2021

Journal of Clinical Virology

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Background A potentially important aspect of the humoral immune response to Covid-19 is avidity, the overall binding strength between antibody and antigen. As low avidity is associated with a risk of re- infection in several viral infections, avidity might be of value to predict risk for reinfection with covid-19. Objectives The purpose of this study was to describe the maturation of IgG avidity and the antibody-levels over time in patients with PCR-confirmed non-severe covid-19. Study design Prospective longitudinal cohort study including patients with RT-PCR confirmed covid-19. Blood samples were drawn 1, 3 and 6 months after infection. Antibody levels and IgG-avidity were analysed. Results The majority had detectable s- and n-antibodies (88,1%, 89,1%, N=75). The level of total n-antibodies significantly increased from 1 to 3 months (median value 28,3 vs 39,3 s/co, p<0.001) and significantly decreased from 3 to 6 months (median value 39,3 vs 17,1 s/co, p<0.001). A significant decrease in the IgG anti-spike levels (median value 37,6, 24,1 and 18,2 RU/ml, p<0.001) as well as a significant increase in the IgG-avidity index (median values 51,6, 66,0 and 71,0 %, p<0.001) were seen from 1 to 3 to 6 months. Conclusion We found a significant ongoing increase in avidity maturation after Covid-19 whilst the levels of antibodies were declining, suggesting a possible aspect of long-term immunity.

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“…Though Luo et al 12 stated that there was a strong correlation between avidity or IgG towards RBD and days after onset of symptoms, their findings are also supporting the findings on low avidity of IgG towards SARS-CoV-2 antigens, as the authors had used the very low concentration of 3 M urea in their study. Navarro et al 22 stated an increase in avidity with time. This study is difficult to interprete in the context of the quantitative studies on avidity, as IgM and IgG avidity were measured without differentiation and their assay was only performed as qualtitative estimation.…”

Section: Low Avidity Of Igg Towards Sars-cov-2 Antigensmentioning

confidence: 97%

The challenge of avidity determination in SARS‐CoV‐2 serology

Bauer

Struck²,

Schreiner³

et al. 2021

Journal of Medical Virology

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The serological responses towards severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleoprotein, receptor-binding domain (RBD), and spike protein S1 are characterized by incomplete avidity maturation. Analysis with varying concentrations of urea allows to determine distinct differences in avidity maturation, though the total process remains at an unusually low level. Despite incomplete avidity maturation, this approach allows to define early and late stages of infection. It therefore can compensate for the recently described irregular kinetic patterns of immunoglobulin M and immunoglobulin G (IgG) directed towards SARS-CoV-2 antigens. The serological responses towards seasonal coronaviruses neither have a negative nor positive impact on SARS-CoV-2 serology in general. Avidity determination in combination with measurement of antibody titers and complexity of the immune response allows to clearly differentiate between IgG responses towards seasonal coronaviruses and SARS-CoV-2.Cross-reactions seem to occur with very low probability. They can be recognized by their pattern of response and through differential treatment with urea. As high avidity has been shown to be essential in several virus systems for the protective effect of neutralizing antibodies, it should be clarified whether high avidity of IgG directed towards RBD indicates protective immunity. If this is the case, monitoring of avidity should be part of the optimization of vaccination programs.

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Qualitative assessment of SARS‐CoV‐2‐specific antibody avidity by lateral flow immunochromatographic IgG/IgM antibody assay

Cited by 15 publications

References 14 publications

Assessment of avidity related to IgG subclasses in SARS-CoV-2 Brazilian infected patients

Assessment of avidity related to IgG subclasses in SARS-CoV-2 Brazilian infected patients

Dynamics of IgG-avidity and antibody levels after Covid-19

The challenge of avidity determination in SARS‐CoV‐2 serology

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