The role of <scp>SARS‐CoV</scp>‐2 antibodies in <scp>COVID</scp>‐19: Healing in most, harm at times

French, Martyn A.; Moodley, Yuben

doi:10.1111/resp.13852

Cited by 35 publications

(32 citation statements)

References 22 publications

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“…Quantitative signal values and their interpretations should be provided by vendors, as reports have shown that greater titres of SARS-CoV-2 antibodies in the early phase of COVID-19 translate to more deleterious outcomes for the patient. 22 In such scenarios, serology may provide insight into prognosis and appropriate clinical management. Importantly, it has been suggested that neutralising antibodies directed against SARS-CoV-2 S and RBD proteins confer immunity upon the host and these have been the focus of several vaccine trials.…”

Section: Discussionmentioning

confidence: 99%

Head-to-head evaluation on diagnostic accuracies of six SARS-CoV-2 serological assays

et al. 2020

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In this study, we evaluated and compared six SARS-CoV-2 serology kits including the Abbott SARS-CoV-2 IgG assay, Beckman Access SARS-CoV-2 IgG assay, OCD Vitros OCD Anti-SARS-CoV-2 Total antibody assay, Roche Elecsys Anti SARS-CoV-2 assay, Siemens SARS-CoV-2 Total assay, and cPass surrogate viral neutralising antibody assay. A total of 336 non-duplicated residual serum samples that were obtained from COVID-19 confirmed patients (n=173) on PCR and negative controls (n=163) obtained pre-December 2019 before the COVID-19 pandemic were used for the study. These were concurrently analysed on the different immunoassay platforms and correlated with clinical characteristics. Our results showed all assays had specificity ranging from 99.3% to 100.0%. Overall sensitivity across all days of symptoms, in descending order were OCD (49.1%, 95% CI 41.8-56.5%), cPass (44.8%, 95% CI 37.5-52.3%), Roche (41.6%, 95% CI 34.5-49.0%), Siemens (39.9%, 95% CI 32.9-47.3%), Abbott (39.8%, 95% CI 32.9-47.3%) and Beckman (39.6%, 95% CI 32.5-47.3%). Testing after at least 14 days from symptom onset is required to achieve AUCs greater than 0.80. OCD and cPass performed the best in terms of sensitivity for >21 days symptoms with 93.3% (95% CI, 73.5-99.2%) and 96.7% (95% CI, 82.8-99.9%), respectively. Both also shared the greatest concordance, kappa 0.963 (95% CI 0.885-1.0), p<0.001, and had the lowest false negative rates. Serology results should be interpreted with caution in certain cases. False negatives were observed in a small number of individuals with COVID-19 on immunosuppressive therapy, paucisymptomatic or who received antiretroviral therapy. In conclusion, all assays exhibited excellent specificity and total antibody assays with spike protein configurations generally outperformed nucleocapsid configurations and IgG assays in terms of diagnostic sensitivity.

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Section: Discussionmentioning

confidence: 99%

Head-to-head evaluation on diagnostic accuracies of six SARS-CoV-2 serological assays

et al. 2020

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“…40,41 Based on the mechanism of avidity maturation, with its many cycles of mutation and clonal selection, the prolonged availability of antigen seems to be an absolute requirement for proper avidity maturation. 32,[42][43][44] The mode of vaccination should fulfill this requirement. Further analysis is required to clarify the potential role of high avidity for protective immunity.…”

Section: Avidity and Protection Towards Infectionmentioning

confidence: 99%

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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“…Although seroconversion, and especially the production of anti-spike IgG antibodies, may neutralize coronaviruses and prevent their binding to ACE2 receptors, the formation of virus-antibody complexes may also lead to pathologic Fc-receptor (FcR) mediated antibody-dependent enhancement (ADE) responses [24] , [25] . Antibodies to S and N proteins may also lead to activation of antiviral effector cells by binding to the expressed peptides and Fcγ receptors on the surface of virally-infected key structural cells such as NK cells and may induce antibody-dependent cellular cytotoxicity and opsonophagocytosis of virus particles [26] . Development of neutralizing IgG antibodies targeting different epitopes of SARS-CoV mediates either immune or pathologic responses in virus-infected and immunized animals [27] , [28] .…”

Section: Humoral Immunity In Covid-19 Recoverymentioning

confidence: 99%