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COVID-19 血清学在肾脏病医护人员中的应用。

COVID-19 serology in nephrology healthcare workers.

机构信息

Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.

Institute of Laboratory Diagnostics, Clinic Favoriten, Vienna Health Care Group, Vienna, Austria.

出版信息

Wien Klin Wochenschr. 2021 Sep;133(17-18):923-930. doi: 10.1007/s00508-021-01848-5. Epub 2021 Apr 9.


DOI:10.1007/s00508-021-01848-5
PMID:33835265
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8034034/
Abstract

BACKGROUND: Chronic kidney disease patients show a high mortality in cases of a severe acute respiratory syndrome coronavirus-2 (SARS-CoV‑2) infection. Thus, information on the sero-status of nephrology personnel might be crucial for patient protection; however, limited information exists about the presence of SARS-CoV‑2 antibodies in asymptomatic individuals. METHODS: We examined the seroprevalence of SARS-CoV‑2 IgG and IgM antibodies among healthcare workers of a tertiary care kidney center during the the first peak phase of the corona virus disease 2019 (COVID-19) crisis in Austria using an orthogonal test strategy and a total of 12 commercial nucleocapsid protein or spike glycoprotein-based assays as well as Western blotting and a neutralization assay. RESULTS: At baseline 60 of 235 study participants (25.5%, 95% confidence interval, CI 20.4-31.5%) were judged to be borderline positive or positive for IgM or IgG using a high sensitivity/low specificity threshold in one test system. Follow-up analysis after about 2 weeks revealed IgG positivity in 12 (5.1%, 95% CI: 2.9-8.8%) and IgM positivity in 6 (2.6%, 95% CI: 1.1-5.6) in at least one assay. Of the healthcare workers 2.1% (95% CI: 0.8-5.0%) showed IgG nucleocapsid antibodies in at least 2 assays. By contrast, positive controls with proven COVID-19 showed antibody positivity among almost all test systems. Moreover, serum samples obtained from healthcare workers did not show SARS-CoV‑2 neutralizing capacity, in contrast to positive controls. CONCLUSION: Using a broad spectrum of antibody tests the present study revealed inconsistent results for SARS-CoV‑2 seroprevalence among asymptomatic individuals, while this was not the case among COVID-19 patients. TRIAL REGISTRATION NUMBER: CONEC, ClinicalTrials.gov number NCT04347694.

摘要

背景:慢性肾脏疾病患者在严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)感染的情况下死亡率较高。因此,有关肾病患者血清状况的信息可能对保护患者至关重要;然而,关于无症状个体中 SARS-CoV-2 抗体存在的信息有限。

方法:我们使用正交测试策略和总共 12 种基于核衣壳蛋白或刺突糖蛋白的商业检测试剂盒以及 Western blot 和中和试验,在奥地利 2019 年冠状病毒病(COVID-19)危机的第一波高峰期期间,检查了一家三级肾脏护理中心的医护人员 SARS-CoV-2 IgG 和 IgM 抗体的血清阳性率。

结果:在基线时,使用一个测试系统,60 名 235 名研究参与者中的(25.5%,95%置信区间,CI 20.4-31.5%)被判断为 IgM 或 IgG 为边缘阳性或阳性。大约 2 周后的随访分析显示,至少有一种检测方法中 IgG 阳性 12 例(5.1%,95%CI:2.9-8.8%),IgM 阳性 6 例(2.6%,95%CI:1.1-5.6)。在医护人员中,2.1%(95%CI:0.8-5.0%)在至少两种检测中显示 IgG 核衣壳抗体阳性。相比之下,经证实患有 COVID-19 的阳性对照在几乎所有检测系统中均显示抗体阳性。此外,与阳性对照相比,来自医护人员的血清样本未显示 SARS-CoV-2 中和能力。

结论:使用广谱抗体检测,本研究显示无症状个体中 SARS-CoV-2 血清阳性率存在不一致的结果,而 COVID-19 患者则不然。

试验注册号:CONEC,ClinicalTrials.gov 编号 NCT04347694。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77b1/8443507/17f9eb12d3ac/508_2021_1848_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77b1/8443507/ba9298b81479/508_2021_1848_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77b1/8443507/17f9eb12d3ac/508_2021_1848_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77b1/8443507/ba9298b81479/508_2021_1848_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77b1/8443507/17f9eb12d3ac/508_2021_1848_Fig2_HTML.jpg

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COVID-19 serology in nephrology healthcare workers.

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Vaccination with BNT162b2 and ChAdOx1 nCoV-19 Induces Cross-Reactive Anti-RBD IgG against SARS-CoV-2 Variants including Omicron.

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[2]
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[3]
Diagnostic performance of two serological assays for the detection of SARS-CoV-2 specific antibodies: surveillance after vaccination.

Diagn Microbiol Infect Dis. 2022-4

[4]
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Addiction. 2021-6

本文引用的文献

[1]
Hospital-Wide SARS-CoV-2 Antibody Screening in 3056 Staff in a Tertiary Center in Belgium.

JAMA. 2020-7-14

[2]
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Nature. 2020-6-8

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Nature. 2020-6-8

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J Infect. 2020-6-4

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Seroprevalence of immunoglobulin M and G antibodies against SARS-CoV-2 in China.

Nat Med. 2020-6-5

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Ann Intern Med. 2020-6-4

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Ann Intern Med. 2020-6-3

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J Am Soc Nephrol. 2020-6-1

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Targets of T Cell Responses to SARS-CoV-2 Coronavirus in Humans with COVID-19 Disease and Unexposed Individuals.

Cell. 2020-5-20

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Presentation and Outcomes of Patients with ESKD and COVID-19.

J Am Soc Nephrol. 2020-5-28

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