Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran; Anesthesiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran.
Am J Emerg Med. 2022 Feb;52:59-63. doi: 10.1016/j.ajem.2021.11.019. Epub 2021 Nov 16.
Serologic testing can provide a safe and fast approach for assessing SARS-CoV-2 antibodies. These tests can be utilized as a complementary method in diagnosis and patients' follow-up, and can also be helpful in epidemiological studies. This study aimed to describe temporal changes in the incidence of COVID-19 IgM and IgG antibodies in emergency medical technicians (EMTs) within a specified time period.
All EMTs working for Tehran Emergency Medical Service (EMS) center during May to September 2020 were eligible for this study. Those EMTs who were suspected/probable/confirmed cases of COVID-19, based on WHO defined criteria and were willing to participate, entered the study. The EMTs underwent serology testing four weeks after the occurrence of exposure (in suspected cases) or onset of their symptoms (in probable/confirmed cases). Cases were further confirmed by RT-PCR and/or lung CT, and antibody testing was performed for the second and third time with 12-week intervals. Finger-stick blood sampling was utilized for the specimen collection in three different phases. Samples were then analyzed by a commercial immunochromatography-based kit for qualitative measurement of serum IgM and IgG antibodies against the COVID-19 S-protein antigen.
Two hundred eighty-four participants met the inclusion criteria; their mean age was 35.9 (SD = 7.6) years and consisted of 244 (85.9%) males. COVID-19 was confirmed in 169 out of 284 participants. Subsequently, 142 and 122 participants were included in phases 2 and 3 of the study, respectively. The number of seronegative patients exceeded seropositive ones in all three phases. At baseline, 162 (57%) patients were seronegative, 27 (9.5%) were only positive for IgG, 3 (1.1%) were only positive for IgM, and 92 (32.4%) were positive for both antibodies; Seventy-eight (54.9%) were seronegative, and 31 (21.8%) were positive for both antibodies in the second phase; These values were 85 (69.6%) and 8 (6.6%) for the third phase, respectively. Among the people who were positive IgG in the first phase (80 people), 56.3% were still positive in the second phase and 27.5% in both subsequent phases.
The results of our study show that there is a significant reduction in COVID-19 antibody seropositivity over time.
血清学检测可提供一种安全、快速的方法来评估 SARS-CoV-2 抗体。这些检测可作为诊断和患者随访的辅助方法,也有助于流行病学研究。本研究旨在描述特定时间段内急诊医疗技术员(EMT)中 COVID-19 IgM 和 IgG 抗体发生率的时间变化。
2020 年 5 月至 9 月期间在德黑兰急救医疗服务(EMS)中心工作的所有 EMT 均符合本研究条件。根据世界卫生组织定义的标准,那些被怀疑/可能/确诊为 COVID-19 的 EMT 且愿意参加的 EMT 进入了研究。EMT 在接触(疑似病例)或症状出现(可能/确诊病例)后四周接受血清学检测。病例通过 RT-PCR 和/或肺部 CT 进一步确认,抗体检测在 12 周间隔内进行了两次和第三次。在三个不同阶段,使用指尖采血进行标本采集。然后使用商业免疫层析试剂盒对血清 COVID-19 S 蛋白抗原的 IgM 和 IgG 抗体进行定性测量。
284 名符合纳入标准的参与者;他们的平均年龄为 35.9(SD=7.6)岁,其中 244 名(85.9%)为男性。在 284 名参与者中,有 169 名被确诊为 COVID-19。随后,有 142 名和 122 名参与者分别进入研究的第 2 阶段和第 3 阶段。在所有三个阶段,血清学阴性患者的数量均超过血清学阳性患者。在基线时,162 名(57%)患者为血清学阴性,27 名(9.5%)仅 IgG 阳性,3 名(1.1%)仅 IgM 阳性,92 名(32.4%)同时为两种抗体阳性;在第 2 阶段,78 名(54.9%)为血清学阴性,31 名(21.8%)为两种抗体均为阳性;在第 3 阶段,这些值分别为 85 名(69.6%)和 8 名(6.6%)。在第 1 阶段 IgG 阳性的人群中(80 人),56.3%在第 2 阶段仍为阳性,27.5%在随后的两个阶段均为阳性。
我们的研究结果表明,COVID-19 抗体血清阳性率随时间显著降低。