Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-24T07:28:06.866Z Has data issue: false hasContentIssue false

Descriptive evaluation of antibody responses to severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection in plasma and gingival crevicular fluid in a nursing home cohort—Arkansas, June–August 2020

Published online by Cambridge University Press:  22 November 2021

Nicole E. Brown*
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Amanda K. Lyons
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Amy J. Schuh
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Megan M. Stumpf
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Jennifer L. Harcourt
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Azaibi Tamin
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Mohammad Ata Ur Rasheed
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Lisa Mills
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Sandra N. Lester
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Natalie J. Thornburg
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Kenny Nguyen
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Veronica Costantini
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Jan Vinjé
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Jennifer Y. Huang
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Sarah E. Gilbert
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Paige Gable
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Susan Bollinger
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Sarah Sabour
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Elizabeth Beshearse
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
Diya Surie
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Caitlin Biedron
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Christopher J. Gregory
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Nakia S. Clemmons
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Brett Whitaker
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Melissa M. Coughlin
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Kathryn A. Seely
Affiliation:
Arkansas Department of Health, Little Rock, Arkansas
Kelley Garner
Affiliation:
Arkansas Department of Health, Little Rock, Arkansas
Trent Gulley
Affiliation:
Arkansas Department of Health, Little Rock, Arkansas
Tafarra Haney
Affiliation:
Arkansas Department of Health, Little Rock, Arkansas
Atul Kothari
Affiliation:
Arkansas Department of Health, Little Rock, Arkansas
Naveen Patil
Affiliation:
Arkansas Department of Health, Little Rock, Arkansas
Alison Laufer Halpin
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
L. Clifford McDonald
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Preeta K. Kutty
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Allison C. Brown
Affiliation:
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Author for correspondence: Nicole E. Brown, E-mail: NBrown6@cdc.gov

Abstract

Objective:

To characterize and compare severe acute respiratory coronavirus virus 2 (SARS-CoV-2)–specific immune responses in plasma and gingival crevicular fluid (GCF) from nursing home residents during and after natural infection.

Design:

Prospective cohort.

Setting:

Nursing home.

Participants:

SARS-CoV-2–infected nursing home residents.

Methods:

A convenience sample of 14 SARS-CoV-2–infected nursing home residents, enrolled 4–13 days after real-time reverse transcription polymerase chain reaction diagnosis, were followed for 42 days. After diagnosis, plasma SARS-CoV-2–specific pan-Immunoglobulin (Ig), IgG, IgA, IgM, and neutralizing antibodies were measured at 5 time points, and GCF SARS-CoV-2–specific IgG and IgA were measured at 4 time points.

Results:

All participants demonstrated immune responses to SARS-CoV-2 infection. Among 12 phlebotomized participants, plasma was positive for pan-Ig and IgG in all 12 participants. Neutralizing antibodies were positive in 11 participants; IgM was positive in 10 participants, and IgA was positive in 9 participants. Among 14 participants with GCF specimens, GCF was positive for IgG in 13 participants and for IgA in 12 participants. Immunoglobulin responses in plasma and GCF had similar kinetics; median times to peak antibody response were similar across specimen types (4 weeks for IgG; 3 weeks for IgA). Participants with pan-Ig, IgG, and IgA detected in plasma and GCF IgG remained positive throughout this evaluation, 46–55 days after diagnosis. All participants were viral-culture negative by the first detection of antibodies.

Conclusions:

Nursing home residents had detectable SARS-CoV-2 antibodies in plasma and GCF after infection. Kinetics of antibodies detected in GCF mirrored those from plasma. Noninvasive GCF may be useful for detecting and monitoring immunologic responses in populations unable or unwilling to be phlebotomized.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

a

Authors of equal contribution.

References

McMichael, TM, Clark, S, Pogosjans, S, et al. COVID-19 in a long-term care facility—King County, Washington, February 27-March 9, 2020. Morb Mortal Wkly Rep 2020;69:339342.CrossRefGoogle Scholar
Garg, S, Kim, L, Whitaker, M, et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019—COVID-NET, 14 states, March 1–30, 2020. Morb Mortal Wkly Rep 2020;69:458464.CrossRefGoogle ScholarPubMed
CDC COVID-19 Response Team. Severe outcomes among patients with coronavirus disease 2019 (COVID-19)—United States, February 12–March 16, 2020. Morb Mortal Wkly Rep 2020;69:343346.CrossRefGoogle Scholar
Seow, J, Graham, C, Merrick, B, et al. Longitudinal observation and decline of neutralizing antibody responses in the three months following SARS-CoV-2 infection in humans. Nat Microbiol 2020;5:15981607.CrossRefGoogle ScholarPubMed
Suthar, MS, Zimmerman, MG, Kauffman, RC, et al. Rapid generation of neutralizing antibody responses in COVID-19 patients. Cell Rep Med 2020;1:100040.CrossRefGoogle ScholarPubMed
Ruopp, MD, Strymish, J, Dryjowicz-Burek, J, Creedon, K, Gupta, K. Durability of SARS-CoV-2 IgG antibody among residents in a long-term care community. J Am Med Dir Assoc 2021;22:510511.CrossRefGoogle Scholar
White, EM, Saade, EA, Yang, X, et al. SARS-CoV-2 antibody detection in skilled nursing facility residents. J Am Geriatr Soc 2021;69:17221728.CrossRefGoogle ScholarPubMed
Fabian, TK, Hermann, P, Beck, A, Fejerdy, P, Fabian, G. Salivary defense proteins: their network and role in innate and acquired oral immunity. Int J Mol Sci 2012;13:42954320.CrossRefGoogle ScholarPubMed
Pisanic, N, Randad, PR, Kruczynski, K, et al. COVID-19 serology at population scale: SARS-CoV-2–specific antibody responses in saliva. J Clin Microbiol 2020;59.Google ScholarPubMed
Dobaño, C, Alonso, S, Vidal, M, et al. Multiplex antibody analysis of IgM, IgA and IgG to SARS-CoV-2 in saliva and serum from infected children and their close contacts. medRxiv 2021 doi: 10.1101/2021.03.22.21254120.CrossRefGoogle Scholar
Cervia, C, Nilsson, J, Zurbuchen, Y, et al. Systemic and mucosal antibody responses specific to SARS-CoV-2 during mild versus severe COVID-19. J Allergy Clin Immunol 2021;147:545-557 e549.Google Scholar
Isho, B, Abe, KT, Zuo, M, et al. Persistence of serum and saliva antibody responses to SARS-CoV-2 spike antigens in COVID-19 patients. Sci Immunol 2020;5.Google ScholarPubMed
Gable, P, Huang, JY, Gilbert, SE, et al. A comparison of less invasive SARS-CoV-2 diagnostic specimens in nursing home residents—Arkansas, June–August 2020. Clin Infect Dis 2021;73:S58S64.CrossRefGoogle ScholarPubMed
Surie, D, Huang, JY, Brown, AC, et al. Infectious period of severe acute respiratory syndrome coronavirus 2 in 17 nursing home residents—Arkansas, June–August 2020. Open Forum Infect Dis 2021;8.Google ScholarPubMed
CDC 2019-novel coronavirus (2019-nCoV) real-time RT-PCR diagnostic panel. US Food and Drug Administration website. 2020. https://www.fda.gov/media/134922/download. Published 2020. Accessed April 15, 2021.Google Scholar
Freeman, B, Lester, S, Mills, L, et al. Validation of a SARS-CoV-2 spike protein ELISA for use in contact investigations and sero-surveillance. bioRxiv 2020 doi: 10.1101/2020.04.24.057323.CrossRefGoogle Scholar
Basavaraju, SV, Patton, ME, Grimm, K, et al. Serologic testing of US blood donations to identify SARS-CoV-2-reactive antibodies: December 2019–January 2020. Clin Infect Dis 2020;72:e1004–e1009.Google Scholar
Costantini, V, Nguyen, K, Lyski, Z, et al. Development and validation of an enzyme immunoassay for detection and quantification of SARS-CoV-2 salivary IgA and IgG. medRxiv 2021. doi: 10.1101/2021.09.03.21263078.CrossRefGoogle Scholar
Interim infection prevention and control recommendations for healthcare personnel during the coronavirus disease 2019 (COVID-19) pandemic. Centers for Disease Control and Prevention website. https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html. Published 2021. Accessed October, 21, 2021.Google Scholar
To, KK, Tsang, OT, Leung, WS, et al. Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study. Lancet Infect Dis 2020;20:565574.CrossRefGoogle ScholarPubMed
Arkhipova-Jenkins, I, Helfand, M, Armstrong, C, et al. Antibody response after SARS-CoV-2 infection and implications for immunity : a rapid living review. Ann Intern Med 2021;174:811821.CrossRefGoogle ScholarPubMed
Killerby, ME, Ata Ur Rasheed, M, Tamin, A, et al. Shedding of culturable virus, seroconversion, and 6-month follow-up antibody responses in the first 14 confirmed cases of COVID-19 in the United States. J Infect Dis 2021;224:771776.CrossRefGoogle ScholarPubMed
De Giorgi, V, West, KA, Henning, AN, et al. Naturally acquired SARS-CoV-2 immunity persists for up to 11 months following infection. J Infect Dis 2021;224:12941304.CrossRefGoogle ScholarPubMed
Iyer, AS, Jones, FK, Nodoushani, A, et al. Persistence and decay of human antibody responses to the receptor binding domain of SARS-CoV-2 spike protein in COVID-19 patients. Sci Immunol 2020;5 :eabe0367.CrossRefGoogle Scholar
Marot, S, Malet, I, Leducq, V, et al. Rapid decline of neutralizing antibodies against SARS-CoV-2 among infected healthcare workers. Nat Commun 2021;12:844.CrossRefGoogle ScholarPubMed
Khoury, DS, Cromer, D, Reynaldi, A, et al. Neutralizing antibody levels are highly predictive of immune protection from symptomatic SARS-CoV-2 infection. Nat Med 2021;27:12051211.CrossRefGoogle ScholarPubMed
Gundlapalli, AV, Salerno, RM, Brooks, JT, et al. SARS-CoV-2 serologic assay needs for the next phase of the US COVID-19 pandemic response. Open Forum Infect Dis 2021;8:ofaa555.CrossRefGoogle ScholarPubMed
Lau, EHY, Tsang, OTY, Hui, DSC, et al. Neutralizing antibody titres in SARS-CoV-2 infections. Nat Commun 2021;12:63.CrossRefGoogle ScholarPubMed
Robbiani, DF, Gaebler, C, Muecksch, F, et al. Convergent antibody responses to SARS-CoV-2 in convalescent individuals. Nature 2020;584:437442.CrossRefGoogle ScholarPubMed
Glans, H, Gredmark-Russ, S, Olausson, M, et al. Shedding of infectious SARS-CoV-2 by hospitalized COVID-19 patients in relation to serum antibody responses. BMC Infect Dis 2021;21:494.CrossRefGoogle ScholarPubMed
Owusu, D, Pomeroy, MA, Lewis, NM, et al. Persistent SARS-CoV-2 RNA shedding without evidence of infectiousness: a cohort study of individuals with COVID-19. J Infect Dis 2021;224:13621371.CrossRefGoogle ScholarPubMed
Noval, MG, Kaczmarek, ME, Koide, A, et al. Antibody isotype diversity against SARS-CoV-2 is associated with differential serum neutralization capacities. Sci Rep 2021;11:5538.CrossRefGoogle ScholarPubMed
Fransen, K, Vermoesen, T, Beelaert, G, et al. Using conventional HIV tests on oral fluid. J Virol Methods 2013;194:4651.CrossRefGoogle ScholarPubMed
Supplementary material: File

Brown et al. supplementary material

Tables S1-S2 and Figures S1-S2

Download Brown et al. supplementary material(File)
File 394.5 KB