Реферат
Background: Serological testing for SARS-CoV-2 plays an important role for epidemiological studies, in aiding the diagnosis of COVID-19, and assess vaccine responses. Little is known on dynamics of SARS-CoV-2 serology in African settings. Here, we aimed to characterize the longitudinal antibody response profile to SARS-CoV-2 in Ethiopia.Methods: In this prospective study, a total of 102 PCR-confirmed COVID-19 patients were enrolled. We obtained 802 plasma samples collected serially. SARS-CoV-2 antibodies were determined using four lateral flow immune-assays (LFIAs), and an electrochemiluminescent immunoassay. We determined the sensitivity, specificity, as well as seroconversion dynamics.Findings: Serological positivity rate ranged between 12%-91%, depending on timing after symptom onset. There was no difference in positivity rate between severe and non-severe COVID-19 cases. The specificity ranged between 90%-99%. Agreement between different assays ranged between 84%-92%. Overall, 28/102 (27.5%) seroconverted by one or more assays tested, within a median time of 11 (IQR: 9–15) days post symptom onset. The median seroconversion time among symptomatic cases tended to be shorter when compared to asymptomatic patients [9 (IQR: 6–11) vs. 15 (IQR: 13–21) days; p=0.002]. Overall, seroconversion reached 100% 5.5 weeks after the onset of symptoms. Notably, 10 (9.8%) patients failed to mount a detectable antibody response by any of the assays tested during of follow-up.Interpretation: Longitudinal assessment of antibody response in African COVID-19 patients revealed heterogeneous responses. This underscores the need for a comprehensive evaluation of seroassays before implementation. Factors associated with failure to seroconvert needs further research.Funding: The European and Developing Countries Clinical Trial Partnership (EDCTP) – European Union.Declaration of Interest: DW is European and Developing Countries Clinical Trials Partnership (EDCTP) Senior Research Fellow, and received funding for EvaLAMP project on Leishmaniasis Diagnostics; he serves as Strategic and Scientific Advisory Board of the Research Networks for Health Innovations in Sub-Saharan Africa (German Federal Ministry of Education and Research), and has received an honorarium for lectures and presentations from the Ethiopian Ministry of Science and Higher Education. TRW is employee of PharmAccess Foundation, is Board Member of Mondial Diagnostics, and Advisory Board member of Healthinc, The Netherlands. All other authors have no declarations to disclose.Ethical Approval: The study protocol was reviewed and approved by the Health Research Ethics Review Committee of Mekelle University College of Health Sciences (#ERC 1769/2020).
Тема - темы
COVID-19 , InfertilityРеферат
Background: COVID-19 symptomatology in Africa appears significantly less serious than in the industrialized world. We and others previously postulated a partial explanation for this phenomenon, being a different, more activated immune system due to parasite infections. We investigated this hypothesis in an endemic area in Africa. Methods: Ethiopian COVID-19 patients were enrolled and screened for intestinal parasites. The primary outcome was the proportion of patients with severe COVID-19. Logistic regression models were used to estimate the association between parasite infection, and COVID-19 severity. Models were adjusted for sex, age, residence, and comorbidities. Findings: 751 SARS-CoV-2 infected patients were enrolled, of whom 284 (37·8%) had intestinal parasitic infection. Only 27/255 (10·6%) severe COVID-19 patients were co-infected with intestinal parasites, while 257/496 (51·8%) non-severe COVID-19 patients appeared parasite positive (p<0.0001). Patients co-infected with parasites had lower odds of developing severe COVID-19, with an adjusted odds ratio (aOR) of 0·14 (95% CI 0·09–0·24; p<0·0001) for all parasites, aOR 0·20 ([95% CI 0·11–0·38]; p<0·0001) for protozoa, and aOR 0·13 ([95% CI 0·07–0·26]; p<0·0001) for helminths. When stratified by species, co-infection with Entamoeba spp. , Hymenolopis nana, and Schistosoma mansoni implied lower probability of developing severe COVID-19. There were 11 deaths (1·5%), and all were among patients without parasites (p=0·009). Interpretation: Parasite co-infection is associated with a reduced risk of severe COVID-19 in African patients. Parasite-driven immunomodulatory responses may mute hyper-inflammation associated with severe COVID-19. Funding: European and Developing Countries Clinical Trials Partnership (EDCTP) and Joep-Lange Institute.Declaration of Interests: We declare no competing interests.Ethics Approval Statement: The study protocol was reviewed and approved by the Health Research Ethics Review Committee of Mekelle University College of Health Sciences (No.: ERC 1769/2020), the Ethiopian Public Health Institute (No: EPHI 6.13/814), and Eka Kotebe General Hospital (No.: EK/150/5/32). Written informed consent was obtained by all participants, or their guardians, for participation in the study.