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      Spike is the most recognized antigen in the whole-blood platform in both acute and convalescent COVID-19 patients

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          Abstract

          Objectives

          To identify the best experimental approach to detect a SARS-CoV-2-specific T cell response using a whole-blood platform.

          Methods

          Whole-blood from 56 COVID-19 and 23 “NO-COVID-19” individuals were overnight stimulated with different concentrations (0.1 or 1 µg/mL) of SARS-CoV-2 PepTivator® Peptide Pools, including spike (pool S), nucleocapsid (pool N), membrane (pool M), and a MegaPool (MP) of these three peptide pools. ELISA was used to analyse IFN-γ levels.

          Results

          IFN-γ-response to every SARS-CoV-2 peptide pool was significantly increased in COVID-19 patients compared with “NO-COVID-19” individuals. Pool S and MegaPool were the most potent immunogenic stimuli (median: 0.51, IQR: 0.14-2.17; and median: 1.18, IQR: 0.27-4.72, respectively) compared to pools N and M (median: 0.22, IQR: 0.032-1.26; and median: 0.22, IQR: 0.01-0.71, respectively). Whole-blood test based on pool S and MegaPool showed a good sensitivity of 77% and a high specificity of 96%. IFN-γ-response was mediated by both CD4 + and CD8 + T cells, and detected independently of clinical parameters in both hospitalized and recovered patients.

          Conclusions

          This easy-to-use assay for detecting SARS-CoV-2-specific T cell response may be implemented in clinical laboratories as a powerful diagnostic tool.

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          Most cited references39

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          Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention

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            Targets of T cell responses to SARS-CoV-2 coronavirus in humans with COVID-19 disease and unexposed individuals

            Summary Understanding adaptive immunity to SARS-CoV-2 is important for vaccine development, interpreting coronavirus disease 2019 (COVID-19) pathogenesis, and calibration of pandemic control measures. Using HLA class I and II predicted peptide ‘megapools’, circulating SARS-CoV-2−specific CD8+ and CD4+ T cells were identified in ∼70% and 100% of COVID-19 convalescent patients, respectively. CD4+ T cell responses to spike, the main target of most vaccine efforts, were robust and correlated with the magnitude of the anti-SARS-CoV-2 IgG and IgA titers. The M, spike and N proteins each accounted for 11-27% of the total CD4+ response, with additional responses commonly targeting nsp3, nsp4, ORF3a and ORF8, among others. For CD8+ T cells, spike and M were recognized, with at least eight SARS-CoV-2 ORFs targeted. Importantly, we detected SARS-CoV-2−reactive CD4+ T cells in ∼40-60% of unexposed individuals, suggesting cross-reactive T cell recognition between circulating ‘common cold’ coronaviruses and SARS-CoV-2.
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              Antibody responses to SARS-CoV-2 in patients with COVID-19

              We report acute antibody responses to SARS-CoV-2 in 285 patients with COVID-19. Within 19 days after symptom onset, 100% of patients tested positive for antiviral immunoglobulin-G (IgG). Seroconversion for IgG and IgM occurred simultaneously or sequentially. Both IgG and IgM titers plateaued within 6 days after seroconversion. Serological testing may be helpful for the diagnosis of suspected patients with negative RT-PCR results and for the identification of asymptomatic infections.
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                Author and article information

                Journal
                Int J Infect Dis
                Int J Infect Dis
                International Journal of Infectious Diseases
                The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
                1201-9712
                1878-3511
                14 April 2021
                14 April 2021
                Affiliations
                [a ]Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
                [b ]UOS Professioni Sanitarie Tecniche, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
                [c ]Clinical Epidemiology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
                [d ]Clinical Division of Respiratory Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
                [e ]UOC Transfusion Medicine and Stem Cell Unit, San Camillo Forlanini Hospital, Rome, Italy
                [f ]Clinical Division of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
                Author notes
                [* ]Corresponding author at: Translational Research Unit of the Research Department, National Institute for Infectious Diseases, Laboratorio del Vecchio, Room 13, Via Portuense 292, Rome 00149, Italy.
                [1]

                These authors equally contributed to the manuscript as first authors.

                Article
                S1201-9712(21)00344-1
                10.1016/j.ijid.2021.04.034
                8045417
                7f57aaba-8183-4275-8964-b4c29870343f
                © 2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 22 March 2021
                : 9 April 2021
                : 9 April 2021
                Categories
                Article

                Infectious disease & Microbiology
                covid-19,sars-cov-2,t cell response,whole-blood,ifn-γ-release assay (igra),spike protein,nucleocapsid protein,membrane protein

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