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      Dynamics of SARS-CoV-2 exposure in Malawian infants between February 2020 and May 2021

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          Abstract

          Background

          Very limited information is available on SARS-CoV-2 seroprevalence in infants in sub-Saharan countries.

          Objective

          In this study, we aimed to determine the rate and the temporal evolution of SARS CoV-2 seropositivity in breastfed Malawian infants.

          Study design

          Blood samples (n=250) from 158 infants, born to HIV-negative women and women living with HIV, collected from February 2020 to May 2021, were first tested using an Anti-IgG/A/M SARS CoV 2 ELISA assay against trimeric spike protein, and then, if positive, confirmed using a second ELISA assay detecting IgG against Receptor Binding Domain.

          Results

          The confirmed prevalence of anti-SARS CoV-2 antibodies was 31.0% (95% CI: 23.7%-38.3%) with no significant difference between HIV-exposed and HIV-unexposed infants (29.3% and 37.1% respectively, P = 0.410). The presence of anti-SARS-CoV-2 IgG was not associated with maternal socioeconomic or demographic indices.

          Conclusions

          Our data underline the wide spread of the SARS-CoV-2 infection in the pediatric population in sub-Saharan Africa. Design of more specific serological tests for African samples and improvements in serosurveillance programs are needed for more rigorous monitoring of the dynamics of SARS-CoV-2 infection in Africa.

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          Most cited references56

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          Evolution of antibody immunity to SARS-CoV-2

          Christian Gaebler, Zijun Wang, Julio C C Lorenzi … (2021)
          Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected 78 million individuals and is responsible for over 1.7 million deaths to date. Infection is associated with the development of variable levels of antibodies with neutralizing activity, which can protect against infection in animal models1,2. Antibody levels decrease with time, but, to our knowledge, the nature and quality of the memory B cells that would be required to produce antibodies upon reinfection has not been examined. Here we report on the humoral memory response in a cohort of 87 individuals assessed at 1.3 and 6.2 months after infection with SARS-CoV-2. We find that titres of IgM and IgG antibodies against the receptor-binding domain (RBD) of the spike protein of SARS-CoV-2 decrease significantly over this time period, with IgA being less affected. Concurrently, neutralizing activity in plasma decreases by fivefold in pseudotype virus assays. By contrast, the number of RBD-specific memory B cells remains unchanged at 6.2 months after infection. Memory B cells display clonal turnover after 6.2 months, and the antibodies that they express have greater somatic hypermutation, resistance to RBD mutations and increased potency, indicative of continued evolution of the humoral response. Immunofluorescence and PCR analyses of intestinal biopsies obtained from asymptomatic individuals at 4 months after the onset of coronavirus disease 2019 (COVID-19) revealed the persistence of SARS-CoV-2 nucleic acids and immunoreactivity in the small bowel of 7 out of 14 individuals. We conclude that the memory B cell response to SARS-CoV-2 evolves between 1.3 and 6.2 months after infection in a manner that is consistent with antigen persistence.
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            A serological assay to detect SARS-CoV-2 seroconversion in humans

            Fatima Amanat, Daniel Stadlbauer, Shirin Strohmeier … (2020)
            Here, we describe a serological enzyme-linked immunosorbent assay for the screening and identification of human SARS-CoV-2 seroconverters. This assay does not require the handling of infectious virus, can be adjusted to detect different antibody types in serum and plasma and is amenable to scaling. Serological assays are of critical importance to help define previous exposure to SARS-CoV-2 in populations, identify highly reactive human donors for convalescent plasma therapy and investigate correlates of protection.
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              Severe Acute Respiratory Syndrome Coronavirus 2−Specific Antibody Responses in Coronavirus Disease Patients

              Nisreen M.A. Okba, Marcel A. Müller, Wentao Li … (2020)
              A new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has recently emerged to cause a human pandemic. Although molecular diagnostic tests were rapidly developed, serologic assays are still lacking, yet urgently needed. Validated serologic assays are needed for contact tracing, identifying the viral reservoir, and epidemiologic studies. We developed serologic assays for detection of SARS-CoV-2 neutralizing, spike protein–specific, and nucleocapsid-specific antibodies. Using serum samples from patients with PCR-confirmed SARS-CoV-2 infections, other coronaviruses, or other respiratory pathogenic infections, we validated and tested various antigens in different in-house and commercial ELISAs. We demonstrated that most PCR-confirmed SARS-CoV-2–infected persons seroconverted by 2 weeks after disease onset. We found that commercial S1 IgG or IgA ELISAs were of lower specificity, and sensitivity varied between the 2 assays; the IgA ELISA showed higher sensitivity. Overall, the validated assays described can be instrumental for detection of SARS-CoV-2–specific antibodies for diagnostic, seroepidemiologic, and vaccine evaluation studies.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Clin Virol Plus
                Journal ID (iso-abbrev): J Clin Virol Plus
                Title: Journal of Clinical Virology plus
                Publisher: Published by Elsevier Ltd.
                ISSN (Electronic): 2667-0380
                Publication date PMC-release: 16 September 2022
                Publication date (Electronic): 16 September 2022
                Electronic Location Identifier: 100110
                Affiliations
                [a ]National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
                [b ]Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
                [c ]DREAM Program, Community of S. Egidio, P.O. Box 30355, Blantyre, Malawi
                [d ]Department of Human Sciences, LUMSA University, Borgo S. Angelo 13, 00193 Rome, Italy
                Author notes
                [* ]Corresponding Author: Silvia Baroncelli, National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00189 Rome, Italy
                [#]

                Silvia Baroncelli and Clementina Maria Galluzzo contributed equally to this work.

                Article
                Publisher Item ID: S2667-0380(22)00049-7 Publisher ID: 100110
                DOI: 10.1016/j.jcvp.2022.100110
                PMC ID: 9477783
                SO-VID: be0e41ae-04a4-4e77-9d34-f9e3b76b807d
                Copyright © © 2022 Published by Elsevier Ltd.
                License:

                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
                Date received : 2 May 2022
                Date revision received : 12 September 2022
                Date accepted : 15 September 2022
                Categories
                Subject: Article

                Keywords: sars-cov-2 antibody prevalence,infants,malawi
                Data availability:
                Keywords: sars-cov-2 antibody prevalence, infants, malawi

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