Ladhani, SN;
Jeffery-Smith, A;
Patel, M;
Janarthanan, R;
Fok, J;
Crawley-Boevey, E;
Vusirikala, A;
Fernandez Ruiz De Olano, E;
Perez, MS;
Tang, S;
et al.
Ladhani, SN; Jeffery-Smith, A; Patel, M; Janarthanan, R; Fok, J; Crawley-Boevey, E; Vusirikala, A; Fernandez Ruiz De Olano, E; Perez, MS; Tang, S; Dun-Campbell, K; Evans, EW; Bell, A; Patel, B; Amin-Chowdhury, Z; Aiano, F; Paranthaman, K; Ma, T; Saavedra-Campos, M; Ellis, J; Chand, M; Brown, K; Ramsay, ME; Hopkins, S; Shetty, N; Chow, JY; Gopal, R; Zambon, M
(2020)
High prevalence of SARS-CoV-2 antibodies in care homes affected by COVID-19: Prospective cohort study, England.
EClinicalMedicine, 28.
p. 100597.
ISSN 2589-5370
https://doi.org/10.1016/j.eclinm.2020.100597
SGUL Authors: Ladhani, Shamez Nizarali
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Abstract
Background: We investigated six London care homes experiencing a COVID-19 outbreak and found high rates of SARS-CoV-2 infection among residents and staff. Here we report follow-up investigations including antibody testing in the same care homes five weeks later. Methods: Residents and staff in the initial investigation had a repeat nasal swab for SARS-CoV-2 RT-PCR and a blood test for SARS CoV-2 antibodies using ELISA based on SARS-CoV-2 native viral antigens derived from infected cells and virus neutralisation. Findings: Of the 518 residents and staff in the initial investigation, 186/241 (77.2%) surviving residents and 208/254 (81.9%) staff underwent serological testing. Almost all SARS-CoV-2 RT-PCR positive residents and staff were seropositive five weeks later, whether symptomatic (residents 35/35, 100%; staff, 22/22, 100%) or asymptomatic (residents 32/33, 97.0%; staff 21/22, 95.5%). Symptomatic but SARS-CoV-2 RT-PCR negative residents and staff also had high seropositivity rates (residents 23/27, 85.2%; staff 18/21, 85.7%), as did asymptomatic RT-PCR negative individuals (residents 61/91, 67.0%; staff 95/143, 66.4%). Neutralising antibody was detected in 118/132 (89.4%) seropositive individuals and was not associated with age or symptoms. Ten residents (10/79 re-tested, 12.7%) remained RT-PCR positive but with higher RT-PCR cycle threshold values; 7/10 had serological testing and all were seropositive. New infections were detected in three residents and one staff. Interpretation: RT-PCR provides a point prevalence of SARS-CoV-2 infection but significantly underestimates total exposure in outbreak settings. In care homes experiencing large COVID-19 outbreaks, most residents and staff had neutralising SARS-CoV-2 antibodies, which was not associated with age or symptoms. Funding: PHE.
Item Type: | Article | ||||||||
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Additional Information: | Crown Copyright © 2020 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) | ||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Infection and Immunity Research Institute (INII) | ||||||||
Journal or Publication Title: | EClinicalMedicine | ||||||||
ISSN: | 2589-5370 | ||||||||
Language: | eng | ||||||||
Dates: |
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Publisher License: | Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0 | ||||||||
PubMed ID: | 33173854 | ||||||||
Web of Science ID: | WOS:000645903100019 | ||||||||
Go to PubMed abstract | |||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/113308 | ||||||||
Publisher's version: | https://doi.org/10.1016/j.eclinm.2020.100597 |
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