High prevalence of SARS-CoV-2 antibodies in care homes affected by COVID-19 : Prospective cohort study, England
Crown Copyright © 2020 Published by Elsevier Ltd..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
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| Enthalten in: |
EClinicalMedicine - 28(2020) vom: 28. Nov., Seite 100597 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ladhani, Shamez N [VerfasserIn] |
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| Anmerkungen: |
Date Revised 18.04.2022 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.eclinm.2020.100597 |
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NLM317414976 |
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| 100 | 1 | |a Ladhani, Shamez N |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a High prevalence of SARS-CoV-2 antibodies in care homes affected by COVID-19 |b Prospective cohort study, England |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Crown Copyright © 2020 Published by Elsevier Ltd. | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a FUNDING: PHE | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Jeffery-Smith, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Monika |e verfasserin |4 aut | |
| 700 | 1 | |a Janarthanan, Roshni |e verfasserin |4 aut | |
| 700 | 1 | |a Fok, Jonathan |e verfasserin |4 aut | |
| 700 | 1 | |a Crawley-Boevey, Emma |e verfasserin |4 aut | |
| 700 | 1 | |a Vusirikala, Amoolya |e verfasserin |4 aut | |
| 700 | 1 | |a Fernandez Ruiz De Olano, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Perez, Marina Sanchez |e verfasserin |4 aut | |
| 700 | 1 | |a Tang, Suzanne |e verfasserin |4 aut | |
| 700 | 1 | |a Dun-Campbell, Kate |e verfasserin |4 aut | |
| 700 | 1 | |a Evans, Edward Wynne- |e verfasserin |4 aut | |
| 700 | 1 | |a Bell, Anita |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Bharat |e verfasserin |4 aut | |
| 700 | 1 | |a Amin-Chowdhury, Zahin |e verfasserin |4 aut | |
| 700 | 1 | |a Aiano, Felicity |e verfasserin |4 aut | |
| 700 | 1 | |a Paranthaman, Karthik |e verfasserin |4 aut | |
| 700 | 1 | |a Ma, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Saavedra-Campos, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Ellis, Joanna |e verfasserin |4 aut | |
| 700 | 1 | |a Chand, Meera |e verfasserin |4 aut | |
| 700 | 1 | |a Brown, Kevin |e verfasserin |4 aut | |
| 700 | 1 | |a Ramsay, Mary E |e verfasserin |4 aut | |
| 700 | 1 | |a Hopkins, Susan |e verfasserin |4 aut | |
| 700 | 1 | |a Shetty, Nandini |e verfasserin |4 aut | |
| 700 | 1 | |a Chow, J Yimmy |e verfasserin |4 aut | |
| 700 | 1 | |a Gopal, Robin |e verfasserin |4 aut | |
| 700 | 1 | |a Zambon, Maria |e verfasserin |4 aut | |
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