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Publications

Journal Article Research Support, Non-U.S. Gov't Epublish

PubMed: 38222091 DOI: 10.3389/fpubh.2023.1290402

Clinical and laboratory considerations: determining an antibody-based composite correlate of risk for reinfection with SARS-CoV-2 or severe COVID-19.

Front Public Health 11:1290402

Authors: Stefan Holdenrieder, Carlos Eduardo Dos Santos Ferreira, Jacques Izopet, Elitza S Theel, Andreas Wieser

Affiliations

  • Institute of Laboratory Medicine, German Heart Centre Munich, Technical University Munich, Munich, Germany.
  • Clinical Laboratory, Department of Laboratory Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil.
  • Laboratory of Virology, Toulouse University Hospital and INFINITY Toulouse Institute for Infections and Inflammatory Diseases, INSERM UMR 1291 CNRS UMR 5051, University Toulouse III, Toulouse, France.
  • Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States.
  • Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany.
  • German Centre for Infection Research (DZIF), Munich, Germany.
  • Faculty of Medicine, Max Von Pettenkofer Institute, LMU Munich, Munich, Germany.
  • Immunology, Infection and Pandemic Research, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Munich, Germany.

Abstract

Much of the global population now has some level of adaptive immunity to SARS-CoV-2 induced by exposure to the virus (natural infection), vaccination, or a combination of both (hybrid immunity). Key questions that subsequently arise relate to the duration and the level of protection an individual might expect based on their infection and vaccination history. A multi-component composite correlate of risk (CoR) could inform individuals and stakeholders about protection and aid decision making. This perspective evaluates the various elements that need to be accommodated in the development of an antibody-based composite CoR for reinfection with SARS-CoV-2 or development of severe COVID-19, including variation in exposure dose, transmission route, viral genetic variation, patient factors, and vaccination status. We provide an overview of antibody dynamics to aid exploration of the specifics of SARS-CoV-2 antibody testing. We further discuss anti-SARS-CoV-2 immunoassays, sample matrices, testing formats, frequency of sampling and the optimal time point for such sampling. While the development of a composite CoR is challenging, we provide our recommendations for each of these key areas and highlight areas that require further work to be undertaken.

MeSH

Research Design, Sars-Cov-2, Laboratories, Vaccines, Antibodies, Insemination, Artificial, Heterologous, Public Health, Vaccination, Covid-19, Immunity, Severe Acute Respiratory Syndrome-Related Coronavirus, Reinfection, Infections