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Journal Article Multicenter Study Epublish 1 citation

PubMed: 39354348 DOI: 10.1186/s12877-024-05402-6

Unravelling the role of secretory Immnuoglobulin-A in COVID-19: a multicentre study in nursing homes during the first wave.

BMC Geriatr 24(1):804

Authors: Rafael Bielza, Patricia Pérez, Nuria García, Laura Ballesteros-Sanabria, Rosa María Martínez, Azam Ghazi, Clara Hernando, María Victoria Rodríguez, Israel J Thuissard, Cristina Andreu-Vázquez, José Manuel Bautista

Affiliations

  • Department of Geriatric Medicine, Infanta Sofía University Hospital. FIIB HUIS HUHEN, Madrid, Spain.
  • Faculty of Biomedical and Health Sciences, Department of Medicine, European University of Madrid, Madrid, Spain.
  • Department of Geriatric Medicine, Infanta Sofía University Hospital. FIIB HUIS HUHEN, Madrid, Spain. Faculty of Biomedical and Health Sciences, Department of Medicine, European University of Madrid, Madrid, Spain.
  • Department of Geriatric Medicine, Infanta Sofía University Hospital. FIIB HUIS HUHEN, Madrid, Spain.
  • Complutense University of Madrid, Madrid, Spain.
  • Faculty of Biomedical and Health Sciences, Department of Medicine, European University of Madrid, Madrid, Spain.

Abstract

BACKGROUND

The function of mucosal secretory IgA (SIgA) seems to be paramount in the immune response against SARS-CoV-2 however, there are few studies addressing this issue specifically in the institutionalized older population. This study aims to determine the levels of secretory IgA against the S1 domain of the SARS-CoV-2 spike (SIgA-S1) in older people living in nursing homes (NH) and to investigate the differences in baseline characteristics, severity of COVID-19, duration of symptoms, 30-day mortality, and reinfection according to the levels of SIgA-S1.

METHODS

In this multicentre longitudinal study, conducted in two NHs attended in coordination with a hospital-based Geriatric team, 305 residents (87.3 years, 74.4% female) were included. A massive collection of nasopharyngeal samples was carried out after the first wave of COVID-19 in May 2020 and an ELISA analysis of SIgA-S1 was performed on frozen samples in May 2023. Values of SIgA-S1 ≥ 57.6 U/mL ("cut-off point") were considered "induced". Resident medical records were reviewed to assess symptoms, comprehensive geriatric assessment (CGA), reinfection, and overall 30-day mortality.

RESULTS

At the time of sample collection, 274 residents (89.8%) exhibited "induced" SIgA-S1 levels (≥ 57.6 U/mL), 46 (15.1%) tested positive for PCR SARS-CoV-2, and 170 (57%) had experienced COVID-19 symptoms. "Induced" SIgA-S1 patients were more likely to be symptomatic (60.3% vs. 29%; p < 0.001) and exhibited upper respiratory tract symptoms more frequently (25.1% vs. 6.5%; p = 0.020) compared to "non-induced" patients. Patients with severe disease and duration of symptoms > 10 days had higher levels of SIgA-S1 than those with mild disease (252 vs.192.6 U/mL; p = 0.012) or duration ≤ 10 days (270.5 vs. 208.1 U/mL; p = 0.043), respectively. No significant differences were observed in age, sex, CGA, duration of symptoms, disease severity, overall 30-day-mortality, or reinfection between "induced" and "non-induced" residents.

CONCLUSIONS

Levels of SIgA-S1 are associated with the duration and type of COVID-19 symptoms, along with the severity of infection. While these findings shed light on the knowledge of SIgA-S1, further interdisciplinary studies are warranted to better understand the immune response to SARS-CoV-2 infection.

MeSH

Mortality, Nursing, Signs And Symptoms, Nursing Homes, Covid-19, Immunoglobulin A, Secretory, Immunity, Geriatrics, Reinfection, Infections