Humoral response and PCR positivity in patients with COVID-19 in the New York City region, USA: an observational study

Ania Wajnberg, MD; Mayce Mansour, MD; Emily Leven, MD; Nicole M Bouvier, MD; Gopi Patel, MD; Adolfo Firpo-Betancourt, ProfMD; Rao Mendu, PhD; Jeffrey Jhang, ProfMD; Suzanne Arinsburg, DO; Melissa Gitman, MD; Jane Houldsworth, PhD; Emilia Sordillo, MD; Alberto Paniz-Mondolfi, MD; Ian Baine, MD; Viviana Simon, ProfMD; Judith Aberg, ProfMD; Florian Krammer, ProfPhD; David Reich, ProfMD; Carlos Cordon-Cardo, ProfMD

The Lancet Microbe (Nov 2020)

Humoral response and PCR positivity in patients with COVID-19 in the New York City region, USA: an observational study

Ania Wajnberg, MD,
Mayce Mansour, MD,
Emily Leven, MD,
Nicole M Bouvier, MD,
Gopi Patel, MD,
Adolfo Firpo-Betancourt, ProfMD,
Rao Mendu, PhD,
Jeffrey Jhang, ProfMD,
Suzanne Arinsburg, DO,
Melissa Gitman, MD,
Jane Houldsworth, PhD,
Emilia Sordillo, MD,
Alberto Paniz-Mondolfi, MD,
Ian Baine, MD,
Viviana Simon, ProfMD,
Judith Aberg, ProfMD,
Florian Krammer, ProfPhD,
David Reich, ProfMD,
Carlos Cordon-Cardo, ProfMD

Affiliations

Ania Wajnberg, MD: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Correspondence to: Dr Ania Wajnberg, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Mayce Mansour, MD: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Emily Leven, MD: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Nicole M Bouvier, MD: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Gopi Patel, MD: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Adolfo Firpo-Betancourt, ProfMD: Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Rao Mendu, PhD: Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Jeffrey Jhang, ProfMD: Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Suzanne Arinsburg, DO: Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Melissa Gitman, MD: Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Jane Houldsworth, PhD: Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Emilia Sordillo, MD: Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Alberto Paniz-Mondolfi, MD: Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Ian Baine, MD: Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Viviana Simon, ProfMD: Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Judith Aberg, ProfMD: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Florian Krammer, ProfPhD: Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
David Reich, ProfMD: Mount Sinai Hospital, New York, NY, USA
Carlos Cordon-Cardo, ProfMD: Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

Journal volume & issue: Vol. 1, no. 7
pp. e283 – e289

Abstract

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Summary: Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic. The proportion of infected individuals who seroconvert is still an open question. In addition, it has been shown in some individuals that viral genome can be detected up to 3 months after symptom resolution. We investigated both seroconversion and PCR positivity in a large cohort of convalescent serum donors in the New York City (NY, USA) region. Methods: In this observational study, we ran an outreach programme in the New York City area. We recruited participants via the REDCap (Vanderbilt University, Nashville, TN, USA) online survey response. Individuals with confirmed or suspected SARS-CoV-2 infection were screened via PCR for presence of viral genome and via ELISA for presence of anti-SARS-CoV-2 spike antibodies. One-way ANOVA and Fisher's exact test were used to measure the association of age, gender, symptom duration, and days from symptom onset and resolution with positive antibody results. Findings: Between March 26 and April 10, 2020, we measured SARS-CoV-2 antibody titres in 1343 people. Of the 624 participants with confirmed SARS-CoV-2 infection who had serologies done after 4 weeks, all but three seroconverted to the SARS-CoV-2 spike protein, whereas 269 (37%) of 719 participants with suspected SARS-CoV-2 infection seroconverted. PCR positivity was detected up to 28 days from symptom resolution. Interpretation: Most patients with confirmed COVID-19 seroconvert, potentially providing immunity to reinfection. We also report that in a large proportion of individuals, viral genome can be detected via PCR in the upper respiratory tract for weeks after symptom resolution, but it is unclear whether this signal represents infectious virus. Analysis of our large cohort suggests that most patients with mild COVID-19 seroconvert 4 weeks after illness, and raises questions about the use of PCR to clear positive individuals. Funding: None.

Published in The Lancet Microbe

ISSN: 2666-5247 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Medicine (General); Science: Microbiology
Website: https://www.journals.elsevier.com/the-lancet-microbe

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