Combined Prospective Seroconversion and PCR Data of Selected Cohorts Indicate a High Rate of Subclinical SARS-CoV-2 Infections-an Open Observational Study in Lower Saxony, Germany

verfasst von: Rebecca Jonczyk, Nils Stanislawski, Lisa K Seiler, Holger Blume, Stefanie Heiden, Henning Lucas, Samir Sarikouch, Philipp-Cornelius Pott, Meike Stiesch, Corinna Hauß, Giulietta Saletti, Mariana González-Hernández, Franziska Karola Kaiser, Guus Rimmelzwaan, Albert Osterhaus, Cornelia Blume
Abstract: Despite lockdown measures, intense symptom-based PCR, and antigen testing, the SARS-CoV-2 pandemic spread further. In this open observational study conducted in Lower Saxony, Germany, voluntary SARS-CoV-2 PCR tests were performed from April 2020 until June 2021, supported by serum antibody testing to prove whether PCR testing in subjects with none or few symptoms of COVID-19 is a suitable tool to manage the pandemic. In different mobile stations, 4,817 subjects from three different working fields participated in the PCR testing. Serum antibody screening using the SARS-CoV-2 ViraChip IgG (Viramed, Germany) and the Elecsys Anti-SARS-CoV-2 assay (Roche, Germany) was performed alongside virus neutralization testing. Subjects were questioned regarding comorbidities and COVID-19 symptoms. Fifty-one subjects with acute SARS-CoV-2 infection were detected of which 31 subjects did not show any symptoms possibly characteristic for COVID-19. An additional 37 subjects reported a previous SARS-CoV-2 infection (total prevalence 1.82%). Seroconversion was discovered in 58 subjects with known SARS-CoV-2 infection and in 58 subjects that never had a positive PCR test. The latter had a significantly lower Charlson Comorbidity Index, and one third of them were asymptomatic. In 50% of all seroconverted subjects, neutralizing serum antibodies (NAbs) were detectable in parallel to N/S1 (n = 16) or N/S1/S2 antigen specific antibodies (n = 40) against SARS-CoV-2. NAb titers decreased within 100 days after PCR-confirmed SARS-CoV-2 acute infection by at least 2.5-fold. A relatively high rate of subclinical SARS-CoV-2 infections may contribute to the spread of SARS-CoV-2, suggesting that in addition to other intervention strategies, systematic screening of asymptomatic persons by PCR testing may significantly enable better pandemic control. IMPORTANCE Within this open observational study, repeated PCR (n > 4,700) and antibody screening (n > 1,600) tests were offered in three different working fields. The study identified 51 subjects with acute SARS-CoV-2 infection and 37 subjects reported to have had a positive PCR test taken externally. Thirty-one of the 51 subjects did not display any symptoms prior to testing. In addition, 58 subjects without PCR-confirmed SARS-CoV-2 infection were identified by seroconversion. Subjects, that had undergone SARS-CoV-2 infection without having noticed, more often had a low grade of immunization with no NAbs, but may have relevantly contributed to the spread of the pandemic. Based on these results, we suggest that both regular PCR and rapid test screening of symptomatic and asymptomatic individuals, specifically within groups or workplaces identifiable as having close quarter contact, thus increased infection transference risk, is necessary to better assess and therefore reduce the spread of a pandemic virus.
Organisationseinheit(en): Institut für Technische Chemie
Institut für Mikroelektronische Systeme
Institut für Innovations-Forschung, Technologie-Management & Entrepreneurship
Externe Organisation(en): MVZ Labor Limbach Hannover
Stiftung Tierärztliche Hochschule Hannover
Medizinische Hochschule Hannover (MHH)
Typ: Artikel
Journal: Microbiology spectrum
Band: 10
ISSN: 2165-0497
Publikationsdatum: 02.2022
Publikationsstatus: Veröffentlicht
Peer-reviewed: Ja
ASJC Scopus Sachgebiete: Mikrobiologie (medizinisch), Infektionskrankheiten, Genetik, Immunologie und Mikrobiologie (insg.), Physiologie, Zellbiologie, Ökologie
Ziele für nachhaltige Entwicklung: SDG 3 – Gute Gesundheit und Wohlergehen
Elektronische Version(en): https://doi.org/10.1128/spectrum.01512-21 (Zugang: Offen)

BibTeX

@article{e2a9c19a4b194163b11363a5206306ec,
title = "Combined Prospective Seroconversion and PCR Data of Selected Cohorts Indicate a High Rate of Subclinical SARS-CoV-2 Infections-an Open Observational Study in Lower Saxony, Germany",
abstract = "Despite lockdown measures, intense symptom-based PCR, and antigen testing, the SARS-CoV-2 pandemic spread further. In this open observational study conducted in Lower Saxony, Germany, voluntary SARS-CoV-2 PCR tests were performed from April 2020 until June 2021, supported by serum antibody testing to prove whether PCR testing in subjects with none or few symptoms of COVID-19 is a suitable tool to manage the pandemic. In different mobile stations, 4,817 subjects from three different working fields participated in the PCR testing. Serum antibody screening using the SARS-CoV-2 ViraChip IgG (Viramed, Germany) and the Elecsys Anti-SARS-CoV-2 assay (Roche, Germany) was performed alongside virus neutralization testing. Subjects were questioned regarding comorbidities and COVID-19 symptoms. Fifty-one subjects with acute SARS-CoV-2 infection were detected of which 31 subjects did not show any symptoms possibly characteristic for COVID-19. An additional 37 subjects reported a previous SARS-CoV-2 infection (total prevalence 1.82%). Seroconversion was discovered in 58 subjects with known SARS-CoV-2 infection and in 58 subjects that never had a positive PCR test. The latter had a significantly lower Charlson Comorbidity Index, and one third of them were asymptomatic. In 50% of all seroconverted subjects, neutralizing serum antibodies (NAbs) were detectable in parallel to N/S1 (n = 16) or N/S1/S2 antigen specific antibodies (n = 40) against SARS-CoV-2. NAb titers decreased within 100 days after PCR-confirmed SARS-CoV-2 acute infection by at least 2.5-fold. A relatively high rate of subclinical SARS-CoV-2 infections may contribute to the spread of SARS-CoV-2, suggesting that in addition to other intervention strategies, systematic screening of asymptomatic persons by PCR testing may significantly enable better pandemic control. IMPORTANCE Within this open observational study, repeated PCR (n > 4,700) and antibody screening (n > 1,600) tests were offered in three different working fields. The study identified 51 subjects with acute SARS-CoV-2 infection and 37 subjects reported to have had a positive PCR test taken externally. Thirty-one of the 51 subjects did not display any symptoms prior to testing. In addition, 58 subjects without PCR-confirmed SARS-CoV-2 infection were identified by seroconversion. Subjects, that had undergone SARS-CoV-2 infection without having noticed, more often had a low grade of immunization with no NAbs, but may have relevantly contributed to the spread of the pandemic. Based on these results, we suggest that both regular PCR and rapid test screening of symptomatic and asymptomatic individuals, specifically within groups or workplaces identifiable as having close quarter contact, thus increased infection transference risk, is necessary to better assess and therefore reduce the spread of a pandemic virus.",
keywords = "Antibody screening tests, COVID-19, Neutralizing antibodies, PCR, SARS-CoV-2 antibody screening, Subclinical cases, Working groups",
author = "Rebecca Jonczyk and Nils Stanislawski and Seiler, {Lisa K} and Holger Blume and Stefanie Heiden and Henning Lucas and Samir Sarikouch and Philipp-Cornelius Pott and Meike Stiesch and Corinna Hau{\ss} and Giulietta Saletti and Mariana Gonz{\'a}lez-Hern{\'a}ndez and Kaiser, {Franziska Karola} and Guus Rimmelzwaan and Albert Osterhaus and Cornelia Blume",
note = "Funding Information: G.S. and G.R. received funding from the Alexander von Humboldt Foundation in the framework of the Alexander von Humboldt Professorship. The work at the Research Center for Emerging Infections and Zooneses was financially supported by the Ministry of Research and Culture of Lower Saxony (COFONI and MWK). F.K.K. was funded by the DFG (German Research Foundation)—398066876/GRK 2485/1 (VIPER).",
year = "2022",
month = feb,
doi = "10.1128/spectrum.01512-21",
language = "English",
volume = "10",
journal = "Microbiology spectrum",
issn = "2165-0497",
publisher = "American Society for Microbiology",
number = "1",
}