Immunity status of Health Care Workers post recovery from COVID-19: An online longitudinal panel survey
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Abstract
Background
Corona virus has literally travelled “around the world in 80 days” akin to Fogg and Passepartoute of Jules Verne fame. Manning of corona virus disease 2019 (COVID-19) wards and ICUs, also surgery on COVID-positive patients is increasingly being relegated to that subset of health care workers (HCW) who themselves have resumed duties after surviving COVID-19 infection. Convalescent plasma therapy has been widely endorsed. Several vaccines are in the pipeline as potential preventive measures against the virus keeping HCW on the priority-list of recipients. Immunity passports are being validated for foreign travel. These events share a common presumption that exposure to COVID-19 virus (natural infection/inoculation) produces protective adaptive immunity. It is unknown whether all (COVID-19) infected patients mount a protective immune response and for how long any protective effect will last.
Methods
This single institutional prospective longitudinal panel survey questions were deployed to the respondents online via email/WhatsApp groups to ascertain the symptomology and immunity status of HCW in the months following COVID-19 infection. The survey was administered to the same set/cohort of health care workers over 6 months.
Results
165 responses from 151 respondents (70 at 1-2months; 95 at 3-4 months including 14 at both time points) were analysed. 7.14% of infected HCW failed to develop IgG antibodies at 4-6 weeks. 91.7% HCW with IgG titres in the highest bracket had experienced anosmia. Mean antibody titres were 12.08 ± 9.56 and 9.72 ± 9.34 at 1-2 months and 3-4 months post-development of first symptom, respectively.
Conclusion
Understanding of COVID-19 patterns of variation in HCW may guide their deployment in the COVID ward and COVID-OTs. Revelation of this enigma (by quantification of serial IgG antibody levels) is critical for predicting response to vaccines under trial, fostering effective stratagems and tactics for pandemic control, ascertaining validity of immunity passports and understanding longevity/durability of protection by forecasting immunological memory against SARS-CoV-2.
Article activity feed
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SciScore for 10.1101/2020.11.27.20239426: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: This prospective longitudinal panel survey was carried out after written informed consent from all patients, and approval from the Scientific Committee and Institutional Review Board.
IRB: Initial three steps of the survey (defining the population and sample, deciding the type of survey, designing the survey-questionnaire) were completed before and the remaining three steps (distribution of survey and response-collection, survey-result analysis, penning the survey results) were conducted after ethics committee approval.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
… SciScore for 10.1101/2020.11.27.20239426: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: This prospective longitudinal panel survey was carried out after written informed consent from all patients, and approval from the Scientific Committee and Institutional Review Board.
IRB: Initial three steps of the survey (defining the population and sample, deciding the type of survey, designing the survey-questionnaire) were completed before and the remaining three steps (distribution of survey and response-collection, survey-result analysis, penning the survey results) were conducted after ethics committee approval.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Antibodies Sentences Resources Antibodies binding to the receptor binding domain of the surface glycoprotein/spike (S) protein of SARS-CoV-2 can neutralize the virus.[6,14,15] The antibody test kit utilized at RGCIRC (VITROS Immunodiagnostic Products Anti-SARS-CoV-2 IgG) is based on the high throughput automated chemiluminescence immunoassay (CLIA) technology and the antibodies tested are those produced against the S-protein of SARS-CoV-2. Anti-SARS-CoV-2 IgGsuggested: NoneSoftware and Algorithms Sentences Resources MedCalc statistical software (version 15; MedCalc Software Ltd; Ostend, Belgium) was utilized for statistical analysis. MedCalcsuggested: (MedCalc, RRID:SCR_015044)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Limitations of the survey: Many HCW who tested COVID-positive by the RT-PCR test between May-July 2020 (prior to initiation of this survey) did not undergo antibody tests at 1-2 months post development of symptoms and did so only at 3-4 months post-infection. This is attributable to various reasons (initial non-availability of IgG antibody testing facility in Delhi as per Delhi government policy, lack of awareness about the test, lack of hospital policy leading to lack of prescription of this test, lack of subsidy on conduction of the test). Many HCW who tested positive did not get their antibody test done (were not convinced of its usefulness, did not find time due to shift duties and quarantine policies in COVID-ward and ICU, survey questionnaire in spam folder of email, attrition from institution, believed they might be obliged to donate convalescent plasma if their IgG-titre was found to be high etc)
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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SciScore for 10.1101/2020.11.27.20239426: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Methodology This prospective longitudinal panel survey was carried out after written informed consent from all patients, and approval from the Scientific Committee and Institutional Review Board. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable This 48y old male HCW was a well-controlled diabetic who underwent dialysis at RGCI for COVID-induced deranged KFT and septic shock as a last resort (Cycle threshold value 12.86 by RT-PCR; D-dimer level 9634ng/ml; CRP 4.8mg%;IL-6 48.6pg/ml; procalcitonin 4.59ng/ml; hemoglobin 7.9gm; TLC 35460/ml; platelet count 60000/ml) Fever: 89/151(58.94%) HCW developed fever lasting … SciScore for 10.1101/2020.11.27.20239426: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Methodology This prospective longitudinal panel survey was carried out after written informed consent from all patients, and approval from the Scientific Committee and Institutional Review Board. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable This 48y old male HCW was a well-controlled diabetic who underwent dialysis at RGCI for COVID-induced deranged KFT and septic shock as a last resort (Cycle threshold value 12.86 by RT-PCR; D-dimer level 9634ng/ml; CRP 4.8mg%;IL-6 48.6pg/ml; procalcitonin 4.59ng/ml; hemoglobin 7.9gm; TLC 35460/ml; platelet count 60000/ml) Fever: 89/151(58.94%) HCW developed fever lasting 1-2 days, 31/151(20.53%) for 3-7 days, 9/151(5.96%) for 1-2w and 2/151(1.32%) for >2 weeks. Table 2: Resources
Software and Algorithms Sentences Resources MedCalc statistical software (version 15; MedCalc Software Ltd; Ostend, Belgium) was utilized for statistical analysis. MedCalcsuggested: (MedCalc, RRID:SCR_015044)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
Limitations of the survey Many HCW who tested COVID-positive by the RT-PCR test between May-July 2020 (prior to initiation of this survey) did not undergo antibody tests at 1-2 months post development of symptoms and did so only at 3-4 months post-infection. This is attributable to various reasons (initial non-availability of IgG antibody testing facility in Delhi as per Delhi government policy, lack of awareness about the test, lack of hospital policy leading to lack of prescription of this test, lack of subsidy on conduction of the test). Many HCW who tested positive did not get their antibody test done (were not convinced of its usefulness, did not find time due to shift duties and quarantine policies in COVID-ward and ICU, survey questionnaire in spam folder of email, attrition from institution, believed they might be obliged to donate convalescent plasma if their IgG-titre was found to be high etc)
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
About SciScore
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