lancet-header

Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.

Longitudinal Profile of Antibody Response to SARS-CoV-2 in Patients with COVID-19 in a Setting from Sub–Saharan Africa: A Prospective Longitudinal Study

26 Pages Posted: 2 Aug 2021

See all articles by Teklay Gebrecherkos

Teklay Gebrecherkos

Mekelle University - College of Health Sciences

Yazezew Kebede

Mekelle University - College of Health Sciences

Feyissa Challa

Ethiopian Public Health Institute

Saro Abdella

Ethiopian Public Health Institute

Atsbeha Gebreegzabher

Ethiopian Public Health Institute

Abraham Desta

Tigray Health Research Institute

Ataklti Hailu Atsbaha

Tigray Health Research Institute

Geremew Tasew

Ethiopian Public Health Institute - Bacterial, Parasitic and Zoonotic Disease Research Directorate

Mahmud Abdulkader

Mekelle University - College of Health Sciences

Masresha Tesema

Ethiopian Public Health Institute

Getachew Tollera

Ethiopian Public Health Institute - Bacterial, Parasitic and Zoonotic Disease Research Directorate

Zekarias Gessesse Arefaine

Mekelle University - College of Health Sciences

Henk H.D.F. Schallig

University of Amsterdam - Department of Medical Microbiology

Emily R. Adams

Liverpool School of Tropical Medicine - Department of Tropical Disease Biology

Britta C. Urban

Liverpool School of Tropical Medicine

Tobias F. Rinke De Wit

Amsterdam Institute for Global Health and Development

Dawit Wolday

Mekelle University - College of Health Sciences

More...

Abstract

Background: Serological testing for SARS-CoV-2 plays an important role for epidemiological studies, in aiding the diagnosis of COVID-19, and assess vaccine responses. Little is known on dynamics of SARS-CoV-2 serology in African settings. Here, we aimed to characterize the longitudinal antibody response profile to SARS-CoV-2 in Ethiopia.

Methods: In this prospective study, a total of 102 PCR-confirmed COVID-19 patients were enrolled. We obtained 802 plasma samples collected serially. SARS-CoV-2 antibodies were determined using four lateral flow immune-assays (LFIAs), and an electrochemiluminescent immunoassay. We determined the sensitivity, specificity, as well as seroconversion dynamics.

Findings: Serological positivity rate ranged between 12%-91%, depending on timing after symptom onset. There was no difference in positivity rate between severe and non-severe COVID-19 cases. The specificity ranged between 90%-99%. Agreement between different assays ranged between 84%-92%. Overall, 28/102 (27.5%) seroconverted by one or more assays tested, within a median time of 11 (IQR: 9–15) days post symptom onset. The median seroconversion time among symptomatic cases tended to be shorter when compared to asymptomatic patients [9 (IQR: 6–11) vs. 15 (IQR: 13–21) days; p=0.002]. Overall, seroconversion reached 100% 5.5 weeks after the onset of symptoms. Notably, 10 (9.8%) patients failed to mount a detectable antibody response by any of the assays tested during of follow-up.

Interpretation: Longitudinal assessment of antibody response in African COVID-19 patients revealed heterogeneous responses. This underscores the need for a comprehensive evaluation of seroassays before implementation. Factors associated with failure to seroconvert needs further research.

Funding: The European and Developing Countries Clinical Trial Partnership (EDCTP) – European Union.

Declaration of Interest: DW is European and Developing Countries Clinical Trials Partnership (EDCTP) Senior Research Fellow, and received funding for EvaLAMP project on Leishmaniasis Diagnostics; he serves as Strategic and Scientific Advisory Board of the Research Networks for Health Innovations in Sub-Saharan Africa (German Federal Ministry of Education and Research), and has received an honorarium for lectures and presentations from the Ethiopian Ministry of Science and Higher Education. TRW is employee of PharmAccess Foundation, is Board Member of Mondial Diagnostics, and Advisory Board member of Healthinc, The Netherlands. All other authors have no declarations to disclose.

Ethical Approval: The study protocol was reviewed and approved by the Health Research Ethics Review Committee of Mekelle University College of Health Sciences (#ERC 1769/2020).

Suggested Citation

Gebrecherkos, Teklay and Kebede, Yazezew and Challa, Feyissa and Abdella, Saro and Gebreegzabher, Atsbeha and Desta, Abraham and Atsbaha, Ataklti Hailu and Tasew, Geremew and Abdulkader, Mahmud and Tesema, Masresha and Tollera, Getachew and Arefaine, Zekarias Gessesse and Schallig, Henk H.D.F. and Adams, Emily R. and Urban, Britta C. and Rinke De Wit, Tobias F. and Wolday, Dawit, Longitudinal Profile of Antibody Response to SARS-CoV-2 in Patients with COVID-19 in a Setting from Sub–Saharan Africa: A Prospective Longitudinal Study. Available at SSRN: https://ssrn.com/abstract=3897696 or http://dx.doi.org/10.2139/ssrn.3897696

Teklay Gebrecherkos

Mekelle University - College of Health Sciences ( email )

P.O. Box 450
Mekelle, Tigray
Ethiopia

Yazezew Kebede

Mekelle University - College of Health Sciences ( email )

P.O. Box 450
Mekelle, Tigray
Ethiopia

Feyissa Challa

Ethiopian Public Health Institute ( email )

P.O.Box: 1242
Addis Ababa
Ethiopia

Saro Abdella

Ethiopian Public Health Institute

P.O.Box: 1242
Addis Ababa
Ethiopia

Atsbeha Gebreegzabher

Ethiopian Public Health Institute

P.O.Box: 1242
Addis Ababa
Ethiopia

Abraham Desta

Tigray Health Research Institute

Mekelle
Ethiopia

Ataklti Hailu Atsbaha

Tigray Health Research Institute ( email )

Mekelle
Ethiopia

Geremew Tasew

Ethiopian Public Health Institute - Bacterial, Parasitic and Zoonotic Disease Research Directorate

Mahmud Abdulkader

Mekelle University - College of Health Sciences ( email )

P.O. Box 450
Mekelle, Tigray
Ethiopia

Masresha Tesema

Ethiopian Public Health Institute

P.O.Box: 1242
Addis Ababa
Ethiopia

Getachew Tollera

Ethiopian Public Health Institute - Bacterial, Parasitic and Zoonotic Disease Research Directorate

Zekarias Gessesse Arefaine

Mekelle University - College of Health Sciences ( email )

P.O. Box 450
Mekelle, Tigray
Ethiopia

Henk H.D.F. Schallig

University of Amsterdam - Department of Medical Microbiology ( email )

Amsterdam, 1105
Netherlands

Emily R. Adams

Liverpool School of Tropical Medicine - Department of Tropical Disease Biology ( email )

Liverpool
United Kingdom

Britta C. Urban

Liverpool School of Tropical Medicine

Liverpool
United Kingdom

Tobias F. Rinke De Wit

Amsterdam Institute for Global Health and Development

Dawit Wolday (Contact Author)

Mekelle University - College of Health Sciences ( email )

P.O. Box 450
Mekelle, Tigray
Ethiopia