COVID-19 Scan for Oct 29, 2020

Long-lasting COVID-19 antibodies
Bloodstream infections in COVID-19

COVID-19 antibodies last at least 5 months in mild-to-moderate cases

A study yesterday in Science reports that the vast majority of patients with mild-to-moderate COVID-19 have stable levels of antibodies for at least 5 months.

Of 30,082 COVID-19 patients in New York City's Mount Sinai Health System, 27,849 (92.6%) had moderate-to-high antibody titer levels (1:320 and up), which an assay test showed would cause at least 90% of the sera to exhibit neutralizing activity for the spike protein of SARS-CoV-2, the virus that causes COVID-19. Researchers conducted approximate 3-month and 5-month follow-ups with 121 people, where they saw a drop of 764 geometric mean titer to 690 and then to 404 at the last time of testing.

"The sustained antibody levels that we subsequently observed are likely produced by long-lived plasma cells in the bone marrow," said Ania Wajnberg, MD, first author of the paper, in a press release from Mount Sinai Hospital/Mount Sinai School of Medicine. "This is similar to what we see in other viruses and likely means they are here to stay. We will continue to follow this group over time to see if these levels remain stable."

For measuring antibody titers, the researchers used enzyme-linked immunosorbent assay (ELISA). Low levels were 1:80 and 1:160, moderate was 1:320, and high was 1:960 and 1:2,880 and up, with 690 (2.2%) and 1,453 (4.8%), 6,675 (22.5%), and 9,564 (31.8%) and 11.610 (38.6%) people falling into each category, respectively. The quantitative microneutralization assay test showed that approximately 50% of sera in the 1:80 to 1:160 titer range had neutralizing activity, 90% in the 1:320 range did, and all sera in the 1:960 and up range did.

The study noted that people in the higher titer range showed a slow titer decline, whereas those with low to moderate levels saw an initial increase. This is in agreement with earlier observations from the team that indicate seroconversion in mild COVID-19 cases might take longer to mount, according to the news release.
Oct 28 Science study
Oct 28 Mount Sinai press release


Study finds high rate of bloodstream infections in COVID-19 ICU patients

A retrospective study of hospitalized COVID-19 patients in an intensive care unit (ICU) in Rome found that nearly half acquired bacterial or fungal bloodstream infections (BSIs), Italian researchers reported today in the Journal of Global Antimicrobial Resistance.

During the study period (Mar 1 to Apr 15), 57 patients were admitted to the ICU. Fifty-two of those patients had an indwelling central venous catheter, 48 were on mechanical ventilation, and 56 had been exposed to antibiotics in the 30 days prior to the study. BSIs occurred in 28 of the 57 patients (49%), with an incident rate of 373 per 10,000 patient-days. The mean time from ICU admission to BSI occurrence was 13 days.

The most commonly isolated organisms were Enterococcus spp (11 cases), Pseudomonas spp (8 cases), and Candida spp (5 cases). In addition, 17 patients (30%) were colonized by vancomycin-resistant Enterococcus (VRE), with 5 patients already colonized upon admission and 12 patients acquiring VRE during ICU hospitalization.

To compare these findings to historic data from the hospital, the researchers looked at blood cultures from 75 patients admitted to the ICU in the first 6 months of 2019. They found that the prevalence of BSIs in those patients was 13% (10/75) and the prevalence of VRE colonization was 15% (11/75).

"In the pre-COVID-19 period, the prevalence of BSI in patients staying in our ICU was 3.8 times lower than the prevalence observed in our ICU COVID-19 patients," the authors wrote.

They suggest that immune dysregulation in severe COVID-19, extensive use of antibiotics, and less adherence to infection prevention and control measures may play a role in the high incidence of bacterial and fungal infections in COVID-19 ICU patients.
Oct 29 J Glob Antimicrob Resist study

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