COVID Breakfast: Can we get a Heineken Test?

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Prof G is going to get a COVID blood test next week. Is he? isn’t he?

This is what we will all be asking ourselves? Are we? Aren’t we?

Have we been infected on not? This will depend on the test. Is it good enough?

We need the Heiniken Test…What’s that? Well based on a Beer Advert about Refreshment, we need a Test that can “Reach the Parts that other Tests Cannot Reach“. Have we got this?

In the UK, so far we have the Roche test and the Abbott test. This is for anti-COVID antibody test and so lets hope they perform well.

The viral detection tests have been out there and the academics have been monitoring and have shown their weaknesses.

Then there are the antibody tests, they detect people who have been infected, if they have been tested after 14 days from symptom. Can you do better than that?

Detection of SARS-CoV-2-Specific Humoral and Cellular Immunity in COVID-19 Convalescent Individuals.Ni L, Ye F, Cheng ML, Feng Y, Deng YQ, Zhao H, Wei P, Ge J, Gou M, Li X, Sun L, Cao T, Wang P, Zhou C, Zhang R, Liang P, Guo H, Wang X, Qin CF, Chen F, Dong C. Immunity. 2020 May 3. pii: S1074-7613(20)30181-3. doi: 10.1016/j.immuni.2020.04.023. [Epub ahead of print].Follow-up analysis on another cohort of six patients 2 weeks post discharge also revealed high titers of immunoglobulin G (IgG) antibodies. In all 14 patients tested, 13 displayed serum-neutralizing activities. Notably, there was a strong correlation between neutralization antibody titers and the numbers of virus-specific T cells.

The current tests are all ace, until they are shown not to be ace. If you have had rip -roaring COVID they largely work. But the battle ground is going to be to spot people who have not had symptoms, but have been infected. At Barts Health, and every where else no doubt, blood and serum samples are being collected and tested. So we have the power to look at this. But every one else is doing this

ProfG talked about Barts Health being on the frontline.

COVID-19: PCR screening of asymptomatic health-care workers at London hospital.Treibel TA, Manisty C, Burton M, McKnight Á, Lambourne J, Augusto JB, Couto-Parada X, Cutino-Moguel T, Noursadeghi M, Moon JC. Lancet. 2020 May 8. pii: S0140-6736(20)31100-4. doi: 10.1016/S0140-6736(20)31100-4. [Epub ahead of print]

However, I must say that the glory boys and girls taking the bloods and getting the papers would not be getting anywhere, but for the massive and dedicated hard work of the “LabRats”. There are loads of people doing the national PCR virus testing and then there are other efforts collecting samples of people with and without infection for other tests. These samples have to be collected, logged processed and stored before, sometime in the future, someone works with them.We have Labrats doing this.

Queen Mary has a colony of real Mole Rats and it also has a colony of Covid Lab(Mole)Rats. Mole rats are like ants, they have a Queen (who gets given stuff) and a Workers. They live underground and have tunnels and like high temperatures.

So it is not that different to the Queen Mary COVID lab-rats. They are collecting and processing the samples and then storing them. Some of the people being monitored will become infected, some will show signs some will not. The labrats have to work in the highest level of containment to work with potentially infected samples, no windows, risking their lives and are working 12-15 hours a day for the past 8 weeks. The heat being kicked out by the freezers storing the samples can give them that MoleRat feeling. Spare a thought for them (Jason, Corina, Joe, Mel, Uppy, Lisa in the Blizard and apologises if I missed any). So I sent them a T shirt to cheer them up. More exclusive, than a Lancet paper these days 🙂 Keep up the Good work.

P.S. The special big one is for DrAngry

They have helped TeamG get anti-drug antibodies made. We asked the question “Can we make antibody tests for anti-drug antibodies and with the help of Mel J (Melerie Jones) our QM “Spice girl”, the response was “yes we Kang”.

Baker D, Ali L, Saxena G, Pryce G, Jones M, Schmierer K, Giovannoni G, Gnanapavan S, Munger KC, Samkoff L, Goodman A, Kang AS. The Irony of Humanization: Alemtuzumab, the First, But One of the Most Immunogenic, Humanized Monoclonal Antibodies. Front Immunol. 2020;11:124. doi: 10.3389/fimmu.2020.00124.

Mel J has been seconded to become a QM COVID LabRat in the effort to collect samples of people before and after they become infected.

However, in reality it is sad that the UK effort will be pipped to the post by other countries ahead in the COVID19 epidemics, like China, Italy, New York. Here is a story from Germany who are ahead of the game in the testing

Symptoms and immunoglobulin development in hospital staff exposed to a SARS-CoV-2 outbreak. Brandstetter S, Roth S, Harner S, Buntrock-Döpke H, Toncheva A, Borchers N, Gruber R, Ambrosch A, Kabesch M. Pediatr Allergy Immunol. 2020 May 15. doi: 10.1111/pai.13278. [Epub ahead of print]

BACKGROUND:Worldwide, the number of SARS-CoV-2 infections is increasing. Serological immunoglobulin tests may help to better understand the development of immune mechanisms against SARS-CoV-2 in COVID-19 cases and exposed but asymptomatic individuals. The aim of this study was to investigate exposure to SARS-CoV-2, symptoms and antibody responses in a large sample of health care workers following a COVID-19 outbreak.

METHODS:A COVID-19 outbreak among staff members of a major German children’s and women’s hospital was followed by massive RT-PCR SARS-CoV-2 tests and provided the opportunity to study symptoms, chains of infection and SARS-CoV-2 specific antibody responses (IgG and IgA) by ELISA. Study participants were classified as COVID-19 cases, and persons with close, moderate or no exposure to SARS-CoV-2 in the clinical setting, respectively.

RESULTS:Out of 201 study participants, 31 were COVID-19 cases. While most study participants experienced many symptoms indicative for SARS-CoV-2 infection, anosmia (loss of taste) and coughing were remarkably more frequent in COVID-19 cases. Approximately 80% of COVID-19 cases developed some specific antibody response (IgA and IgG) approximately 3 weeks after onset of symptoms. Subjects in the non COVID-19 groups had also elevated IgG (1.8%) and IgA values (7.6%) irrespective of contact history with cases.

CONCLUSION:We found that a significant number of diseased did not develop relevant antibody responses three weeks after symptom onset. Our data also suggests that exposure to COVID-19 positive co-workers in a hospital setting is not leading to the development of measurable immune responses in a significant proportion of asymptomatic contact-persons.

However, here lies the problem. We have the CE marked ELISA (above) test and is it failed to detect 20% of people who have been infected with the SARS2-Cov-2 virus. The people who know they have been infected will no doubt be positive. This is not as bad as some tests where the failure rate to detect asymptomatic people was closer to 80% (Best not name and Shame this one for being SH1). However, it suggests there is room for improvement and that we do need the Heinikang test. Should we have a look to see what we can do with the techology? Stick to MS? or Use the technology to work on MS? Could we do it? In that respect, the answer is simple.

Yes we Kang!

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