Enhancing detection of SARS-CoV-2 re-infections using longitudinal sero-monitoring: demonstration of a methodology in a cohort of people experiencing homelessness in Toronto, Canada
Abstract Background Accurate estimation of SARS-CoV-2 re-infection is crucial to understanding the connection between infection burden and adverse outcomes. However, relying solely on PCR testing results in underreporting. We present a novel approach that includes longitudinal serologic data, and co...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-024-09013-9 |
| _version_ | 1827328459575132160 |
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| author | Lucie Richard Rosane Nisenbaum Karen Colwill Sharmistha Mishra Roya M. Dayam Michael Liu Cheryl Pedersen Anne-Claude Gingras Stephen W. Hwang |
| author_facet | Lucie Richard Rosane Nisenbaum Karen Colwill Sharmistha Mishra Roya M. Dayam Michael Liu Cheryl Pedersen Anne-Claude Gingras Stephen W. Hwang |
| author_sort | Lucie Richard |
| collection | DOAJ |
| description | Abstract Background Accurate estimation of SARS-CoV-2 re-infection is crucial to understanding the connection between infection burden and adverse outcomes. However, relying solely on PCR testing results in underreporting. We present a novel approach that includes longitudinal serologic data, and compared it against testing alone among people experiencing homelessness. Methods We recruited 736 individuals experiencing homelessness in Toronto, Canada, between June and September 2021. Participants completed surveys and provided saliva and blood serology samples every three months over 12 months of follow-up. Re-infections were defined as: positive PCR or rapid antigen test (RAT) results > 90 days after initial infection; new serologic evidence of infection among individuals with previous infection who sero-reverted; or increases in anti-nucleocapsid in seropositive individuals whose levels had begun to decrease. Results Among 381 participants at risk, we detected 37 re-infections through PCR/RAT and 98 re-infections through longitudinal serology. The comprehensive method identified 37.4 re-infection events per 100 person-years, more than four-fold more than the rate detected through PCR/RAT alone (9.0 events/100 person-years). Almost all test-confirmed re-infections (85%) were also detectable by longitudinal serology. Conclusions Longitudinal serology significantly enhances the detection of SARS-CoV-2 re-infections. Our findings underscore the importance and value of combining data sources for effective research and public health surveillance. |
| first_indexed | 2024-03-07T15:18:12Z |
| format | Article |
| id | doaj.art-9511cbbf5f174f2b859a7485a06554ff |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-07T15:18:12Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-9511cbbf5f174f2b859a7485a06554ff2024-03-05T17:49:35ZengBMCBMC Infectious Diseases1471-23342024-02-012411910.1186/s12879-024-09013-9Enhancing detection of SARS-CoV-2 re-infections using longitudinal sero-monitoring: demonstration of a methodology in a cohort of people experiencing homelessness in Toronto, CanadaLucie Richard0Rosane Nisenbaum1Karen Colwill2Sharmistha Mishra3Roya M. Dayam4Michael Liu5Cheryl Pedersen6Anne-Claude Gingras7Stephen W. Hwang8MAP Centre for Urban Health Solutions, Unity Health TorontoMAP Centre for Urban Health Solutions, Unity Health TorontoSinai Health, Lunenfeld-Tanenbaum Research InstituteMAP Centre for Urban Health Solutions, Unity Health TorontoSinai Health, Lunenfeld-Tanenbaum Research InstituteMAP Centre for Urban Health Solutions, Unity Health TorontoMAP Centre for Urban Health Solutions, Unity Health TorontoSinai Health, Lunenfeld-Tanenbaum Research InstituteMAP Centre for Urban Health Solutions, Unity Health TorontoAbstract Background Accurate estimation of SARS-CoV-2 re-infection is crucial to understanding the connection between infection burden and adverse outcomes. However, relying solely on PCR testing results in underreporting. We present a novel approach that includes longitudinal serologic data, and compared it against testing alone among people experiencing homelessness. Methods We recruited 736 individuals experiencing homelessness in Toronto, Canada, between June and September 2021. Participants completed surveys and provided saliva and blood serology samples every three months over 12 months of follow-up. Re-infections were defined as: positive PCR or rapid antigen test (RAT) results > 90 days after initial infection; new serologic evidence of infection among individuals with previous infection who sero-reverted; or increases in anti-nucleocapsid in seropositive individuals whose levels had begun to decrease. Results Among 381 participants at risk, we detected 37 re-infections through PCR/RAT and 98 re-infections through longitudinal serology. The comprehensive method identified 37.4 re-infection events per 100 person-years, more than four-fold more than the rate detected through PCR/RAT alone (9.0 events/100 person-years). Almost all test-confirmed re-infections (85%) were also detectable by longitudinal serology. Conclusions Longitudinal serology significantly enhances the detection of SARS-CoV-2 re-infections. Our findings underscore the importance and value of combining data sources for effective research and public health surveillance.https://doi.org/10.1186/s12879-024-09013-9SARS-CoV-2ReinfectionSerological testingCOVID-19 testingCOVID-19Homeless persons |
| spellingShingle | Lucie Richard Rosane Nisenbaum Karen Colwill Sharmistha Mishra Roya M. Dayam Michael Liu Cheryl Pedersen Anne-Claude Gingras Stephen W. Hwang Enhancing detection of SARS-CoV-2 re-infections using longitudinal sero-monitoring: demonstration of a methodology in a cohort of people experiencing homelessness in Toronto, Canada BMC Infectious Diseases SARS-CoV-2 Reinfection Serological testing COVID-19 testing COVID-19 Homeless persons |
| title | Enhancing detection of SARS-CoV-2 re-infections using longitudinal sero-monitoring: demonstration of a methodology in a cohort of people experiencing homelessness in Toronto, Canada |
| title_full | Enhancing detection of SARS-CoV-2 re-infections using longitudinal sero-monitoring: demonstration of a methodology in a cohort of people experiencing homelessness in Toronto, Canada |
| title_fullStr | Enhancing detection of SARS-CoV-2 re-infections using longitudinal sero-monitoring: demonstration of a methodology in a cohort of people experiencing homelessness in Toronto, Canada |
| title_full_unstemmed | Enhancing detection of SARS-CoV-2 re-infections using longitudinal sero-monitoring: demonstration of a methodology in a cohort of people experiencing homelessness in Toronto, Canada |
| title_short | Enhancing detection of SARS-CoV-2 re-infections using longitudinal sero-monitoring: demonstration of a methodology in a cohort of people experiencing homelessness in Toronto, Canada |
| title_sort | enhancing detection of sars cov 2 re infections using longitudinal sero monitoring demonstration of a methodology in a cohort of people experiencing homelessness in toronto canada |
| topic | SARS-CoV-2 Reinfection Serological testing COVID-19 testing COVID-19 Homeless persons |
| url | https://doi.org/10.1186/s12879-024-09013-9 |
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