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Authors: Weisberg et al. 

Link to paper: https://doi.org/10.1101/2020.07.12.20151068        

Journal/ Pre-Print: MedRxiv 

Tags; Immunology/Immunity, Clinical/ Diagnostics 

Research Highlights

1.     Measured anti-SARS-CoV-2 Spike (S) and anti-SARS-CoV-2 Nucleocapsid (N) antibodies levels as well as neutralisation activity of plasma/sera in MIS-C, convalescent plasma donors, and severe COVID-19 ARDS adult patients. 

2.     MIS-C patients had a reduced antibody breadth and specificity for CoV-2; with IgG responses mainly directed against S protein. 

3.   MIS-C patients had reduced neutralising activity compared to the other cohorts.  

Summary 

Weisberg et al. examined a cohort of 15 MIS-C patients, 14 COVID-19 adult ARDS patients, 19 convalescent plasma donors (CPD), and 8 pre-pandemic healthy controls. They compared levels of IgM, IgA and IgG to SARS-CoV-2 S and IgG to SARS-CoV-2 N proteins for the different groups. CPD and MIS-C patients had similar levels of antibodies against S protein, with higher levels in the COVID-19 ARDS groupHowever, MIS-C patients had reduced levels of anti-N antibodies compared with the other groups. Neutralizing activity of sera from MIS-C patients was reduced compared with the other CoV-infected groups.  

Impact for SARS-CoV2/COVID19 research efforts 

Understand the immune response to  SARS-CoV2/COVID19 

Study Type 

·      Clinical Cohort study (e.g. drug trials) 

Strengths and limitations of the paper 

Novelty: Comparison of IgM, IgA and IgG antibody levels to anti-S and anti-N in COVID-ARDS, MIS-C and donated convalescent plasma showing interesting differences that may be linked to the pathogenesis 

Standing in the field: Anti-SARS-CoV-2 antibodies measured for COVID-19 ARDS and CPD in previous studies. New information regarding antibodies in MIS-C patients with an analysis of specificity against S and N proteins.          

Appropriate statistics: Accurate and appropriate statistics, but more p-values needed for graphs. 

Viral model used: SARS-CoV-2 antigens and pseudovirus neutralisation assay  

Translatability: May be useful for diagnostic/prognostic purposes, and in the future to direct potential antibody-based therapies (e.g. using convalescent plasma when needed) 

Main limitations: 

  • Would have been interest to include other proteins such as RBD to the anti-SARS-CoV-2 antibody measurements 

  • P-values needed for comparison between negative controls and comparison groups 

  • No antibody comparison to recovered children without MIS-C. 

  • Pseudovirus neutralization assay has a relatively high negative control measurement. 

  • More information needed on whether any children received IVIG which may impact antibody data.