As the COVID-19 pandemic enters its third year, Northwestern Medicine scientists continue to help advance understanding of the disease and its impact, from studying antibody protection against COVID reinfection -19 to elevating women in academic research and highlighting racial and ethnic disparities in COVID -19 hospital mortality in Illinois.
Prior infection with SARS-COV-2 does not guarantee antibody protection
Alexis Demonbreun, PhD, assistant professor of pharmacology, was lead author on the study published in Open Forum Infectious Diseases.
A team of investigators from Northwestern Medicine found that among people previously infected with SARS-COV-2, less than half had antibody levels that were moderate to high enough to protect them from reinfection. The findings, published in Open Forum on Infectious Diseaseshelp dispel the myth that natural immunity after SARS-CoV-2 infection is more effective than vaccines in reducing the risk of hospitalization or death, the authors say.
“These results suggest that prior infection with SARS-CoV-2 does not guarantee a high level of antibody-mediated protection against reinfection,” said Thomas McDade, PhD, professor of medical social sciences and first author of the study. ‘study.
Investigators measured levels of antibody-mediated neutralization of the spike protein receptor – ACE2 – which allows the SARS-COV-2 virus to infect healthy host cells – in blood samples from participants previously enrolled in the neighborhood coronavirus antibody screening (SCAN) study. Participants were recruited for SCAN between June 24, 2020 and November 11, 2020.
Overall, moderate to high levels of protective antibodies against SARS-COV-2 were present in less than half of participants requiring clinical care – 41.3%. Moreover, protective immunity was present in only 7.9% of symptomatic infections and 1.9% of asymptomatic infections.
“This information may be important for public health messaging to the large and growing proportion of the world’s population that has already been infected with SARS-CoV-2 and remains unvaccinated, or only partially vaccinated,” Alexis said. Demonbreun, PhD, assistant professor of pharmacology and senior study author.
Study co-authors include Richard D’Aquila, MD, Howard Taylor Ricketts, MD, professor of medicine in the Division of Infectious Diseases and associate vice president of research; Brian Mustanski, PhD, Professor of Medical Social Sciences, Psychiatry, and Behavioral Sciences and Director of the Institute for Sexual and Gender Minority Health and Wellbeing; and Elizabeth M McNally, MD, PhD, Elizabeth J. Ward Professor of Genetic Medicine and Director of the Center for Genetic Medicine.
D’Aquila and Mustanski are members of the Robert H. Lurie Comprehensive Cancer Center at Northwestern University.
This work was supported by National Science Foundation grant 2035114, National Institutes of Health grant 3UL1TR001422-06S4, and Northwestern University Office of Research.
Elevating Women in Academic Research
William Lowe, Jr., MD, Thomas D. Spies Professor of Genetic Metabolism and Professor of Medicine in the Division of Endocrinology, Metabolism, and Molecular Medicine, was co-author of the editorial published in Nature Medicine.
The COVID-19 pandemic continued to have a disproportionate impact on certain demographic groups, particularly women. Since the start of the pandemic, women have left the workforce in greater numbers than men due to childcare and home care responsibilities and, for these reasons, many have still not yet returned to work. the work market.
In a recent editorial published in natural medicineauthors from academic medical centers across the United States have discussed how the pandemic has created a long-term negative impact for women in academic research and how academia can help elevate and retain them.
“Women scholars have lagged behind in publications and grants during the COVID-19 pandemic and are at risk of abandoning research personnel altogether unless urgent action is taken by institutes and funders “, wrote the authors.
William Lowe, Jr., MD, Thomas D. Spies Professor of Genetic Metabolism and Associate Dean for Academic Affairs, was co-author of the study.
In the editorial, the authors suggest a framework for stakeholders, including academic institutions, foundations, professional organizations and federal funders, to retain women in academic research, calling for a commitment to change. financial, cultural and specific operational.
“Lastly, and perhaps most importantly, substantial national and global efforts to change societal norms that position women as responsible caregivers by default are essential to enable women to succeed in the labor market, including in academic research careers,” the authors wrote.
Ongoing global surveillance for SARS-CoV-2 variants
Egon Ozer, MD, PhD, ’08 GME, assistant professor of medicine in the Division of Infectious Diseases and director of the Center for Pathogen Genomics and Microbial Evolution, was a co-author on the study published in Nature Communications.
An international team of researchers has found that the A.27 variant of SARS-CoV-2, which was first identified in Germany in spring 2021, successfully evades currently available monoclonal antibody treatments.
The findings, published in Nature Communicationemphasize the need for continued global surveillance of novel variant strains of SARS-COV-2, as they continually demonstrate their ability to evade current treatment regimens.
From phylogenetic analysis of SARS-CoV-2 genome sequence data obtained from the Robert Koch Institute in Germany, investigators detected the presence of A.27 in 31 countries from December 2020 to June 2021 and determined that it likely originated from separate intro events. from West Africa.
“Thanks to our research collaborators in Nigeria, we were able to sequence examples of these viruses from samples taken from patients in Nigeria in January and February 2021, suggesting that this lineage may have arisen in West Africa” , said Egon Ozer, MD, PhD. , ’08 GME, assistant professor of medicine in the Division of Infectious Diseases, director of the Center for Pathogen Genomics and Microbial Evolution, and co-author of the study.
They also found that A.27 has a specific mutation in the SARS-CoV-2 spike protein, which allows the virus to infect healthy host cells. The investigators also demonstrated that A.27 is less sensitive to SARS-CoV-2 specific antibodies and that current COVID-19 vaccines and treatments may not fully protect patients against infection.
“The presence of S mutations of concern in an A-derived line supports the idea that the same escape mutations may arise in relatively distant genomic contexts with similar phenotypic consequences. Therefore, global molecular surveillance must continue to detect new new variants and to support the assessment of their risk to the human population,” the authors wrote.
Racial and ethnic disparities in COVID-19 hospital mortality in Illinois
Joseph Feinglass, PhD, a research professor of medicine in the Division of General Internal Medicine and Geriatrics and Preventive Medicine in the Division of Public Health Practice, was senior author of the study published in the Journal of Racial and Ethnic Health Disparities.
In Illinois hospitals, Hispanic patients with COVID-19 had a higher mortality risk than non-Hispanic white patients, while non-Hispanic black patients had a lower overall mortality risk, a Northwestern study found. Medicine published in the Journal of Racial and Ethnic Disparities in Health.
Our study adds to the evidence that there is a significant degree of variability in COVID-19 mortality rates between patients of different racial or ethnic groups and between hospitals, even after adjusting for individual patient characteristics.
Joseph Feinglass, Ph.D., research professor of medicine in the Division of General Internal Medicine and Geriatrics, preventive medicine in the Division of Public Health Practice and lead study author
The study analyzed hospital data for adult patients diagnosed with COVID-19 who were discharged from acute care, in Illinois hospitals; overall, 14.5% of admissions resulted in death or discharge from hospice.
After adjusting for patient and hospital characteristics, the researchers found that Hispanic patients had a higher mortality risk than non-Hispanic white patients, while non-Hispanic black patients had a lower mortality risk than non-Hispanic patients. non-Hispanic whites.
Additionally, safety net hospitals receiving disproportionate hospital funds from Illinois Medicaid had a higher mortality risk than other hospitals.
“To achieve a more equitable response to the pandemic, policies aimed at reducing repeated strain in the face of pandemic surges will require scaling up support to safety net hospitals already under considerable resource strain,” the authors wrote. .
The art of nephrology during COVID-19
Susan Quaggin, MD, chief and Charles H. Mayo, MD, professor of medicine in the Division of Nephrology and Hypertension, wrote an editorial published by the American Society of Nephrology.
In a recent editorial published by the American Society of Nephrology (ASN), Susan Quaggin, MD, chief and Charles H. Mayo, MD, professor of medicine in the Division of Nephrology and Hypertension and president-elect of the ASN, reflected on COVID-19 has had on the field of nephrology while applauding leadership, innovation, advances in research, and commitment to patient care and advocacy.
“We have witnessed firsthand the major impact of acute infection and long-term complications of COVID-19 on kidney health. We also understand the increased burden of kidney disease that the world will surely face in the years to come,” wrote Quaggin, who is also director of the Feinberg Cardiovascular and Renal Research Institute.
Quaggin wrote that the field should learn from the COVID-19 pandemic to transform and advance all aspects of nephrology, and noted two ways the field is already improving: by prioritizing kidney health and disease prevention and by committing to justice and access to health care.
“Let’s continue to build on these advances and build on what we’ve learned over the past two years,” Quaggin wrote. “Responding successfully to major crises and being visionary at the heart of our concerns: these efforts represent the art of nephrology.”
