This study compares SARS-CoV-2 immune responses in high pretest probability swab negative hospitalized PUI patients vs. low pretest probability swab negative hospitalized APS (Asymptomatic Persons being Screened) patients to try to understand the appropriateness and safety of clinical decisions made in these patient populations based on swab results.
This is essentially a two phase blood drawing and immune assays study. Phase 1 will be a
single convalescent timing immune retrospective study; phase 2 will include paired samples to
increase immune response accuracy in a prospective study. In phase 1, hospitalized PUI and
APS patients with negative nasopharyngeal PCR swabs selected by Epic query of Bassett
records, will be contacted by telephone (or in person if hospitalized), offered enrollment in
the study, and provided informed consent if they're interested. For consented/enrolled
patients, routine baseline demographic and clinical data will be obtained by interview (in
person or telephone) and/or EMR (Epic) review. These data will be needed to describe baseline
characteristics and to assess for predictors of serologic conversion and other immune
responses in the two study populations. Up to two to three visits will be required for brief
interviews, record review, and blood draws. Phase 1 patients will have visits/blood draws on
days 14 and 28 after hospitalization or at 28 days after hospitalization only (-3 days, +60
days) if patients are beyond day 14 at the time of study initiation; phase 2 patients will
have visits/blood draws aiming for days 0, 14 (+/- 3 days), and 28 (+/- 3 days) after
hospital admission.
Blood will be drawn for SARS-CoV-2 specific immune assays (below). For phase 1 patients,
baseline immune assays will not be available as blood is not available for them; thus, for
many phase 1 patients, only one of the day 14 and 28 immune assays will be practical. In
Phase 2, these procedures will be the same except baseline blood draws will be possible at
hospitalization as well. Thus, blood drawing will be at target days 0, 14, and 28 for phase 2
patients. Short interviews at days 14 and 28 will be conducted to assess for new COVID-19
compatible illnesses that may confound immune response results.
Up to 27.5 ml of blood will be required at each timepoint (PAXgene tube 2.5 ml, heparinized
tube 10 ml, EDTA tube 10 ml, SST tube 5 ml). Total blood drawing will be up to 55 ml in phase
1 patients and up to 82.5 ml in phase 2 patients. Serologic and additional immune assays will
be conducted on blood drawn at these time points to assess for SARS-CoV-2 specific immune
responses (see below).
Diagnostic Test: SARS-CoV-2 antibody testing
venipuncture for SARS-CoV-2 IgG
Inclusion criteria:
- Hospitalized patient (PUI or APS) and tested for SARS-CoV-2 by NP PCR swab
- At least one negative SARS-CoV-2 NP PCR swab within 2 wks of hospitalization
- Adult >/= 18 yrs old
- Patient or LAR provides informed consent
- Patient or LAR agree to follow-up procedures in informed consent form
Exclusion criteria:
- Prior reaction to blood drawing considered significant safety issue by study
investigator
- Other factor considered significant safety issue by study investigator
- At least one positive SARS-CoV-2 NP PCR swab within 2 wks of hospitalization
Bassett Medical Center
Cooperstown, New York, United States
Daniel Freilich, MD, Principal Investigator
Bassett Medical Center