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Diagnosing COVID-19 in human sera with detected immunoglobulins IgM and IgG by means of Raman spectroscopy.

ABSTRACT: The severe COVID-19 pandemic requires the development of novel, rapid, accurate, and label-free techniques that facilitate the detection and discrimination of SARS-CoV-2 infected subjects. Raman spectroscopy has been used to diagnose COVID-19 in serum samples of suspected patients without clinical symptoms of COVID-19 but presented positive immunoglobulins M and G (IgM and IgG) assays versus Control (negative IgM and IgG). A dispersive Raman spectrometer (830 nm, 350 mW) was employed, and triplicate spectra were obtained. A total of 278 spectra were used from 94 serum samples (54 Control and 40 COVID-19). The main spectral differences between the positive IgM and IgG versus Control, evaluated by principal component analysis (PCA), were features assigned to proteins including albumin (lower in the group COVID-19 and in the group IgM/IgG and IgG positive) and features assigned to lipids, phospholipids, and carotenoids (higher the group COVID-19 and in the group IgM/IgG positive). Features referred to nucleic acids, tryptophan, and immunoglobulins were also seen (higher the group COVID-19). A discriminant model based on partial least squares regression (PLS-DA) found sensitivity of 84.0%, specificity of 95.0%, and accuracy of 90.3% for discriminating positive Ig groups versus Control. When considering individual Ig group versus Control, it was found sensitivity of 77.3%, specificity of 97.5%, and accuracy of 88.8%. The higher classification error was found for the IgM group (no success classification). Raman spectroscopy may become a technique of choice for rapid serological evaluation aiming COVID-19 diagnosis, mainly detecting the presence of IgM/IgG and IgG after COVID-19 infection.

SUBMITTER: Goulart ACC

PROVIDER: S-EPMC8427108 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundA profound inflammation-mediated lung injury with long-term acute respiratory distress and high mortality is one of the major complications of critical COVID-19. Immunoglobulin M (IgM)-enriched immunoglobulins seem especially capable of mitigating the inflicted inflammatory harm. However, the efficacy of intravenous IgM-enriched preparations in critically ill patients with COVID-19 is largely unclear.MethodsIn this retrospective multicentric cohort study, 316 patients with laboratory-confirmed critical COVID-19 were treated in ten German and Austrian ICUs between May 2020 and April 2021. The primary outcome was 30-day mortality. Analysis was performed by Cox regression models. Covariate adjustment was performed by propensity score weighting using machine learning-based SuperLearner to overcome the selection bias due to missing randomization. In addition, a subgroup analysis focusing on different treatment regimens and patient characteristics was performed.ResultsOf the 316 ICU patients, 146 received IgM-enriched immunoglobulins and 170 cases did not, which served as controls. There was no survival difference between the two groups in terms of mortality at 30 days in the overall cohort (HRadj: 0.83; 95% CI: 0.55 to 1.25; p = 0.374). An improved 30-day survival in patients without mechanical ventilation at the time of the immunoglobulin treatment did not reach statistical significance (HRadj: 0.23; 95% CI: 0.05 to 1.08; p = 0.063). Also, no statistically significant difference was observed in the subgroup when a daily dose of ≥ 15 g and a duration of ≥ 3 days of IgM-enriched immunoglobulins were applied (HRadj: 0.65; 95% CI: 0.41 to 1.03; p = 0.068).ConclusionsAlthough we cannot prove a statistically reliable effect of intravenous IgM-enriched immunoglobulins, the confidence intervals may suggest a clinically relevant effect in certain subgroups. Here, an early administration (i.e. in critically ill but not yet mechanically ventilated COVID-19 patients) and a dose of ≥ 15 g for at least 3 days may confer beneficial effects without concerning safety issues. However, these findings need to be validated in upcoming randomized clinical trials. Trial registration DRKS00025794 , German Clinical Trials Register, https://www.drks.de . Registered 6 July 2021.

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Diagnosing COVID-19 in human sera with detected immunoglobulins IgM and IgG by means of Raman spectroscopy.

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