Official Title
Differences in Susceptibility to SARS CoV-2 Infection According to ACE2 and CD26 Receptors, Specific CD4/CD8 T Cell Response to Viral Peptides, and KIR Receptors Among Health Care Workers Highly Exposed to Patients With COVID-19 Diagnosis.
Brief Title
Different Susceptibility to SARS CoV-2 Infection Among Health Care Workers Highly Exposed to COVID-19.
Protocol ID
NCT04402827
Lead Sponsor
Asociacion para el Estudio de las Enfermedades Infecciosas
Brief Summary
The primary objective of this study is to establish differences in susceptibility to SARS
CoV-2 infection among health care workers (HCW) highly exposed to patients with COVID-19
diagnosis. To ascertain this issue, we evaluated:
- Changes in receptor polymorphism (ACE2 and CD26 receptor study.
- SARS-CoV-2 CD4/CD8 T cell response (CTL)
- Different KIR phenotypes
Detailed Description
Only 24% of health care workers (HCW) had developed inmunological response to SARS CoV-2
infection in one centre attending thousands of COVID-19 patients, and with shorteness of
personal protective equipments. Our hypothesis is that this relatively low number of
infected HCW could be secondary to:
1. Differences in susceptibility to infection mediated by changes in viral receptors.
Thus, it is important to characterize and genotyping the main receptor for
SARS-CoV-2, ACE2, and other related receptor, such as CD26.
2. Increased cellular immune response, offering cross-immunity against SARS CoV-2
infection by previous exposure to other coronavirus or respiratory pathogens. A
specific CD4/CD8 T cell response to viral peptides could respond this question
3. Specific KIR phenotypes (Killer Immunoglobulin-like Receptors): Natural killer cells
(NK) response to alterations of class I HLA molecules presented in infected cells.
An increase in class I HLA expression could lead to an increase in NK activation by
increasing its ability to produce IFN-gamma.
Study Period
-
Enrollment Count
140 participants
Eligibility Criteria
Inclusion criteria
- HCW older than 18 years
- Highly exposed to COVID-19 according to the definition
- Negative (cases) or positive (controls) serology against SARS-CoV-2 infection
Exclusion criteria
- Presence of any disease / treatment which could alter the susceptibility (corticoid
therapy, chemotherapy, monoclonal antibodies)
- Pregnancy
High exposure definition: direct and continued care of COVID-19 diagnosed patients for 2
weeks or more, without aerosol- generating procedures, with inappropriate personal
protective equipment (PPE), or unprotected exposure to patients with COVID-19 during
aerosol-generating procedures.
The definition of appropriate PPE was based on previous recommendations. The absence of
any part of the PPE constituted an unprotected exposure. We defined the following as
aerosol-generating procedures: airway suction, application of a high-flow O2 instrument,
bronchoscopy, endotracheal intubation, tracheostomy, nebulizer treatment, sputum
induction, positive pressure ventilation, manual ventilation and cardiopulmonary
resuscitation.
Filters
Health Care Worker Patient Transmission
Receptor Site Alteration
Susceptibility, Disease
Immune Response
COMPLETED
ADULT
OLDER_ADULT