Keynote Presentation: Implementation of Serological and Molecular Tools to Inform COVID-19 Patient Management​ with Live Q&A

Severe acute respiratory syndrome coronavirus (SARS-CoV-2) is a novel virus that causes COVID-19 and has considerable variability in clinical outcomes among infected patients. The GENCOV study links laboratory data (including genetic, immunology, biochemistry, microbiology and hematology) and patient characteristics to provide a comprehensive understanding of factors that contribute to variability in COVID-19 patient outcomes. GENCOV includes 25 co-investigators and collaborators across 6 hospital sites in Ontario to study 1,500 Covid-19 patients over a 12-month period. This lecture will describe the GENCOV study protocol and the clinical characteristics of Covid-19 infected patients that increase odds of hospitalization, including age, ethnicity, BMI, viral variant and presence of hypertension. Surveys results that relate to participants understanding of Covid-19 serological testing will be described. To our knowledge, GENCOV is the first study to assess public knowledge of SARS-CoV-2 antibodies and serological testing. Our findings indicate that age, household income and level of education play a role in understanding information related to Covid-19 serology. Lastly, serial antibody titer levels, antigen target and viral neutralization are longitudinally assessed using an in-house developed immunoassay and the Health Canada approved Roche Elecsys® SARS-CoV-2 immunoassay. Our findings show that unvaccinated inpatients 1-month post-infection have significantly greater IgG antibody levels against all antigen targets (spike, receptor binding domain or nucleocapsid) when compared to unvaccinated outpatients. Patients with breakthrough or hybrid infections show higher antibody levels at 1 and 6 months post infection in comparison to those who are infected without vaccination. Understanding the basis for the variation in immune response and how this correlates to patient outcomes will help to better characterize future vaccine development and roll out plans.

Learning Objectives:

1. Describe how laboratory and clinical characteristics can be linked to provide a comprehensive understanding of factors that contribute to variability in COVID-19 patient outcomes.

2. Describe short and long-term COVID-19 serological findings in vaccinated and unvaccinated individuals.

3. Identify populations at risk of knowledge gaps related to COVID-19 serology.