Updated: 4 p.m. on Friday May 1, 2020
Two northeast Ohio health systems, University Hospitals and MetroHealth, are using antibody tests on frontline employees to better understand COVID-19 and if it’s possible to become re-infected with the virus.
University Hospitals plans to test about 10,000 employees, nearly half its staff, for the coronavirus to see if they have developed antibodies, said Dr. Robert Salata, chair of the department of medicine at UH.
The point of this testing is not to see if these employees have the virus right now, but to determine if they ever had it and are now carrying antibodies in their system, Salata said.
“It takes on the order of seven to 10 days for the antibodies to show up in your bloodstream. These are made by our own white blood cells,” he said.
UH is using a high-quality IgG antibody test from Abbott for this research, he said. There has been some concern in the research community about some of the antibody tests on the market and whether they are giving false results. The test from Abbott is one of the few antibody tests on the market that has received Emergency Use Authorization from the Food and Drug Administration.
The information that the research team at UH will collect from testing the health care workers is just one piece of the puzzle to help doctors understand the virus, said Salata. He said it could help determine how to treat COVID-19 and provide more data to calculate the death rate.
“I am not trying in any way, shape, or form to underestimate how devastating this infection has been, but I think maybe the true death rate has not been quite as large because I think maybe there’s been a significant amount of community-based transmission we don’t even know about,” he said.
UH plans to begin testing its frontline staff and first responders by mid-May. The antibody testing will be made available to the larger community through UH providers sometime later this summer, he said.
One of the challenges in doing this type of research is that there is no concrete proof at this time that people who had the virus and develop antibodies will be protected in the future, he said.
Cleveland Clinic is holding off on testing its employees for antibodies, and the medical director of immunopathology there agrees that there is not enough evidence about the tests to suggest that they are useful or accurate.
“We don’t know if the mere presence of antibodies really means anything, (if) it means really protection against re-infection,” said Dr. Kamran Kadkhoda. “That is something that will be determined through vaccine trials over time, as it was determined for so many other things, such as measles or hepatitis B.”
He said if an individual has coronavirus antibodies, it’s unknown if they will be immune to COVID-19 in the future. And even if they are, he says that immunity could be short-lived. Plus, he said, research shows other common coronaviruses could show up in the COVID-19 antibody test, which could lead to false positives.
“I think there’s some degree of hastiness among these hospitals, some degree of lack of information and some sort of an exaggerated or hasty response to this pandemic is actually occurring,” Kadkhoda said. Kadkhoda recently published a study in the Journal of Clinical Microbiology questioning the use of antibody testing.
Another research study at MetroHealth may help provide more insight about COVID-19 immunity.
MetroHealth has launched a new study among Cleveland first responders to test whether it’s possible to become re-infected with COVID-19 after having it, said Adam Perzynski, associate professor at Case Western Reserve University and MetroHealth.
The observational study will include 300 people who will be tested twice – with both the standard COVID-19 diagnostic test to see if they currently have the virus, and with an antibody blood test to show if they ever had it in the past, Perzynski said.
“We’ll be able to see, among those people who are antibody positive, do we have any new infections later on. It will be a small test, a sort of pilot, of whether folks with antibodies can become re-infected,” he said.
The study may also show what the level of risk is for EMS workers who are being exposed to the virus on the job.
The MetroHealth researchers plan to submit the results to a peer-reviewed scientific journal in June.
MetroHealth also announced earlier in April that they would be starting to test their some of their frontline health care workers for COVID antibodies. They did not specify the type of test they are using or what they plan to do with the results.
