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Summary: Multiple myeloma (MM) and anti‐MM therapy cause profound immunosuppression, leaving patients vulnerable to coronavirus disease 2019 (COVID‐19) and other infections. We investigated anti‐severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) antibodies longitudinally in ultra‐high‐risk patients with MM receiving risk‐adapted, intensive anti‐CD38 combined therapy in the Myeloma UK (MUK) nine trial. Despite continuous intensive therapy, seroconversion was achieved in all patients, but required a greater number of vaccinations compared to healthy individuals, highlighting the importance of booster vaccinations in this population. Reassuringly, high antibody cross‐reactivity was found with current variants of concern, prior to Omicron subvariant adapted boostering. Multiple booster vaccine doses can provide effective protection from COVID‐19, even with intensive anti‐CD38 therapy for high‐risk MM. [ABSTRACT FROM AUTHOR]

Detecting antibody responses during and after SARS‐CoV‐2 infection is essential in determining the seroepidemiology of the virus and the potential role of antibody in disease. Scalable, sensitive and specific serological assays are essential to this process. The detection of antibody in hospitalized patients with severe disease has proven relatively straightforward; detecting responses in subjects with mild disease and asymptomatic infections has proven less reliable. We hypothesized that the suboptimal sensitivity of antibody assays and the compartmentalization of the antibody response may contribute to this effect. We systematically developed an ELISA, optimizing different antigens and amplification steps, in serum and saliva from non‐hospitalized SARS‐CoV‐2‐infected subjects. Using trimeric spike glycoprotein, rather than nucleocapsid, enabled detection of responses in individuals with low antibody responses. IgG1 and IgG3 predominate to both antigens, but more anti‐spike IgG1 than IgG3 was detectable. All antigens were effective for detecting responses in hospitalized patients. Anti‐spike IgG, IgA and IgM antibody responses were readily detectable in saliva from a minority of RT‐PCR confirmed, non‐hospitalized symptomatic individuals, and these were mostly subjects who had the highest levels of anti‐spike serum antibodies. Therefore, detecting antibody responses in both saliva and serum can contribute to determining virus exposure and understanding immune responses after SARS‐CoV‐2 infection. [ABSTRACT FROM AUTHOR]

Although anti-S IgA and IgG were more similar in children and adult COVID-19 patients, anti-N IgA and IgG antibodies were higher in ITU patients (Figure 1C,D). Since antibody isotypes can reflect recent infection (IgM), or more historic infections (IgG and IgA), we examined individual antibody isotypes and presented these results as area under the curve (AUC). Therefore, children with Kawasaki-like inflammatory syndrome, negative by PCR, can have IgG1, IgG3, and IgA antibody levels to SARS-CoV-2 in the absence of maintained IgM responses. Screening of sera, diluted 1:40, to detect IgG, IgA, and IgM demonstrated that all children had antibodies against the SARS-CoV-2 S glycoprotein (Figure 1A). [Extracted from the article]