PROJECT
CONTEXT
Since January 2020, the world is experiencing one of the worst public health emergencies since the 1918 Spanish flu, which led the WHO to declare COVID-19 as a pandemic on March 11, 2020.
The clinical spectrum of the infection, the severity of the disease in high-risk individuals, the efficiency of the respiratory transmission and the worldwide spread of the outbreak raise critical challenges for public health and sanitary services, medical organization, security and economical fields.
A major weapon to control the pandemic is to detect as soon as possible infected individuals and to implement measures of prevention, which require affordable large-scale diagnostic capacity. The diagnosis of COVID-19 disease is currently performed through RT-PCR tests using predominantly upper respiratory specimens. However, there are some limitations in the use of RT-PCR test due to the low detection rate and the necessity to perform the test in specialized laboratories by specialized operators. Finally, the time-window of viral replication may be missed resulting in false negative results.
Therefore, there is an urgent need to develop serological assays able to detect antibodies against the SARS-Cov-2. The overreaching objective of ASCENT is to provide a robust and affordable serologic test able to detect with a high reproducibility and sensibility antibodies specific to SARS-CoV-2. The implementation of the serologic test developed in this project will impact significantly the capacity of countries partners to expeditiously scale up diagnostic testing capacity linked to enhanced surveillance and clinical management of people with severe COVID-19. The estimation of the seroprevalence in the general population as well as the detection of antibody responses, as earlier as possible, in individuals infected with COVID-19 will have general impact both in terms of public health policy and in the practical care of patients. Moreover, this test is easier to perform and allows a rapid and efficient transfer of technology in routine hospital or research laboratories partners of this project.
OBJECTIVES & STRATEGY
The main goal of ASCENT is to implement a robust and reproducible serologic test ready and easy to use in South Africa and Burkina Faso.
This advance in diagnostic tools of COVID-19 infection will improve the knowledge of the natural history of the infection, clinical care and management of infected individuals and will allow modelling studies of the prevalence of the infection in the general population. The achievement of this project will impact directly in countries partners of this project their surveillance capacities and public health policies.
The specific objectives include:
To investigate and implement in the field a sensitive and reproducible Luminex-based serologic test to evaluate the prevalence of individuals with a positive serology (IgG) against SARS-CoV-2 in the general population and the dynamics of the epidemic in South Africa and Burkina-Faso.
To develop and implement in the field a luciferase reporter-based VSV-SARS-CoV-2 pseudo-virus assay to evaluate the neutralizing capacities of the antibodies.
To correlate clinical symptoms/status with the appearance of antibody response.
To determine the level of cross-reactivity between the antibody response against SARS-Cov-2 and the other members of coronavirus family.
To measure the proportion of asymptomatic and pauci-symptomatic individuals among seropositive individuals.
To estimate the number of infected people and key parameters of the dynamics of the epidemics including the basic reproductive number (R0).
To evaluate the impact of public health interventions in the two countries.
To achieve its goal, the project is divided in 4 scientific work packages and a management/ communication work package:
WP1
Seroconversion/serological assay for binding antibodies against SARS-CoV-2 Spike proteins RBD and S1
Lead partner: CHUV, Switzerland
WP2
Neutralization assay screening of seropositive donors to define prevalence of an anti-viral neutralizing antibody response
Lead partner: UU, Netherlands
WP3
Modelling the epidemics
Lead partner: SAMRC, South Africa & Inserm, France
WP4
Assay Implementation and Cross Sectional Study
Lead partner: CM, Burkina Faso & SAMRC, South Africa
WP5
Consortium Coordination, Dissemination and exploitation
Lead partner: Inserm, France
EXPECTED RESULTS
ASCENT is expected to have a significant impact on the global response to COVID-19 pandemic and strengthen the preparedness and response capacities to any future outbreaks both in Sub-Sahara Africa and Europe.
More specifically, ASCENT will contribute to the following 4 impacts:
1
Addressing urgent research questions in the context of the current COVID-19 outbreak, as part of the efforts to manage and prevent the spread of the current pandemic
For this purpose, ASCENT is implementing a robust and reproducible serologic test ready and easy to use in South Africa and Burkina-Faso. This high throughput test, which enables screening large volume of samples with a rapid turn around time will contribute to the establishment of seroprevalence of SARS-CoV-2 infection within a given country. Such data will have an important bearing on the prevention and control of COVID-19 pandemic, and help the policy makers to develop the most effective measures to curb the COVID-19 pandemic.
2
New knowledge to manage and prevent the current COVID-19 outbreak
ASCENT will provide a simple but very important information for policy makers: the number of people who have been infected. This information is very important as it helps guiding the public health strategies to control the epidemics. With the modelling, ASCENT will give the unique opportunity to forecast the epidemics in two countries of sub-saharan Africa using the most up-to-date seroprevalence assessment.
3
Strengthening of national and local research capacity to manage outbreaks
ASCENT is a highly integrated project with partners from West Africa, South Africa and Europe. The project facilitates and ensures seamless communication and transition of knowledge and know-how, leveraging the efforts made in laboratory assay development, standardization and implementation as well as clinical infrastructure. ASCENT also aims to foster cooperation between West and South Africa in the development and implementation of serological diagnostic assay and the conduct of the prospective observational study.
4
Leveraging and contributing to other ongoing global fight against COVID-19
ASCENT also aims to foster cooperation between West and South Africa in the development and implementation of serological diagnostic assay and the conduct of the prospective observational study. This includes the French & Swiss COVID-19 cohorts (Inserm & CHUV), the South African prospective observational cohort COVID-19 POX Study (SARMC), the H2020 MANCO project (UU) and the COVID-19 CoronaCheck initiative, which funded the development of the SARS2-S VSV pseudotyping assay for testing neutralization activity of purified antibodies and Luminex based SARS-CoV-2 serological assay respectively.