Sensitive assays are essential for the accurate identification of individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we report a multiplexed assay for the fluorescence-based detection of seroconversion in infected individuals from less than 1 µl of blood, and as early as the day of the first positive nucleic acid test after symptom onset. The assay uses dye-encoded antigen-coated beads to quantify the levels of immunoglobulin G (IgG), IgM and IgA antibodies against four SARS-CoV-2 antigens. A logistic regression model trained using samples collected during the pandemic and samples collected from healthy individuals and patients with respiratory infections before the first outbreak of coronavirus disease 2019 (COVID-19) was 99% accurate in the detection of seroconversion in a blinded validation cohort of samples collected before the pandemic and from patients with COVID-19 five or more days after a positive nasopharyngeal test by PCR with reverse transcription. The high-throughput serological profiling of patients with COVID-19 allows for the interrogation of interactions between antibody isotypes and viral proteins, and should help us to understand the heterogeneity of clinical presentations.

Background Functional health literacy—including the ability to read or understand medication labels, physician instructions, and educational materials—is essential for self-management of chronic diseases and preventive health behaviors. Cancer patients with low health literacy may be at greater risk for worse care and outcomes. Methods We assessed health literacy using the Short Test of Functional Health Literacy in Adults (S-TOFHLA) in 347 colorectal cancer (CRC) patients nested within a prospective observational study of system, provider, and patient characteristics influencing cancer outcomes. Results We found that having adequate health literacy increased the chances that Stage III/IV patients received chemotherapy (odds ratio [OR] = 3.29, 95% Confidence Interval [CI] 1.23, 8.80) but had no effect on cancer stage at diagnosis or vital status at last observation during post-enrollment follow-up. Examining survey responses among Stage III and IV patients, we found no differences by health literacy status regarding patient beliefs and preferences about chemotherapy, nor in patients’ roles in deciding whether to receive chemotherapy. Conclusions Patients with lower health literacy were less likely to receive chemotherapy compared with patients with higher health literacy. Clearer communication around such key healthcare decisions may lead to less disparities by health literacy level.

The association of sCD14 and LPS with NHL risk supports an etiologic role for gut microbial translocation in lymphomagenesis among HIV-infected individuals. Additional studies with larger sample sizes are needed to confirm these observations.

Background Endometrial tumors arise from a hormonally-responsive tissue. Defining subtypes by hormone receptors might better inform etiology and prediction of patient outcomes. We evaluated the potential role of tumor estrogen receptor (ER) and progesterone receptor (PR) expression to define endometrial cancer subtypes. Methods We measured semi-continuous ER and PR protein expression in tissue specimens from 360 endometrial primary tumors from the Nurses’ Health Study. To explore the impact of different definitions of marker positivity, we dichotomized ER and PR expression at different cut points in increments of 5% positive cells. Logistic regression was used to estimate associations between endometrial cancer risk factors, such as body mass index, with dichotomous ER or PR status. Reclassification statistics were used to assess whether adding dichotomous ER or PR status to standard prognostic factors of stage, grade, and histologic type would improve prediction. Results Compared to not being obese, obesity increased the odds of having an ER-positive tumor at cut points of 0–20% (maximum OR=2.92, 95% CI 1.34, 6.33) as well as the odds of having a PR-positive tumor at cut points of 70–90% (maximum OR=2.53, 95% CI 1.36, 4.68). Adding dichotomous tumor ER or PR status to the panel of standard predictors did not improve both model discrimination and calibration. Conclusion Obesity may be associated with greater endometrial tumor expression of ER and PR. Adding either marker does not appear to improve mortality prediction beyond the standard predictors. Impact Body mass index might explain some of the biological variation among endometrial tumors.