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Antibody Responses to SARS-CoV-2 in Patients With Novel Coronavirus Disease 2019.
Clin Infect Dis. 2020 11 19; 71(16):2027-2034.CI

Abstract

BACKGROUND

The novel coronavirus SARS-CoV-2 is a newly emerging virus. The antibody response in infected patients remains largely unknown, and the clinical value of antibody testing has not been fully demonstrated.

METHODS

173 patients with SARS-CoV-2 infection were enrolled. Their serial plasma samples (n = 535) collected during hospitalization were tested for total antibodies (Ab), IgM, and IgG against SARS-CoV-2. The dynamics of antibodies with disease progress were analyzed.

RESULTS

Among 173 patients, the seroconversion rates for Ab, IgM, and IgG were 93.1%, 82.7%, and 64.7%, respectively. The reason for the negative antibody findings in 12 patients might be due to the lack of blood samples at the later stage of illness. The median seroconversion times for Ab, IgM, and then IgG were days 11, 12, and 4, respectively. The presence of antibodies was <40% among patients within 1 week of onset, and rapidly increased to 100.0% (Ab), 94.3% (IgM), and 79.8% (IgG) by day 15 after onset. In contrast, RNA detectability decreased from 66.7% (58/87) in samples collected before day 7 to 45.5% (25/55) during days 15-39. Combining RNA and antibody detection significantly improved the sensitivity of pathogenic diagnosis for COVID-19 (P < .001), even in the early phase of 1 week from onset (P = .007). Moreover, a higher titer of Ab was independently associated with a worse clinical classification (P = .006).

CONCLUSIONS

Antibody detection offers vital clinical information during the course of SARS-CoV-2 infection. The findings provide strong empirical support for the routine application of serological testing in the diagnosis and management of COVID-19 patients.

Authors+Show Affiliations

Institute of Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, Shenzhen, China.The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health and School of Life Science, Xiamen University, Xiamen, China. School of Public Health, Xiamen University, Xiamen, China.Institute of Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, Shenzhen, China.The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health and School of Life Science, Xiamen University, Xiamen, China. School of Public Health, Xiamen University, Xiamen, China.Institute of Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, Shenzhen, China.The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health and School of Life Science, Xiamen University, Xiamen, China. School of Public Health, Xiamen University, Xiamen, China.Institute of Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, Shenzhen, China.Department for Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China.The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health and School of Life Science, Xiamen University, Xiamen, China. School of Public Health, Xiamen University, Xiamen, China.Department of Critical Care Medicine, Shenzhen Third People's Hospital, Shenzhen, China.Institute of Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, Shenzhen, China.The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health and School of Life Science, Xiamen University, Xiamen, China. School of Public Health, Xiamen University, Xiamen, China.Department for Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China.Department for Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China. The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, China.The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, China.The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, China.School of Public Health, Xiamen University, Xiamen, China.The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health and School of Life Science, Xiamen University, Xiamen, China. School of Public Health, Xiamen University, Xiamen, China.The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health and School of Life Science, Xiamen University, Xiamen, China. School of Public Health, Xiamen University, Xiamen, China.School of Medicine, Southern University of Science and Technology, Shenzhen, China.The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health and School of Life Science, Xiamen University, Xiamen, China. School of Public Health, Xiamen University, Xiamen, China.Institute of Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, Shenzhen, China. The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, China.The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health and School of Life Science, Xiamen University, Xiamen, China. School of Public Health, Xiamen University, Xiamen, China.The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health and School of Life Science, Xiamen University, Xiamen, China. School of Public Health, Xiamen University, Xiamen, China.Institute of Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, Shenzhen, China. The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32221519

Citation

Zhao, Juanjuan, et al. "Antibody Responses to SARS-CoV-2 in Patients With Novel Coronavirus Disease 2019." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 71, no. 16, 2020, pp. 2027-2034.
Zhao J, Yuan Q, Wang H, et al. Antibody Responses to SARS-CoV-2 in Patients With Novel Coronavirus Disease 2019. Clin Infect Dis. 2020;71(16):2027-2034.
Zhao, J., Yuan, Q., Wang, H., Liu, W., Liao, X., Su, Y., Wang, X., Yuan, J., Li, T., Li, J., Qian, S., Hong, C., Wang, F., Liu, Y., Wang, Z., He, Q., Li, Z., He, B., Zhang, T., ... Zhang, Z. (2020). Antibody Responses to SARS-CoV-2 in Patients With Novel Coronavirus Disease 2019. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 71(16), 2027-2034. https://doi.org/10.1093/cid/ciaa344
Zhao J, et al. Antibody Responses to SARS-CoV-2 in Patients With Novel Coronavirus Disease 2019. Clin Infect Dis. 2020 11 19;71(16):2027-2034. PubMed PMID: 32221519.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antibody Responses to SARS-CoV-2 in Patients With Novel Coronavirus Disease 2019. AU - Zhao,Juanjuan, AU - Yuan,Quan, AU - Wang,Haiyan, AU - Liu,Wei, AU - Liao,Xuejiao, AU - Su,Yingying, AU - Wang,Xin, AU - Yuan,Jing, AU - Li,Tingdong, AU - Li,Jinxiu, AU - Qian,Shen, AU - Hong,Congming, AU - Wang,Fuxiang, AU - Liu,Yingxia, AU - Wang,Zhaoqin, AU - He,Qing, AU - Li,Zhiyong, AU - He,Bin, AU - Zhang,Tianying, AU - Fu,Yang, AU - Ge,Shengxiang, AU - Liu,Lei, AU - Zhang,Jun, AU - Xia,Ningshao, AU - Zhang,Zheng, PY - 2020/03/12/received PY - 2020/03/27/accepted PY - 2020/3/30/pubmed PY - 2020/12/15/medline PY - 2020/3/30/entrez KW - COVID-19 KW - SARS-CoV-2 KW - antibody SP - 2027 EP - 2034 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 71 IS - 16 N2 - BACKGROUND: The novel coronavirus SARS-CoV-2 is a newly emerging virus. The antibody response in infected patients remains largely unknown, and the clinical value of antibody testing has not been fully demonstrated. METHODS: 173 patients with SARS-CoV-2 infection were enrolled. Their serial plasma samples (n = 535) collected during hospitalization were tested for total antibodies (Ab), IgM, and IgG against SARS-CoV-2. The dynamics of antibodies with disease progress were analyzed. RESULTS: Among 173 patients, the seroconversion rates for Ab, IgM, and IgG were 93.1%, 82.7%, and 64.7%, respectively. The reason for the negative antibody findings in 12 patients might be due to the lack of blood samples at the later stage of illness. The median seroconversion times for Ab, IgM, and then IgG were days 11, 12, and 4, respectively. The presence of antibodies was <40% among patients within 1 week of onset, and rapidly increased to 100.0% (Ab), 94.3% (IgM), and 79.8% (IgG) by day 15 after onset. In contrast, RNA detectability decreased from 66.7% (58/87) in samples collected before day 7 to 45.5% (25/55) during days 15-39. Combining RNA and antibody detection significantly improved the sensitivity of pathogenic diagnosis for COVID-19 (P < .001), even in the early phase of 1 week from onset (P = .007). Moreover, a higher titer of Ab was independently associated with a worse clinical classification (P = .006). CONCLUSIONS: Antibody detection offers vital clinical information during the course of SARS-CoV-2 infection. The findings provide strong empirical support for the routine application of serological testing in the diagnosis and management of COVID-19 patients. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/32221519/full_citation L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciaa344 DB - PRIME DP - Unbound Medicine ER -