Clinical features and antibody response of patients from a COVID-19 treatment hospital in Wuhan, China.

Abstract

Coronavirus disease 2019 (COVID-19) has rapidly evolved into a global pandemic. A total of 1578 patients admitted into a newly built hospital specialized for COVID-19 treatment in Wuhan, China, were enrolled. Clinical features and the levels of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin (Ig)M and IgG were analyzed. In total, 1532 patients (97.2%) were identified as laboratory-confirmed cases. Seventy-seven patients were identified as asymptomatic carriers (n = 64) or SARS-CoV-2 RNA positive before symptom onset (n = 13). The positive rates of SARS-CoV-2 IgM and IgG were 80.4% and 96.8%, respectively. The median of IgM and IgG titers were 37.0A U/ml (interquartile range [IQR]: 13.4-81.1 AU/ml) and 156.9 AU/ml (IQR: 102.8-183.3 AU/ml), respectively. The IgM and IgG levels of asymptomatic patients (median titers, 8.3 AU/ml and 100.3 AU/ml) were much lower than those in symptomatic patients (median titers, 38.0 AU/ml and 158.2 AU/ml). A much lower IgG level was observed in critically ill patients 42-60 days after symptom onset. There were 153 patients with viral RNA shedding after IgG detection. These patients had a higher proportion of critical illness during hospitalization (p < .001) and a longer hospital stay (p < .001) compared to patients with viral clearance after IgG detection. Coronary heart disease (odds ratio [OR], 1.89 [95% confidence interval [CI], 1.11-3.24]; p = .020), and intensive care unit admission (OR, 2.47 [95% CI, 1.31-4.66]; p = .005) were independent risk factors associated with viral RNA shedding after IgG detection. Symptomatic patients produced more antibodies than asymptomatic patients. The patients who had SARS-CoV-2 RNA shedding after developing IgG were more likely to be sicker patients.

• Authors: Yong Chen, Yuehua Ke, Xiong Liu, Zhihua Wang, Ruizhong Jia, Wei Liu, Chaojie Yang, Leili Jia, Yong Wang, Li Han, Xinyi Xia, Sibing Zhang, Changjun Wang
• Journal: Journal of medical virology (J Med Virol) Vol. 93 Issue 5 Pg. 2782-2789 (05 2021) ISSN: 1096-9071 [Electronic] United States
• PMID: 33085103 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: © 2020 Wiley Periodicals LLC.

Chemical References

• Antibodies, Viral
• Immunoglobulin G
• Immunoglobulin M
• RNA, Viral

Topics

• Adolescent
• Adult
• Aged
• Antibodies, Viral (immunology)
• Antibody Formation
• COVID-19 (immunology, physiopathology)
• China
• Female
• Hospitalization
• Hospitals
• Humans
• Immunoglobulin G (immunology)
• Immunoglobulin M (immunology)
• Male
• Middle Aged
• Pandemics
• RNA, Viral
• Retrospective Studies
• Risk Factors
• SARS-CoV-2
• Virus Shedding
• Young Adult
• COVID-19 Drug Treatment