The Fall in Antibody Response to SARS-CoV-2: a Longitudinal Study of Asymptomatic to Critically Ill Patients Up to 10 Months after Recovery.
The Fall in Antibody Response to SARS-CoV-2: a Longitudinal Study of Asymptomatic to Critically Ill Patients Up to 10 Months after Recovery.
复制标题
抗体对SARS-COV-2的反应下降：恢复后10个月的无症状至危重患者的纵向研究。
DOI：
10.1128/jcm.01138-21
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发表时间：
2021-10-19
影响因子：
9.4
通讯作者：
Tascini C
中科院分区：
文献类型：
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作者：
Peghin M;De Martino M;Fabris M;Palese A;Visintini E;Graziano E;Gerussi V;Bontempo G;D'Aurizio F;Biasotto A;Sartor A;Pipan C;Marzinotto S;Curcio F;Bouza E;Isola M;Tascini C
本研究的目的是评估原发性感染后严重急性呼吸综合征冠状病毒2型血清学反应的长期动态和相关因素。对第一波（2020年3月至5月）期间在乌迪内医院（意大利）就诊的2019冠状病毒病（COVID-19）所有康复成人住院和门诊患者进行了前瞻性纵向研究，在前4个月每月进行血清学随访，然后在发病后6、8和10个月进行随访。共纳入546名个体（289名女性，平均年龄53.1岁），大多数为轻度COVID-19（370，68.3%）。患者随访时间中位数为302天（四分位距，186 - 311）。2个月内的总血清转换率为32%的IgM和90%的IgG。在4个月时观察到90%的IgM患者血清逆转，在10个月时观察到47%的IgG患者血清逆转。年龄较大、急性发作时的症状数量和急性COVID-19的严重程度都是长期免疫的独立预测因素，（β，线性回归系数，1.10，P = 0.001; β 5.15 P = 0.014; β 43.84 P = 0.021）和IgG（分别为β 1.43 P < 0.001; β 10.46 P < 0.001; β 46.79 P < 0.001），而初始IgG峰值仅与IgG持续时间相关（β 1.12，P < 0.001）。IgM抗体在4个月时消失，IgG抗体在急性COVID-19后10个月约有一半患者下降。这些影响取决于初始抗体反应的强度、年龄和急性COVID-19的负担。
The aim of this study was to assess the long-term dynamics and factors associated with the serological response against the severe acute respiratory syndrome coronavirus 2 after primary infection. A prospective longitudinal study was conducted with monthly serological follow-up during the first 4 months, and then at 6, 8, and 10 months after the disease onset of all recovered adult in- and outpatients with coronavirus disease 2019 (COVID-19) attending Udine Hospital (Italy) during the first wave (from March to May 2020). A total of 546 individuals were included (289 female, mean age 53.1 years), mostly with mild COVID-19 (370, 68.3%). Patients were followed for a median of 302 days (interquartile range, 186 to 311). The overall seroconversion rate within 2 months was 32% for IgM and 90% for IgG. Seroreversion was observed in 90% of patients for IgM at 4 months and in 47% for IgG at 10 months. Older age, number of symptoms at acute onset, and severity of acute COVID-19 were all independent predictors of long-term immunity both for IgM (β, linear regression coefficient, 1.10, P = 0.001; β 5.15 P = 0.014; β 43.84 P = 0.021, respectively) and for IgG (β 1.43 P < 0.001; β 10.46 P < 0.001; β 46.79 P < 0.001, respectively), whereas the initial IgG peak was associated only with IgG duration (β 1.12, P < 0.001). IgM antibodies disappeared at 4 months, and IgG antibodies declined in about half of patients 10 months after acute COVID-19. These effects varied depending on the intensity of the initial antibody response, age, and burden of acute COVID-19.