Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections
Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections
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DOI：
10.1038/s41591-020-0965-6
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发表时间：
2020-06-18
期刊：
影响因子：
82.9
通讯作者：
Huang, Ai-Long
中科院分区：
文献类型：
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作者：
Long, Quan-Xin;Tang, Xiao-Jun;Huang, Ai-Long
与年龄和性别相匹配的有症状感染者相比，一组无症状SARS冠状病毒2型（SARS-CoV-2）感染者的病毒特异性IgG抗体水平显著降低。无症状SARS冠状病毒2型（SARS-CoV-2）感染者的临床特征和免疫应答尚未得到很好的描述。我们研究了万州区37名无症状感染者，他们被诊断为RT-PCR确诊的SARS-CoV-2感染者，但在前14 d和住院期间没有任何相关临床症状。无症状者按政策（一）收住政府定点万州人民医院集中隔离。无症状组的病毒脱落中位持续时间为19 d（四分位距（IQR），15-26 d）。无症状组的病毒脱落持续时间显著长于有症状组（log-rankP = 0.028）。在急性期，无症状组的病毒特异性IgG水平（中位数S/CO，3.4; IQR，1.6-10.7）显著低于（P = 0.005）有症状组（中位数S/CO，20.5; IQR，5.8-38.2）。在无症状者中，93.3%（28/30）和81.1%（30/37）的IgG和中和抗体水平分别在恢复期早期下降，而有症状者分别为96.8%（30/31）和62.2%（23/37）。40%的无症状患者在恢复期血清学阴性，12.9%的有症状患者在恢复期IgG阴性。此外，无症状个体表现出较低水平的18促炎和抗炎细胞因子。这些数据表明，无症状个体对SARS-CoV-2感染的免疫应答较弱。IgG和中和抗体水平的下降在早期恢复阶段可能有免疫策略和血清学调查的影响。
A cohort of asymptomatic patients infected with SARS-CoV-2 had significantly lower levels of virus-specific IgG antibodies compared to a cohort of age- and sex-matched symptomatic infected patients.The clinical features and immune responses of asymptomatic individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have not been well described. We studied 37 asymptomatic individuals in the Wanzhou District who were diagnosed with RT-PCR-confirmed SARS-CoV-2 infections but without any relevant clinical symptoms in the preceding 14 d and during hospitalization. Asymptomatic individuals were admitted to the government-designated Wanzhou People's Hospital for centralized isolation in accordance with policy(1). The median duration of viral shedding in the asymptomatic group was 19 d (interquartile range (IQR), 15-26 d). The asymptomatic group had a significantly longer duration of viral shedding than the symptomatic group (log-rankP = 0.028). The virus-specific IgG levels in the asymptomatic group (median S/CO, 3.4; IQR, 1.6-10.7) were significantly lower (P = 0.005) relative to the symptomatic group (median S/CO, 20.5; IQR, 5.8-38.2) in the acute phase. Of asymptomatic individuals, 93.3% (28/30) and 81.1% (30/37) had reduction in IgG and neutralizing antibody levels, respectively, during the early convalescent phase, as compared to 96.8% (30/31) and 62.2% (23/37) of symptomatic patients. Forty percent of asymptomatic individuals became seronegative and 12.9% of the symptomatic group became negative for IgG in the early convalescent phase. In addition, asymptomatic individuals exhibited lower levels of 18 pro- and anti-inflammatory cytokines. These data suggest that asymptomatic individuals had a weaker immune response to SARS-CoV-2 infection. The reduction in IgG and neutralizing antibody levels in the early convalescent phase might have implications for immunity strategy and serological surveys.