Humoral Immune Response to SARS-CoV-2 in Iceland
Humoral Immune Response to SARS-CoV-2 in Iceland
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DOI：
10.1056/nejmoa2026116
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发表时间：
2020-10-29
影响因子：
158.5
通讯作者：
Stefansson, Kari
中科院分区：
文献类型：
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作者：
Gudbjartsson, Daniel F.;Norddahl, Gudmundur L.;Stefansson, Kari
背景是鲜为人知的性质和持久性的体液免疫应答感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）。MethodsWe测量抗体血清样本从30,576人在冰岛，使用6个测定（包括两个泛免疫球蛋白[泛Ig]测定），我们确定了适当的措施血清阳性是一个积极的结果与两个泛Ig测定。我们测试了2102个样本，从1237人长达4个月后诊断的定量聚合酶链反应（qPCR）测定。我们检测了4222名曾接触过SARS-CoV-2的隔离人员和23,452名未知接触过SARS-CoV-2的人员的抗体。（91.1%）为血清阳性;通过qPCR诊断后2个月内，通过两种泛Ig测定法测定的抗病毒抗体滴度增加，并在研究的剩余时间内保持稳定。在被隔离的人中，2.3%的人血清反应呈阳性;在接触情况不明的人中，0.3%的人呈阳性。我们估计有0.9%的冰岛人感染了SARS-CoV-2，并且有0.3%的人感染致命。我们还估计，冰岛所有SARS-CoV-2感染中有56%是通过qPCR诊断的，14%发生在未经qPCR检测的隔离人员中（或未收到阳性结果，如果测试），30%发生在隔离区以外的人群中，未进行qPCR检测。2例在确诊后4个月内未下降。我们估计感染死亡的风险为0.3%，冰岛44%的SARS-CoV-2感染者未被qPCR诊断。这项对冰岛人群的大型比较研究表明，感染后4个月内体液反应没有下降，44%的感染者未被qPCR诊断，感染致死风险为0.3%。
BackgroundLittle is known about the nature and durability of the humoral immune response to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).MethodsWe measured antibodies in serum samples from 30,576 persons in Iceland, using six assays (including two pan-immunoglobulin [pan-Ig] assays), and we determined that the appropriate measure of seropositivity was a positive result with both pan-Ig assays. We tested 2102 samples collected from 1237 persons up to 4 months after diagnosis by a quantitative polymerase-chain-reaction (qPCR) assay. We measured antibodies in 4222 quarantined persons who had been exposed to SARS-CoV-2 and in 23,452 persons not known to have been exposed.ResultsOf the 1797 persons who had recovered from SARS-CoV-2 infection, 1107 of the 1215 who were tested (91.1%) were seropositive; antiviral antibody titers assayed by two pan-Ig assays increased during 2 months after diagnosis by qPCR and remained on a plateau for the remainder of the study. Of quarantined persons, 2.3% were seropositive; of those with unknown exposure, 0.3% were positive. We estimate that 0.9% of Icelanders were infected with SARS-CoV-2 and that the infection was fatal in 0.3%. We also estimate that 56% of all SARS-CoV-2 infections in Iceland had been diagnosed with qPCR, 14% had occurred in quarantined persons who had not been tested with qPCR (or who had not received a positive result, if tested), and 30% had occurred in persons outside quarantine and not tested with qPCR.ConclusionsOur results indicate that antiviral antibodies against SARS-CoV-2 did not decline within 4 months after diagnosis. We estimate that the risk of death from infection was 0.3% and that 44% of persons infected with SARS-CoV-2 in Iceland were not diagnosed by qPCR.This large comparative study of the Icelandic population showed that the humoral response did not decline within 4 months after infection, that 44% of persons who had been infected had not been diagnosed with qPCR, and that the infection fatality risk was 0.3%.