High neutralizing antibody titer in intensive care unit patients with COVID-19
High neutralizing antibody titer in intensive care unit patients with COVID-19
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DOI：
10.1080/22221751.2020.1791738
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发表时间：
2020-01-01
影响因子：
13.2
通讯作者：
Chen, Zhiwei
中科院分区：
文献类型：
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作者：
Liu, Li;To, Kelvin Kai-Wang;Chen, Zhiwei
2019冠状病毒病（COVID-19）具有从轻度上呼吸道症状到呼吸衰竭的广泛疾病严重程度。中和抗体（NAb）反应在疾病进展中的作用仍然难以捉摸。这项研究确定了2018年4月至2020年2月期间香港特别行政区733名非COVID-19个体的血清阳性率，并比较了8名入住重症监护室（ICU）的COVID-19患者与42名未入住ICU的患者的中和抗体（NAb）反应。我们发现，在733名非COVID-19个体的任何匿名血清标本中均未检测到抗SARS-CoV-2的NAb。8名ICU患者的峰值血清几何平均NAb滴度显著高于42名非ICU患者（7280 [95%置信区间（CI）1468-36099] vs 671 [95% CI，368-1223]）。此外，NAb滴度在ICU患者感染的早期阶段显著高于非ICU患者。ICU患者在症状发作后达到Nab滴度峰值的中位天数（17.6天）比非ICU患者（20.1天）短。多因素分析显示，入院时需氧量和发热是与NAb滴度升高独立相关的唯一临床因素。我们的数据显示，SARS-CoV-2不太可能在COVID-19在香港出现之前悄悄传播。与非ICU患者相比，ICU患者的NAb反应加速和增强，这与疾病严重程度相关。需要进一步的研究来了解高NAb反应和疾病严重程度之间的关系。
Coronavirus disease 2019 (COVID-19) has a wide spectrum of disease severity from mild upper respiratory symptoms to respiratory failure. The role of neutralizing antibody (NAb) response in disease progression remains elusive. This study determined the seroprevalence of 733 non-COVID-19 individuals from April 2018 to February 2020 in the Hong Kong Special Administrative Region and compared the neutralizing antibody (NAb) responses of eight COVID-19 patients admitted to the intensive care unit (ICU) with those of 42 patients not admitted to the ICU. We found that NAb against SARS-CoV-2 was not detectable in any of the anonymous serum specimens from the 733 non-COVID-19 individuals. The peak serum geometric mean NAb titer was significantly higher among the eight ICU patients than the 42 non-ICU patients (7280 [95% confidence interval (CI) 1468-36099]) vs (671 [95% CI, 368-1223]). Furthermore, NAb titer increased significantly at earlier infection stages among ICU patients than among non-ICU patients. The median number of days to reach the peak Nab titers after symptoms onset was shorter among the ICU patients (17.6) than that of the non-ICU patients (20.1). Multivariate analysis showed that oxygen requirement and fever during admission were the only clinical factors independently associated with higher NAb titers. Our data suggested that SARS-CoV-2 was unlikely to have silently spread before the COVID-19 emergence in Hong Kong. ICU patients had an accelerated and augmented NAb response compared to non-ICU patients, which was associated with disease severity. Further studies are required to understand the relationship between high NAb response and disease severity.