Neutralizing Antibody Responses to Severe Acute Respiratory Syndrome Coronavirus 2 in Coronavirus Disease 2019 Inpatients and Convalescent Patients
Neutralizing Antibody Responses to Severe Acute Respiratory Syndrome Coronavirus 2 in Coronavirus Disease 2019 Inpatients and Convalescent Patients
复制标题
DOI：
10.1093/cid/ciaa721
复制
发表时间：
2020-11-15
影响因子：
11.8
通讯作者：
Wang, Quanyi
中科院分区：
文献类型：
--
作者：
Wang, Xiaoli;Guo, Xianghua;Wang, Quanyi
背景2019冠状病毒病（COVID-19）是一种没有特定抗病毒治疗或疫苗的大流行病。目前迫切需要探索不同临床特征患者的中和抗体。从70名COVID-19住院患者和康复患者中共采集了117份血液样本。采用改良的细胞病变中和试验（NA）和酶联免疫吸附试验（ELISA）测定抗体。分析不同临床特征患者不同时间点血清中和抗体水平的动态变化。发病20天内血清阳性率达100.0%，41 ~ 53天仍为100.0%。NA法测定的总几何平均滴度为1：163.7（95%置信区间[CI]，128.5-208.6），ELISA法测定的总几何平均滴度为1：12441.7（95%CI，9754.5-15869.2）。NA和ELISA抗体水平在发病后第31-40天达到高峰，随后略有下降。在多变量广义估计方程分析中，31-45岁、46-60岁和61-84岁患者的中和抗体水平高于16-30岁患者（β =1.0470，P = 0.0125; P β =1.0613，P = 0.0307; β =1.3713，P = 0.0020）。临床分型越差的患者中和抗体滴度越高（β = 0.4639，P = 0.0227）。中和抗体甚至在疾病的早期阶段就被检测到，并且在恢复期患者中显示出显著的应答。
Background. Coronavirus disease 2019 (COVID-19) is a pandemic with no specific antiviral treatments or vaccines. There is an urgent need for exploring the neutralizing antibodies from patients with different clinical characteristics.Methods. A total of 117 blood samples were collected from 70 COVID-19 inpatients and convalescent patients. Antibodies were determined with a modified cytopathogenic neutralization assay (NA) based on live severe acute respiratory syndrome coronavirus 2 and enzyme-linked immunosorbent assay (ELISA). The dynamics of neutralizing antibody levels at different time points with different clinical characteristics were analyzed.Results. The seropositivity rate reached up to 100.0% within 20 days since onset, and remained 100.0% till days 41-53. The total geometric mean titer was 1:163.7 (95% confidence interval [CI], 128.5-208.6) by NA and 1:12441.7 (95% CI, 9754.5-15869.2) by ELISA. The antibody level by NA and ELISA peaked on days 31-40 since onset, and then decreased slightly. In multivariate generalized estimating equation analysis, patients aged 31-45, 46-60, and 61-84 years had a higher neutralizing antibody level than those aged 16-30 years (beta=1.0470, P = .0125; P beta =1.0613, P = .0307; beta =1.3713, P = .0020). Patients with a worse clinical classification had a higher neutralizing antibody titer (beta = 0.4639, P = .0227).Conclusions. The neutralizing antibodies were detected even at the early stage of disease, and a significant response was shown in convalescent patients.