Humoral response and PCR positivity in patients with COVID-19 in the New York City region, USA: an observational study.
Humoral response and PCR positivity in patients with COVID-19 in the New York City region, USA: an observational study.
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DOI：
10.1016/s2666-5247(20)30120-8
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发表时间：
2020-11
期刊：
影响因子：
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通讯作者：
Cordon-Cardo C
中科院分区：
文献类型：
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作者：
Wajnberg A;Mansour M;Leven E;Bouvier NM;Patel G;Firpo-Betancourt A;Mendu R;Jhang J;Arinsburg S;Gitman M;Houldsworth J;Sordillo E;Paniz-Mondolfi A;Baine I;Simon V;Aberg J;Krammer F;Reich D;Cordon-Cardo C
严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）已引起全球大流行。感染者血清转化的比例仍然是一个悬而未决的问题。此外，在一些个体中已经显示，在症状消退后长达3个月可以检测到病毒基因组。我们调查了纽约市（NY，USA）地区恢复期血清供体的大队列中的血清转换和PCR阳性。在这项观察性研究中，我们在纽约市地区开展了一项外展计划。我们通过REDCap（范德比尔特大学，纳什维尔，田纳西州，美国）在线调查响应招募参与者。通过PCR筛选确认或疑似SARS-CoV-2感染的个体是否存在病毒基因组，并通过ELISA筛选是否存在抗SARS-CoV-2刺突抗体。单因素方差分析和Fisher精确检验用于测量年龄、性别、症状持续时间和症状发作和消退的天数与阳性抗体结果的相关性。在2020年3月26日至4月10日期间，我们测量了1343人的SARS-CoV-2抗体滴度。在624名确诊为SARS-CoV-2感染并在4周后进行血清学检查的参与者中，除3名外，所有参与者均血清转化为SARS-CoV-2刺突蛋白，而719名疑似SARS-CoV-2感染的参与者中有269名（37%）血清转化。PCR阳性检测到28天的症状解决。大多数确诊COVID-19的患者发生血清转化，可能为再次感染提供免疫力。我们还报告说，在很大比例的个体中，在症状缓解后的几周内，可以通过PCR在上呼吸道中检测到病毒基因组，但尚不清楚这种信号是否代表感染性病毒。对我们的大型队列的分析表明，大多数轻度COVID-19患者在患病后4周发生血清转化，并对使用PCR清除阳性个体提出了疑问。没有。
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic. The proportion of infected individuals who seroconvert is still an open question. In addition, it has been shown in some individuals that viral genome can be detected up to 3 months after symptom resolution. We investigated both seroconversion and PCR positivity in a large cohort of convalescent serum donors in the New York City (NY, USA) region. In this observational study, we ran an outreach programme in the New York City area. We recruited participants via the REDCap (Vanderbilt University, Nashville, TN, USA) online survey response. Individuals with confirmed or suspected SARS-CoV-2 infection were screened via PCR for presence of viral genome and via ELISA for presence of anti-SARS-CoV-2 spike antibodies. One-way ANOVA and Fisher's exact test were used to measure the association of age, gender, symptom duration, and days from symptom onset and resolution with positive antibody results. Between March 26 and April 10, 2020, we measured SARS-CoV-2 antibody titres in 1343 people. Of the 624 participants with confirmed SARS-CoV-2 infection who had serologies done after 4 weeks, all but three seroconverted to the SARS-CoV-2 spike protein, whereas 269 (37%) of 719 participants with suspected SARS-CoV-2 infection seroconverted. PCR positivity was detected up to 28 days from symptom resolution. Most patients with confirmed COVID-19 seroconvert, potentially providing immunity to reinfection. We also report that in a large proportion of individuals, viral genome can be detected via PCR in the upper respiratory tract for weeks after symptom resolution, but it is unclear whether this signal represents infectious virus. Analysis of our large cohort suggests that most patients with mild COVID-19 seroconvert 4 weeks after illness, and raises questions about the use of PCR to clear positive individuals. None.