Profiling Early Humoral Response to Diagnose Novel Coronavirus Disease (COVID-19)
Profiling Early Humoral Response to Diagnose Novel Coronavirus Disease (COVID-19)
复制标题
DOI：
10.1093/cid/ciaa310
复制
发表时间：
2020-08-01
影响因子：
11.8
通讯作者：
Wang, Jianwei
中科院分区：
文献类型：
--
作者：
Guo, Li;Ren, Lili;Wang, Jianwei
背景2019冠状病毒病（COVID-19）的出现是一个重大的医疗保健威胁。目前的检测方法涉及基于定量聚合酶链反应（qPCR）的技术，该技术可在病毒核酸以足够量存在时进行鉴定。可能会出现假阴性结果，未能隔离受感染的患者将是遏制病毒传播的重大挫折。我们的目的是描述针对2019新型冠状病毒（SARS-CoV-2）产生的各种抗体的时间动力学，并评估抗体检测诊断COVID-19的潜力。用ELISA法检测重组病毒核衣壳蛋白对宿主的体液免疫应答，包括伊加、IgM和IgG免疫应答。从82例确诊病例和58例疑似病例（qPCR阴性但具有典型表现）中采集208份血浆样本。评价IgM抗体在本组病例中的诊断价值。IgM和伊加抗体检测的中位持续时间为5（IQR，3-6）d，而IgG在症状出现后14（IQR，10-18）d检测，阳性率分别为85.4%、92.7%和77.9%。确诊和疑似病例IgM抗体阳性率分别为75.6%和93.1%。在症状发作5.5天后，IgM ELISA的检测效率高于qPCR。IgM ELISA法与PCR法联合应用，对每例患者的阳性检出率（98.6%）明显高于单一qPCR法（51.9%）。对SARS-CoV-2的体液反应可以帮助诊断COVID-19，包括亚临床病例。
Background. The emergence of coronavirus disease 2019 (COVID-19) is a major healthcare threat. The current method of detection involves a quantitative polymerase chain reaction (qPCR)-based technique, which identifies the viral nucleic acids when present in sufficient quantity. False-negative results can be achieved and failure to quarantine the infected patient would be a major setback in containing the viral transmission. We aim to describe the time kinetics of various antibodies produced against the 2019 novel coronavirus (SARS-CoV-2) and evaluate the potential of antibody testing to diagnose COVID-19.Methods. The host humoral response against SARS-CoV-2, including IgA, IgM, and IgG response, was examined by using an ELISA-based assay on the recombinant viral nucleocapsid protein. 208 plasma samples were collected from 82 confirmed and 58 probable cases (qPCR negative but with typical manifestation). The diagnostic value of IgM was evaluated in this cohort.Results. The median duration of IgM and IgA antibody detection was 5 (IQR, 3-6) days, while IgG was detected 14 (IQR, 10-18) days after symptom onset, with a positive rate of 85.4%, 92.7%, and 77.9%, respectively. In confirmed and probable cases, the positive rates of IgM antibodies were 75.6% and 93.1%, respectively. The detection efficiency by IgM ELISA is higher than that of qPCR after 5.5 days of symptom onset. The positive detection rate is significantly increased (98.6%) when combining IgM ELISA assay with PCR for each patient compared with a single qPCR test (51.9%).Conclusions. The humoral response to SARS-CoV-2 can aid in the diagnosis of COVID-19, including subclinical cases.