Lack of Antibodies to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in a Large Cohort of Previously Infected Persons
Lack of Antibodies to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in a Large Cohort of Previously Infected Persons
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DOI：
10.1093/cid/ciaa1685
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发表时间：
2021-11-01
影响因子：
11.8
通讯作者：
Akinbami, Lara J.
中科院分区：
文献类型：
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作者：
Petersen, Lyle R.;Sami, Samira;Akinbami, Lara J.
背景报告表明，一些先前感染过严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的人缺乏可检测到的免疫球蛋白G（IgG）抗体。我们的目的是确定IgG血清阴性的比例和血清阴性的预测因素在先前感染SARS-CoV-2的人。我们分析了从纽约市和底特律大都会区的医护人员和第一反应者中收集的血清学数据，这些人有SARS-CoV-2逆转录聚合酶链反应（RT-PCR）检测结果阳性的病史，并在症状发作后至少2周进行了SARS-CoV-2刺突蛋白IgG抗体检测。在2547名先前确认的SARS-CoV-2感染者中，160人（6.3%）为血清阴性。在2112例既往有症状的患者中，从症状发作后14天到90天，血清阴性的比例略有增加（P =.06）。血清反应阴性的比例从79名既往住院患者中的0%到308名无症状感染者中的11.0%不等。在一个多变量模型中，服用免疫抑制药物的人更有可能是血清阴性的，（31.9%; 95%置信区间[CI]，10.7%-64.7%），而非西班牙裔黑人种族/民族的参与者（vs非西班牙裔白色人; 2.7%; 95%CI，1.5%-4.8%），严重肥胖（vs体重不足/正常; 3.9%; 95%CI，1.7%-8.6%），或有更多症状的患者不太可能是血清阴性。在我们的人群与以前的RT-PCR确认感染，约1/16的人缺乏IgG抗体。抗体的缺乏因疾病严重程度、人种/种族、肥胖和免疫抑制药物治疗而独立变化。在症状发作后90天内，接受检测的人中血清反应阴性的比例保持相对稳定。
Background. Reports suggest that some persons previously infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lack detectable immunoglobulin G (IgG) antibodies. We aimed to determine the proportion IgG seronegative and predictors for seronegativity among persons previously infected with SARS-CoV-2.Methods. We analyzed serologic data collected from healthcare workers and first responders in New York City and the Detroit metropolitan area with a history of a positive SARS-CoV-2 reverse-transcription polymerase chain reaction (RT-PCR) test result and who were tested for IgG antibodies to SARS-CoV-2 spike protein at least 2 weeks after symptom onset.Results. Of 2547 persons with previously confirmed SARS-CoV-2 infection, 160 (6.3%) were seronegative. Of 2112 previously symptomatic persons, the proportion seronegative slightly increased from 14 to 90 days post symptom onset (P =.06). The proportion seronegative ranged from 0% among 79 persons previously hospitalized to 11.0% among 308 persons with asymptomatic infections. In a multivariable model, persons who took immunosuppressive medications were more likely to be seronegative (31.9%; 95% confidence interval [CI], 10.7%-64.7%), while participants of non-Hispanic Black race/ethnicity (vs non-Hispanic White; 2.7%; 95% CI, 1.5%-4.8%), with severe obesity (vs under/normal weight; 3.9%; 95% CI, 1.7%-8.6%), or with more symptoms were less likely to be seronegative.Conclusions. In our population with previous RT-PCR-confirmed infection, approximately 1 in 16 persons lacked IgG antibodies. Absence of antibodies varied independently by illness severity, race/ethnicity, obesity, and immunosuppressive drug therapy. The proportion seronegative remained relatively stable among persons tested up to 90 days post symptom onset.