Liu Xintian, Zheng Xuan, Liu Bo, Wu Mingxiang, Zhang Zhenlu, Zhang Gangcheng, Su Xi
Intensive Care Unit, Wuhan Asia General Hospital, Wuhan 430050, China.
Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan 430022, China.
Aging (Albany NY). 2020 Jul 6;12(13):12432-12440. doi: 10.18632/aging.103417.
Severe/critical patients with coronavirus disease 2019 (COVID-19) have become the central issue in the current global pandemic due to their high mortality rate. However, the relationship between antibody response and clinical outcomes has not been well described in this group. We conducted a single-center, retrospective, cohort study to investigate the relationship between serum immunoglobulin G (IgG) and IgM and clinical outcomes in severe/critical patients with COVID-19. Seventy-nine severe/critical patients with COVID-19 admitted in Wuhan Asia General Hospital in Wuhan, China during January 22, 2020 to March 6, 2020 were included. Serum antibodies were measured at day 25 (SD, 7) post illness onset. The median IgG titer was 113 (IQR 81-167) AU/ml, and IgM titer was 50 (IQR, 23-105) AU/ml. Patients whose IgM titer ≥ 50 AU/ml had higher in-hospital mortality (p=0.026). IgM titer ≥ 50 AU/ml was also correlated with higher incidences of Acute Respiratory Distress Syndrome (ARDS) and sepsis shock. Antibody remeasurements were performed in 42 patients, where IgM titer declined significantly in survivors (p0.031). Serum IgM titer changes according to the COVID-19 progression. The severe/critical patients with COVID-19 have a higher risk of clinical adverse events when IgM titer ≥ 50 AU/ml. Further decreasing of IgM could imply a better outcome in severe/critical cases.
2019冠状病毒病（COVID-19）的重症/危重症患者因其高死亡率已成为当前全球大流行的核心问题。然而，该群体中抗体反应与临床结局之间的关系尚未得到充分描述。我们进行了一项单中心、回顾性队列研究，以调查重症/危重症COVID-19患者血清免疫球蛋白G（IgG）和IgM与临床结局之间的关系。纳入了2020年1月22日至2020年3月6日在中国武汉亚洲心脏病医院收治的79例重症/危重症COVID-19患者。在发病后第25天（标准差7天）检测血清抗体。IgG滴度中位数为113（四分位间距81-167）AU/ml，IgM滴度为50（四分位间距，23-'105）AU/ml。IgM滴度≥50 AU/ml的患者院内死亡率更高（p=0.026）。IgM滴度≥50 AU/ml也与急性呼吸窘迫综合征（ARDS）和脓毒症休克的更高发生率相关。对42例患者进行了抗体复测，其中幸存者的IgM滴度显著下降（p<0.031）。血清IgM滴度随COVID-19病程变化。当IgM滴度≥50 AU/ml时，重症/危重症COVID-19患者发生临床不良事件的风险更高。在重症/危重症病例中，IgM进一步下降可能意味着预后更好。
