Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Lancet Microbe. 2020 Nov;1(7):e283-e289. doi: 10.1016/S2666-5247(20)30120-8. Epub 2020 Sep 25.
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.
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严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）已在全球范围内引发大流行。血清学转换的感染者比例仍是一个悬而未决的问题。此外，在一些个体中已经表明，在症状缓解后，病毒基因组可检测长达 3 个月。我们在纽约市（美国）地区的大型恢复期血清供体队列中研究了血清学转换和 PCR 阳性率。
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（美国田纳西州纳什维尔市范德比尔特大学）在线调查回复招募参与者。通过 PCR 检测病毒基因组和 ELISA 检测抗 SARS-CoV-2 刺突抗体来筛选确诊或疑似 SARS-CoV-2 感染的个体。使用单因素方差分析和 Fisher 精确检验来测量年龄、性别、症状持续时间以及从症状发作到缓解的天数与抗体阳性结果之间的关联。
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。在完成 4 周后进行血清学检查的 624 名确诊 SARS-CoV-2 感染患者中，除 3 名患者外，所有患者均对 SARS-CoV-2 刺突蛋白发生血清学转换，而在 719 名疑似 SARS-CoV-2 感染患者中，有 269 名（37%）发生血清学转换。PCR 阳性可在症状缓解后 28 天内检测到。
大多数确诊 COVID-19 的患者发生血清学转换，可能对再次感染提供免疫力。我们还报告说，在很大一部分个体中，病毒基因组可通过 PCR 在症状缓解后数周内在上呼吸道中检测到，但尚不清楚该信号是否代表传染性病毒。对我们的大型队列的分析表明，大多数轻度 COVID-19 患者在发病后 4 周发生血清学转换，并对使用 PCR 清除阳性个体提出质疑。
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