The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, China.
Center for Global Health, School of Public Health, Nanjing Medical University, 211166, Nanjing, Jiangsu, China.
Nat Commun. 2020 Nov 27;11(1):6044. doi: 10.1038/s41467-020-19943-y.
Deciphering the dynamic changes in antibodies against SARS-CoV-2 is essential for understanding the immune response in COVID-19 patients. Here we analyze the laboratory findings of 1,850 patients to describe the dynamic changes of the total antibody, spike protein (S)-, receptor-binding domain (RBD)-, and nucleoprotein (N)-specific immunoglobulin M (IgM) and G (IgG) levels during SARS-CoV-2 infection and recovery. The generation of S-, RBD-, and N-specific IgG occurs one week later in patients with severe/critical COVID-19 compared to patients with mild/moderate disease, while S- and RBD-specific IgG levels are 1.5-fold higher in severe/critical patients during hospitalization. The RBD-specific IgG levels are 4-fold higher in older patients than in younger patients during hospitalization. In addition, the S- and RBD-specific IgG levels are 2-fold higher in the recovered patients who are SARS-CoV-2 RNA negative than those who are RNA positive. Lower S-, RBD-, and N-specific IgG levels are associated with a lower lymphocyte percentage, higher neutrophil percentage, and a longer duration of viral shedding. Patients with low antibody levels on discharge might thereby have a high chance of being tested positive for SARS-CoV-2 RNA after recovery. Our study provides important information for COVID-19 diagnosis, treatment, and vaccine development.
解析针对 SARS-CoV-2 的抗体的动态变化对于理解 COVID-19 患者的免疫反应至关重要。在这里，我们分析了 1850 名患者的实验室检查结果，以描述 SARS-CoV-2 感染和康复期间总抗体、刺突蛋白（S）、受体结合域（RBD）和核衣壳蛋白（N）特异性免疫球蛋白 M（IgM）和 G（IgG）水平的动态变化。与轻症/中度疾病患者相比，重症/危重症 COVID-19 患者的 S-、RBD-和 N-特异性 IgG 的产生滞后一周，而住院期间重症/危重症患者的 S-和 RBD-特异性 IgG 水平高 1.5 倍。住院期间，老年患者的 RBD 特异性 IgG 水平比年轻患者高 4 倍。此外，在 SARS-CoV-2 RNA 阴性的康复患者中，S-和 RBD-特异性 IgG 水平是 RNA 阳性患者的 2 倍。较低的 S-、RBD-和 N-特异性 IgG 水平与较低的淋巴细胞百分比、较高的中性粒细胞百分比和较长的病毒脱落持续时间相关。出院时抗体水平较低的患者在康复后可能有很高的机会检测到 SARS-CoV-2 RNA 阳性。我们的研究为 COVID-19 的诊断、治疗和疫苗开发提供了重要信息。
