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美国两个城市住院患者中新冠病毒 IgM 和 IgG 血清转化情况的比较。

Comparison of SARS-CoV-2 IgM and IgG seroconversion profiles among hospitalized patients in two US cities.

作者信息

Orner Erika P, Rodgers Mary A, Hock Karl, Tang Mei San, Taylor Russell, Gardiner Mary, Olivo Ana, Fox Amy, Prostko John, Cloherty Gavin, Farnsworth Christopher W

机构信息

Department of Pathology, Montefiore Medical Center, Bronx, NY, USA.

Abbott Laboratories, IL, USA.

出版信息

Diagn Microbiol Infect Dis. 2021 Apr;99(4):115300. doi: 10.1016/j.diagmicrobio.2020.115300. Epub 2020 Dec 24.

Abstract

The clinical and public health utility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serologic testing requires a better understanding of the dynamics of the humoral response to infection. To track seroconversion of IgG and IgM antibodies in patients with SARS-CoV-2 infection and its association with patient and clinical factors and outcomes. Residual patient specimens were analyzed on the Abbott ARCHITECT i2000 instrument using the Abbott SARS-CoV-2 IgG assay and prototype SARS-CoV-2 IgM assay. Age, sex, comorbidities, symptom onset date, mortality, and specimen collection date were obtained from electronic medical records. Three hundred fifty-nine longitudinal samples were collected from 89 hospitalized patients 0 to 82 days postsymptom onset. Of all, 51.7% of the patients developed IgG and IgM antibodies simultaneously; 32.8% seroconverted for IgM before IgG. On average, patients seroconverted for IgG by 8 days and for IgM by 7 days postsymptom onset. All patients achieved IgG seropositivity by 19 days and IgM seropositivity by 17 days. Median time to IgG and IgM seroconversion was prolonged and initial levels of IgG were lower in immunocompromised patients and patients <65 years of age compared to immune competent patients and those ≥65 years of age. Immunocompromised patients also had persistently lower levels of IgM that peaked on day 17.6 and decreased thereafter compared to immune competent patients. IgM seroconversion in patients who died reached significantly higher levels later after symptom onset than in those who recovered. SARS-CoV-2 infected patients have similar time to seroconversion for IgG and IgM. However, differences in immune status and age alter time to seroconversion. These results may help guide serologic testing application in COVID-19 management.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)血清学检测的临床和公共卫生效用需要更好地了解对感染的体液反应动态。以追踪SARS-CoV-2感染患者中IgG和IgM抗体的血清转化及其与患者、临床因素和结局的关联。使用雅培SARS-CoV-2 IgG检测方法和SARS-CoV-2 IgM检测原型,在雅培ARCHITECT i2000仪器上对剩余患者标本进行分析。从电子病历中获取年龄、性别、合并症、症状出现日期、死亡率和标本采集日期。在症状出现后0至82天,从89名住院患者中收集了359份纵向样本。其中,51.7%的患者同时产生了IgG和IgM抗体;32.8%的患者在IgG之前出现IgM血清转化。平均而言,患者在症状出现后8天出现IgG血清转化,7天出现IgM血清转化。所有患者在19天达到IgG血清阳性,17天达到IgM血清阳性。与免疫功能正常的患者和65岁及以上的患者相比,免疫功能低下的患者和65岁以下的患者IgG和IgM血清转化的中位时间延长,IgG初始水平较低。免疫功能低下的患者IgM水平也持续较低,在第17.6天达到峰值,此后与免疫功能正常的患者相比有所下降。死亡患者的IgM血清转化在症状出现后比康复患者达到更高水平的时间更晚。SARS-CoV-2感染患者的IgG和IgM血清转化时间相似。然而,免疫状态和年龄的差异会改变血清转化时间。这些结果可能有助于指导COVID-19管理中的血清学检测应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/724d/7759125/738d76be6f86/gr1_lrg.jpg

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