意大利某转诊 COVID-19 医院中针对 SARS-CoV-2 感染的 IgA 和 IgG 抗体反应特征。
Characteristic of IgA and IgG antibody response to SARS-CoV-2 infection in an Italian referral COVID-19 Hospital.
机构信息
Department of Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Department of Laboratory Sciences and Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
出版信息
Intern Emerg Med. 2022 Jan;17(1):53-64. doi: 10.1007/s11739-021-02750-8. Epub 2021 May 10.
INTRODUCTION
Antibody response plays a fundamental role in the natural history of infectious disease. A better understanding of the immune response in patients with SARS-CoV-2 infection could be important for identifying patients at greater risk of developing a more severe form of disease and with a worse prognosis.
METHODS
We performed a cross-sectional analysis to determine the presence and the levels of both anti-SARS-CoV-2 IgG and IgA in a cohort of hospitalized patients with confirmed infection at different times in the natural history of the disease. Patients enrolled when admitted at the emergency department were prospectively followed up during hospital stay.
RESULTS
Overall, 131 patients were considered with a total of 237 samples processed. Cross-sectional analysis showed that seroconversion for IgA seems to occur between days 6 and 15, while IgG response seems to occur slightly later, peaking at day 20 after symptoms onset. Both IgA and IgG were maintained beyond 2 months. Severe patients showed a higher IgA response compared with mild patients when analyzing optical density (8.3 versus 5.6, p < 0.001). Prospective analysis conducted on 55 patients confirmed that IgA appear slightly earlier than IgG. After stratifying for the severity of disease, both the IgA and IgG responses were more vigorous in severe cases. Moreover, while IgG tended to stabilize, there was a relevant decline after the first month of IgA levels in mild cases.
CONCLUSION
IgA and IgG antibody response is closely related, although seroconversion for IgA occurs earlier. Both IgA and IgG are maintained beyond 2 months. Severe patients showed a more vigorous IgA and IgG response. IgA levels seem to decline after 1 month since the onset of symptoms in mild cases. Our results should be interpreted with cautions due to several limitations in our study, mainly the small number of cases, lack of data on viral load and clinical setting.
简介
抗体反应在传染病的自然史中起着至关重要的作用。更好地了解 SARS-CoV-2 感染患者的免疫反应对于识别发生更严重疾病和预后更差的风险较高的患者可能很重要。
方法
我们进行了一项横断面分析，以确定在疾病自然史的不同时间点确诊感染的住院患者中 SARS-CoV-2 抗体 IgG 和 IgA 的存在和水平。在急诊科入院时入组的患者在住院期间进行了前瞻性随访。
结果
总体而言，共考虑了 131 例患者，共处理了 237 个样本。横断面分析表明，IgA 的血清转换似乎发生在第 6 至 15 天之间，而 IgG 反应似乎发生得稍晚，在症状出现后第 20 天达到峰值。IgA 和 IgG 均在 2 个月后维持。在分析光密度时，重症患者的 IgA 反应明显高于轻症患者（8.3 对 5.6，p<0.001）。对 55 例患者进行的前瞻性分析证实，IgA 出现的时间略早于 IgG。对疾病严重程度进行分层后，重症病例的 IgA 和 IgG 反应均更为强烈。此外，尽管 IgG 趋于稳定，但在轻症病例的 IgA 水平第一个月后出现明显下降。
结论
IgA 和 IgG 抗体反应密切相关，尽管 IgA 的血清转换发生较早。IgA 和 IgG 均在 2 个月后维持。重症患者表现出更强烈的 IgA 和 IgG 反应。在轻症病例中，自症状出现以来 1 个月后，IgA 水平似乎下降。由于我们研究中的几个限制，包括病例数较少、缺乏病毒载量和临床背景的数据，我们的结果应谨慎解释。
Zotero 插件