Department of Infectious Diseases, Karolinska University Hospital, SE-141 86, Stockholm, Sweden.
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
BMC Infect Dis. 2021 May 27;21(1):494. doi: 10.1186/s12879-021-06202-8.
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global pandemic. The understanding of the transmission and the duration of viral shedding in SARS-CoV-2 infection is still limited.
To assess the timeframe and potential risk of SARS-CoV-2 transmission from hospitalized COVID-19 patients in relation to antibody response.
We performed a cross-sectional study of 36 COVID-19 patients hospitalized at Karolinska University Hospital. Patients with more than 8 days of symptom duration were sampled from airways, for PCR analysis of SARS-CoV-2 RNA and in vitro culture of replicating virus. Serum SARS-CoV-2-specific immunoglobulin G (IgG) and neutralizing antibodies titers were assessed by immunofluorescence assay (IFA) and microneutralization assay.
SARS-CoV-2 RNA was detected in airway samples in 23 patients (symptom duration median 15 days, range 9-53 days), whereas 13 patients were SARS-CoV-2 RNA negative (symptom duration median 21 days, range 10-37 days). Replicating virus was detected in samples from 4 patients at 9-16 days. All but two patients had detectable levels of SARS-CoV-2-specific IgG in serum, and SARS-CoV-2 neutralizing antibodies were detected in 33 out of 36 patients. Total SARS-CoV-2-specific IgG titers and neutralizing antibody titers were positively correlated. High levels of both total IgG and neutralizing antibody titers were observed in patients sampled later after symptom onset and in patients where replicating virus could not be detected.
Our data suggest that the presence of SARS-Cov-2 specific antibodies in serum may indicate a lower risk of shedding infectious SARS-CoV-2 by hospitalized COVID-19 patients.
由严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引起的 2019 年冠状病毒病（COVID-19）是一种全球性大流行疾病。人们对 SARS-CoV-2 感染中的传播途径和病毒脱落持续时间的了解仍然有限。
评估与抗体反应相关的住院 COVID-19 患者中 SARS-CoV-2 传播的时间框架和潜在风险。
我们对在卡罗林斯卡大学医院住院的 36 例 COVID-19 患者进行了一项横断面研究。对症状持续时间超过 8 天的患者进行呼吸道采样，进行 SARS-CoV-2 RNA 的 PCR 分析和复制病毒的体外培养。通过免疫荧光分析（IFA）和微量中和试验评估 SARS-CoV-2 特异性免疫球蛋白 G（IgG）和中和抗体滴度。
在 23 例患者的气道样本中检测到 SARS-CoV-2 RNA（症状持续时间中位数为 15 天，范围为 9-53 天），而 13 例患者的 SARS-CoV-2 RNA 为阴性（症状持续时间中位数为 21 天，范围为 10-37 天）。在 9-16 天从 4 例患者的样本中检测到复制病毒。除 2 例患者外，所有患者的血清中均检测到可检测水平的 SARS-CoV-2 特异性 IgG，36 例患者中有 33 例检测到 SARS-CoV-2 中和抗体。SARS-CoV-2 特异性 IgG 总滴度和中和抗体滴度呈正相关。在症状发作后较晚采样的患者和未能检测到复制病毒的患者中，观察到高滴度的总 IgG 和中和抗体。
我们的数据表明，血清中存在 SARS-CoV-2 特异性抗体可能表明住院 COVID-19 患者传染性 SARS-CoV-2 脱落的风险较低。
