血清学研究表明，百岁老人和患有衰弱症的极高龄老人在感染病毒后可产生具有病毒中和功能的持久性严重急性呼吸综合征冠状病毒2（SARS-CoV-2）刺突特异性免疫球蛋白G（IgG）抗体。
Centenarians and extremely old people living with frailty can elicit durable SARS-CoV-2 spike specific IgG antibodies with virus neutralization functions following virus infection as determined by serological study.
作者信息
Foley Mary K, Searle Samuel D, Toloue Ali, Booth Ryan, Falkenham Alec, Falzarano Darryl, Rubino Salvatore, Francis Magen E, McNeil Mara, Richardson Christopher, LeBlanc Jason, Oldford Sharon, Gerdts Volker, Andrew Melissa K, McNeil Shelly A, Clarke Barry, Rockwood Kenneth, Kelvin David J, Kelvin Alyson A
机构信息
Department of Microbiology and Immunology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, B3H 4R2, Canada.
Divsion of Geriatrics, Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, B3H 4R2, Canada.
出版信息
EClinicalMedicine. 2021 Jul;37:100975. doi: 10.1016/j.eclinm.2021.100975. Epub 2021 Jun 27.
BACKGROUND
The SARS-CoV-2 (Severe Acute Respiratory Syndrome coronavirus 2) has led to more than 165 million COVID-19 cases and >3.4 million deaths worldwide. Epidemiological analysis has revealed that the risk of developing severe COVID-19 increases with age. Despite a disproportionate number of older individuals and long-term care facilities being affected by SARS-CoV-2 and COVID-19, very little is understood about the immune responses and development of humoral immunity in the extremely old person after SARS-CoV-2 infection. Here we conducted a serological study to investigate the development of humoral immunity in centenarians following a SARS-CoV-2 outbreak in a long-term care facility.
METHODS
Extreme aged individuals and centenarians who were residents in a long-term care facility and infected with or exposed to SARS-CoV-2 were investigated between April and June 2020 for the development of antibodies to SARS-CoV-2. Blood samples were collected from positive and bystander individuals 30 and 60 days after original diagnosis of SARS-CoV-2 infection. Plasma was used to quantify IgG, IgA, and IgM isotypes and subsequent subclasses of antibodies specific for SARS-CoV-2 spike protein. The function of anti-spike was then assessed by virus neutralization assays against the native SARS-CoV-2 virus.
FINDINGS
Fifteen long-term care residents were investigated for SARS-CoV-2 infection. All individuals had a Clinical Frailty scale score ≥5 and were of extreme older age or were centenarians. Six women with a median age of 98.8 years tested positive for SARS-CoV-2. Anti-spike IgG antibody titers were the highest titers observed in our cohort with all IgG positive individuals having virus neutralization ability. Additionally, 5 out of the 6 positive participants had a robust IgA anti-SARS-CoV-2 response. In all 5, antibodies were detected after 60 days from initial diagnosis.
背景
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）已在全球导致超过1.65亿例新冠肺炎病例和超过340万例死亡。流行病学分析表明，患重症新冠肺炎的风险随年龄增长而增加。尽管有不成比例数量的老年人和长期护理机构受到SARS-CoV-2和新冠肺炎的影响，但对于SARS-CoV-2感染后极老龄人群的免疫反应和体液免疫发展了解甚少。在此，我们进行了一项血清学研究，以调查长期护理机构中发生SARS-CoV-2疫情后百岁老人的体液免疫发展情况。
方法
对2020年4月至6月期间居住在长期护理机构且感染或接触过SARS-CoV-2的极老龄个体和百岁老人进行调查，以检测其针对SARS-CoV-2的抗体产生情况。在SARS-CoV-2感染最初诊断后的30天和60天，从阳性个体和旁观者个体采集血样。血浆用于定量IgG、IgA和IgM同种型以及随后针对SARS-CoV-2刺突蛋白的抗体亚类。然后通过针对天然SARS-CoV-2病毒的病毒中和试验评估抗刺突抗体的功能。
研究结果
对15名长期护理机构居民进行了SARS-CoV-2感染调查。所有个体的临床衰弱量表评分均≥5，均为极老龄或百岁老人。6名年龄中位数为98.8岁的女性SARS-CoV-2检测呈阳性。抗刺突IgG抗体滴度是我们队列中观察到的最高滴度，所有IgG阳性个体均具有病毒中和能力。此外，6名阳性参与者中有5人对SARS-CoV-2产生了强烈的IgA反应。在所有5人中，抗体在初次诊断60天后被检测到。
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