Division of Immunology, Transplantation and Infectious Disease, Immunobiology of HIV Group, San Raffaele Scientific Institute, Milan, Italy.
University Centre of Statistics in the Biomedical Sciences, Vita-Salute San Raffaele University, Milan, Italy.
Front Immunol. 2021 Nov 3;12:772239. doi: 10.3389/fimmu.2021.772239. eCollection 2021.
This contribution explores in a new statistical perspective the antibody responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 141 coronavirus disease 2019 (COVID-19) patients exhibiting a broad range of clinical manifestations. This cohort accurately reflects the characteristics of the first wave of the SARS-CoV-2 pandemic in Italy. We determined the IgM, IgA, and IgG levels towards SARS-CoV-2 S1, S2, and NP antigens, evaluating their neutralizing activity and relationship with clinical signatures. Moreover, we longitudinally followed 72 patients up to 9 months postsymptoms onset to study the persistence of the levels of antibodies. Our results showed that the majority of COVID-19 patients developed an early virus-specific antibody response. The magnitude and the neutralizing properties of the response were heterogeneous regardless of the severity of the disease. Antibody levels dropped over time, even though spike reactive IgG and IgA were still detectable up to 9 months. Early baseline antibody levels were key drivers of the subsequent antibody production and the long-lasting protection against SARS-CoV-2. Importantly, we identified anti-S1 IgA as a good surrogate marker to predict the clinical course of COVID-19. Characterizing the antibody response after SARS-CoV-2 infection is relevant for the early clinical management of patients as soon as they are diagnosed and for implementing the current vaccination strategies.
本研究从新的统计角度探讨了 141 例具有广泛临床表现的 2019 年冠状病毒病(COVID-19)患者对严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的抗体反应。该队列准确反映了 SARS-CoV-2 在意大利的第一波大流行的特征。我们测定了针对 SARS-CoV-2 S1、S2 和 NP 抗原的 IgM、IgA 和 IgG 水平,评估了其中和活性及其与临床特征的关系。此外,我们对 72 例患者进行了长达 9 个月的随访,以研究抗体水平的持续时间。结果表明,大多数 COVID-19 患者产生了早期的病毒特异性抗体反应。无论疾病的严重程度如何,反应的幅度和中和特性均存在异质性。抗体水平随时间下降,尽管 Spike 反应性 IgG 和 IgA 仍可检测到 9 个月。早期基线抗体水平是随后产生抗体和对 SARS-CoV-2 产生长期保护的关键驱动因素。重要的是,我们确定了抗 S1 IgA 是预测 COVID-19 临床过程的良好替代标志物。对 SARS-CoV-2 感染后的抗体反应进行特征分析,对于患者一旦被诊断后尽早进行临床管理以及实施当前的疫苗接种策略具有重要意义。
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