Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
Department of Internal Medicine V, Medical University of Innsbruck, Innsbruck, Austria.
Sci Rep. 2022 Mar 7;12(1):3677. doi: 10.1038/s41598-022-07489-6.
The CovILD study is a prospective, multicenter, observational cohort study to systematically follow up patients after coronavirus disease-2019 (COVID-19). We extensively evaluated 145 COVID-19 patients at 3 follow-up visits scheduled for 60, 100, and 180 days after initial confirmed diagnosis based on typical symptoms and a positive reverse transcription-polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). We employed comprehensive pulmonary function and laboratory tests, including serum concentrations of IgG against the viral spike (S) glycoprotein, and compared the results to clinical data and chest computed tomography (CT). We found that at the 60 day follow-up, 131 of 145 (90.3%) participants displayed S-specific serum IgG levels above the cut-off threshold. Notably, the highly elevated IgG levels against S glycoprotein positively correlated with biomarkers of immune activation and negatively correlated with pulmonary function and the extent of pulmonary CT abnormalities. Based on the association between serum S glycoprotein-specific IgG and clinical outcome, we generated an S-specific IgG-based recovery score that, when applied in the early convalescent phase, accurately predicted delayed pulmonary recovery after COVID-19. Therefore, we propose that S-specific IgG levels serve as a useful immunological surrogate marker for identifying at-risk individuals with persistent pulmonary injury who may require intensive follow-up care after COVID-19.
CovILD 研究是一项前瞻性、多中心、观察性队列研究，旨在对新冠肺炎（COVID-19）患者进行系统随访。我们在最初确诊后 60、100 和 180 天的 3 次随访中，对 145 例 COVID-19 患者进行了广泛评估，依据是典型症状和严重急性呼吸综合征冠状病毒-2（SARS-CoV-2）的逆转录-聚合酶链反应（RT-PCR）阳性。我们采用了全面的肺功能和实验室检测，包括针对病毒刺突（S）糖蛋白的血清 IgG 浓度，并将结果与临床数据和胸部计算机断层扫描（CT）进行了比较。我们发现，在 60 天随访时，145 例患者中有 131 例（90.3%）的 S 特异性血清 IgG 水平超过了临界值。值得注意的是，针对 S 糖蛋白的高 IgG 水平与免疫激活的生物标志物呈正相关，与肺功能和肺 CT 异常程度呈负相关。基于血清 S 糖蛋白特异性 IgG 与临床结局之间的关联，我们生成了一种基于 S 特异性 IgG 的恢复评分，在早期恢复期应用时，可准确预测 COVID-19 后肺部恢复的延迟。因此，我们提出 S 特异性 IgG 水平可作为识别持续性肺部损伤高危个体的有用免疫学替代标志物，这些个体在 COVID-19 后可能需要密切随访。
