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新冠康复患者体内特异性抗体的动态变化

Dynamics of specific antibodies in COVID-19 patients after recovery.

作者信息

Deng Zhi-Bo, Cheng Feng, Zhang Yong

机构信息

Department of General Surgery, Jianli People's Hospital, Jingzhou, China.

Department of Clinical Laboratory, Jianli People's Hospital, Jingzhou, China.

出版信息

Epidemiol Infect. 2022 Mar 22;150:1-27. doi: 10.1017/S0950268822000528.

Abstract

The ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to an unprecedented global public health crisis. The objectives of this study were to analyse the dynamic trend in specific antibodies in the serum of patients infected with SARS-CoV-2 within 12 months after recovery and to make a preliminary assessment of the protective effect of vaccination. Eighty-seven patients with confirmed COVID-19 who were admitted to our hospital from January to February 2020 were followed after recovery. Three-millilitre blood samples were collected for specific antibody detection at four time points: 1, 6 and 12 months after recovery and 1 month after vaccination. The changes in specific immunoglobulin G (IgG) antibody and total antibody levels over 12 months were analysed. Moreover, an independent comparison of the neutralising antibody levels of patients after vaccination with those of healthy medical staff after vaccination was performed to compare the inhibition rates of the neutralising antibody to the virus. No statistically significant difference in the sex distribution between groups was observed ( > 0.05). Older patients had a greater risk of developing severe and critical COVID-19 ( < 0.05). The percentages of subjects positive for IgG antibodies at 1, 6 and 12 months after recovery were 88.5%, 75.9% and 50.6%, respectively. The rate of IgG antibody conversion from positive to negative was not uniform across time points: the change was slow in the first 6 months but increased significantly in the last 6 months ( < 0.05). The positive rate of critically ill patients in the first 6 months was 100.0%. The trend over time in total antibody levels was similar to that of IgG antibody levels. Over 12 months, the sample/cut off value of total antibodies continued to decrease, while that of different disease severities was significantly different ( < 0.05). After vaccine administration, the total antibody level exceeded the detection level in the first month, which was independent of disease severity ( > 0.05). Significant differences were observed in the inhibition rate of the neutralising antibody against the virus in the disease group and the control group ( < 0.05). IgG antibody produced by patients naturally infected with SARS-CoV-2 has a duration of no less than 1 year, and the change trend graph of total antibody levels was the same as that of IgG antibody levels. Under vaccine stimulation, the positive rate of IgG antibody was as high as 100%, and the total antibody concentration reached the highest level, which was independent of disease severity. Neutralising antibodies following vaccination in patients who recovered from COVID-19 had a higher inhibition rate against SARS-CoV-2 than those of vaccinated healthy controls, indicating that these COVID-19 patients had a lower risk of reinfection and were better protected.

摘要

由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的2019冠状病毒病(COVID-19)大流行已导致一场前所未有的全球公共卫生危机。本研究的目的是分析SARS-CoV-2感染患者康复后12个月内血清中特异性抗体的动态变化趋势,并对疫苗接种的保护效果进行初步评估。对2020年1月至2月入住我院的87例确诊COVID-19患者康复后进行随访。在四个时间点采集3毫升血液样本进行特异性抗体检测:康复后1个月、6个月和12个月以及接种疫苗后1个月。分析了12个月内特异性免疫球蛋白G(IgG)抗体和总抗体水平的变化。此外,对患者接种疫苗后的中和抗体水平与健康医护人员接种疫苗后的中和抗体水平进行独立比较,以比较中和抗体对病毒的抑制率。各组间性别分布无统计学显著差异(P>0.05)。老年患者发生重症和危重症COVID-19的风险更大(P<0.05)。康复后1个月、6个月和12个月时IgG抗体阳性受试者的比例分别为88.5%、75.9%和50.6%。IgG抗体从阳性转为阴性的速率在各时间点并不一致:前6个月变化缓慢,但后6个月显著增加(P<0.05)。重症患者在前6个月的阳性率为100.0%。总抗体水平随时间的变化趋势与IgG抗体水平相似。在12个月内,总抗体的样本/临界值持续下降,而不同疾病严重程度的样本/临界值有显著差异(P<0.05)。接种疫苗后,总抗体水平在第1个月超过检测水平,且与疾病严重程度无关(P>0.05)。疾病组和对照组中中和抗体对病毒的抑制率存在显著差异(P<0.05)。SARS-CoV-2自然感染患者产生的IgG抗体持续时间不少于1年,总抗体水平的变化趋势图与IgG抗体水平相同。在疫苗刺激下,IgG抗体阳性率高达100%,总抗体浓度达到最高水平,且与疾病严重程度无关。COVID-19康复患者接种疫苗后的中和抗体对SARS-CoV-2的抑制率高于接种疫苗的健康对照者,表明这些COVID-19患者再次感染的风险较低,受到的保护更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55be/8987644/6a54904c13a1/S0950268822000528_fig1.jpg

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