Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, South Korea.
Department of Radiology, Chung-Ang University Hospital, Seoul, South Korea.
J Microbiol Immunol Infect. 2022 Dec;55(6 Pt 1):1094-1100. doi: 10.1016/j.jmii.2022.04.005. Epub 2022 May 5.
It remains unclear whether high titers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies aggravate clinical manifestations in patients or whether severe clinical manifestations result in high antibody titers. Thus, we investigated the cause-effect relationship between SARS-CoV-2 antibody titers and disease severity.
We prospectively enrolled patients admitted with the diagnosis of coronavirus disease-19 (COVID-19) from February 2020 to August 2020. We measured SARS-CoV-2 antibody titers, namely anti-receptor-binding domain (RBD) antibody and neutralizing antibody (NAb), from blood samples and calculated the chest radiograph (CXR) scores of the patients to evaluate the severity of COVID-19.
Overall, 40 patients with COVID-19 were enrolled. Pneumonia was observed in more than half of the patients (25/40, 60%). SARS-CoV-2 antibody titers were higher in patients who were aged >60 years (anti-RBD antibodies, P = 0.003 and NAb, P = 0.009), presented with pneumonia (P = 0.006 and 0.007, respectively), and required oxygen therapy (P = 0.003 and 0.004, respectively) than in those who were not. CXR scores peaked (at 15-21 days after the onset of symptoms) statistically significantly earlier than SARS-CoV-2 antibody titers (at 22-30 days for NAb and at 31-70 days for anti-RBD antibody). There was a close correlation between the maximum CXR score and the maximum SAR-CoV-2 antibody titer.
Based on the comparison of the peak time of SARS-CoV-2 antibody titers with the CXR score after symptom onset, we suggest that severe clinical manifestations result in high titers of SARS-CoV-2 antibodies.
目前尚不清楚严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）抗体的高滴度是否会加重患者的临床表现，或者严重的临床表现是否会导致高抗体滴度。因此，我们研究了 SARS-CoV-2 抗体滴度与疾病严重程度之间的因果关系。
我们前瞻性地招募了 2020 年 2 月至 2020 年 8 月因冠状病毒病-19（COVID-19）住院的患者。我们从血液样本中测量了 SARS-CoV-2 抗体滴度，即抗受体结合域（RBD）抗体和中和抗体（NAb），并计算了患者的胸部 X 线（CXR）评分，以评估 COVID-19 的严重程度。
总体而言，共纳入了 40 例 COVID-19 患者。超过一半的患者（25/40，60%）出现肺炎。年龄>60 岁的患者（抗-RBD 抗体，P=0.003 和 NAb，P=0.009）、有肺炎（P=0.006 和 0.007，分别）和需要氧疗（P=0.003 和 0.004，分别）的患者 SARS-CoV-2 抗体滴度较高。CXR 评分的峰值（症状出现后 15-21 天）明显早于 SARS-CoV-2 抗体滴度（NAb 的峰值为 22-30 天，抗-RBD 抗体的峰值为 31-70 天）。最大 CXR 评分与最大 SARS-CoV-2 抗体滴度之间存在密切相关性。
根据 SARS-CoV-2 抗体滴度峰值与症状出现后 CXR 评分的比较，我们认为严重的临床表现导致 SARS-CoV-2 抗体的高滴度。
