Sun Jin, Yang Zhen-Dong, Xie Xiong, Li Li, Zeng Hua-Song, Gong Bo, Xu Jian-Qiang, Wu Ji-Hong, Qu Bei-Bei, Song Guo-Wei
Medical Innovation Research Office, Sinopharm Gezhouba Central Hospital, Third Clinical Medical College of Three Gorges University, Yichang 443002, Hubei Province, China.
Department of Respiratory, Beijing Jindu Children Hospital, Beijing 102208, China.
World J Clin Cases. 2023 Apr 6;11(10):2168-2180. doi: 10.12998/wjcc.v11.i10.2168.
The purpose of this study was to investigate the clinical application of severe acute respiratory distress syndrome coronavirus-2 (SARS-CoV-2) specific antibody detection and anti-SARS-CoV-2 specific monoclonal antibodies (mAbs) in the treatment of coronavirus infectious disease 2019 (COVID-19). The dynamic changes of SARS-CoV-2 specific antibodies during COVID-19 were studied. Immunoglobulin M (IgM) appeared earlier and lasted for a short time, while immunoglobulin G (IgG) appeared later and lasted longer. IgM tests can be used for early diagnosis of COVID-19, and IgG tests can be used for late diagnosis of COVID-19 and identification of asymptomatic infected persons. The combination of antibody testing and nucleic acid testing, which complement each other, can improve the diagnosis rate of COVID-19. Monoclonal anti-SARS-CoV-2 specific antibodies can be used to treat hospitalized severe and critically ill patients and non-hospitalized mild to moderate COVID-19 patients. COVID-19 convalescent plasma, highly concentrated immunoglobulin, and anti-SARS-CoV-2 specific mAbs are examples of anti-SARS-CoV-2 antibody products. Due to the continuous emergence of mutated strains of the novel coronavirus, especially omicron, its immune escape ability and infectivity are enhanced, making the effects of authorized products reduced or invalid. Therefore, the optimal application of anti-SARS-CoV-2 antibody products (especially anti-SARS-CoV-2 specific mAbs) is more effective in the treatment of COVID-19 and more conducive to patient recovery.
本研究旨在探讨严重急性呼吸综合征冠状病毒2（SARS-CoV-2）特异性抗体检测及抗SARS-CoV-2特异性单克隆抗体（mAbs）在2019冠状病毒病（COVID-19）治疗中的临床应用。研究了COVID-19期间SARS-CoV-2特异性抗体的动态变化。免疫球蛋白M（IgM）出现较早且持续时间短，而免疫球蛋白G（IgG）出现较晚且持续时间长。IgM检测可用于COVID-19的早期诊断，IgG检测可用于COVID-19的晚期诊断及无症状感染者的识别。抗体检测与核酸检测相互补充，可提高COVID-19的诊断率。抗SARS-CoV-2特异性单克隆抗体可用于治疗住院的重症和危重症患者以及非住院的轻至中度COVID-19患者。COVID-19康复期血浆、高浓度免疫球蛋白和抗SARS-CoV-2特异性mAbs均为抗SARS-CoV-2抗体产品的实例。由于新型冠状病毒变异株不断出现，尤其是奥密克戎，其免疫逃逸能力和传染性增强，导致获批产品的效果降低或无效。因此，优化抗SARS-CoV-2抗体产品（尤其是抗SARS-CoV-2特异性mAbs）的应用在治疗COVID-19方面更有效，更有利于患者康复。
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