Mink Sylvia, Reimann Patrick, Fraunberger Peter
Central Medical Laboratories, Feldkirch, Austria.
Private University in the Principality of Liechtenstein, Triesen, Principality of Liechtenstein.
Clin Chem Lab Med. 2024 Feb 13;62(6):1029-1043. doi: 10.1515/cclm-2023-1487. Print 2024 May 27.
Globally, over 772 million cases of COVID-19 have been reported. New variants of interest with corresponding spikes in case numbers continue to be identified. Vulnerable patients, including older adults or patients with severe comorbidities, continue to be at risk. A large body of evidence has been accumulated regarding anti-SARS-CoV-2-antibodies and COVID-19 but the usefulness of antibody measurements remains unclear. This systematic review aims to assess the prognostic value of anti-SARS-CoV-2-antibodies and their usefulness for guiding booster vaccinations.
Studies in English and published between January 2020 and October 2023 were included. Studies that relied on multiparameter-models or comprised fewer than 100 participants were excluded. PubMed and via the WHO COVID-19 research database, Embase and Medline databases were searched. Study selection and quality assessment was conducted independently by two researchers.
After screening 1,160 studies, 33 studies comprising >30 million individuals were included. Anti-SARS-CoV-2-antibodies were strongly associated with reduced risk of SARS-CoV-2-infection and better outcomes, including mortality. Risk of infection and COVID-19 severity decreased with increasing antibody levels.
Anti-SARS-CoV-2-antibodies are useful for early identification of high-risk patients and timely adjustment of therapy. Protective thresholds may be applied to advise booster vaccinations but verification in separate cohorts is required.
全球已报告超过7.72亿例新冠肺炎病例。仍在不断发现引起关注的新变种，病例数相应激增。包括老年人或患有严重合并症的患者在内的脆弱患者仍然面临风险。关于抗SARS-CoV-2抗体与新冠肺炎，已经积累了大量证据，但抗体检测的实用性仍不明确。本系统评价旨在评估抗SARS-CoV-2抗体的预后价值及其在指导加强疫苗接种方面的实用性。
纳入2020年1月至2023年10月期间发表的英文研究。排除依赖多参数模型或参与者少于100人的研究。检索了PubMed以及通过世界卫生组织新冠肺炎研究数据库、Embase和Medline数据库。由两名研究人员独立进行研究选择和质量评估。
在筛选了1160项研究后，纳入了33项研究，涉及超过3000万人。抗SARS-CoV-2抗体与降低SARS-CoV-2感染风险及改善包括死亡率在内的预后密切相关。随着抗体水平的升高，感染风险和新冠肺炎严重程度降低。
抗SARS-CoV-2抗体有助于早期识别高危患者并及时调整治疗。保护阈值可用于指导加强疫苗接种建议，但需要在单独队列中进行验证。
