Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019

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Abstract

Background

The novel coronavirus SARS-CoV-2 is a newly emerging virus. The antibody response in infected patient remains largely unknown, and the clinical values of antibody testing have not been fully demonstrated.

Methods

A total of 173 patients with SARS-CoV-2 infection were enrolled. Their serial plasma samples (n=535) collected during the hospitalization were tested for total antibodies (Ab), IgM and IgG against SARS-CoV-2. The dynamics of antibodies with the disease progress was analyzed.

Results

Among 173 patients, the seroconversion rate for Ab, IgM and IgG was 93.1%, 82.7% and 64.7%, respectively. The reason for the negative antibody findings in 12 patients might due to the lack of blood samples at the later stage of illness. The median seroconversion time for Ab, IgM and then IgG were day-11, day-12 and day-14, separately. The presence of antibodies was <40% among patients within 1-week since onset, and rapidly increased to 100.0% (Ab), 94.3% (IgM) and 79.8% (IgG) since day-15 after onset. In contrast, RNA detectability decreased from 66.7% (58/87) in samples collected before day-7 to 45.5% (25/55) during day 15-39. Combining RNA and antibody detections significantly improved the sensitivity of pathogenic diagnosis for COVID-19 (p<0.001), even in early phase of 1-week since onset (p=0.007). Moreover, a higher titer of Ab was independently associated with a worse clinical classification (p=0.006).

Conclusions

The antibody detection offers vital clinical information during the course of SARS-CoV-2 infection. The findings provide strong empirical support for the routine application of serological testing in the diagnosis and management of COVID-19 patients.

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Author and article information

Journal

Journal ID (nlm-ta): Clin Infect Dis

Journal ID (iso-abbrev): Clin. Infect. Dis

Journal ID (publisher-id): cid

Title: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America

Publisher: Oxford University Press (US )

ISSN (Print): 1058-4838

ISSN (Electronic): 1537-6591

Publication date (Electronic): 28 March 2020

Publication date PMC-release: 28 March 2020

Electronic Location Identifier: ciaa344

Affiliations

[1 ] Institute of Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People’s Hospital , Shenzhen, Guangdong Province, China

[2 ] The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health & School of Life Science, Xiamen University , Xiamen, Fujian, China

[3 ] Department for Infectious Diseases, Shenzhen Third People’s Hospital , Shenzhen, Guangdong Province, China

[4 ] School of Public Health, Xiamen University , Xiamen, Fujian, China

[5 ] Department of Critical Care Medicine，Shenzhen Third People’s Hospital , Shenzhen, Guangdong Province, China

[6 ] The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology , Shenzhen, Guangdong Province, China

[7 ] School of Medicine, Southern University of Science and Technology , Shenzhen, Guangdong Province, China

Author notes

Corresponding Authors: Prof. Zheng Zhang, PhD, MD. Institute of Hepatology, Shenzhen 3rd People’s Hospital, Shenzhen 518112, Guangdong Province, China; Phone: 86-755-81238983; Fax: 86-755-81238983; Email: zhangzheng1975@ 123456aliyun.com .

Drs. Zhao, Yuan, Wang, Liu, Liao and Su contributed equally to this article.

Article

Publisher ID: ciaa344

DOI: 10.1093/cid/ciaa344

PMC ID: 7184337

PubMed ID: 32221519

SO-VID: d828cf89-e267-4300-b719-b8f679fd1a4f

License:

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