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Antibody Responses to SARS-CoV-2 in Patients of Novel Coronavirus Disease 2019

31 Pages Posted: 3 Mar 2020

See all articles by Juanjuan Zhao

Juanjuan Zhao

Zhengzhou University - Department of Hematology

Quan Yuan

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Haiyan Wang

Southern University of Science and Technology - Institute of Hepatology

Wei Liu

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Xuejiao Liao

Southern University of Science and Technology - Institute of Hepatology

Yingying Su

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Xin Wang

Southern University of Science and Technology - Institute of Hepatology

Jing Yuan

Southern University of Science and Technology - Department of Infectious Diseases

Tingdong Li

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Jinxiu Li

Southern University of Science and Technology - Department of Critical Care Medicine

Shen Qian

Southern University of Science and Technology - Institute of Hepatology

Congming Hong

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Fuxiang Wang

Southern University of Science and Technology - Department of Critical Care Medicine

Liu Yingxia

Southern University of Science and Technology - State Key Discipline of Infectious Disease

Wang Zhaoqin

Southern University of Science and Technology - Diagnosis and Treatment of Infectious Diseases Research Laboratory

He Qing

Southern University of Science and Technology - National Clinical Research Center for Infectious Diseases

Bin He

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Tianying Zhang

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Shengxiang Ge

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Lei Liu

Southern University of Science and Technology - Diagnosis and Treatment of Infectious Diseases Research Laboratory

Jun Zhang

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Ningshao Xia

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Zheng Zhang

302 Military Hospital, Center of Therapeutic Research for Liver Cancer; Southern University of Science and Technology - Institute of Hepatology

More...

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

Findings: Among 173 patients, the seroconversion rate for Ab, IgM and IgG was 93.1% (161/173), 82.7% (143/173) and 64.7% (112/173), respectively. Twelve patients who had not seroconverted were those only blood samples at the early stage of illness were collected. The seroconversion sequentially appeared for Ab, IgM and then IgG, with a median time of 11, 12 and 14 days, respectively. The presence of antibodies was < 40% among patients in the first 7 days of illness, and then rapidly increased to 100.0%, 94.3% and 79.8% for Ab, IgM and IgG respectively since day 15 after onset. In contrast, the positive rate of RNA decreased from 66.7% (58/87) in samples collected before day 7 to 45.5% (25/55) during days 15 to 39. Combining RNA and antibody detections significantly improved the sensitivity of pathogenic diagnosis for COVID-19 patients (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).

Interpretation: 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.

Funding Statement: This study was supported by National Key R&D Program of China (SQ2020YFC080015), and the Science and Technology Major Project of Shenzhen, Fujian (2020YZ0106), Xiamen (3502Z2020YJ01) and Bill & Melinda Gates Foundation.

Declaration of Interests: The authors declare no competing interests.

Ethics Approval Statement: This study was reviewed and approved by the Medical Ethical Committee of Shenzhen Third People’s Hospital (approval number 2020-0018). Written informed consent was obtained from each enrolled patient.

Keywords: SARS-CoV-2; COVID-19; Antibody; Immunoassay; IgM; Diagnosis; Serology; Disease severity; Sensitivity

Suggested Citation

Zhao, Juanjuan and Yuan, Quan and Wang, Haiyan and Liu, Wei and Liao, Xuejiao and Su, Yingying and Wang, Xin and Yuan, Jing and Li, Tingdong and Li, Jinxiu and Qian, Shen and Hong, Congming and Wang, Fuxiang and Yingxia, Liu and Zhaoqin, Wang and Qing, He and He, Bin and Zhang, Tianying and Ge, Shengxiang and Liu, Lei and Zhang, Jun and Xia, Ningshao and Zhang, Zheng, Antibody Responses to SARS-CoV-2 in Patients of Novel Coronavirus Disease 2019 (February 25, 2020). Available at SSRN: https://ssrn.com/abstract=3546052 or http://dx.doi.org/10.2139/ssrn.3546052

Juanjuan Zhao

Zhengzhou University - Department of Hematology

Zhengzhou, Henan
China

Quan Yuan

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Xiamen
China

Haiyan Wang

Southern University of Science and Technology - Institute of Hepatology

China

Wei Liu

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Xiamen
China

Xuejiao Liao

Southern University of Science and Technology - Institute of Hepatology

China

Yingying Su

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Xiamen
China

Xin Wang

Southern University of Science and Technology - Institute of Hepatology

China

Jing Yuan

Southern University of Science and Technology - Department of Infectious Diseases

China

Tingdong Li

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Xiamen
China

Jinxiu Li

Southern University of Science and Technology - Department of Critical Care Medicine

China

Shen Qian

Southern University of Science and Technology - Institute of Hepatology

China

Congming Hong

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Xiamen
China

Fuxiang Wang

Southern University of Science and Technology - Department of Critical Care Medicine

China

Liu Yingxia

Southern University of Science and Technology - State Key Discipline of Infectious Disease ( email )

Shenzhen
China

Wang Zhaoqin

Southern University of Science and Technology - Diagnosis and Treatment of Infectious Diseases Research Laboratory

Shenzhen
China

He Qing

Southern University of Science and Technology - National Clinical Research Center for Infectious Diseases

China

Bin He

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Xiamen
China

Tianying Zhang

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Xiamen
China

Shengxiang Ge

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Xiamen
China

Lei Liu

Southern University of Science and Technology - Diagnosis and Treatment of Infectious Diseases Research Laboratory

Shenzhen
China

Jun Zhang

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics

Xiamen
China

Ningshao Xia

Xiamen University - State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics ( email )

Xiamen
China

Zheng Zhang (Contact Author)

302 Military Hospital, Center of Therapeutic Research for Liver Cancer ( email )

China

Southern University of Science and Technology - Institute of Hepatology ( email )

China

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