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The Production and Clinical Implications of SARS-CoV-2 Antibodies

19 Pages Posted: 30 Apr 2020

See all articles by Qianfang Hu

Qianfang Hu

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Xiaoping Cui

Chongqing Three Gorges Central Hospital - Department of Medical Laboratory

Xinzhu Liu

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Bin Peng

Chongqing Medical University - Department of Health Statistics

Jinyue Jiang

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Xiaohui Wang

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Yan Li

Chongqing Three Gorges Central Hospital - Department of Health Management Centre

Wenhui Hu

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Zhi Ao

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Jun Duan

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Xue Wang

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Linxiao Zhu

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Guicheng Wu

Chongqing Three Gorges Central Hospital - Department of Hepatopathy

Shuliang Guo

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

More...

Abstract

Background: Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2), a novel betacoronavirus, has caused an outburst of pneumonia cases in Wuhan, China. We report the production of specific IgM and IgG antibodies after the infection of SARS-CoV-2 and its implication for the diagnosis, pathology and the course of the disease as well as the recurrence of positive nucleic acid tests after discharge.

Methods: Test results for SARS-CoV-2 IgM and IgG antibodies of 221 confirmed COVID-19 patients were retrospectively examined, and their clinical data were collected and analyzed based on various subgroups. SARS-CoV-2 IgM and IgG antibodies were determined with the chemiluminescence method.

Findings: The concentration (S/CO) of SARS-CoV-2 IgM and IgG antibodies peaked on day 19-21 after symptom onset, with a median of 17.38 (IQR 4·39-36·4) for IgM and 5·59 (IQR 0·73-13·65) for IgG. Detection rates reached highest on day 16-18 and day 19-21 for IgM and IgG, which were 73·6% and 98·6%, respectively, with significantly higher concentration of IgG in critically ill patients than in those with mild to moderate disease (P=0·027). The concentration of the antibodies on day 16-21 is not correlated with the course or outcome of the disease (Spearman r < 0·20, P > 0·05). Nasopharyngeal swabs revealed positive SARS-CoV-2 RNA in up to 52.7% of recovered patients after discharge, whose IgG proved to be significantly lower than that of those with negative RNA results (P = 0·009). IgG and IgM were tested twice within 14 days after discharge with a 7-day interval, and the second testing of these antibodies displayed a decrease in concentration of 21·2% (IQR, 11·2%,34·48%) for IgG and 23.05% (IQR, -27·96%,46·13%) for IgM, without statistical significance between the patients with re-detectable positive RNA results and those with negative RNA results after discharge; however, those with positive results experienced a count decrease in lymphocyte subsets.

Interpretation: The concentration of SARS-CoV-2 IgM and IgG antibodies peaked on day 19-21 after symptom onset, and antibody testing on day 16-21 is associated with increased detection rates, but the antibody concentration does not affect the course and outcome of the infection. Recovering patients with re-detectable positive SARS-CoV-2 RNA displayed lower concentration of IgG, but the downward trend of IgG during recovery indicated its limited duration of protection, and the protective effect of IgG remains to be investigated.

Funding Statement: This work is funded by Chongqing Education Board “new coronavirus infection and prevention” emergency scientific research project (KYYJ202006). Chongqing Science and Technology Bureau “new crown pneumonia epidemic emergency science and technology special” the fourth batch of projects. Famous teacher project of Chongqing talent plan.

Declaration of Interests: The authors declare no competing interests.

Ethics Approval Statement: This study was approved by the Medical Ethical Committee of the First Affiliated Hospital of Chongqing Medical University (approval number 20200601). Due to the special reasons of the epidemic, the patients’ informed consent was not obtained.

Keywords: severe acute respiratory syndrome coronavirus 2; Corona virus disease 2019; IgG antibody; IgM antibody; clinical implication

Suggested Citation

Hu, Qianfang and Cui, Xiaoping and Liu, Xinzhu and Peng, Bin and Jiang, Jinyue and Wang, Xiaohui and Li, Yan and Hu, Wenhui and Ao, Zhi and Duan, Jun and Wang, Xue and Zhu, Linxiao and Wu, Guicheng and Guo, Shuliang, The Production and Clinical Implications of SARS-CoV-2 Antibodies (4/15/2020). Available at SSRN: https://ssrn.com/abstract=3576845 or http://dx.doi.org/10.2139/ssrn.3576845

Qianfang Hu

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Chongqing
China

Xiaoping Cui

Chongqing Three Gorges Central Hospital - Department of Medical Laboratory

China

Xinzhu Liu

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Chongqing
China

Bin Peng

Chongqing Medical University - Department of Health Statistics ( email )

No. 1 Yixueyuan Road
Yuzhong District
Chongqing, 400016
China

Jinyue Jiang

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Chongqing
China

Xiaohui Wang

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Chongqing
China

Yan Li

Chongqing Three Gorges Central Hospital - Department of Health Management Centre

China

Wenhui Hu

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Chongqing
China

Zhi Ao

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Chongqing
China

Jun Duan

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Chongqing
China

Xue Wang

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Chongqing
China

Linxiao Zhu

Chongqing Medical University - Department of Respiratory and Critical Care Medicine

Chongqing
China

Guicheng Wu

Chongqing Three Gorges Central Hospital - Department of Hepatopathy

China

Shuliang Guo (Contact Author)

Chongqing Medical University - Department of Respiratory and Critical Care Medicine ( email )

Chongqing
China