Kinetics of viral load and antibody response in relation to COVID-19 severity
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent for coronavirus 2019 (COVID-19) pneumonia. Little is known about the kinetics, tissue distribution, cross-reactivity, and neutralization antibody response in patients with COVID-19. Two groups of patients with RT-PCR...
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| Published in | The Journal of clinical investigation Vol. 130; no. 10; pp. 5235 - 5244 |
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| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
American Society for Clinical Investigation
01.10.2020
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| Subjects | |
| Online Access | Get full text |
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| Abstract | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent for coronavirus 2019 (COVID-19) pneumonia. Little is known about the kinetics, tissue distribution, cross-reactivity, and neutralization antibody response in patients with COVID-19. Two groups of patients with RT-PCR-confirmed COVID-19 were enrolled in this study: 12 severely ill patients in intensive care units who needed mechanical ventilation and 11 mildly ill patients in isolation wards. Serial clinical samples were collected for laboratory detection. Results showed that most of the severely ill patients had viral shedding in a variety of tissues for 20-40 days after onset of disease (8/12, 66.7%), while the majority of mildly ill patients had viral shedding restricted to the respiratory tract and had no detectable virus RNA 10 days after onset (9/11, 81.8%). Mildly ill patients showed significantly lower IgM response compared with that of the severe group. IgG responses were detected in most patients in both the severe and mild groups at 9 days after onset, and remained at a high level throughout the study. Antibodies cross-reactive to SARS-CoV and SARS-CoV-2 were detected in patients with COVID-19 but not in patients with MERS. High levels of neutralizing antibodies were induced after about 10 days after onset in both severely and mildly ill patients which were higher in the severe group. SARS-CoV-2 pseudotype neutralization test and focus reduction neutralization test with authentic virus showed consistent results. Sera from patients with COVID-19 inhibited SARS-CoV-2 entry. Sera from convalescent patients with SARS or Middle East respiratory syndrome (MERS) did not. Anti-SARS-CoV-2 S and N IgG levels exhibited a moderate correlation with neutralization titers in patients' plasma. This study improves our understanding of immune response in humans after SARS-CoV-2 infection. |
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| AbstractList | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent for coronavirus 2019 (COVID-19) pneumonia. Little is known about the kinetics, tissue distribution, cross-reactivity, and neutralization antibody response in patients with COVID-19. Two groups of patients with RT-PCR–confirmed COVID-19 were enrolled in this study: 12 severely ill patients in intensive care units who needed mechanical ventilation and 11 mildly ill patients in isolation wards. Serial clinical samples were collected for laboratory detection. Results showed that most of the severely ill patients had viral shedding in a variety of tissues for 20–40 days after onset of disease (8/12, 66.7%), while the majority of mildly ill patients had viral shedding restricted to the respiratory tract and had no detectable virus RNA 10 days after onset (9/11, 81.8%). Mildly ill patients showed significantly lower IgM response compared with that of the severe group. IgG responses were detected in most patients in both the severe and mild groups at 9 days after onset, and remained at a high level throughout the study. Antibodies cross-reactive to SARS-CoV and SARS-CoV-2 were detected in patients with COVID-19 but not in patients with MERS. High levels of neutralizing antibodies were induced after about 10 days after onset in both severely and mildly ill patients which were higher in the severe group. SARS-CoV-2 pseudotype neutralization test and focus reduction neutralization test with authentic virus showed consistent results. Sera from patients with COVID-19 inhibited SARS-CoV-2 entry. Sera from convalescent patients with SARS or Middle East respiratory syndrome (MERS) did not. Anti–SARS-CoV-2 S and N IgG levels exhibited a moderate correlation with neutralization titers in patients’ plasma. This study improves our understanding of immune response in humans after SARS-CoV-2 infection. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent for coronavirus 2019 (COVID-19) pneumonia. Little is known about the kinetics, tissue distribution, cross-reactivity, and neutralization antibody response in patients with COVID-19. Two groups of patients with RT-PCR-confirmed COVID-19 were enrolled in this study: 12 severely ill patients in intensive care units who needed mechanical ventilation and 11 mildly ill patients in isolation wards. Serial clinical samples were collected for laboratory detection. Results showed that most of the severely ill patients had viral shedding in a variety of tissues for 20-40 days after onset of disease (8/12, 66.7%), while the majority of mildly ill patients had viral shedding restricted to the respiratory tract and had no detectable virus RNA 10 days after onset (9/11, 81.8%). Mildly ill patients showed significantly lower IgM response compared with that of the severe group. IgG responses were detected in most patients in both the severe and mild groups at 9 days after onset, and remained at a high level throughout the study. Antibodies cross-reactive to SARS-CoV and SARS-CoV-2 were detected in patients with COVID-19 but not in patients with MERS. High levels of neutralizing antibodies were induced after about 10 days after onset in both severely and mildly ill patients which were higher in the severe group. SARS-CoV-2 pseudotype neutralization test and focus reduction neutralization test with authentic virus showed consistent results. Sera from patients with COVID-19 inhibited SARS-CoV-2 entry. Sera from convalescent patients with SARS or Middle East respiratory syndrome (MERS) did not. Anti-SARS-CoV-2 S and N IgG levels exhibited a moderate correlation with neutralization titers in patients' plasma. This study improves our understanding of immune response in humans after SARS-CoV-2 infection.Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent for coronavirus 2019 (COVID-19) pneumonia. Little is known about the kinetics, tissue distribution, cross-reactivity, and neutralization antibody response in patients with COVID-19. Two groups of patients with RT-PCR-confirmed COVID-19 were enrolled in this study: 12 severely ill patients in intensive care units who needed mechanical ventilation and 11 mildly ill patients in isolation wards. Serial clinical samples were collected for laboratory detection. Results showed that most of the severely ill patients had viral shedding in a variety of tissues for 20-40 days after onset of disease (8/12, 66.7%), while the majority of mildly ill patients had viral shedding restricted to the respiratory tract and had no detectable virus RNA 10 days after onset (9/11, 81.8%). Mildly ill patients showed significantly lower IgM response compared with that of the severe group. IgG responses were detected in most patients in both the severe and mild groups at 9 days after onset, and remained at a high level throughout the study. Antibodies cross-reactive to SARS-CoV and SARS-CoV-2 were detected in patients with COVID-19 but not in patients with MERS. High levels of neutralizing antibodies were induced after about 10 days after onset in both severely and mildly ill patients which were higher in the severe group. SARS-CoV-2 pseudotype neutralization test and focus reduction neutralization test with authentic virus showed consistent results. Sera from patients with COVID-19 inhibited SARS-CoV-2 entry. Sera from convalescent patients with SARS or Middle East respiratory syndrome (MERS) did not. Anti-SARS-CoV-2 S and N IgG levels exhibited a moderate correlation with neutralization titers in patients' plasma. This study improves our understanding of immune response in humans after SARS-CoV-2 infection. |
| Audience | Academic |
| Author | Li, Yimin Tan, Haitao Wang, Junxiang Li, Min Zhao, Jincun Jiang, Yongliang Zhong, Nanshan Tang, Lan Huang, Yongbo Deng, Ying Zhao, Jingxian Huang, Xiaofang Chen, Zhao Chen, Chunke Zhang, Lu Huang, Jicheng Alshukairi, Abeer N. Wang, Yanqun Song, Tie Lv, Huibin Zhu, Airu Zhuo, Jianfen Zhang, Yanjun Li, Fang Gan, Mian Perlman, Stanley Sang, Ling Mok, Chris Ka Pun Ruan, Shicong Ye, Feng Liang, Jieling Chen, Rongchang Al Gethamy, Manal M. Wen, Liyan Kuang, Lijun Malik Peiris, J.S. Zhong, Bei Li, Zhengtu Lin, Yimin Luo, Ling Sun, Jing Zhang, Zhaoyong Li, Yuming Zhuang, Zhen |
| AuthorAffiliation | 9 Al Nour Specialist Hospital, Makkah, Saudi Arabia 2 Institute of Infectious disease, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China 1 State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital, and 5 Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China 8 HKU–Pasteur Research Pole, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China 6 King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia 11 Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, USA 4 Sixth Affiliated Hospital, Guangzhou Medical University, Qingyuan People’s Hospital, Qingyuan, Guangdong, China 7 Shenzhen Institute of Respiratory Disease, First Affiliated Hospital (Shenzhen People’s Hospital), South University of Science and Technology of |
| AuthorAffiliation_xml | – name: 1 State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital, and – name: 2 Institute of Infectious disease, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China – name: 11 Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, USA – name: 3 Yangjiang People’s Hospital, Yangjiang, Guangdong, China – name: 6 King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia – name: 4 Sixth Affiliated Hospital, Guangzhou Medical University, Qingyuan People’s Hospital, Qingyuan, Guangdong, China – name: 5 Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China – name: 8 HKU–Pasteur Research Pole, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China – name: 7 Shenzhen Institute of Respiratory Disease, First Affiliated Hospital (Shenzhen People’s Hospital), South University of Science and Technology of China, Shenzhen, Guangdong, China – name: 10 Technology Centre, Guangzhou Customs, Guangzhou, Guangdong, China – name: 9 Al Nour Specialist Hospital, Makkah, Saudi Arabia |
| Author_xml | – sequence: 1 givenname: Yanqun surname: Wang fullname: Wang, Yanqun – sequence: 2 givenname: Lu surname: Zhang fullname: Zhang, Lu – sequence: 3 givenname: Ling surname: Sang fullname: Sang, Ling – sequence: 4 givenname: Feng surname: Ye fullname: Ye, Feng – sequence: 5 givenname: Shicong surname: Ruan fullname: Ruan, Shicong – sequence: 6 givenname: Bei surname: Zhong fullname: Zhong, Bei – sequence: 7 givenname: Tie surname: Song fullname: Song, Tie – sequence: 8 givenname: Abeer N. surname: Alshukairi fullname: Alshukairi, Abeer N. – sequence: 9 givenname: Rongchang surname: Chen fullname: Chen, Rongchang – sequence: 10 givenname: Zhaoyong surname: Zhang fullname: Zhang, Zhaoyong – sequence: 11 givenname: Mian surname: Gan fullname: Gan, Mian – sequence: 12 givenname: Airu surname: Zhu fullname: Zhu, Airu – sequence: 13 givenname: Yongbo surname: Huang fullname: Huang, Yongbo – sequence: 14 givenname: Ling surname: Luo fullname: Luo, Ling – sequence: 15 givenname: Chris Ka Pun surname: Mok fullname: Mok, Chris Ka Pun – sequence: 16 givenname: Manal M. surname: Al Gethamy fullname: Al Gethamy, Manal M. – sequence: 17 givenname: Haitao surname: Tan fullname: Tan, Haitao – sequence: 18 givenname: Zhengtu surname: Li fullname: Li, Zhengtu – sequence: 19 givenname: Xiaofang surname: Huang fullname: Huang, Xiaofang – sequence: 20 givenname: Fang surname: Li fullname: Li, Fang – sequence: 21 givenname: Jing surname: Sun fullname: Sun, Jing – sequence: 22 givenname: Yanjun surname: Zhang fullname: Zhang, Yanjun – sequence: 23 givenname: Liyan surname: Wen fullname: Wen, Liyan – sequence: 24 givenname: Yuming surname: Li fullname: Li, Yuming – sequence: 25 givenname: Zhao surname: Chen fullname: Chen, Zhao – sequence: 26 givenname: Zhen surname: Zhuang fullname: Zhuang, Zhen – sequence: 27 givenname: Jianfen surname: Zhuo fullname: Zhuo, Jianfen – sequence: 28 givenname: Chunke surname: Chen fullname: Chen, Chunke – sequence: 29 givenname: Lijun surname: Kuang fullname: Kuang, Lijun – sequence: 30 givenname: Junxiang surname: Wang fullname: Wang, Junxiang – sequence: 31 givenname: Huibin surname: Lv fullname: Lv, Huibin – sequence: 32 givenname: Yongliang surname: Jiang fullname: Jiang, Yongliang – sequence: 33 givenname: Min surname: Li fullname: Li, Min – sequence: 34 givenname: Yimin surname: Lin fullname: Lin, Yimin – sequence: 35 givenname: Ying surname: Deng fullname: Deng, Ying – sequence: 36 givenname: Lan surname: Tang fullname: Tang, Lan – sequence: 37 givenname: Jieling surname: Liang fullname: Liang, Jieling – sequence: 38 givenname: Jicheng surname: Huang fullname: Huang, Jicheng – sequence: 39 givenname: Stanley orcidid: 0000-0003-4213-2354 surname: Perlman fullname: Perlman, Stanley – sequence: 40 givenname: Nanshan surname: Zhong fullname: Zhong, Nanshan – sequence: 41 givenname: Jingxian surname: Zhao fullname: Zhao, Jingxian – sequence: 42 givenname: J.S. orcidid: 0000-0001-8217-5995 surname: Malik Peiris fullname: Malik Peiris, J.S. – sequence: 43 givenname: Yimin orcidid: 0000-0003-0810-5256 surname: Li fullname: Li, Yimin – sequence: 44 givenname: Jincun surname: Zhao fullname: Zhao, Jincun |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32634129$$D View this record in MEDLINE/PubMed |
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