Increasing evidence suggests that dysregulated immune responses are associated with the clinical outcome of coronavirus disease 2019 (COVID-19). Nucleocapsid protein (NP)-, spike (S)-, receptor binding domain (RBD)- specific immunoglobulin (Ig) isotypes, IgG subclasses and neutralizing antibody (NAb) were analyzed in 123 serum from 63 hospitalized patients with severe, moderate, mild or asymptomatic COVID-19. Mild to modest correlations were found between disease severity and antigen specific IgG subclasses in serum, of which IgG1 and IgG3 were negatively associated with viral load in nasopharyngeal swab. Multiple cytokines were significantly related with antigen-specific Ig isotypes and IgG subclasses, and IL-1β was positively correlated with most antibodies. Furthermore, the old patients (≥ 60 years old) had higher levels of chemokines, increased NAb activities and SARS-CoV-2 specific IgG1, and IgG3 responses and compromised T cell responses compared to the young patients (≤ 18 years old), which are related with more severe cases. Higher IgG1 and IgG3 were found in COVID-19 patients with comorbidities while biological sex had no effect on IgG subclasses. Overall, we have identified diseases severity was related to higher antibodies, of which IgG subclasses had weakly negative correlation with viral load, and cytokines were significantly associated with antibody response. Further, advancing age and comorbidities had obvious effect on IgG1 and IgG3.
The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic is ongoing and multiple studies have elucidated its pathogenesis, however, the related‐ microbiome imbalance caused by SARS‐CoV‐2 is still not clear. In this study, we have comprehensively compared the microbiome composition and associated function alterations in the oropharyngeal swabs of healthy controls and coronavirus disease 2019 (COVID‐19) patients with moderate or severe symptoms by metatranscriptomic sequencing. We did observe a reduced microbiome alpha‐diversity but significant enrichment of opportunistic microorganisms in patients with COVID‐19 compared with healthy controls, and the microbial homeostasis was rebuilt following the recovery of COVID‐19 patients. Correspondingly, less functional genes in multiple biological processes and weakened metabolic pathways such as carbohydrate metabolism, energy metabolism were also observed in COVID‐19 patients. We only found higher relative abundance of limited genera such as Lachnoanaerobaculum between severe patients and moderate patients while no worthy‐noting microbiome diversity and function alteration were observed. Finally, we noticed that the co‐occurrence of antibiotic resistance and virulence was closely related to the microbiome alteration caused by SRAS‐CoV‐2. Overall, our findings demonstrate that microbial dysbiosis may enhance the pathogenesis of SARS‐CoV‐2 and the antibiotics treatment should be critically considered.
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