Delayed specific IgM antibody responses observed among COVID-19 patients with severe progression

Shen, Liang; Wang, Chunhua; Zhao, Jiahui; Tang, Xiaoyong; Shen, Ying; Lu, Mingqing; Ding, Zhe; Huang, Chao‐Feng; Zhang, Ji; Li, Shichao; Lan, Jiaming; Wong, Gary; Zhu, Yufang

doi:10.1080/22221751.2020.1766382

Cited by 67 publications

(59 citation statements)

References 25 publications

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“…22,35,53,56 • A number of studies report earlier antibody response to more severe disease 134,135 , including specifically for IgG; 7 a shorter time to peak antibody titre, 19,26,[136][137][138] including specifically for IgA; 30 and that IgG persists for longer in severe disease compared to milder cases. 139,140 • Three studies report an earlier antibody response to milder disease, 19,43 including specifically IgM 141 and IgA, 140 shorter time to peak for IgG, 140 and IgG persists for longer compared to severe cases. 142…”

Section: Onward Research Questionsmentioning

confidence: 99%

Antibody response to SARS-CoV-2 infection in humans: a systematic review

Post

Eddy

Huntley

et al. 2020

Preprint

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Introduction Progress in characterising the humoral immune response to Severe Acute Respiratory Syndrome 2 (SARS-CoV-2) has been rapid but areas of uncertainty persist. This review comprehensively evaluated evidence describing the antibody response to SARS-CoV-2 published from 01/01/2020-26/06/2020. Methods Systematic review. Keyword-structured searches were carried out in MEDLINE, Embase and COVID-19 Primer. Articles were independently screened on title, abstract and full text by two researchers, with arbitration of disagreements. Data were double-extracted into a pre-designed template, and studies critically appraised using a modified version of the MetaQAT tool, with resolution of disagreements by consensus. Findings were narratively synthesised. Results 150 papers were included. Most studies (75%) were observational in design, and included papers were generally of moderate quality based on hospitalised patients. Few considered mild or asymptomatic infection. Antibody dynamics were well described in the acute phase, and up to around 3 months from disease onset, although inconsistencies remain concerning clinical correlates. Development of neutralising antibodies following SARS-CoV-2 infection is typical, although titres may be low. Specific and potent neutralising antibodies have been isolated from convalescent plasma. Cross reactivity but limited cross neutralisation occurs with other HCoVs. Evidence for protective immunity in vivo is limited to small, short-term animal studies, which show promising initial results in the immediate recovery phase. Interpretation Published literature on immune responses to SARS-CoV-2 is of variable quality with considerable heterogeneity with regard to methods, study participants, outcomes measured and assays used. Antibody dynamics have been evaluated thoroughly in the acute phase but longer follow up and a comprehensive assessment of the role of demographic characteristics and disease severity is needed. The role of protective neutralising antibodies is emerging, with implications for therapeutics and vaccines. Large, cross-national cohort studies using appropriate statistical analysis and standardised serological assays and clinical classifications should be prioritised.

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Section: Onward Research Questionsmentioning

confidence: 99%

Antibody response to SARS-CoV-2 infection in humans: a systematic review

Post

Eddy

Huntley

et al. 2020

Preprint

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“…The copyright holder for this preprint this version posted July 9, 2020. ; https://doi.org/10.1101/2020.07.05.20145888 doi: medRxiv preprint presence and characterization of antibody responses in COVID-19 patients by serological assays has been described in several reports [9,10,11,12,13,14]; a key observation is that across many patients, antibodies are detected at ∼ 10 days post-onset of symptoms.…”

Section: Introductionmentioning

confidence: 99%

Initial characterisation of commercially available ELISA tests and the immune response of the clinically correlated SARS-CoV-2 biobank “SERO-BL-COVID-19” collected during the pandemic onset in Switzerland

Kaltenbach

Rudolf

Linnik

et al. 2020

Preprint

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Background: To accurately measure seroprevalance in the population, boththe expected immune response as well as the assay performances have to be well characterised. Here, we describe the collection and initial characterisation of a blood and saliva biobank obtained after the initial peak of the SARS-CoV-2 pandemic in Switzerland. Methods: Two laboratory ELISA assays measuring IgA & IgG (Euroimmun), and IgM & IgG (Epitope Diagnostics) were used to characterise the biobank collected from 349 re- and convalescent patients from the canton of Basel-Landschaft. Findings: The antibody response in terms of recognized epitopes is diverse, especially in oligosymptomatic patients, while the average strength of the antibody response of the population does correlate with the severity of the disease at each time point. Interpretation: The diverse immune response presents a challenge when conducting epidemiological studies as the used assays only detect 90% of the oligosymptomatic cases. This problem cannot be rectified by using more sensitive assays or lower cut-offs as they concomitantly reduce specificity. Funding Funding was obtained from the Amt fur Gesundheit of the canton Basel-Landschaft, Switzerland.

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“…It was possible that the viral load of SARS-CoV-2 was high in patients with critically severe COVID-19 [29]. Moreover, the reduction of viral load correlated with seroconversion in SARS [30] and seroconversion was delayed in patients with severe COVID-19 [31]. Viral load or viral clearance rate may be associated with the severity of COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of SARS-CoV-2 clearance period in patients with COVID-19: a systematic review and meta-analysis

Okita¹,

Morita²,

Kumanogoh³

2020

Preprint

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Background: There is insufficient consensus on the viral shedding period in each background of patients with coronavirus disease 2019 (COVID-19).Methods: We conducted a comprehensive systematic review and meta-analysis according to the PRISMA guidelines. PubMed and Web of Science were searched for original studies reporting the viral shedding period in patients with COVID-19. A random effects model was used to calculate the mean number of days from the onset. Subanalysis was performed focusing on age, sex, severity, locality, and treatment.Results Of 55 studies identified, 12 met the selection criteria. The viral shedding period tended to be longer in sputum (19.03 days) than in nasopharynx (14.58 days). The viral shedding period in nasopharynx tended to be longer in severe patients (23.65 days) than in nonsevere patients (12.67 days). It also tended to be longer in patients treated with steroid (21.24 days) than in patients treated without steroid (12.20 days). This period tended to be longer in Asia (16.07 days) than in Europe (12.57 days). Age, sex, and anti-viral drugs did not affect the viral shedding period.Conclusions Severity, steroid usage, and locality may affect the viral shedding period.

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Delayed specific IgM antibody responses observed among COVID-19 patients with severe progression

Cited by 67 publications

References 25 publications

Antibody response to SARS-CoV-2 infection in humans: a systematic review

Antibody response to SARS-CoV-2 infection in humans: a systematic review

Initial characterisation of commercially available ELISA tests and the immune response of the clinically correlated SARS-CoV-2 biobank “SERO-BL-COVID-19” collected during the pandemic onset in Switzerland

Evaluation of SARS-CoV-2 clearance period in patients with COVID-19: a systematic review and meta-analysis

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