Clinical significance of serum IgM and IgG levels in COVID-19 patients in Hubei Province, China

被引:7
作者
Bai, Zhenjiang [1 ]
Li, Qing [2 ]
Chen, Qinghui [3 ]
Niu, Changming [4 ]
Wei, Yu [5 ]
Huang, Hanpeng [6 ]
Zhao, Wei [7 ]
Chen, Nian [8 ]
Yao, Xin [9 ]
Zhang, Qiang [10 ]
Mu, Chuanyong [11 ]
Feng, Jian [12 ]
Zhu, Chuanlong [8 ]
Li, Zhuo [13 ]
Ding, Ming [10 ]
Feng, Binhui [14 ]
Jin, Chaochao [15 ]
Lu, Xiang [16 ]
Yang, Yi [2 ]
Wu, Shuiyan [1 ]
Shu, Xiaochen [17 ]
Hu, Lifang [18 ,19 ]
Qiu, Haibo [2 ]
Huang, Yingzi [2 ]
机构
[1] Soochow Univ, Childrens Hosp, Pediat Intens Care Unit, Suzhou 215025, Jiangsu, Peoples R China
[2] Southeast Univ, Zhongda Hosp, Sch Med, Dept Crit Care Med, 87 Dingjiaqiao Rd, Nanjing 210009, Jiangsu, Peoples R China
[3] Soochow Univ, Dept Infect Dis, Childrens Hosp, Suzhou 215025, Jiangsu, Peoples R China
[4] Nanjing Med Univ, Dept Pulm & Crit Care Med, Affiliated Hosp 2, Nanjing 210011, Jiangsu, Peoples R China
[5] Jiangsu Prov Hosp TCM, Dept Orthoped & Traumatol, Nanjing 210029, Jiangsu, Peoples R China
[6] Jiangsu Univ, Affiliated Hosp, Dept Respirol, Zhenjiang 212001, Jiangsu, Peoples R China
[7] Nanjing Med Univ, SIR RUN RUN Hosp, Dept Crit Care Med, Nanjing 211100, Jiangsu, Peoples R China
[8] Nanjing Med Univ, Dept Infect Dis, Affiliated Hosp 1, Nanjing, Jiangsu, Peoples R China
[9] Nanjing Med Univ, Affiliated Jiangning Hosp, Dept Resp & Crit Care Med, Nanjing, Jiangsu, Peoples R China
[10] Southeast Univ, Zhongda Hosp, Dept Rehabil, Nanjing 210009, Jiangsu, Peoples R China
[11] Soochow Univ, Dept Pulm & Crit Care Med, Affiliated Hosp 1, Suzhou 215006, Peoples R China
[12] Nantong Univ, Dept Neurol, Affiliated Hosp, Nantong 226019, Jiangsu, Peoples R China
[13] Nanjing Med Univ, Dept Emergency, Childrens Hosp, Nanjing 210008, Jiangsu, Peoples R China
[14] Edong Healthcare Huangshi Cent Hosp, Dept Pulm & Crit Care Med, Huangshi, Hubei, Peoples R China
[15] Huangshi Hosp, TCM Infect Dis Hosp, Dept Crit Care Med, Huangshi 435003, Hubei, Peoples R China
[16] Nanjing Med Univ, Sir Run Run Hosp, Dept Geriatr Med, Nanjing 211100, Jiangsu, Peoples R China
[17] Med Coll Soochow Univ, Sch Publ Hlth, Dept Epidemiol, Suzhou 215123, Jiangsu, Peoples R China
[18] Soochow Univ, Jiangsu Key Lab Neuropsychiat Dis, Suzhou 215031, Jiangsu, Peoples R China
[19] Soochow Univ, Inst Neurosci, Suzhou 215031, Jiangsu, Peoples R China
来源
JOURNAL OF INTENSIVE MEDICINE | 2022年 / 2卷 / 01期
关键词
COVID-19; Severe acute respiratory; syndrome-coronavirus-2 (SARS-CoV-2); Serum IgM; Serum IgG; Clinical significance; RESPIRATORY-SYNDROME SARS; CORONAVIRUS SPIKE PROTEIN; NUCLEOCAPSID PROTEIN; COV; ANTIBODIES; INTERFERON; PNEUMONIA; VACCINE;
D O I
10.1016/j.jointm.2021.09.001
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: There have been many studies about coronavirus disease 2019 (COVID-19), but the clinical significance of quantitative serum severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-specific IgM and IgG levels of COVID-19 patients have not been exhaustively analyzed. We aimed to investigate the time profiles of these IgM/IgG levels in COVID-19 patients and their correlations with clinical features. Methods: A multicenter clinical study was conducted from February 20 to March 5 2020. It involved 179 COVID19 patients (108 males and 71 females) from five hospitals in Huangshi in Hubei Province, China. To detect SARS-CoV-2-specific IgM/IgG, quantitative antibody assays (two-step indirect immunoassays with direct chemiluminescence technology) based on the nucleocapsid protein (NP) and spike protein 1 (S1) were used. For normally distributed data, means were compared using the t- test, 2-test, or exact probability method. For categorical data, medians were compared using Mann-Whitney U test. Results: The median age was 57 (44-69) years (58 [38-69] for males and 57 [49-68] for females). The median duration of positive nucleic acid test was 22.32 (17.34-27.43) days. The mortality rate was relatively low (3/179, 1.68%). Serum SARS-CoV-2-specific IgG was detected around week 1 after illness onset, gradually increased until peaking in weeks 4 and 5, and then declined. Serum IgM peaked in weeks 2 and 3, then gradually declined and returned to its normal range by week 7 in all patients. Notably, children had milder respiratory symptoms with lower SARS-CoV-2-specific IgM/IgG levels. The duration of positive nucleic acid test in the chronic obstructive pulmonary disease (COPD) group was 30.36 (18.99-34.76) days, which was significantly longer than that in the non-COPD group (21.52 [16.75-26.51] days; P = 0.025). The peak serum SARS-CoV-2-specific IgG was significantly positively correlated with the duration of positive nucleic acid test. The incidence rate of severe and critical cases in the IgMhigroup (using the median IgM level of 29.95 AU/mL as the cutoff for grouping) was about 38.0% (19/50), which was twice as much as that in the IgMlo group (18.4%; 9/49). The patients with positive chest imaging and lymphocytopenia ( < 1 x 10 9 /L) had a higher SARS-CoV-2-specific IgM level. Conclusions: Quantitative SARS-CoV-2-specific IgM and IgG levels are helpful for the diagnosis, severity classification, and management of COVID-19 patients, and they should be monitored in each stage of this disease.
引用
收藏
页码:32 / 38
页数:7
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