Factors of Severity in Patients with COVID-19: Cytokine/Chemokine Concentrations, Viral Load, and Antibody Responses

被引:64
作者
Kwon, Ji-Soo [1 ]
Kim, Ji [2 ]
Kim, Min-Chul [3 ]
Park, Se [4 ]
Kim, Baek-Nam [5 ]
Bae, Seongman [2 ]
Cha, Hye [2 ]
Jung, Jiwon [2 ]
Kim, Min-Jae [2 ]
Lee, Myung [5 ]
Choi, Seong-Ho [3 ]
Chung, Jin-Won [3 ]
Shin, Eui-Cheol [1 ]
Kim, Sung-Han [2 ]
机构
[1] Korea Adv Inst Sci & Technol, Grad Sch Med Sci & Engn, Daejeon, South Korea
[2] Univ Ulsan, Asan Med Ctr, Dept Infect Dis, Coll Med, 88,Olymp Ro 43 Gil, Seoul 05505, South Korea
[3] Chung Ang Univ, Chung Ang Univ Hosp, Dept Internal Med, Div Infect Dis,Coll Med, Seoul, South Korea
[4] Soonchunhyang Univ, Soonchunhyang Univ Seoul Hosp, Dept Infect Dis, Coll Med, Seoul, South Korea
[5] Inje Univ, Inje Univ Sanggye Paik Hosp, Dept Infect Dis, Coll Med, Seoul, South Korea
关键词
OUTCOMES;
D O I
10.4269/ajtmh.20-1110
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
The severity of COVID-19 ranges from mild to critical diseases. However, limited data have been published on the detailed kinetics of viral load and host immune response throughout the disease course depending on disease severity. In this study, we comprehensively analyzed viral load, antibody responses to SARS-CoV-2, and cytokines/chemokines during the disease course, and identified the factors related to severity. Nasopharyngeal (NP) and plasma specimens were obtained from 31 patients with COVID-19 during hospitalization. Viral RNA in NP specimens was quantified by reverse transcription-PCR. Anti-SARS-CoV-2 antibodies and cytokines/chemokines in plasma specimens were analyzed by ELISA and cytometric bead array. The viral load in patients with COVID-19 peaked at the early stage of the disease and continuously decreased. Severe and critical cases showed higher viral load and prolonged viral shedding than asymptomatic and mild cases. Whereas plasma IgG was gradually increased and maintained during hospitalization, plasma IgM peaked at 3 weeks after symptom onset and dissipated. The antibody response in severe and critical cases was slightly delayed but stronger than those in others. High levels of interferon (IFN)-alpha, IFN-gamma-induced protein-10, monokine induced by IFN-gamma, and interleukin-6 at 5-10 days from symptom onset were associated with the severity of COVID-19. Our data indicate that high viral load in the respiratory tract and excessive production of cytokines and chemokines between 1 and 2 weeks from the symptom onset were significantly associated with the severity of COVID-19.
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页码:2412 / 2418
页数:7
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