临床和抗体特征显示重症和非重症SARS-CoV-2患者的不同特征。

IF 4.8 1区 医学 Q1 INFECTIOUS DISEASES
Hongye Wang, Dongshan Yan, Ya Li, Yanfei Gong, Yulin Mai, Bingxiang Li, Xiaoyong Zhu, Xinrui Wan, Liyun Xie, HuaKe Jiang, Min Zhang, Ming Sun, Yufeng Yao, Yongzhang Zhu
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引用次数: 15

摘要

背景:COVID-19大流行仍在继续,明确重症和非重症病例的临床特征和抗体反应特征将有利于预后和治疗。方法:收集2020年1月25日至2月18日在岳阳市第一人民医院就诊的37例新冠肺炎重症和非重症患者的119份血清样本。全面观察临床特征、针对SARS-CoV-2刺突蛋白(S)及其不同结构域的抗体应答、SARS-CoV-2特异性Ig同型、IgG亚类、ACE2竞争抗体、与FcγIIa和FcγIIb受体的结合滴度以及14种细胞因子。重度组与非重度组间差异分析采用Mann-Whitney U检验或Fisher精确检验。结果:重症组9例患者淋巴细胞计数较低,中性粒细胞计数较高,LDH、总胆汁酸(TBA) (P -4)、r-谷氨酰胺酶(P = 0.011)、腺苷脱氨酶(P -4)、降钙素原(P = 0.004)、c反应蛋白(P -4)、d -二聚体(P = 0.049)水平高于非重症组(28例)。值得注意的是,与非严重组相比,严重组观察到更高水平的IgG靶向S,不同的S结构域(RBD, RBM, NTD和CTD), FcγRIIa和FcγRIIb结合能力,其中IgG1和IgG3是主要的IgG亚类。严重组和非严重组RBD-IgG均与S-IgG呈强相关。此外,在非严重组中,CTD-IgG与S-IgG呈强相关。RBD-ACE2结合抑制阳性与高滴度抗体(S-IgG1、S-IgG3、NTD-IgG、RBD-IgA、NTD-IgA、CTD-IgA)密切相关,严重组尤其与RBD-IgG、CTD-IgG相关,非严重组S-IgG3、RBD-IgG、NTD-IgG、NTD-IgM与ACE2阻断率相关。重度组S-IgG1、NTD-IgM、S-IgM与发病天数呈负相关,重度组S-IgG3、RBD-IgA、CTD-IgA与发病天数呈正相关(r = 0.363, P = 0.011),非重度组S-IgG1、NTD-IgA、CTD-IgA与发病天数呈正相关。严重组GRO-α、IL-6、IL-8、IP-10、MCP-1、MCP-3、MIG、BAFF均显著升高。结论:抗体检测在COVID-19过程中提供了重要的临床信息。COVID-19重症组和非重症组之间IgG同型、IgG亚类和抗体特异性的不同特征将有助于未来治疗和预防措施的制定。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Clinical and antibody characteristics reveal diverse signatures of severe and non-severe SARS-CoV-2 patients.

Clinical and antibody characteristics reveal diverse signatures of severe and non-severe SARS-CoV-2 patients.

Clinical and antibody characteristics reveal diverse signatures of severe and non-severe SARS-CoV-2 patients.

Clinical and antibody characteristics reveal diverse signatures of severe and non-severe SARS-CoV-2 patients.

Background: COVID-19 pandemic continues, clarifying signatures in clinical characters and antibody responses between severe and non-severe COVID-19 cases would benefit the prognosis and treatment.

Methods: In this study, 119 serum samples from 37 severe or non-severe COVID-19 patients from the First People's Hospital of Yueyang were collected between January 25 and February 18 2020. The clinical features, antibody responses targeting SARS-CoV-2 spike protein (S) and its different domains, SARS-CoV-2-specific Ig isotypes, IgG subclasses, ACE2 competitive antibodies, binding titers with FcγIIa and FcγIIb receptors, and 14 cytokines were comprehensively investigated. The differences between severe and non-severe groups were analyzed using Mann-Whitney U test or Fisher's exact test.

Results: Severe group including 9 patients represented lower lymphocyte count, higher neutrophil count, higher level of LDH, total bile acid (TBA) (P < 1 × 10-4), r-glutaminase (P = 0.011), adenosine deaminase (P < 1 × 10-4), procalcitonin (P = 0.004), C-reactive protein (P < 1 × 10-4) and D-dimer (P = 0.049) compared to non-severe group (28 patients). Significantly, higher-level Igs targeting S, different S domains (RBD, RBM, NTD, and CTD), FcγRIIa and FcγRIIb binding capability were observed in a severe group than that of a non-severe group, of which IgG1 and IgG3 were the main IgG subclasses. RBD-IgG were strongly correlated with S-IgG both in severe and non-severe group. Additionally, CTD-IgG was strongly correlated with S-IgG in a non-severe group. Positive RBD-ACE2 binding inhibition was strongly associated with high titers of antibody (S-IgG1, S-IgG3, NTD-IgG, RBD-IgA, NTD-IgA, and CTD-IgA) especially RBD-IgG and CTD-IgG in the severe group, while in the non-severe group, S-IgG3, RBD-IgG, NTD-IgG, and NTD-IgM were correlated with ACE2 blocking rate. S-IgG1, NTD-IgM and S-IgM were negatively associated with illness day in a severe group, while S-IgG3, RBD-IgA, CTD-IgA in the severe group (r = 0.363, P = 0.011) and S-IgG1, NTD-IgA, CTD-IgA in the non-severe group were positively associated with illness day. Moreover, GRO-α, IL-6, IL-8, IP-10, MCP-1, MCP-3, MIG, and BAFF were also significantly elevated in the severe group.

Conclusion: Antibody detection provides important clinical information in the COVID-19 process. The different signatures in Ig isotypes, IgG subclasses, antibody specificity between the COVID-19 severe and non-severe group will contribute to future therapeutic and preventive measures development.

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来源期刊
Infectious Diseases of Poverty
Infectious Diseases of Poverty Medicine-Public Health, Environmental and Occupational Health
CiteScore
16.70
自引率
1.20%
发文量
368
审稿时长
13 weeks
期刊介绍: Infectious Diseases of Poverty is a peer-reviewed, open access journal that focuses on essential public health questions related to infectious diseases of poverty. It covers a wide range of topics and methods, including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies, and their application. The journal also explores the impact of transdisciplinary or multisectoral approaches on health systems, ecohealth, environmental management, and innovative technologies. It aims to provide a platform for the exchange of research and ideas that can contribute to the improvement of public health in resource-limited settings. In summary, Infectious Diseases of Poverty aims to address the urgent challenges posed by infectious diseases in impoverished populations. By publishing high-quality research in various areas, the journal seeks to advance our understanding of these diseases and contribute to the development of effective strategies for prevention, diagnosis, and treatment.
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