Cited by 2,607SARS-CoV-2 and COVID-19 ResearchSARS-CoV-2 detection and testingCOVID-19 Clinical Research Studies

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Antibody Responses to SARS-CoV-2 in Patients With Novel Coronavirus Disease 2019

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Zhao, Juanjuan, Yuan, Quan, Wang, Haiyan, Liu, Wei, Liao, Xuejiao, Su, Yingying, Wang, Xin, Yuan, Jing, Li, Tingdong, Li, Jinxiu, Qian, Shen, Hong, Congming, Wang, Fuxiang, Liu, Yingxia, Wang, Zhaoqin, He, Qing, Li, Zhiyong, He, Bin, Zhang, Tianying, Fu, Yang, Ge, Shengxiang, Liu, Lei, Zhang, Jun, Xia, Ningshao, Zhang, Zheng·2020·Clinical Infectious Diseases

DOI 10.1093/cid/ciaa344PMC PMC7184337

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Abstract

Background: The novel coronavirus SARS-CoV-2 is a newly emerging virus. The antibody response in infected patients remains largely unknown, and the clinical value of antibody testing has not been fully demonstrated. Methods: 173 patients with SARS-CoV-2 infection were enrolled. Their serial plasma samples (n = 535) collected during hospitalization were tested for total antibodies (Ab), IgM, and IgG against SARS-CoV-2. The dynamics of antibodies with disease progress were analyzed. Results: Among 173 patients, the seroconversion rates for Ab, IgM, and IgG were 93.1%, 82.7%, and 64.7%, respectively. The reason for the negative antibody findings in 12 patients might be due to the lack of blood samples at the later stage of illness. The median seroconversion times for Ab, IgM, and then IgG were days 11, 12, and 4, respectively. The presence of antibodies was <40% among patients within 1 week of onset, and rapidly increased to 100.0% (Ab), 94.3% (IgM), and 79.8% (IgG) by day 15 after onset. In contrast, RNA detectability decreased from 66.7% (58/87) in samples collected before day 7 to 45.5% (25/55) during days 15–39. Combining RNA and antibody detection significantly improved the sensitivity of pathogenic diagnosis for COVID-19 (P < .001), even in the early phase of 1 week from onset (P = .007). Moreover, a higher titer of Ab was independently associated with a worse clinical classification (P = .006). Conclusions: Antibody detection offers vital clinical information during the course of SARS-CoV-2 infection. The findings provide strong empirical support for the routine application of serological testing in the diagnosis and management of COVID-19 patients.

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Authors: Zhao, J., Yuan, Q., Wang, H., Liu, W., Liao, X., Su, Y., Wang, X., Yuan, J., Li, T., Li, J., Qian, S., Hong, C., Wang, F., Liu, Y., Wang, Z., He, Q., Li, Z., He, B., Zhang, T., Fu, Y., Ge, S., Liu, L., Zhang, J., Xia, N., & Zhang, Z.
Affiliations: Shenzhen Third People’s Hospital (CN)
Xiamen University (CN)
Southern University of Science and Technology (CN)
Corresponding author: Zhang, Zheng
ORCID: Zhao, Juanjuan
Yuan, Quan
Wang, Haiyan
Liu, Wei
Su, Yingying
Yuan, Jing
Li, Tingdong
Li, Jinxiu
Qian, Shen
Wang, Fuxiang
Liu, Yingxia
Wang, Zhaoqin
He, Qing
Li, Zhiyong
He, Bin
Zhang, Tianying
Fu, Yang
Ge, Shengxiang
Liu, Lei
Zhang, Jun
Xia, Ningshao
Zhang, Zheng
Venue: Clinical Infectious Diseases
Publisher: Oxford University Press (OUP)
Published: 2020-05-28
Volume: 71
Issue: 16
Pages: 2027-2034
ISSN: 1058-4838 (ISSN-L)
1537-6591
DOI: 10.1093/cid/ciaa344
PMC: PMC7184337
OpenAlex: W3013985547
Cited by: 2,607
References: 13
Citations by year: 2026: 14 · 2025: 54 · 2024: 95 · 2023: 175 · 2022: 359 · 2021: 862 · 2020: 1046
FWCI: 80.11
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations: Clinical Infectious Diseases (publishedVersion)
medRxiv (acceptedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Bill and Melinda Gates Foundation
Topics: Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 detection and testing
Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Keywords: SARS-CoV-2, COVID-19 pandemic, antibody response, seroconversion, IgM, IgG, serological diagnosis, viral RNA detection, disease severity, antibody titers, diagnostic sensitivity
MeSH terms: COVID-19, SARS-CoV-2, Adult, Aged, Antibodies, Viral, Antibody Formation, Enzyme-Linked Immunosorbent Assay, Female, Humans, Immunoglobulin G, Immunoglobulin M, Male, Middle Aged, Serologic Tests, Pandemics

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