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. 2006 Feb;35(2):179-84.
doi: 10.1016/j.jcv.2005.07.005. Epub 2005 Aug 19.

Anti-SARS-CoV IgG response in relation to disease severity of severe acute respiratory syndrome

Nelson Lee  1 , P K S Chan, Margaret Ip, Eric Wong, Jenny Ho, Catherine Ho, C S Cockram, David S Hui
Affiliations

Anti-SARS-CoV IgG response in relation to disease severity of severe acute respiratory syndrome

Nelson Lee et al. J Clin Virol. 2006 Feb.

Abstract

Background: The association between a robust or depressed antibody response and clinical severity of SARS remains unknown.

Objectives: To study seroconversion and the magnitude of IgG responses in a SARS cohort with different disease severities.

Study design and method: A retrospective analysis of all acute and convalescent-phase sera collected from a cohort of laboratory-confirmed SARS cases. Anti-SARS-CoV IgG antibody was detected using indirect immunofluorescence technique and quantified by two-fold serial dilutions. Characteristics of patients who seroconverted "early" (<median interval) were compared to those documented to remain sero-negative during the same time interval. Median IgG levels in convalescent-phase sera (collected within 30 days) were compared among patients with different disease severities. Correlations between IgG levels and important laboratory parameters were assessed.

Results: A total of 325 laboratory-confirmed SARS cases were analyzed; of which 301 (92.6%) had anti-SARS-CoV IgG detected in their sera at the time of sampling. IgG was first detected on day 4 of illness; seroconversion occurred at a median of 16 days (range 4-35 days), and IgG peak levels were reached in the fourth week. Early seroconversion (<day 16) occurred more frequently among patients who required ICU-admission (chi2; p=0.011). Higher IgG levels were detected in patients who required supplemental oxygen (Mann-Whitney; p=0.002), ICU-admission (p=0.001), had negative pre-discharge fecal RT-PCR results (p=0.004), and lymphopenia at presentation (p=0.028). Peak IgG titres also correlated positively with peak LDH levels (Spearman's r=+0.360; p<0.001) among survivors.

Conclusions: Severe SARS is associated with a more robust IgG response.

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Figures

Fig. 1
Fig. 1
(a and b) Median anti-SARS-CoV IgG titres in patients with different disease severities within first 4 weeks of illness. ICU: intensive care unit; O2-therapy: oxygen supplement required to maintain oxygen saturation >95%; IFA: indirect immunofluorescence assay.
See this image and copyright information in PMC

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