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. 2020 Dec;9(1):1096-1101.
doi: 10.1080/22221751.2020.1766382.

Delayed specific IgM antibody responses observed among COVID-19 patients with severe progression

Liang Shen  1 , Chunhua Wang  1 , Jianzhong Zhao  1 , Xiaoyong Tang  1 , Ying Shen  1 , Mingqing Lu  2 , Zhe Ding  2 , Canping Huang  2 , Ji Zhang  1 , Shichao Li  1 , Jiaming Lan  2 , Gary Wong  2   3 , Yufang Zhu  1
Affiliations

Delayed specific IgM antibody responses observed among COVID-19 patients with severe progression

Liang Shen et al. Emerg Microbes Infect. 2020 Dec.

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly worldwide since it was confirmed as the causative agent of COVID-19. Molecular diagnosis of the disease is typically performed via nucleic acid-based detection of the virus from swabs, sputum or bronchoalveolar lavage fluid (BALF). However, the positive rate from the commonly used specimens (swabs or sputum) was less than 75%. Immunological assays for SARS-CoV-2 are needed to accurately diagnose COVID-19. Sera were collected from patients or healthy people in a local hospital in Xiangyang, Hubei Province, China. The SARS-CoV-2 specific IgM antibodies were then detected using a SARS-CoV-2 IgM colloidal gold immunochromatographic assay (GICA). Results were analysed in combination with sera collection date and clinical information. The GICA was found to be positive with the detected 82.2% (37/45) of RT-qPCR confirmed COVID-19 cases, as well as 32.0% (8/25) of clinically confirmed, RT-qPCR negative patients (4-14 days after symptom onset). Investigation of IgM-negative, RT-qPCR-positive COVID-19 patients showed that half of them developed severe disease. The GICA was found to be a useful test to complement existing PCR-based assays for confirmation of COVID-19, and a delayed specific IgM antibody response was observed among COVID-19 patients with severe progression.

Keywords: COVID-19; GICA; IgM antibody; delayed; severity.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Use of the GICA for the detection of SARS-CoV-2 specific IgM in human sera. (A) Sample negative or positive IgM test. (B) Positive IgM antibody rates between COVID-19 patients, clinically confirmed but RT-qPCR negative patients, non-COVID-19 respiratory illness and healthy people. (C) Comparison of IgM detection rates in RT-qPCR confirmed, mild vs. severe, COVID-19 patients. **P < 0.01.
Figure 2.
Figure 2.
IgM responses in mild vs. severe COVID-19 patients. (A) The positive rates of the SARS-CoV-2 IgM antibodies in mild and severe COVID-19 patients over time. P < 0.01.
See this image and copyright information in PMC

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