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. 2020 Oct:130:110629.
doi: 10.1016/j.biopha.2020.110629. Epub 2020 Aug 13.

SARS-CoV-2 neutralizing antibody levels are correlated with severity of COVID-19 pneumonia

Wei Chen  1 , Jie Zhang  2 , Xijian Qin  3 , Weixiao Wang  1 , Miaomiao Xu  4 , Lin-Fa Wang  5 , Chuanjun Xu  6 , Shuangshuang Tang  3 , Pei Liu  3 , Libo Zhang  7 , Xuan Liu  8 , Yongchen Zhang  8 , Changhua Yi  4 , Zhiliang Hu  9 , Yongxiang Yi  10
Affiliations

SARS-CoV-2 neutralizing antibody levels are correlated with severity of COVID-19 pneumonia

Wei Chen et al. Biomed Pharmacother. 2020 Oct.

Abstract

The emerging coronavirus disease 2019 (COVID-19) has become a serious global public health threat. With more and more recovered patients, it is urgently needed for evaluation of the neutralizing antibody (NAb) in these patients. In this study, we collected blood samples from 49 patients recently recovered from COVID-19. Serum NAbs were measured using a novel surrogate virus neutralization test (sVNT). Factors associated with NAb titers were analyzed using Ordinary Least Squares regression model. The median age of the study participants was 37 years (IQR, 30.0-54.5) and 55.1 % (27/49) of which were male. The median time to blood collection (for NAb analysis) from illness onset, viral clearance and discharge were 43.0 days (IQR, 36.0-50.0), 27.0 days (IQR, 20.5-37) and 17.0 days (IQR, 15.0-33.0), respectively. Patients had a median NAb titer of 1: 40 (IQR, 1:15-1:120). NAbs were not detected in two asymptomatic children who quickly cleared the virus. NAb titers were higher in patients with older age (p = 0.020), symptomatic infection (p = 0.044), more profound lung involvement (p＜0.001), abnormal C-reactive protein level (p＜0.01) and elevated lactate dehydrogenase (p = 0.019). Multivariable analysis revealed that severity of pneumonia and having comorbidity positively correlated with NAb titers in recovered patients (p = 0.02), while use of corticosteroids negatively impacted NAb titers (p = 0.01). Our study suggests that some COVID-19 patients may not have detectable NAb after recovery. SARS-CoV-2 NAb titers are positively correlated with severity of COVID-19 pneumonia.

Keywords: Antibody-dependent enhancement; COVID-19; Humoral immunity; Neutralizing antibody; Pneumonia; SARS-CoV-2.

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Conflict of interest statement

Authors XQ, ST and PL were employed by the company GenScript Biotech. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Fig. 1
Fig. 1
Distribution of neutralizing antibody titers in different patient groups. NAb, neutralizing antibody; CT, computed tomography; CRP, C-reactive protein; LDH, lactate dehydrogenase.
Fig. 2
Fig. 2
Correlation between neutralizing antibody titers and CT scores.
Fig. 3
Fig. 3
Antibody analysis in two patients with negative neutralizing antibody test results. RBD, receptor binding domain; N, nucleocapsid protein.
See this image and copyright information in PMC

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