SARS-CoV-2 Antibodies and Associated Factors at Different Hospitalization Time Points in 192 COVID-19 Cases

  1. Jingyi Ou
  2. Mingkai Tan
  3. Haolan He
  4. Haiyan Tan
  5. Jiewen Mai
  6. Yaoxiang Long
  7. Xiaowen Jiang
  8. Qing He
  9. Ying Huang
  10. Yan Li
  11. Renshen Chen
  12. Liya Li
  13. Yaling Shi
  14. Fang Li

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Abstract

Background

We launched a retrospective analysis of SARS-CoV-2 antibodies in 192 patients with COVID-19, aiming to depict the kinetic profile of SARS-CoV-2 antibodies and explore the factors related to SARS-CoV-2 antibody expression.

Methods

Data on 192 confirmed patients with COVID-19 between January and February 2020 was collected from the designated hospital that received patients with COVID-19 in Guangzhou, China. Moreover, a cohort of 130 suspected patients with COVID-19 and 209 healthy people were also enrolled in this study. IgM and IgG antibodies to SARS-CoV-2 were detected by the chemiluminescence immunoassay kits in different groups.

Results

A total of 192 COVID-19 cases were analyzed, of which had 81.8% anti-SARS-CoV-2 IgM detected and 93.2% anti-SARS-CoV-2 IgG detected, respectively, at the time of sampling. The kinetics of anti-SARS-CoV-2 IgM and IgG showed that, the confirmed cases had anti-SARS-CoV-2 IgM seroconversion occurred 5–10 days after the onset of the symptoms, and then IgM rose rapidly to reach a peak within around 2–3 weeks, maintaining at its peak for 1 week before its decline. While they had anti-SARS-CoV-2 IgG seroconversion simultaneously or sequentially with IgM, reaching its peak within around 3 to 4 weeks and began to decline after the fifth week. Besides, correlation analysis showed that in patients with COVID-19 the level of IgM was related to gender and disease severity (P < 0.01), and the level of IgG was related to age and disease severity (P < 0.001). The univariate analysis of relevant factors indicated that the level of IgG had a weak correlation with age (r = 0.374, P < 0.01). The level of IgM in male patients was higher than that in female patients (P < 0.001). The expression level of anti-SARS-CoV-2 IgM and IgG were positively correlated with the severity of COVID-19 and the duration of the virus in the patients.

Conclusion

The findings of this study show that anti-SARS-CoV-2 IgM and IgG can be important assisting COVID-19 diagnosis, especially in the early phase of infection. Furthermore, antibody expression in patients with COVID-19 is also correlated with disease severity, age, gender, and virus clearance or continuous replication.

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  1. Version published to 10.1093/jalm/jfab003
  2. ScreenIT

    SciScore for 10.1101/2020.05.22.20102525: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: All patients in this study have signed the informed consent, and the experimental protocol was approved by the Ethics Committee of Guangzhou Eighth People’s Hospital(No.20200547).
    IRB: All patients in this study have signed the informed consent, and the experimental protocol was approved by the Ethics Committee of Guangzhou Eighth People’s Hospital(No.20200547).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableThe median age of the healthy people was 49(IQR, 32-56years) years and 47.8% was male.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analysis were performed by SPSS version 22.0(IBM SPSS, Chicago, Illinois) and GraphPad Prism version 5.0(Graphpad Software, Inc., CA, USA).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)
    Graphpad
    suggested: (GraphPad, RRID:SCR_000306)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Due to the limitations of the study, it is difficult for us to observe the results of daily blood sampling after admission to the hospital, which will inevitably cause missed IgM seroconversion. This is also one of the limitations of the research. The first serological blood samples were drawn from COVID-19 patients within two days of admission. We sorted out the detection results of 3 time points (the first test point, the last negative point and the first positive point).The results of 3 time points were compared with the results of the control group, we found that the concentration of antibodies in patients before the seroconversion was higher than that of healthy population, with an increasing trend. It indicated that the antibodies of COVID-19 patients began to produce early in the infection, however the concentration of them have not reached the threshold we set so couldn’t be detected. Therefore, COVID-19 suspects whose concentration of antibodies are below “sea level” cannot be judged uninfected by only one test. The serological test of COVID-19 suspects should be dynamically observed multiple times to find out whether the antibody has an upward trend. In the cohort of our observation, IgM and IgG of 13 patients were not detected, while 12 patients were observed during hospitalization to rehabilitation period, and only one patient remained negative during hospitalization, unfortunately missing observation in rehabilitation period. All of them are non-severe patients, ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.05.22.20102525 on medRxiv