Early Humoral Response Correlates with Disease Severity and Outcomes in COVID-19 Patients
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Abstract
The Coronavirus Disease 2019 (COVID-19), caused by SARS-CoV-2, continues to spread globally with significantly high morbidity and mortality rates. Antigen-specific responses are of unquestionable value for clinical management of COVID-19 patients. Here, we investigated the kinetics of IgM, IgG against the spike (S) and nucleoproteins (N) proteins and their neutralizing capabilities in hospitalized COVID-19 patients with different disease presentations (i.e., mild, moderate or severe), need for intensive care units (ICU) admission or outcomes (i.e., survival vs death). We show that SARS-CoV-2 specific IgG, IgM and neutralizing antibodies (nAbs) were readily detectable in almost all COVID-19 patients with various clinical presentations. Interestingly, significantly higher levels of nAbs as well as anti-S1 and -N IgG and IgM antibodies were found in patients with more severe symptoms, patients requiring admission to ICU or those with fatal outcomes. More importantly, early after symptoms onset, we found that the levels of anti-N antibodies correlated strongly with disease severity. Collectively, these findings provide new insights into the kinetics of antibody responses in COVID-19 patients with different disease severity.
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SciScore for 10.1101/2020.09.21.20198309: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: Human subjects: Signed informed consent forms were obtained from all patients as per institutional ethical approvals obtained from the Unit of Biomedical Ethics in King Abdulaziz University Hospital (Reference No 245-20), the Institutional Review Board at the Ministry of Health, Saudi Arabia (IRB Numbers: H-02-K-076-0320-279 and H-02-K-076-0420-285), and the Global Center for Mass Gatherings Medicine, Saudi Arabia (GCMGM) (No. 20/03A).
IRB: Human subjects: Signed informed consent forms were obtained from all patients as per institutional ethical approvals obtained from the Unit of Biomedical Ethics in King Abdulaziz University Hospital (Reference No …SciScore for 10.1101/2020.09.21.20198309: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: Human subjects: Signed informed consent forms were obtained from all patients as per institutional ethical approvals obtained from the Unit of Biomedical Ethics in King Abdulaziz University Hospital (Reference No 245-20), the Institutional Review Board at the Ministry of Health, Saudi Arabia (IRB Numbers: H-02-K-076-0320-279 and H-02-K-076-0420-285), and the Global Center for Mass Gatherings Medicine, Saudi Arabia (GCMGM) (No. 20/03A).
IRB: Human subjects: Signed informed consent forms were obtained from all patients as per institutional ethical approvals obtained from the Unit of Biomedical Ethics in King Abdulaziz University Hospital (Reference No 245-20), the Institutional Review Board at the Ministry of Health, Saudi Arabia (IRB Numbers: H-02-K-076-0320-279 and H-02-K-076-0420-285), and the Global Center for Mass Gatherings Medicine, Saudi Arabia (GCMGM) (No. 20/03A).Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Cell Line Authentication not detected. Table 2: Resources
Antibodies Sentences Resources After another washing, plates were incubated with HRP□conjugated goat anti□human IgG (H□+□L) or IgM antibodies (Jackson ImmunoResearch, West Grove, PA) for 1 h, washed again, and incubated with TMB (3,3’,5,5’-tetramethylbenzidine) substrate (KPL, Gaithersburg, MD) at room temperature for 30□min. anti□human IgGsuggested: NoneIgMsuggested: NoneTo completely remove any excess amount of the rVSV-ΔG/G*-luciferase, 15 ml of DMEM containing rabbit polyclonal anti VSV-G antibody were added to the cells monolayer and incubated for 24 h at 37°C in 5% CO2 humidified incubator. anti VSV-Gsuggested: NoneExperimental Models: Cell Lines Sentences Resources Cells: Baby Hamster kidney BHK-21/WI-2 cell line (Kerafast, EH1011) and African Green monkey kidney-derived Vero E6 cell line (ATCC, 1586) were cultured in Dulbecco’s modified essential medium (DMEM) contained 100 U/ml of penicillin, and 100 μg/ml of streptomycin and supplemented with 5 and 10% fetal bovine serum (FBS) in a 5% CO2 environment at 37°C. BHK-21/WI-2suggested: RRID:CVCL_HB78)Briefly, a T-175 tissue culture flask of BHK21/WI-2 cells were transfected with 46 μg of pcDNA expressing codon-optimized full-length SARS-CoV-2 S protein (GenBank accession number: MN908947) using Lipofectamine ™ 2000 transfection reagent (Invitrogen). BHK21/WI-2suggested: RRID:CVCL_HB78)Then, a 100 μl of the pseudovirus–serum mixtures were transferred onto Vero E6 cell monolayers and incubated at 37°C in a 5% CO2 humidified incubator for 24 h. Vero E6suggested: NoneSoftware and Algorithms Sentences Resources Median Inhibitory Concentration (IC50) neutralization titers were determined using four-parameter logistic (4PL) curve in GraphPad Prism V8 software (GraphPad Co.). GraphPadsuggested: (GraphPad Prism, RRID:SCR_002798)Statistical analysis: Statistical analyses and graphical presentations were conducted with GraphPad Prism version 8.0 software ( GraphPad Prismsuggested: (GraphPad Prism, RRID:SCR_002798)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: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.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.
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