COVID-19 confirmed patients with negative antibodies results
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CASE REPORT
Open Access
COVID-19 confirmed patients with negative antibodies results Jian Wang1,2, Chong Chen3, Qilin Li1,2, Pengcheng Cai1, Zheng Wang2,4*
and Lin Wang1,2*
Abstract Background: A new coronavirus disease 2019 (COVID-19) has escalated to a pandemic since its first outbreak in Wuhan, China. A small proportion of patients may have difficulty in generating IgM or IgG antibodies against SARSCoV-2, and little attention has been paid to them. Case presentations: We present two cases of confirmed COVID-19 patients and characterize their initial symptoms, chest CT results, medication, and laboratory test results in detail (including RT-PCR, IgM/ IgG, cytokine and blood cell counts). Conclusion: Both of patients with confirmed COVID-19 pneumonia failed to produce either IgM or IgG even 40 to 50 days after their symptoms onset. This work provides evidence demonstrating that at least a small proportion of patients may have difficulty in rapidly gaining immunity against SARS-CoV-2. Keywords: Case report, COVID-19, IgM, IgG, Negative antibodies results
Background During the outbreak of coronavirus 2019 (COVID-19) [1–3], a small proportion of confirmed COVID-19 patients fail to produce IgM or IgG antibodies against SARS-CoV-2 even 40 days or longer periods of time after onset of their initial symptoms. However, most of the current studies so far are focused on the general population but for these patients. From January 30 to March 15, 310 of COVID-19 patients who were positive for SARS-CoV-2 real time reverse-transcription PCR (RT-PCR) testing and received IgM and IgG detection at Wuhan Union Hospital (Wuhan, China) were enrolled. RT-PCR was performed through amplifying ORF1ab gene and N gene of SARSCoV-2 (BioGerm, Shanghai, China) using oropharyngeal swab specimens of all patients. From March 4 to 15, * Correspondence: [email protected]; [email protected] 2 Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China 1 Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China Full list of author information is available at the end of the article
IgM and IgG of SARS-CoV-2 were tested using blood samples for all these 310 patients. Two different kits were used to detect antibodies through immune colloidal gold (ICG) technique (Yingnuote, Tangshan, China) and chemiluminescence immunoassay (CLIA) technique (Yahuilong, Shenzhen, China). Laboratory test results were collected and analyzed. Among 310 COVID-19-confirmed patients, 308 of them were tested positive for IgM and/ or IgG, but only two patients were negative for IgM and IgG detection.
Case presentations Case 1
Patient 1 (Fig. 1), a 29-year-old man, developed a cough and a sore throat with no fever on January 28. Groundglass opacities in chest CT and positive RT-PCR test results were obtained on February 2 and 8, respectively. Four days later (February 12), this patien
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