Viral and Antibody Kinetics of COVID-19 Patients with Different Disease Severities in Acute and Convalescent Phases: A 6
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RESEARCH ARTICLE
Viral and Antibody Kinetics of COVID-19 Patients with Different Disease Severities in Acute and Convalescent Phases: A 6-Month Follow-Up Study Xiaoyong Zhang1,4 • Suwen Lu1 • Hui Li1 • Yi Wang2 • Zhen Lu2 • Zhihong Liu1 • Qingtao Lai1 • Yali Ji1 • Xuan Huang1 • Yongyin Li1 • Jian Sun1 • Yingsong Wu3 • Xiaoning Xu5 • Jinlin Hou1,4 Received: 1 September 2020 / Accepted: 23 November 2020 Ó Wuhan Institute of Virology, CAS 2020
Abstract Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread rapidly around the world, posing a major threat to human health and the economy. Currently, long-term data on viral shedding and the serum antibody responses in COVID-19 patients are still limited. Herein, we report the clinical features, viral RNA loads, and serum antibody levels in a cohort of 112 COVID-19 patients admitted to the Honghu People’s Hospital, Hubei Province, China. Overall, 5.36% (6/112) of patients showed persistent viral RNA shedding ([ 45 days). The peak viral load was higher in the severe disease group than in the mild group (median cycle threshold value, 36.4 versus 31.5; P = 0.002). For most patients the disappearance of IgM antibodies occurred approximately 4–6 weeks after symptoms onset, while IgG persisted for over 194 days after the onset of symptoms, although patients showed a 46% reduction in antibodies titres against SARS-CoV-2 nucleocapsid protein compared with the acute phase. We also studied 18 asymptomatic individuals with RT-qPCR confirmed SARS-CoV-2 infection together with 17 symptomatic patients, and the asymptomatic individuals were the close contacts of these symptomatic cases. Delayed IgG seroconversion and lower IgM seropositive rates were observed in asymptomatic individuals. These data indicate that higher viral loads and stronger antibody responses are related to more severe disease status in patients with SARS-CoV-2 infection, and the antibodies persisted in the recovered patient for more than 6 months so that the vaccine may provide protection against SARS-CoV-2 infection. Keywords Coronavirus disease 2019 (COVID-19) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Viral shedding Antibody response Disease severity
Introduction
Xiaoyong Zhang and Suwen Lu have contributed equally to this work.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12250-020-00329-9) contains supplementary material, which is available to authorized users. & Jinlin Hou [email protected] 1
2
State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510000, China Department of Laboratory Medicine, The People’s Hospital of Honghu, Jingzhou 433200, China
Since the outbreak in Wuhan, Hubei Province, China in December 2019, Coronavirus disea
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