Serum antibody response in critically ill patients with COVID-19
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LETTER
Serum antibody response in critically ill patients with COVID‑19 Alban Longchamp1,2,3 , Justine Longchamp1,3, Antony Croxatto4, Gilbert Greub4, Bienvenido Sanchez1*, Julie Delaloye1* on behalf of the Study Group © 2020 Springer-Verlag GmbH Germany, part of Springer Nature
Dear Editor, Coronavirus disease 19 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), which has affected more than 7 million people. High mortality rates were reported among elderly, and those requiring mechanical ventilation in the intensive care unit (ICU) [1, 2]. Understanding virus kinetics, and host serological response to SARS-CoV-2 is crucial to guide treatment, vaccine design and epidemiological control [3]. Currently, the antibody response against SARS-CoV-2 in critically ill patients remains unknown. We analyzed the antibody response in 28 critically Ill patients, with laboratory confirmed SARS-Cov-2 infection, admitted to Sion hospital ICU (Switzerland), between March 8th and April 4th, 2020. Only patients with serum samples available at two different time points were included. Experimental methods are described in the electronic supplementary material. The characteristics of the cohort are summarized in Table S1-3. 27 (96%) patients required mechanical ventilation, and 5 (19%) patients died. The median (IQR) intervals from symptom onset to ICU, and hospital admission were 9 (7–12), and 6 (4–10) days, respectively (Table S1). 26 (93%) patients had available serum sample within ± 2 days of ICU admission. Of them, 15 (58%)
*Correspondence: [email protected]; Julie.Delaloye@ hopitalvs.ch 1 Department of Intensive Care Medicine, Centre Hospitalier du Valais Romand de l’Hôpital du Valais, (Site de Sion) Avenue du Grand‑Champsec 80, 1951 Sion, Switzerland Full author information is available at the end of the article Alban Longchamp, Justine Longchamp, Bienvenido Sanchez and Julie Delaloye have contributed equally. Members of study group are listed in acknowledgement section.
already had virus-specific IgG antibodies. (Table S2, and Fig. 1a, b). The distribution of IgG seroconversion time from the date of ICU admission showed 2 peaks, the first one on admission, the second one about 20 days later. The median (IQR) time was 17 (1–22) days (Fig. 1b). The distribution of IgG seroconversion time, since the onset of symptoms showed only one peak, with the median (IQR) time at 10 (7–13) days (Fig. 1c). The proportion of patients with positive virus-specific IgG reached 96% over the follow-up period (Fig. 1a, and Table S2). At ICU admission, anti-N IgG levels correlated with the time from symptom onset (Fig. 1d). No association was seen between anti-N IgG levels and age, or any of the other clinical, and laboratory data assessed (Fig. S1). Interestingly, two patients had no, or weak IgG seroconversion in the ICU. One had leukemia, the other one lymphoma. They died on day 4, and 38 respectively. Patients were then split into survivors (that were discharged from the ICU), and non-s
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