tetano
Editor, Senior Moderator
Crit Care Explor
. 2021 Mar 12;3(3):e0369.
doi: 10.1097/CCE.0000000000000369. eCollection 2021 Mar.
Detection and Profiling of Human Coronavirus Immunoglobulins in Critically Ill Coronavirus Disease 2019 Patients
Douglas D Fraser[SUP] 1 2 3 4 [/SUP], Gediminas Cepinskas[SUP] 1 5 [/SUP], Marat Slessarev[SUP] 1 6 [/SUP], Claudio M Martin[SUP] 1 6 [/SUP], Mark Daley[SUP] 1 7 8 [/SUP], Maitray A Patel[SUP] 7 [/SUP], Michael R Miller[SUP] 1 2 [/SUP], Eric K Patterson[SUP] 1 [/SUP], David B O'Gorman[SUP] 1 9 10 [/SUP], Sean E Gill[SUP] 1 4 6 [/SUP], Susanne Oehler[SUP] 11 [/SUP], Markus Miholits[SUP] 11 [/SUP], Brian Webb[SUP] 12 [/SUP]
Affiliations
Abstract
Objectives: Coronavirus disease 2019 continues to spread worldwide with high levels of morbidity and mortality. We performed anticoronavirus immunoglobulin G profiling of critically ill coronavirus disease 2019 patients to better define their underlying humoral response.
Design: Blood was collected at predetermined ICU days to measure immunoglobulin G with a research multiplex assay against four severe acute respiratory syndrome coronavirus 2 proteins/subunits and against all six additionally known human coronaviruses.
Setting: Tertiary care ICU and academic laboratory.
Subjects: ICU patients suspected of being infected with severe acute respiratory syndrome coronavirus 2 had blood collected until either polymerase chain reaction testing was confirmed negative on ICU day 3 (coronavirus disease 2019 negative) or until death or discharge if the patient tested polymerase chain reaction positive (coronavirus disease 2019 positive).
Interventions: None.
Measurements and main results: Age- and sex-matched healthy controls and ICU patients who were either coronavirus disease 2019 positive or coronavirus disease 2019 negative were enrolled. Cohorts were well-balanced with the exception that coronavirus disease 2019 positive patients had greater body mass indexes, presented with bilateral pneumonias more frequently, and suffered lower Pao[SUB]2[/SUB]:Fio[SUB]2[/SUB] ratios, when compared with coronavirus disease 2019 negative patients (p < 0.05). Mortality rate for coronavirus disease 2019 positive patients was 50%. On ICU days 1-3, anti-severe acute respiratory syndrome coronavirus 2 immunoglobulin G was significantly elevated in coronavirus disease 2019 positive patients, as compared to both healthy control subjects and coronavirus disease 2019 negative patients (p < 0.001). Weak severe acute respiratory syndrome coronavirus immunoglobulin G serologic responses were also detected, but not other coronavirus subtypes. The four anti-severe acute respiratory syndrome coronavirus 2 immunoglobulin G were maximal by ICU day 3, with all four anti-severe acute respiratory syndrome coronavirus 2 immunoglobulin G providing excellent diagnostic potential (severe acute respiratory syndrome coronavirus 2 Spike 1 protein immunoglobulin G, area under the curve 1.0, p < 0.0005; severe acute respiratory syndrome coronavirus receptor binding domain immunoglobulin G, area under the curve, 0.93-1.0; p ? 0.0001; severe acute respiratory syndrome coronavirus 2 Spike proteins immunoglobulin G, area under the curve, 1.0; p < 0.0001; severe acute respiratory syndrome coronavirus 2 Nucleocapsid protein immunoglobulin G area under the curve, 0.90-0.95; p ? 0.0003). Anti-severe acute respiratory syndrome coronavirus 2 immunoglobulin G increased and/or plateaued over 10 ICU days.
Conclusions: Critically ill coronavirus disease 2019 patients exhibited anti-severe acute respiratory syndrome coronavirus 2 immunoglobulin G, whereas serologic responses to non-severe acute respiratory syndrome coronavirus 2 antigens were weak or absent. Detection of human coronavirus immunoglobulin G against the different immunogenic structural proteins/subunits with multiplex assays may be useful for pathogen identification, patient cohorting, and guiding convalescent plasma therapy.
Keywords: coronavirus disease 2019; humoral response; immunoglobulins; intensive care unit; multiplex.
. 2021 Mar 12;3(3):e0369.
doi: 10.1097/CCE.0000000000000369. eCollection 2021 Mar.
Detection and Profiling of Human Coronavirus Immunoglobulins in Critically Ill Coronavirus Disease 2019 Patients
Douglas D Fraser[SUP] 1 2 3 4 [/SUP], Gediminas Cepinskas[SUP] 1 5 [/SUP], Marat Slessarev[SUP] 1 6 [/SUP], Claudio M Martin[SUP] 1 6 [/SUP], Mark Daley[SUP] 1 7 8 [/SUP], Maitray A Patel[SUP] 7 [/SUP], Michael R Miller[SUP] 1 2 [/SUP], Eric K Patterson[SUP] 1 [/SUP], David B O'Gorman[SUP] 1 9 10 [/SUP], Sean E Gill[SUP] 1 4 6 [/SUP], Susanne Oehler[SUP] 11 [/SUP], Markus Miholits[SUP] 11 [/SUP], Brian Webb[SUP] 12 [/SUP]
Affiliations
- PMID: 33786445
- PMCID: PMC7994038
- DOI: 10.1097/CCE.0000000000000369
Abstract
Objectives: Coronavirus disease 2019 continues to spread worldwide with high levels of morbidity and mortality. We performed anticoronavirus immunoglobulin G profiling of critically ill coronavirus disease 2019 patients to better define their underlying humoral response.
Design: Blood was collected at predetermined ICU days to measure immunoglobulin G with a research multiplex assay against four severe acute respiratory syndrome coronavirus 2 proteins/subunits and against all six additionally known human coronaviruses.
Setting: Tertiary care ICU and academic laboratory.
Subjects: ICU patients suspected of being infected with severe acute respiratory syndrome coronavirus 2 had blood collected until either polymerase chain reaction testing was confirmed negative on ICU day 3 (coronavirus disease 2019 negative) or until death or discharge if the patient tested polymerase chain reaction positive (coronavirus disease 2019 positive).
Interventions: None.
Measurements and main results: Age- and sex-matched healthy controls and ICU patients who were either coronavirus disease 2019 positive or coronavirus disease 2019 negative were enrolled. Cohorts were well-balanced with the exception that coronavirus disease 2019 positive patients had greater body mass indexes, presented with bilateral pneumonias more frequently, and suffered lower Pao[SUB]2[/SUB]:Fio[SUB]2[/SUB] ratios, when compared with coronavirus disease 2019 negative patients (p < 0.05). Mortality rate for coronavirus disease 2019 positive patients was 50%. On ICU days 1-3, anti-severe acute respiratory syndrome coronavirus 2 immunoglobulin G was significantly elevated in coronavirus disease 2019 positive patients, as compared to both healthy control subjects and coronavirus disease 2019 negative patients (p < 0.001). Weak severe acute respiratory syndrome coronavirus immunoglobulin G serologic responses were also detected, but not other coronavirus subtypes. The four anti-severe acute respiratory syndrome coronavirus 2 immunoglobulin G were maximal by ICU day 3, with all four anti-severe acute respiratory syndrome coronavirus 2 immunoglobulin G providing excellent diagnostic potential (severe acute respiratory syndrome coronavirus 2 Spike 1 protein immunoglobulin G, area under the curve 1.0, p < 0.0005; severe acute respiratory syndrome coronavirus receptor binding domain immunoglobulin G, area under the curve, 0.93-1.0; p ? 0.0001; severe acute respiratory syndrome coronavirus 2 Spike proteins immunoglobulin G, area under the curve, 1.0; p < 0.0001; severe acute respiratory syndrome coronavirus 2 Nucleocapsid protein immunoglobulin G area under the curve, 0.90-0.95; p ? 0.0003). Anti-severe acute respiratory syndrome coronavirus 2 immunoglobulin G increased and/or plateaued over 10 ICU days.
Conclusions: Critically ill coronavirus disease 2019 patients exhibited anti-severe acute respiratory syndrome coronavirus 2 immunoglobulin G, whereas serologic responses to non-severe acute respiratory syndrome coronavirus 2 antigens were weak or absent. Detection of human coronavirus immunoglobulin G against the different immunogenic structural proteins/subunits with multiplex assays may be useful for pathogen identification, patient cohorting, and guiding convalescent plasma therapy.
Keywords: coronavirus disease 2019; humoral response; immunoglobulins; intensive care unit; multiplex.