tetano
Editor, Senior Moderator
Infect Dis
. 2021 May 24;jiab283.
doi: 10.1093/infdis/jiab283. Online ahead of print.
Virological and serological characterization of critically ill patients with COVID-19 in the UK: Interactions of viral load, antibody status and B.1.1.7 variant infection
Jeremy Ratcliff[SUP] 1 [/SUP], Dung Nguyen[SUP] 1 [/SUP], Matthew Fish[SUP] 2 [/SUP], Jennifer Rynne[SUP] 2 [/SUP], Aislinn Jennings[SUP] 2 [/SUP], Sarah Williams[SUP] 1 [/SUP], Farah Al-Beidh[SUP] 3 [/SUP], David Bonsall[SUP] 4 5 [/SUP], Amy Evans[SUP] 6 [/SUP], Tanya Golubchik[SUP] 5 [/SUP], Anthony C Gordon[SUP] 3 7 [/SUP], Abigail Lamikanra[SUP] 8 [/SUP], Pat Tsang[SUP] 8 [/SUP], Nick A Ciccone[SUP] 9 [/SUP], Ullrich Leuscher[SUP] 8 [/SUP], Wendy Slack[SUP] 8 [/SUP], Emma Laing[SUP] 6 [/SUP], Paul R Mouncey[SUP] 10 [/SUP], Sheba Ziyenge[SUP] 11 [/SUP], Marta Oliveira[SUP] 11 12 [/SUP], Rutger Ploeg[SUP] 11 12 [/SUP], Kathryn M Rowan[SUP] 10 [/SUP], Manu Shankar-Hari[SUP] 2 13 [/SUP], David J Roberts[SUP] 8 9 [/SUP], David K Menon[SUP] 14 [/SUP], Lise Estcourt[SUP] 6 9 [/SUP], Peter Simmonds[SUP] 1 [/SUP], Heli Harvala[SUP] 15 [/SUP]
Affiliations
Abstract
Background: Convalescent plasma containing neutralising antibody to SARS-CoV-2 is under investigation for COVID-19 treatment. We report diverse virological characteristics of UK intensive care patients enrolled in the Immunoglobulin Domain of the REMAP-CAP randomised controlled trial that potentially influence treatment outcomes.
Methods: SARS-CoV-2 RNA in nasopharyngeal swabs collected pre-treatment was quantified by PCR. Antibody status was determined by spike-protein ELISA. B.1.1.7 was differentiated from other SARS-CoV-2 strains using allele-specific probes or restriction site polymorphism (SfcI) targeting D1118H.
Results: Of 1274 subjects, 90% were PCR-positive with viral loads 118-1.7x10 11 IU/ml. Median viral loads were 40-fold higher in those seronegative for IgG antibodies (n=354; 28%) compared to seropositives (n=939; 72%). Frequencies of B.1.1.7 increased from <1% in early November, 2020 to 82% of subjects in January 2021. Seronegative individuals with wild-type SARS-CoV-2 had significantly higher viral loads than seropositives (medians 5.8x10 6 and 2.0 x10 5 IU/ml respectively; p=2x10 -15). However, viral load distributions were elevated in both seronegative and seropositive subjects infected with B.1.1.7 (4.0x10 6 and 1.6x10 6 IU/ml respectively).
Conclusions: High viral loads in seropositive B.1.1.7-infected subjects and resistance to seroconversion indicate less effective clearance by innate and adaptive immune responses. SARS-CoV-2 strain, viral loads and antibody status define subgroups for analysis of treatment efficacy.
Keywords: Coronavirus; Polymerase Chain Reaction; SARS-CoV-2 COVID-19.
. 2021 May 24;jiab283.
doi: 10.1093/infdis/jiab283. Online ahead of print.
Virological and serological characterization of critically ill patients with COVID-19 in the UK: Interactions of viral load, antibody status and B.1.1.7 variant infection
Jeremy Ratcliff[SUP] 1 [/SUP], Dung Nguyen[SUP] 1 [/SUP], Matthew Fish[SUP] 2 [/SUP], Jennifer Rynne[SUP] 2 [/SUP], Aislinn Jennings[SUP] 2 [/SUP], Sarah Williams[SUP] 1 [/SUP], Farah Al-Beidh[SUP] 3 [/SUP], David Bonsall[SUP] 4 5 [/SUP], Amy Evans[SUP] 6 [/SUP], Tanya Golubchik[SUP] 5 [/SUP], Anthony C Gordon[SUP] 3 7 [/SUP], Abigail Lamikanra[SUP] 8 [/SUP], Pat Tsang[SUP] 8 [/SUP], Nick A Ciccone[SUP] 9 [/SUP], Ullrich Leuscher[SUP] 8 [/SUP], Wendy Slack[SUP] 8 [/SUP], Emma Laing[SUP] 6 [/SUP], Paul R Mouncey[SUP] 10 [/SUP], Sheba Ziyenge[SUP] 11 [/SUP], Marta Oliveira[SUP] 11 12 [/SUP], Rutger Ploeg[SUP] 11 12 [/SUP], Kathryn M Rowan[SUP] 10 [/SUP], Manu Shankar-Hari[SUP] 2 13 [/SUP], David J Roberts[SUP] 8 9 [/SUP], David K Menon[SUP] 14 [/SUP], Lise Estcourt[SUP] 6 9 [/SUP], Peter Simmonds[SUP] 1 [/SUP], Heli Harvala[SUP] 15 [/SUP]
Affiliations
- PMID: 34031695
- DOI: 10.1093/infdis/jiab283
Abstract
Background: Convalescent plasma containing neutralising antibody to SARS-CoV-2 is under investigation for COVID-19 treatment. We report diverse virological characteristics of UK intensive care patients enrolled in the Immunoglobulin Domain of the REMAP-CAP randomised controlled trial that potentially influence treatment outcomes.
Methods: SARS-CoV-2 RNA in nasopharyngeal swabs collected pre-treatment was quantified by PCR. Antibody status was determined by spike-protein ELISA. B.1.1.7 was differentiated from other SARS-CoV-2 strains using allele-specific probes or restriction site polymorphism (SfcI) targeting D1118H.
Results: Of 1274 subjects, 90% were PCR-positive with viral loads 118-1.7x10 11 IU/ml. Median viral loads were 40-fold higher in those seronegative for IgG antibodies (n=354; 28%) compared to seropositives (n=939; 72%). Frequencies of B.1.1.7 increased from <1% in early November, 2020 to 82% of subjects in January 2021. Seronegative individuals with wild-type SARS-CoV-2 had significantly higher viral loads than seropositives (medians 5.8x10 6 and 2.0 x10 5 IU/ml respectively; p=2x10 -15). However, viral load distributions were elevated in both seronegative and seropositive subjects infected with B.1.1.7 (4.0x10 6 and 1.6x10 6 IU/ml respectively).
Conclusions: High viral loads in seropositive B.1.1.7-infected subjects and resistance to seroconversion indicate less effective clearance by innate and adaptive immune responses. SARS-CoV-2 strain, viral loads and antibody status define subgroups for analysis of treatment efficacy.
Keywords: Coronavirus; Polymerase Chain Reaction; SARS-CoV-2 COVID-19.