tetano
Editor, Senior Moderator
J Allergy Clin Immunol
. 2020 Nov 19;S0091-6749(20)31623-7.
doi: 10.1016/j.jaci.2020.10.040. Online ahead of print.
Systemic and mucosal antibody responses specific to SARS-CoV-2 during mild versus severe COVID-19
Carlo Cervia[SUP] 1 [/SUP], Jakob Nilsson[SUP] 1 [/SUP], Yves Zurbuchen[SUP] 1 [/SUP], Alan Valaperti[SUP] 1 [/SUP], Jens Schreiner[SUP] 1 [/SUP], Aline Wolfensberger[SUP] 2 [/SUP], Miro E Raeber[SUP] 1 [/SUP], Sarah Adamo[SUP] 1 [/SUP], Sebastian Weigang[SUP] 3 [/SUP], Marc Emmenegger[SUP] 4 [/SUP], Sara Hasler[SUP] 1 [/SUP], Philipp P Bosshard[SUP] 5 [/SUP], Elena De Cecco[SUP] 4 [/SUP], Esther B?chli[SUP] 6 [/SUP], Alain Rudiger[SUP] 7 [/SUP], Melina St?ssi-Helbling[SUP] 8 [/SUP], Lars C Huber[SUP] 8 [/SUP], Annelies S Zinkernagel[SUP] 2 [/SUP], Dominik J Schaer[SUP] 9 [/SUP], Adriano Aguzzi[SUP] 4 [/SUP], Georg Kochs[SUP] 10 [/SUP], Ulrike Held[SUP] 11 [/SUP], Elsbeth Probst-M?ller[SUP] 1 [/SUP], Silvana K Rampini[SUP] 9 [/SUP], Onur Boyman[SUP] 12 [/SUP]
Affiliations
Abstract
Background: Whereas severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific antibody tests are increasingly used to estimate the prevalence of SARS-CoV-2 infection, the determinants of these antibody responses remain unclear.
Objectives: To evaluate systemic and mucosal antibody responses toward SARS-CoV-2 in mild versus severe coronavirus disease 2019 (COVID-19) cases.
Methods: Using immunoassays specific for SARS-CoV-2 spike proteins, we determined SARS-CoV-2-specific immunoglobulin A (IgA) and immunoglobulin G (IgG) in sera and mucosal fluids of two cohorts, including SARS-CoV-2 polymerase chain reaction (PCR)[SUP]+[/SUP] patients (n = 64) as well as PCR[SUP]+[/SUP] and PCR[SUP]-[/SUP] healthcare workers (n = 109).
Results: SARS-CoV-2-specific serum IgA titers in mild COVID-19 cases were often transiently positive, whereas serum IgG titers remained negative or became positive 12-14 days after symptom onset. Conversely, patients with severe COVID-19 showed a highly significant increase of SARS-CoV-2-specific serum IgA and IgG titers after symptom onset. Very high titers of SARS-CoV-2-specific serum IgA correlated with severe acute respiratory distress syndrome (ARDS). Interestingly, some healthcare workers with negative SARS-CoV-2-specific serum antibody titers showed SARS-CoV-2-specific IgA in mucosal fluids with virus-neutralizing capacity in some cases. SARS-CoV-2-specific IgA titers in nasal fluids inversely correlated with age.
Conclusions: Systemic antibody production against SARS-CoV-2 develops mainly in severe COVID-19, with very high IgA titers seen in patients with severe ARDS, whereas mild disease may be associated with transient production of SARS-CoV-2-specific antibodies but stimulate mucosal SARS-CoV-2-specific IgA secretion.
Keywords: COVID-19; COVID-19 seroprevalence; COVID-19 severity; Humoral immune response; Mucosal immune response; SARS-CoV-2; SARS-CoV-2-specific IgA; SARS-CoV-2-specific IgG; SARS-CoV-2-specific antibodies.
. 2020 Nov 19;S0091-6749(20)31623-7.
doi: 10.1016/j.jaci.2020.10.040. Online ahead of print.
Systemic and mucosal antibody responses specific to SARS-CoV-2 during mild versus severe COVID-19
Carlo Cervia[SUP] 1 [/SUP], Jakob Nilsson[SUP] 1 [/SUP], Yves Zurbuchen[SUP] 1 [/SUP], Alan Valaperti[SUP] 1 [/SUP], Jens Schreiner[SUP] 1 [/SUP], Aline Wolfensberger[SUP] 2 [/SUP], Miro E Raeber[SUP] 1 [/SUP], Sarah Adamo[SUP] 1 [/SUP], Sebastian Weigang[SUP] 3 [/SUP], Marc Emmenegger[SUP] 4 [/SUP], Sara Hasler[SUP] 1 [/SUP], Philipp P Bosshard[SUP] 5 [/SUP], Elena De Cecco[SUP] 4 [/SUP], Esther B?chli[SUP] 6 [/SUP], Alain Rudiger[SUP] 7 [/SUP], Melina St?ssi-Helbling[SUP] 8 [/SUP], Lars C Huber[SUP] 8 [/SUP], Annelies S Zinkernagel[SUP] 2 [/SUP], Dominik J Schaer[SUP] 9 [/SUP], Adriano Aguzzi[SUP] 4 [/SUP], Georg Kochs[SUP] 10 [/SUP], Ulrike Held[SUP] 11 [/SUP], Elsbeth Probst-M?ller[SUP] 1 [/SUP], Silvana K Rampini[SUP] 9 [/SUP], Onur Boyman[SUP] 12 [/SUP]
Affiliations
- PMID: 33221383
- DOI: 10.1016/j.jaci.2020.10.040
Abstract
Background: Whereas severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific antibody tests are increasingly used to estimate the prevalence of SARS-CoV-2 infection, the determinants of these antibody responses remain unclear.
Objectives: To evaluate systemic and mucosal antibody responses toward SARS-CoV-2 in mild versus severe coronavirus disease 2019 (COVID-19) cases.
Methods: Using immunoassays specific for SARS-CoV-2 spike proteins, we determined SARS-CoV-2-specific immunoglobulin A (IgA) and immunoglobulin G (IgG) in sera and mucosal fluids of two cohorts, including SARS-CoV-2 polymerase chain reaction (PCR)[SUP]+[/SUP] patients (n = 64) as well as PCR[SUP]+[/SUP] and PCR[SUP]-[/SUP] healthcare workers (n = 109).
Results: SARS-CoV-2-specific serum IgA titers in mild COVID-19 cases were often transiently positive, whereas serum IgG titers remained negative or became positive 12-14 days after symptom onset. Conversely, patients with severe COVID-19 showed a highly significant increase of SARS-CoV-2-specific serum IgA and IgG titers after symptom onset. Very high titers of SARS-CoV-2-specific serum IgA correlated with severe acute respiratory distress syndrome (ARDS). Interestingly, some healthcare workers with negative SARS-CoV-2-specific serum antibody titers showed SARS-CoV-2-specific IgA in mucosal fluids with virus-neutralizing capacity in some cases. SARS-CoV-2-specific IgA titers in nasal fluids inversely correlated with age.
Conclusions: Systemic antibody production against SARS-CoV-2 develops mainly in severe COVID-19, with very high IgA titers seen in patients with severe ARDS, whereas mild disease may be associated with transient production of SARS-CoV-2-specific antibodies but stimulate mucosal SARS-CoV-2-specific IgA secretion.
Keywords: COVID-19; COVID-19 seroprevalence; COVID-19 severity; Humoral immune response; Mucosal immune response; SARS-CoV-2; SARS-CoV-2-specific IgA; SARS-CoV-2-specific IgG; SARS-CoV-2-specific antibodies.