Systemic and mucosal antibody responses specific to SARS-CoV-2 during mild versus severe COVID-19

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:147

Article

Cervia, Carlo¹  Nilsson, Jakob¹  Zurbuchen, Yves¹  Valaperti, Alan¹  Schreiner, Jens¹  Wolfensberger, Aline²  Raeber, Miro E.¹  Adamo, Sarah¹  Weigang, Sebastian⁶  Emmenegger, Marc³  Hasler, Sara¹  Bosshard, Philipp P.⁴  De Cecco, Elena³  Baechli, Esther⁸  Rudiger, Alain⁹  Stuessi-Helbling, Melina¹⁰  Huber, Lars C.¹⁰  Zinkernagel, Annelies S.²  Schaer, Dominik J.⁵  Aguzzi, Adriano³  Kochs, Georg^6,7  Held, Ulrike¹¹  Probst-Mueller, Elsbeth¹  Rampini, Silvana K.⁵  Boyman, Onur^1,12 

[1] Univ Hosp Zurich, Dept Immunol, Gloriastr 23, CH-8091 Zurich, Switzerland

[2] Univ Hosp Zurich, Dept Infect Dis & Hosp Epidemiol, Zurich, Switzerland

[3] Univ Hosp Zurich, Inst Neuropathol, Zurich, Switzerland

[4] Univ Hosp Zurich, Dept Dermatol, Zurich, Switzerland

[5] Univ Hosp Zurich, Dept Internal Med, Zurich, Switzerland

[6] Univ Freiburg, Inst Virol, Med Ctr, Freiburg, Germany

[7] Univ Freiburg, Fac Med, Freiburg, Germany

[8] Uster Hosp, Clin Internal Med, Uster, Switzerland

[9] Limmattal Hosp, Dept Med, Schlieren, Switzerland

[10] City Hosp Triemli Zurich, Clin Internal Med, Zurich, Switzerland

[11] Univ Zurich, Epidemiol Biostat & Prevent Inst, Dept Biostat, Zurich, Switzerland

[12] Univ Zurich, Fac Med, Zurich, Switzerland

关键词: COVID-19;    SARS-CoV-2;    SARS-CoV-2-specific antibodies;    SARS-CoV-2-specific IgA;    SARS-CoV-2-specific IgG;    humoral immune response;    mucosal immune response;    COVID-19 severity;    COVID-19 seroprevalence;   

DOI  :  10.1016/j.jaci.2020.10.040

来源: Elsevier

【 摘 要 】

Background: Whereas severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific antibody tests are increasingly being used to estimate the prevalence of SARS-CoV-2 infection, the determinants of these antibody responses remain unclear. Objectives: Our aim was 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 IgA and IgG in sera and mucosal fluids of 2 cohorts, including SARS-CoV-2 PCR-positive patients (n 5 64) and PCR-positive and PCRnegtive health care workers (n 5 109). Results: SARS-CoV-2-specific serum IgA titers in patients with mild COVID-19 were often transiently positive, whereas serum IgG titers remained negative or became positive 12 to 14 days after symptom onset. Conversely, patients with severe COVID19 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 were correlated with severe acute respiratory distress syndrome. Interestingly, some health care 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. SARSCoV-2-specific IgA titers in nasal fluids were inversely correlated with age. Conclusions: Systemic antibody production against SARS-CoV2 develops mainly in patients with severe COVID-19, with very high IgA titers seen in patients with severe acute respiratory distress syndrome, whereas mild disease may be associated with transient production of SARS-CoV-2-specific antibodies but may stimulate mucosal SARS-CoV-2-specific IgA secretion. (J Allergy

【 授权许可】

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