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10.1093/cid/ciaa1280

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32856707!7499509!32856707
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suck abstract from ncbi


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pmid32856707      Clin+Infect+Dis 2021 ; 73 (9): e2932-e2942
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  • Viral Dynamics and Immune Correlates of Coronavirus Disease 2019 (COVID-19) Severity #MMPMID32856707
  • Young BE; Ong SWX; Ng LFP; Anderson DE; Chia WN; Chia PY; Ang LW; Mak TM; Kalimuddin S; Chai LYA; Pada S; Tan SY; Sun L; Parthasarathy P; Fong SW; Chan YH; Tan CW; Lee B; Rotzschke O; Ding Y; Tambyah P; Low JGH; Cui L; Barkham T; Lin RTP; Leo YS; Renia L; Wang LF; Lye DC
  • Clin Infect Dis 2021[Nov]; 73 (9): e2932-e2942 PMID32856707show ga
  • BACKGROUND: Key knowledge gaps remain in the understanding of viral dynamics and immune response of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. METHODS: We evaluated these characteristics and established their association with clinical severity in a prospective observational cohort study of 100 patients with PCR-confirmed SARS-CoV-2 infection (mean age, 46 years; 56% male; 38% with comorbidities). Respiratory samples (n = 74) were collected for viral culture, serum samples for measurement of IgM/IgG levels (n = 30), and plasma samples for levels of inflammatory cytokines and chemokines (n = 81). Disease severity was correlated with results from viral culture, serologic testing, and immune markers. RESULTS: Fifty-seven (57%) patients developed viral pneumonia, of whom 20 (20%) required supplemental oxygen, including 12 (12%) with invasive mechanical ventilation. Viral culture from respiratory samples was positive for 19 of 74 patients (26%). No virus was isolated when the PCR cycle threshold (Ct) value was >30 or >14 days after symptom onset. Seroconversion occurred at a median (IQR) of 12.5 (9-18) days for IgM and 15.0 (12-20) days for IgG; 54/62 patients (87.1%) sampled at day 14 or later seroconverted. Severe infections were associated with earlier seroconversion and higher peak IgM and IgG levels. Levels of IP-10, HGF, IL-6, MCP-1, MIP-1alpha, IL-12p70, IL-18, VEGF-A, PDGF-BB, and IL-1RA significantly correlated with disease severity. CONCLUSIONS: We found virus viability was associated with lower PCR Ct value in early illness. A stronger antibody response was associated with disease severity. The overactive proinflammatory immune signatures offer targets for host-directed immunotherapy, which should be evaluated in randomized controlled trials.
  • |*COVID-19[MESH]
  • |*Pneumonia, Viral[MESH]
  • |Antibodies, Viral[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Immunoglobulin M[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Prospective Studies[MESH]
  • |SARS-CoV-2[MESH]


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