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Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 J+Infect+Dis 2021 ; 224 (4): 595-605 Nephropedia Template TP
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Virological Characterization of Critically Ill Patients With COVID-19 in the United Kingdom: Interactions of Viral Load, Antibody Status, and B 1 1 7 Infection #MMPMID34031695
Ratcliff J; Nguyen D; Fish M; Rynne J; Jennings A; Williams S; Al-Beidh F; Bonsall D; Evans A; Golubchik T; Gordon AC; Lamikanra A; Tsang P; Ciccone NA; Leuscher U; Slack W; Laing E; Mouncey PR; Ziyenge S; Oliveira M; Ploeg R; Rowan KM; Shankar-Hari M; Roberts DJ; Menon DK; Estcourt L; Simmonds P; Harvala H
J Infect Dis 2021[Aug]; 224 (4): 595-605 PMID34031695show ga
BACKGROUND: Convalescent plasma containing neutralizing antibody to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is under investigation for coronavirus disease 2019 (COVID-19) treatment. We report diverse virological characteristics of UK intensive care patients enrolled in the Immunoglobulin Domain of the REMAP-CAP randomized controlled trial that potentially influence treatment outcomes. METHODS: SARS-CoV-2 RNA in nasopharyngeal swabs collected pretreatment 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 118-1.7 x 1011IU/mL. Median viral loads were 40-fold higher in those IgG seronegative (n = 354; 28%) compared to seropositives (n = 939; 72%). Frequencies of B.1.1.7 increased from <1% in 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 5.8 x 106 and 2.0 x 105 IU/mL, respectively; P = 2 x 10-15). 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.