J Med Virol. 2020 Oct 21. doi: 10.1002/jmv.26617. Online ahead of print.
BACKGROUND: Coronavirus disease 2019 (COVID-19) has rapidly evolved into a global pandemic.
METHODS: A total of 1578 patients admitted into a newly built hospital specialized for COVID-19 treatment in Wuhan, China, were enrolled. Clinical features and the levels of SARS-CoV-2 IgM and IgG were analyzed.
RESULTS: In total, 1532 patients (97.2%) were identified as laboratory-confirmed cases. Seventy-seven patients were identified as asymptomatic carriers (n=64) or SARS-CoV-2 RNA positive before symptom onset (n=13). The positive rates of SARS-CoV-2 IgM and IgG were 80.4% and 96.8%, respectively. The median of IgM and IgG titers were 37.0 AU/mL (IQR: 13.4-81.1 AU/mL) and 156.9 AU/mL (IQR: 102.8-183.3 AU/mL), respectively. The IgM and IgG levels of asymptomatic patients (median titers, 8.3 AU/mL and 100.3 AU/mL) were much lower than those in symptomatic patients (median titers, 38.0 AU/mL and 158.2 AU/mL). A much lower of IgG level was observed in critical ill patients 42 to 60 days after symptom onset. There were 153 patients with viral RNA shedding after IgG detection. These patients had a higher proportion of critical illness during hospitalization (P<0.001) and a longer hospital stay (P<0.001) compared to patients with viral clearance after IgG detection. Coronary heart disease (OR, 1.89 [95% CI, 1.11-3.24], p=0.020), and ICU admission (OR, 2.47 [95% CI, 1.31-4.66], p=0.005) were independent risk factors associated with viral RNA shedding after IgG detection.
CONCLUSION: Symptomatic patients produced more antibodies than asymptomatic patients. The patients who had SARS-CoV-2 RNA shedding after developing IgG were more likely to be sicker patients. This article is protected by copyright. All rights reserved.