摘要
目的通过回顾性分析66例新型冠状病毒肺炎(COVID-19)康复者资料,研究新型冠状病毒(SARS-CoV-2)抗体的动态变化规律,为新冠肺炎防治及临床实践提供依据。方法以北京佑安医院自2020年1月21日以来收治并参与随访的66例新冠肺炎康复者为研究对象,采用胶体金法检测其出院后第14天、28天、56天、84天和168天IgM/IgG抗体。结果将新冠肺炎康复者按照临床分型分为两组,即普通型组、重型与危重型组。从抗体类别分析,IgM抗体在随访第14天、28天阳性率分别为41.9%、41.5%,在随访第56天、84天和168天分别为11.9%、6.5%、7.1%;两组间差异有统计学意义(P<0.05)。IgG抗体阳性率在第14天、28天阳性率达到96.8%、94.3%,第56天、84天和168天分别为94.9%、91.3%、96.4%;两组间差异无统计学意义(P>0.05)。随康复时间延长,IgM、IgG抗体双阳性占比逐渐下降,IgM、IgG抗体双阴性占比逐渐上升。按临床分型来看,IgM抗体从随访第14天至168天,重型与危重型组阳性率始终高于普通型组。从随访第14天至28天,两组间差异有统计学意义(P<0.05),重型与危重型组IgM抗体转阴中位数为75.5d,普通型组为57.0d,重型与危重型组IgM抗体阴转时间长于普通型组,两组间差异无统计学意义(P>0.05)。IgG抗体自随访第14天至随访168天,普通组、重型与危重型组均保持较高水平的阳性率,两组间差异无统计学意义(P>0.05)。结论SARS-CoV-2 IgM抗体反应可能与疾病严重程度呈正相关;大部分新冠康复者体内IgG抗体可维持较长时间,但其是否可作为中和性抗体应对新冠突变株,以及部分特异性抗体转阴康复者机体免疫水平,仍有待进一步观察研究。
Objective By retrospectively analyzing the data of 66 patients who recovered from COVID-19,the dynamic changes of SARS-CoV-2 antibodies were studied to provide evidence for the prevention and treatment of COVID-19 and clinical practice.Methods A total of 66 COVID-19 patients admitted to Beijing You’an Hospital after January 21,2020 and participating in the follow-up were selected as the study subjects.All recovered patients were tested with the rapid colloidal gold immunochromatographic assay at 14days,28days,56days,84days and 168days after discharge.Results The recovered COVID-19 patients were divided into two groups according to clinical classification:the general group,the severe and the critical group.According to the analysis of antibody types,the positive rate of IgM antibody were 41.9%and 41.5%on the 14th and 28th day of follow-up respectively,and 11.9%,6.5%and 7.1%on the 56th,84th and 168th days of follow-up respectively.The difference between the two groups was statistically significant(P<0.05).The positive rate of IgG antibody were 96.8%and 94.3%on day 14 and 28,94.9%,91.3%and 96.4%on day 56,84 and 168,respectively.There was no significant difference between the two groups(P>0.05).With the prolongation of recovery time,the double positive proportion of IgM and IgG antibody gradually decreased,while the double negative proportion of IgM and IgG antibody gradually increased.According to clinical classification,the positive rate of IgM antibody in the severe and critical groups was always higher than that in the normal group from 14 days to 168 days of follow-up.From 14 days to 28 days of follow-up,the difference between the two groups was statistically significant(P<0.05).The median time of negative conversion of IgM antibody was 75.5 days in the severe and critical group and 57.0 days in the general group.The time of negative conversion of IgM antibody in the severe and critical group was longer than that in the general group,and there was no statistical significance between the two groups(P>0.05).The positive rate of IgG antibody remained high in the normal group,severe and critical group from 14 days to 168 days follow-up,and there was no statistical significance between the two groups(P>0.05).Conclusion SARS-CoV-2 IgM antibody response could be positively correlated with disease severity;IgG antibody in most COVID-19 survivors can be maintained for a long duration,but whether it can be used as a neutral antibody to cope with the SARS-CoV-2 mutant strain,as well as the level of immunity of partial specific antibody transnegative convalescent,remains to be further observed and studied.
作者
范冉
娄金丽
李秀惠
李丽
FAN Ran;LOU Jinli;LI Xiuhui;LI Li(Department of Clinical Laboratory,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China;Integrated Traditional Chinese and Western Medicine Center,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China)
出处
《标记免疫分析与临床》
CAS
2022年第5期786-789,806,共5页
Labeled Immunoassays and Clinical Medicine
基金
国家科技重大专项(编号:2017ZX10305501)。
