低抗 SARS-CoV-2 S 抗体水平预示着重症 COVID-19 患者的死亡率增加和血液中病毒成分的传播。
Low anti-SARS-CoV-2 S antibody levels predict increased mortality and dissemination of viral components in the blood of critical COVID-19 patients.
机构信息
Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain.
Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca, (IBSAL), Gerencia Regional de Salud, Salamanca, Spain.
出版信息
J Intern Med. 2022 Feb;291(2):232-240. doi: 10.1111/joim.13386. Epub 2021 Oct 5.
BACKGROUND
Anti-SARS-CoV-2 S antibodies prevent viral replication. Critically ill COVID-19 patients show viral material in plasma, associated with a dysregulated host response. If these antibodies influence survival and viral dissemination in ICU-COVID patients is unknown.
PATIENTS/METHODS: We studied the impact of anti-SARS-CoV-2 S antibodies levels on survival, viral RNA-load in plasma, and N-antigenaemia in 92 COVID-19 patients over ICU admission.
RESULTS
Frequency of N-antigenaemia was >2.5-fold higher in absence of antibodies. Antibodies correlated inversely with viral RNA-load in plasma, representing a protective factor against mortality (adjusted HR [CI 95%], p): (S IgM [AUC ≥ 60]: 0.44 [0.22; 0.88], 0.020); (S IgG [AUC ≥ 237]: 0.31 [0.16; 0.61], <0.001). Viral RNA-load in plasma and N-antigenaemia predicted increased mortality: (N1-viral load [≥2.156 copies/ml]: 2.25 [1.16; 4.36], 0.016); (N-antigenaemia: 2.45 [1.27; 4.69], 0.007).
CONCLUSIONS
Low anti-SARS-CoV-2 S antibody levels predict mortality in critical COVID-19. Our findings support that these antibodies contribute to prevent systemic dissemination of SARS-CoV-2.
背景
抗 SARS-CoV-2 S 抗体可阻止病毒复制。危重症 COVID-19 患者的血浆中存在病毒物质，这与宿主反应失调有关。如果这些抗体影响 ICU-COVID 患者的生存率和病毒传播，目前尚不清楚。
患者/方法：我们研究了 92 名 COVID-19 患者 ICU 入院时抗 SARS-CoV-2 S 抗体水平对生存率、血浆中病毒 RNA 载量和 N 抗原血症的影响。
结果
在没有抗体的情况下，N 抗原血症的频率高出 2.5 倍以上。抗体与血浆中的病毒 RNA 载量呈负相关，是降低死亡率的保护因素（调整后的 HR [95%CI]，p）：（S IgM [AUC≥60]：0.44 [0.22；0.88]，0.020）；（S IgG [AUC≥237]：0.31 [0.16；0.61]，<0.001）。血浆中的病毒 RNA 载量和 N 抗原血症预测死亡率增加：（N1-病毒载量 [≥2.156 拷贝/ml]：2.25 [1.16；4.36]，0.016）；（N 抗原血症：2.45 [1.27；4.69]，0.007）。
结论
低抗 SARS-CoV-2 S 抗体水平预测 COVID-19 患者的死亡率。我们的发现支持这些抗体有助于防止 SARS-CoV-2 的全身传播。
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