Profiling Early Humoral Response to Diagnose Novel Coronavirus Disease (COVID-19)

Author:

Guo Li1,Ren Lili1,Yang Siyuan2,Xiao Meng3,Chang De4,Yang Fan5,Dela Cruz Charles S6,Wang Yingying1,Wu Chao1,Xiao Yan1,Zhang Lulu1,Han Lianlian1,Dang Shengyuan1,Xu Yan7,Yang Qi-Wen3,Xu Sheng-Yong8,Zhu Hua-Dong8,Xu Ying-Chun3,Jin Qi5,Sharma Lokesh6,Wang Linghang9,Wang Jianwei110

Affiliation:

1. National Health Commission (NHC) Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

2. Laboratory of Infectious Diseases Center of Beijing Ditan Hospital, Capital Medical University, Beijing, China

3. Department of Laboratory Medicine and Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

4. Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China

5. NHC Key Laboratory of Systems Biology of Pathogens, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

6. Section of Pulmonary and Critical Care and Sleep Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA

7. Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

8. Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

9. Emergency Department of Infectious Diseases of Beijing Ditan Hospital, Capital Medical University, Beijing, China

10. Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

Abstract

Abstract Background The emergence of coronavirus disease 2019 (COVID-19) is a major healthcare threat. The current method of detection involves a quantitative polymerase chain reaction (qPCR)–based technique, which identifies the viral nucleic acids when present in sufficient quantity. False-negative results can be achieved and failure to quarantine the infected patient would be a major setback in containing the viral transmission. We aim to describe the time kinetics of various antibodies produced against the 2019 novel coronavirus (SARS-CoV-2) and evaluate the potential of antibody testing to diagnose COVID-19. Methods The host humoral response against SARS-CoV-2, including IgA, IgM, and IgG response, was examined by using an ELISA-based assay on the recombinant viral nucleocapsid protein. 208 plasma samples were collected from 82 confirmed and 58 probable cases (qPCR negative but with typical manifestation). The diagnostic value of IgM was evaluated in this cohort. Results The median duration of IgM and IgA antibody detection was 5 (IQR, 3–6) days, while IgG was detected 14 (IQR, 10–18) days after symptom onset, with a positive rate of 85.4%, 92.7%, and 77.9%, respectively. In confirmed and probable cases, the positive rates of IgM antibodies were 75.6% and 93.1%, respectively. The detection efficiency by IgM ELISA is higher than that of qPCR after 5.5 days of symptom onset. The positive detection rate is significantly increased (98.6%) when combining IgM ELISA assay with PCR for each patient compared with a single qPCR test (51.9%). Conclusions The humoral response to SARS-CoV-2 can aid in the diagnosis of COVID-19, including subclinical cases.

Funder

Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences

Central Research Institute Fund of CAMS

National Major Science & Technology Project for Control and Prevention of Major Infectious Diseases in China

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

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