新型冠状病毒感染者血清中和抗体检测及临床意义

doi:10.19871/j.cnki.xfcrbzz.2023.02.007

摘要/Abstract

摘要： 目的观察新型冠状病毒感染（COVID-19）患者血清抗SARS-CoV-2中和抗体水平的变化规律,为临床判断COVID-19患者的疾病进展及预后提供依据。方法选取2020年2月至2021年3月在石家庄市第五医院进行隔离治疗的COVID-19患者172例,分别收集患者感染早期(第1~7天)、中期(第8~14天)、后期(第15~21天)、恢复期(第22~41天)的血清样本,采用磁微粒化学发光免疫分析法检测抗SARS-CoV-2中和抗体。结果随着COVID-19患者病程进展中和抗体的阳性率逐渐升高,在感染后期达到峰值（90%以上感染者产生了中和抗体）;中和抗体水平与感染天数之间有显著性相关(R=0.35,P<0.001);在感染早期,COVID-19无症状感染者血清中和抗体的阳性率及抗体水平均高于轻型、中型、重型患者,差异有统计学意义（P<0.05）;感染后期和恢复期的患者,其中和抗体的阳性率及抗体水平随着病情的严重程度逐渐增加,差异有统计学意义（P<0.001）。在感染早期,<60岁组患者的血清中和抗体的阳性率及抗体水平均显著高于≥60岁组（P<0.05）;在病程中后期及恢复期,<60岁组与≥60岁组患者的血清中和抗体的阳性率及抗体水平比较无显著性差异。结论 COVID-19患者血清抗SARS-CoV-2中和抗体阳性率及抗体水平与疾病进程及患者病情严重程度密切相关。血清抗SARS-CoV-2中和抗体是评估COVID-19患者病情发展及预后的参考指标。

关键词: 新型冠状病毒感染, 新型冠状病毒, 中和抗体, 磁微粒化学发光

Abstract: Objective To analyze the levels of neutralizing antibody in the serum of patients infected with SARS-CoV-2,and to evaluate the severity and prognosis. Method In this study, 172 COVID-19 patients who underwent isolation treatment at Shijiazhuang Fifth Hospital from February 2020 to March 2021 were selected, serum samples were collected from COVID-19 patients, including patients with early(1-7d), intermediate(8-14d), late(15-21d), and recovery(22-41d) stages of infection. The levels of SARS-CoV-2 neutralizing antibody were detected by magnetic particle-based chemiluminescence immunoassay. Result The positive rates of neutralizing antibody increased gradually with disease progression, peaking at 90% in the late stage of infection.The levels of SARS-CoV-2 neutralizing antibody were positively corrected with the length of infection(R=0.35, P<0.001). In early stage,the positive rates of neutralizing antibody were significantly higher in the asymptomatic infected persons than in the symptomatic patients (P<0.05), and the positive rates and levels of neutralizing antibody were significantly higher in patients <60 years old than in patients ≥60 years old.In the late and recovery stages, the positive rates and levels of neutralizing antibody increased gradually with disease progression (P<0.001),and were not correlated with age. Conclusion The positive rates and levels of SARS-CoV-2 neutralizing antibody in serum were related with the severity of COVID-19 patients, and maybe an indicator for evaluating the prognosis.

Key words: Coronavirus disease 2019, Severe acute respiratory syndrome coronavirus 2, Neutralizing antibody, Magnetism microparticulate chemiluminescence

中图分类号:

R511

许怡, 许恒, 郭云, 黄颖, 高鹏, 胡倩, 高会霞. 新型冠状病毒感染者血清中和抗体检测及临床意义[J]. 新发传染病电子杂志, 2023, 8(2): 34-38.

Xu Yi, Xu Heng, Guo Yun, Huang Ying, Gao Peng, Hu Qian, Gao Huixia. Analysis of serum neutralizing antibodies in patients with COVID-19 and its clinical significance[J]. Electronic Journal of Emerging Infectious Diseases, 2023, 8(2): 34-38.

参考文献

[1] LING N, FANG Y, MENGLC. Detection of SARS-CoV-2-Specific Humoral and Cellular Immunity in COVID-19 Convalescent Individuals[J]. Immunity, 2020, 52(6):971-977.
[2] 张茜, 冯振卿. 新型冠状病毒肺炎的抗体应对策略[J]. 南京医科大学学报(自然科学版),2020,40(2):155-159.
[3] MARKUS H, HANNAH KW, SIMON S, et al.SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor[J]. Cell, 2020, 181(2):271-280.
[4] WALLS AC, PARK YJ, TORTORICI MA, et al.Structure, function,and antigenicity of the SARS-CoV-2 spike glycoprotein[J]. Cell, 2020, 181(2):281-292.
[5] ZHOU P, YANG XL, WANG XG, et al.A pneumonia outbreak associsted with a new coronavirus of probable batorigin[J]. Nature, 2020, 579(7798):270-273.
[6] 周阳春, 丁世家, 唐彦, 等. 建立磁微粒化学发光免疫分析法检测血清CTX[J]. 国际检验医学杂志, 2020, 41(18):2236-2238.
[7] 国家中医药局综合司, 国家卫生健康委员会办公厅. 关于印发新型冠状病毒感染诊疗方案(试行第十版)的通知[EB/OL]. http://www.gov.cn/zhengce/.
[8] SARA A, YOUSEF F, MAHDI Z, et al.COVID-19:Significance of antibodies[J]. Hum Antibodies, 2020, 28(4):287-297.
[9] LARRY LL, BRETT PR, DANIEL KJ.Serological Assays Estimate Highly Variable SARS-CoV-2 Neutralizing Antibody Activity in Recovered COVID-19 Patients[J]. J Clin Microbiol, 2020,58(12):1-14.
[10] 郝鹏飞, 许汪, 杜寿文, 等. 冠状病毒起源、受体及新型冠状病毒检测与疫苗最新研究进展[J/CD]. 新发传染病电子杂志, 2020, 5(2):74-78.
[11] SURYADEVARA N, SHRIHARI S, GILCHUK P, et al.Neutralizing and protective human monoclonal antibodies recognizing the N-terminal domain of the SARS-CoV-2 spike protein[J]. Cell, 2021, 184(9):2316-2331.
[12] WU Y, WANG F, SHEN C, et al.A noncompeting pair of human neutralizing antibodies block COVID-19 virus binding to its receptor ACE2[J]. Science, 2020, 368(6496):1274-1278.
[13] EAMON OM, PAULA B, KIERAN AW.Immune response following infection with SARS-CoV-2 and other coronaviruses:A rapid review[J]. Rev Med Virol, 2021, 31(2):1-11.
[14] 李幸乐, 卢世栋, 李金月, 等. 新型冠状病毒肺炎病例血清中和抗体动态变化及影响因素[J]. 中华实验和临床病毒学杂志, 2021, 35(3):341-344.
[15] 王俊, 何兰, 陈晴晴, 等. 43例新型冠状病毒肺炎患者血清抗体动态检测结果分析[J]. 中国病原生物学杂志, 2021, 16(10):1143-1147.
[16] BERISLAV B, SASKIA CS, STEFANIE W.Low serum neutralizing anti-SARS-CoV-2 S antibody levels in mildly affected COVID-19 convalescent patients revealed by two different detection methods[J]. Cell Mol Immunol, 2021, 18(4):936-944.
[17] FAN W, MEI L, AOJIE W.Evaluating the Association of Clinical Characteristics With Neutralizing Antibody Levels in Patients Who Have Recovered From Mild COVID-19 in Shanghai,China[J]. JAMA Intern Med, 2020,180(10):1356-1362.
[18] QING L, HOU HY, CAI ZY, et al.Kinetics of Neutralizing Antibody Response Underscores Clinical COVID-19 Progression[J]. J Immunol Res, 2021:9822706.