Abstract
Coronavirus disease 2019 (COVID-19) has a wide spectrum of disease severity from mild upper respiratory symptoms to respiratory failure. The role of neutralizing antibody (NAb) response in disease progression remains elusive. This study determined the seroprevalence of 733 non-COVID-19 individuals from April 2018 to February 2020 in the Hong Kong Special Administrative Region and compared the neutralizing antibody (NAb) responses of eight COVID-19 patients admitted to the intensive care unit (ICU) with those of 42 patients not admitted to the ICU. We found that NAb against SARS-CoV-2 was not detectable in any of the anonymous serum specimens from the 733 non-COVID-19 individuals. The peak serum geometric mean NAb titer was significantly higher among the eight ICU patients than the 42 non-ICU patients (7280 [95% confidence interval (CI) 1468-36099]) vs (671 [95% CI, 368-1223]). Furthermore, NAb titer increased significantly at earlier infection stages among ICU patients than among non-ICU patients. The median number of days to reach the peak Nab titers after symptoms onset was shorter among the ICU patients (17.6) than that of the non-ICU patients (20.1). Multivariate analysis showed that oxygen requirement and fever during admission were the only clinical factors independently associated with higher NAb titers. Our data suggested that SARS-CoV-2 was unlikely to have silently spread before the COVID-19 emergence in Hong Kong. ICU patients had an accelerated and augmented NAb response compared to non-ICU patients, which was associated with disease severity. Further studies are required to understand the relationship between high NAb response and disease severity.
Keywords:
COVID19; ICU patient; SARS-CoV-2; disease severity; neutralizing antibody.
MeSH terms
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Adult
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Aged
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Antibodies, Neutralizing / blood*
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Antibodies, Viral / blood*
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Betacoronavirus / immunology*
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COVID-19
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Cells, Cultured
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Coronavirus Infections / immunology*
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Female
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Humans
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Intensive Care Units
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Male
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Middle Aged
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Pandemics
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Pneumonia, Viral / immunology*
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SARS-CoV-2
Substances
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Antibodies, Neutralizing
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Antibodies, Viral
Grants and funding
This work was partly supported by Theme-Based Research Scheme [grant number T11-706/18-N to ZC] of the Hong Kong Research Grants Council, University Development Fund and Li Ka Shing Faculty of Medicine Matching Fund from HKU to AIDS Institute. Funding supports to KY include the donations of the Shaw Foundation Hong Kong, Richard Yu and Carol Yu, May Tam Mak Mei Yin, Michael Seak-Kan Tong, Respiratory Viral Research Foundation Limited, Hui Ming, Hui Hoy and Chow Sin Lan Charity Fund Limited, Chan Yin Chuen Memorial Charitable Foundation, Marina Man-Wai Lee, the Hong Kong Hainan Commercial Association South China Microbiology Research Fund, the Jessie & George Ho Charitable Foundation, Perfect Shape Medical Limited, and Kai Chong Tong; and funding from the Health and Medical Research Fund [grant numbers COVID190121 and CPVOD1901123], the Food and Health Bureau, The Government of the Hong Kong Special Administrative Region; the National Program on Key Research Project of China [grant numbers 2020YFA0707500 and 2020YFA0707504]; the Consultancy Service for Enhancing Laboratory Surveillance of Emerging Infectious Diseases and Research Capability on Antimicrobial Resistance for Department of Health of the Hong Kong Special Administrative Region Government; the Theme-Based Research Scheme [grant number T11/707/15] of the Research Grants Council, Hong Kong Special Administrative Region; Sanming Project of Medicine in Shenzhen, China [grant number SZSM201911014]; and the High Level-Hospital Program, Health Commission of Guangdong Province, China. The funding sources had no role in study design, data collection, analysis, interpretation, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.