Background: COVID-19 outbreak began in Wuhan and pandemics occur. Although SARSCoV-2-specific immunoglobulins have been detected in serum of COVID-19 patients, their dynamics and association with outcomes have not been fully characterized. Methods: This retrospective cohort study investigated the association between SARS-CoV -2-specific immunoglobulins and clinical outcomes of COVID-19 patients. We recruited 137 participants who were diagnosed with COVID-19 in four wards of the Tongji Hospital in Wuhan, China. Among the 137 participants, 81 patients were recovered, 23 patients died, and 33 patients remained hospitalized by the end of the study. SARS-CoV-2-specific immunoglobulins were analyzed by chemiluminescence assays. Laboratory and radiological characteristics, and clinical outcomes were compared between the recovered group and the deceased group. Furthermore, a matched cohort study was conducted in which each nonsurvivor was matched to two recovered patients of similar age. Results: SARS-CoV-2-specific IgM levels peaked in the fourth week after the onset of COVID-19, while serum IgG levels rose earlier and remained high up to the eighth week. In the age-matched cohort study, the serum IgM, but not IgG levels, were higher among the non-survivors than in the recovered group (P = 0.006). The area under the ROC curve for the IgM and IgG levels was 0.702 (95% CI: 0.560-0.845, P = 0.006) and 0.596 (95% confidence interval: 0.449-0.744, P = 0.194), respectively. We also showed that patients with COVID-19 who had high IgM or IgG levels (stratified according to best cut-off) exhibited significantly lower overall survival (Kaplan-Meier survival curves, P < 0.05). Discussion: These results indicate the association between immunoglobulins and outcome in patients with COVID-19 and demonstrated that elevated serum IgM levels could indicate poor outcomes in patients with COVID-19. Further, the information about the profile of SARS-CoV-2-specific IgGs may be useful for the future epidemiological investigations of COVID-19 therapies.
基金:
National Natural Science Foundation of China [81702989]; Hubei Provincial Natural Science Foundation [2020CFB765]
第一作者单位:[1]Huazhong Univ Sci & Technol,Tongji Med Coll,Tongji Hosp,Dept Urol,1095 Jiefang Rd,Wuhan 430030,Peoples R China
通讯作者:
推荐引用方式(GB/T 7714):
Hu Zhiquan,Li Jingjing,Yang Chunguang,et al.Elevated SARS-Cov-2-Specific IgM Levels Indicate Clinically Unfavorable Outcomes in Patients with COVID-19: A Retrospective Cohort Study[J].INTERNATIONAL JOURNAL OF GENERAL MEDICINE.2021,14:10429-10438.doi:10.2147/IJGM.S322971.
APA:
Hu, Zhiquan,Li, Jingjing,Yang, Chunguang,Chen, Fen,Wang, Zhihua...&Shen, Guanxin.(2021).Elevated SARS-Cov-2-Specific IgM Levels Indicate Clinically Unfavorable Outcomes in Patients with COVID-19: A Retrospective Cohort Study.INTERNATIONAL JOURNAL OF GENERAL MEDICINE,14,
MLA:
Hu, Zhiquan,et al."Elevated SARS-Cov-2-Specific IgM Levels Indicate Clinically Unfavorable Outcomes in Patients with COVID-19: A Retrospective Cohort Study".INTERNATIONAL JOURNAL OF GENERAL MEDICINE 14.(2021):10429-10438