Abstract
In this study, we comprehensively analyzed multispecific antibody kinetics of different immunoglobulins in hospitalized patients with acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Three hundred fifty-four blood samples longitudinally obtained from 81 IgG-seroconverting progressed coronavirus disease 2019 (CoVID-19) patients were quantified for spike 1 (S1), S2, and nucleocapsid protein (NCP)-specific IgM, IgA, IgG, and total Ig antibodies using a microarray, 11 different enzyme-linked immunosorbent assays (ELISAs)/chemiluminescence immunoassays (CLIAs), and 1 rapid test by seven manufacturers. The assays’ specificity was assessed in 130 non-CoVID-19 pneumonia patients. Using the microarray, NCP-specific IgA and IgG antibodies continuously displayed higher detection rates during acute CoVID-19 than S1- and S2-specific ones. S1-specific IgG antibodies, however, reached higher peak values. Until the 26th day post-symptom onset, all patients developed IgG responses against S1, S2, and NCP. Although detection rates by ELISAs/CLIAs generally resembled those of the microarray, corresponding to the target antigen, sensitivities and specificities varied among all tests. Notably, patients with more severe CoVID-19 displayed higher IgG and IgA levels, but this difference was mainly observed with S1-specific immunoassays. In patients with high SARS-CoV-2 levels in the lower respiratory tract, we observed high detection rates of IgG and total Ig immunoassays with a particular rise of S1-specific IgG antibodies when viral concentrations in the tracheal aspirate subsequently declined over time. In summary, our study demonstrates that differences in sensitivity among commercial immunoassays during acute SARS-CoV-2 infection are only partly related to the target antigen. Importantly, our data indicate that NCP-specific IgA and IgG antibodies are detected earlier, while higher S1-specific IgA antibody levels occur in severely ill patients.
Keywords: ELISA; IgA; SARS; SARS-CoV-2; antibodies; coronavirus; immunoassay; microarray.
【저자키워드】 antibodies, SARS-CoV-2, coronavirus, SARS, ELISA, immunoassay, IgA, Microarray, 【초록키워드】 coronavirus disease, IgG, IgM, Coronavirus disease 2019, coronavirus, Pneumonia, antibody, immunoglobulins, Infection, hospitalized patients, ELISA, nucleocapsid protein, Antigen, immunoassays, immunoassay, sensitivity, specificity, enzyme-linked immunosorbent assay, IgG antibody, Viral, Rapid test, Immunoglobulin, IgG antibodies, enzyme-linked immunosorbent assays, antibody kinetics, Patient, Microarray, respiratory, detection rate, patients, ELISAs, Lower respiratory tract, IgG responses, IgG response, Viral concentration, acute respiratory syndrome, acute respiratory syndrome coronavirus, Blood samples, post-symptom onset, blood sample, acute SARS-CoV-2 infection, sensitivities, acute COVID-19, severely ill patients, viral concentrations, Specificities, IgA levels, total Ig, specific IgM, commercial immunoassay, Seven, analyzed, occur, hospitalized patient, reached, tracheal, quantified, declined, progressed, the microarray, 【제목키워드】 IgG, IgM, Kinetics, assessment, Other,