Abstract
Background: Anti-SARS-CoV-2 S antibodies prevent viral replication. Critically ill COVID-19 patients show viral material in plasma, associated with a dysregulated host response. If these antibodies influence survival and viral dissemination in ICU-COVID patients is unknown.
Patients/methods: We studied the impact of anti-SARS-CoV-2 S antibodies levels on survival, viral RNA-load in plasma, and N-antigenaemia in 92 COVID-19 patients over ICU admission.
Results: Frequency of N-antigenaemia was >2.5-fold higher in absence of antibodies. Antibodies correlated inversely with viral RNA-load in plasma, representing a protective factor against mortality (adjusted HR [CI 95%], p): (S IgM [AUC ≥ 60]: 0.44 [0.22; 0.88], 0.020); (S IgG [AUC ≥ 237]: 0.31 [0.16; 0.61], <0.001). Viral RNA-load in plasma and N-antigenaemia predicted increased mortality: (N1-viral load [≥2.156 copies/ml]: 2.25 [1.16; 4.36], 0.016); (N-antigenaemia: 2.45 [1.27; 4.69], 0.007).
Conclusions: Low anti-SARS-CoV-2 S antibody levels predict mortality in critical COVID-19. Our findings support that these antibodies contribute to prevent systemic dissemination of SARS-CoV-2.
Keywords: COVID-19; RNA; antibodies; antigenaemia; mortality.
【저자키워드】 COVID-19, antibodies, Mortality, RNA, antigenaemia, 【초록키워드】 SARS-CoV-2, IgG, IgM, Mortality, antibody, host response, survival, viral replication, Patient, ICU admission, plasma, dissemination, Critical, predict, COVID-19 patient, Support, protective factor, Anti-SARS-CoV-2 S, Prevent, predicted, adjusted, contribute, absence, correlated, representing, dysregulated, 【제목키워드】 antibody, dissemination, predict, Blood, increased mortality, component, Anti-SARS-CoV-2 S, critical COVID-19 patient,