SARS-CoV-2–induced human antibody repertoire in patients with COVID-19 reveals immune markers of disease severity and recovery. Limited knowledge exists on immune markers associated with disease severity or recovery in patients with coronavirus disease 2019 (COVID-19). Here, we elucidated longitudinal evolution of SARS-CoV-2 antibody repertoire in patients with acute COVID-19. Differential kinetics was observed for immunoglobulin M (IgM)/IgG/IgA epitope diversity, antibody binding, and affinity maturation in “severe” versus “mild” COVID-19 patients. IgG profile demonstrated immunodominant antigenic sequences encompassing fusion peptide and receptor binding domain (RBD) in patients with mild COVID-19 who recovered early compared with “fatal” COVID-19 patients. In patients with severe COVID-19, high-titer IgA were observed, primarily against RBD, especially in patients who succumbed to SARS-CoV-2 infection. The patients with mild COVID-19 showed marked increase in antibody affinity maturation to prefusion SARS-CoV-2 spike that associated with faster recovery from COVID-19. This study revealed antibody markers associated with disease severity and resolution of clinical disease that could inform development and evaluation of effective immune-based countermeasures against COVID-19.
【초록키워드】 COVID-19, coronavirus disease, IgG, severe COVID-19, knowledge, SARS-COV-2 infection, disease severity, Receptor binding domain, Antibody binding, Immunoglobulin, RBD, IgA, Patient, Evolution of SARS-CoV-2, Mild, fusion peptide, epitope, COVID-19 patients, Affinity maturation, SARS-CoV-2 spike, antibody repertoire, antibody affinity, maturation, antigenic, sequence, acute COVID-19, prefusion, clinical disease, immunodominant, effective, faster, demonstrated, increase in, reveal, antibody marker, immune marker, Limited, patients with COVID-19, 【제목키워드】 disease severity, longitudinal, COVID-19 patient, antibody repertoire, reveal, immune marker,