1. Virological Characterization of Critically Ill Patients With COVID-19 in the United Kingdom: Interactions of Viral Load, Antibody Status, and B.1.1.7 Infection
- Author
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Tanya Golubchik, Anthony C. Gordon, Rutger J. Ploeg, Ullrich Leuscher, Wendy Slack, Pat Tsang, Manu Shankar-Hari, David K. Menon, Paul R Mouncey, Sarah Williams, Lise J Estcourt, Sheba Ziyenge, Farah Al-Beidh, Heli Harvala, Nick A Ciccone, Peter Simmonds, David J. Roberts, Jeremy Ratcliff, Kathryn M Rowan, Abigail Lamikanra, Jennifer Rynne, Amy Evans, Dung Nguyen, Aislinn Jennings, Matthew Fish, Emma Laing, David Bonsall, and Marta S Oliveira
- Subjects
Male ,0301 basic medicine ,Critical Illness ,medicine.disease_cause ,SARS-CoV-2/immunology ,Immunoglobulin G ,Serology ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,Intensive care ,Humans ,Immunology and Allergy ,Medicine ,Antibodies, Viral/immunology ,030212 general & internal medicine ,Seroconversion ,Immunoglobulin G/immunology ,Aged ,Coronavirus ,Serologic Tests/methods ,biology ,business.industry ,Viral Load/immunology ,Immunization, Passive ,Middle Aged ,RNA, Viral/immunology ,Antibodies, Neutralizing/immunology ,United Kingdom ,3. Good health ,COVID-19/immunology ,030104 developmental biology ,Infectious Diseases ,Immunology ,biology.protein ,Female ,Spike Glycoprotein, Coronavirus/immunology ,Antibody ,business ,Viral load - Abstract
BackgroundConvalescent plasma containing neutralizing antibody to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is under investigation for coronavirus disease 2019 (COVID-19) treatment. We report diverse virological characteristics of UK intensive care patients enrolled in the Immunoglobulin Domain of the REMAP-CAP randomized controlled trial that potentially influence treatment outcomes.MethodsSARS-CoV-2 RNA in nasopharyngeal swabs collected pretreatment was quantified by PCR. Antibody status was determined by spike-protein ELISA. B.1.1.7 was differentiated from other SARS-CoV-2 strains using allele-specific probes or restriction site polymorphism (SfcI) targeting D1118H.ResultsOf 1274 subjects, 90% were PCR positive with viral loads 118–1.7 × 1011IU/mL. Median viral loads were 40-fold higher in those IgG seronegative (n = 354; 28%) compared to seropositives (n = 939; 72%). Frequencies of B.1.1.7 increased from ConclusionsHigh viral loads in seropositive B.1.1.7-infected subjects and resistance to seroconversion indicate less effective clearance by innate and adaptive immune responses. SARS-CoV-2 strain, viral loads, and antibody status define subgroups for analysis of treatment efficacy.
- Published
- 2021