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Viral Dynamics and Immune Correlates of Coronavirus Disease 2019 (COVID-19) Severity.
- Source :
- Clinical Infectious Diseases; 11/1/2021, Vol. 73 Issue 9, pe2932-e2942, 11p
- Publication Year :
- 2021
-
Abstract
- Background Key knowledge gaps remain in the understanding of viral dynamics and immune response of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. Methods We evaluated these characteristics and established their association with clinical severity in a prospective observational cohort study of 100 patients with PCR-confirmed SARS-CoV-2 infection (mean age, 46 years; 56% male; 38% with comorbidities). Respiratory samples (n = 74) were collected for viral culture, serum samples for measurement of IgM/IgG levels (n = 30), and plasma samples for levels of inflammatory cytokines and chemokines (n = 81). Disease severity was correlated with results from viral culture, serologic testing, and immune markers. Results Fifty-seven (57%) patients developed viral pneumonia, of whom 20 (20%) required supplemental oxygen, including 12 (12%) with invasive mechanical ventilation. Viral culture from respiratory samples was positive for 19 of 74 patients (26%). No virus was isolated when the PCR cycle threshold (Ct) value was >30 or >14 days after symptom onset. Seroconversion occurred at a median (IQR) of 12.5 (9–18) days for IgM and 15.0 (12–20) days for IgG; 54/62 patients (87.1%) sampled at day 14 or later seroconverted. Severe infections were associated with earlier seroconversion and higher peak IgM and IgG levels. Levels of IP-10, HGF, IL-6, MCP-1, MIP-1α, IL-12p70, IL-18, VEGF-A, PDGF-BB, and IL-1RA significantly correlated with disease severity. Conclusions We found virus viability was associated with lower PCR Ct value in early illness. A stronger antibody response was associated with disease severity. The overactive proinflammatory immune signatures offer targets for host-directed immunotherapy, which should be evaluated in randomized controlled trials. [ABSTRACT FROM AUTHOR]
- Subjects :
- VIRAL physiology
CYTOKINES
BIOMARKERS
VIRAL pneumonia
INTERLEUKINS
COVID-19
SCIENTIFIC observation
IMMUNOGLOBULINS
VIRAL load
SERODIAGNOSIS
SEROCONVERSION
SEVERITY of illness index
ARTIFICIAL respiration
POLYMERASE chain reaction
CHEMOKINES
VASCULAR endothelial growth factors
LONGITUDINAL method
COMORBIDITY
PLATELET-derived growth factor
MICROBIAL sensitivity tests
Subjects
Details
- Language :
- English
- ISSN :
- 10584838
- Volume :
- 73
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- Clinical Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 153439869
- Full Text :
- https://doi.org/10.1093/cid/ciaa1280