Antibody dynamics to SARS-CoV-2 in asymptomatic COVID-19 infections
- 31 January 2021
- Vol. 76 (2), 551-561
- https://doi.org/10.1111/all.14622
Abstract
Background The missing asymptomatic COVID-19 infections have been overlooked because of the imperfect sensitivity of the nucleic acid testing (NAT). Globally understanding the humoral immunity in asymptomatic carriers will provide scientific knowledge for developing serological tests, improving early identification, and implementing more rational control strategies against the pandemic. Measure Utilizing both NAT and commercial kits for serum IgM and IgG antibodies, we extensively screened 11 766 epidemiologically suspected individuals on enrollment and 63 asymptomatic individuals were detected and recruited. Sixty-three healthy individuals and 51 mild patients without any preexisting conditions were set as controls. Serum IgM and IgG profiles were further probed using a SARS-CoV-2 proteome microarray, and neutralizing antibody was detected by a pseudotyped virus neutralization assay system. The dynamics of antibodies were analyzed with exposure time or symptoms onset. Results A combination test of NAT and serological testing for IgM antibody discovered 55.5% of the total of 63 asymptomatic infections, which significantly raises the detection sensitivity when compared with the NAT alone (19%). Serum proteome microarray analysis demonstrated that asymptomatics mainly produced IgM and IgG antibodies against S1 and N proteins out of 20 proteins of SARS-CoV-2. Different from strong and persistent N-specific antibodies, S1-specific IgM responses, which evolved in asymptomatic individuals as early as the seventh day after exposure, peaked on days from 17 days to 25 days, and then disappeared in two months, might be used as an early diagnostic biomarker. 11.8% (6/51) mild patients and 38.1% (24/63) asymptomatic individuals did not produce neutralizing antibody. In particular, neutralizing antibody in asymptomatics gradually vanished in two months. Conclusion Our findings might have important implications for the definition of asymptomatic COVID-19 infections, diagnosis, serological survey, public health, and immunization strategies.Keywords
Funding Information
- Research and Development (2016YFA0500600, YG2020YQ10, 31670831)
- Shanghai Jiao Tong University
- National Natural Science Foundation of China (21907065 31670831 31900112 31970130 81971909)
This publication has 31 references indexed in Scilit:
- Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 CasesRadiology, 2020
- Evaluation of Nucleocapsid and Spike Protein-Based Enzyme-Linked Immunosorbent Assays for Detecting Antibodies against SARS-CoV-2Journal of Clinical Microbiology, 2020
- Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2)Science, 2020
- Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in ChinaJama-Journal Of The American Medical Association, 2020
- Familial cluster of COVID-19 infection from an asymptomaticCritical Care, 2020
- Transmission of 2019-nCoV Infection from an Asymptomatic Contact in GermanyNew England Journal of Medicine, 2020
- Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, ChinaScience China Life Sciences, 2020
- A Novel Coronavirus from Patients with Pneumonia in China, 2019New England Journal of Medicine, 2020
- A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family clusterThe Lancet, 2020
- Commensal–Pathogen Interactions along the Human Nasal PassagesPLoS Pathogens, 2016