Delayed specific IgM antibody responses observed among COVID-19 patients with severe progression

Emerg Microbes Infect. 2020 Dec;9(1):1096-1101. doi: 10.1080/22221751.2020.1766382.

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly worldwide since it was confirmed as the causative agent of COVID-19. Molecular diagnosis of the disease is typically performed via nucleic acid-based detection of the virus from swabs, sputum or bronchoalveolar lavage fluid (BALF). However, the positive rate from the commonly used specimens (swabs or sputum) was less than 75%. Immunological assays for SARS-CoV-2 are needed to accurately diagnose COVID-19. Sera were collected from patients or healthy people in a local hospital in Xiangyang, Hubei Province, China. The SARS-CoV-2 specific IgM antibodies were then detected using a SARS-CoV-2 IgM colloidal gold immunochromatographic assay (GICA). Results were analysed in combination with sera collection date and clinical information. The GICA was found to be positive with the detected 82.2% (37/45) of RT-qPCR confirmed COVID-19 cases, as well as 32.0% (8/25) of clinically confirmed, RT-qPCR negative patients (4-14 days after symptom onset). Investigation of IgM-negative, RT-qPCR-positive COVID-19 patients showed that half of them developed severe disease. The GICA was found to be a useful test to complement existing PCR-based assays for confirmation of COVID-19, and a delayed specific IgM antibody response was observed among COVID-19 patients with severe progression.

Keywords: COVID-19; GICA; IgM antibody; delayed; severity.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Viral / blood*
  • Antibodies, Viral / immunology
  • Antibody Formation*
  • Betacoronavirus
  • COVID-19
  • COVID-19 Testing
  • Child
  • China
  • Clinical Laboratory Techniques
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / immunology*
  • Disease Progression
  • Female
  • Humans
  • Immunoassay
  • Immunoglobulin M / blood*
  • Immunoglobulin M / immunology
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / immunology*
  • Real-Time Polymerase Chain Reaction
  • SARS-CoV-2
  • Young Adult

Substances

  • Antibodies, Viral
  • Immunoglobulin M

Grants and funding

This work was supported by the Doctoral Fund of Xiangyang Central Hospital (RC202001), the One Belt and One Road major project for infectious diseases (2018ZX10101004-003). Gary Wong is supported by a G4 grant from IP, FMX and CAS.