Antibodies are key immune effectors that confer protection against pathogenic threats. The nature and longevity of the antibody response to SARS-CoV-2 infection is not well defined. We charted longitudinal antibody responses to SARS-CoV-2 in 92 subjects after symptomatic COVID-19. Antibody responses to SARS-CoV-2 are unimodally distributed over a broad range, with symptom severity correlating directly with virus-specific antibody magnitude. Seventy-six subjects followed longitudinally to ∼100 days demonstrated marked heterogeneity in antibody duration dynamics. Virus-specific IgG decayed substantially in most individuals, whereas a distinct subset had stable or increasing antibody levels in the same timeframe despite similar initial antibody magnitudes. These individuals with increasing responses recovered rapidly from symptomatic COVID-19 disease, harbored increased somatic mutations in virus-specific memory B cell antibody genes, and had persistent higher frequencies of previously activated CD4 + T cells. These findings illuminate an efficient immune phenotype that connects rapid symptom clearance to differential antibody durability dynamics.

Background: Racial inequities for patients with heart failure (HF) have been widely documented. HF patients who receive cardiology care during a hospital admission have better outcomes. It is unknown whether there are differences in admission to a cardiology or general medicine service by race. This study examined the relationship between race and admission service, and its effect on 30-day readmission and mortality Methods: We performed a retrospective cohort study from September 2008 to November 2017 at a single large urban academic referral center of all patients self-referred to the emergency department and admitted to either the cardiology or general medicine service with a principal diagnosis of HF, who self-identified as white, black, or Latinx. We used multivariable generalized estimating equation models to assess the relationship between race and admission to the cardiology service. We used Cox regression to assess the association between race, admission service, and 30-day readmission and mortality. Results: Among 1967 unique patients (66.7% white, 23.6% black, and 9.7% Latinx), black and Latinx patients had lower rates of admission to the cardiology service than white patients (adjusted rate ratio, 0.91; 95% CI, 0.84–0.98, for black; adjusted rate ratio, 0.83; 95% CI, 0.72–0.97 for Latinx). Female sex and age >75 years were also independently associated with lower rates of admission to the cardiology service. Admission to the cardiology service was independently associated with decreased readmission within 30 days, independent of race. Conclusions: Black and Latinx patients were less likely to be admitted to cardiology for HF care. This inequity may, in part, drive racial inequities in HF outcomes.

Chronic urticaria has detrimental effects on the quality of life and mental health, whereas psychiatric comorbidities could aggravate urticaria activity, which, in turn, results in a vicious circle. More importantly, the needs for disease control remain largely unmet in chronic urticaria, because a substantial number of patients benefit little from H 1 antihistamines. 7 Consequently, research for novel mechanisms involved in the neuroimmune inflammation in urticaria is needed, because it will enlighten the development of new therapeutic strategies for patients with unsatisfied disease control and impaired quality of life. Admittedly, we realized that a social stressor is not the Achilles' heel of urticaria, because it only contributed to approximately 20% of the total effect. In addition, we observed no significant correlation between income loss and the total score of the UAS partly because of the lack of associations of income loss with the frequency of itch and severity of wheals. This might introduce additional measurement errors and conceal the true effect toward null. Another possible explanation is the effect modification by SES. A study found that lower SES was associated with a larger increase in perceived stress and higher levels of interleukin-6 in survivors who experienced a disaster, indicating that individuals from different SES backgrounds respond differently to stressors both psychosocially and biologically. 8 In conclusion, during this pandemic period, dermatologists and psychologists can work together and remotely to identify the patients who have experienced loss of income and social distancing and to provide personalized care to minimize the adverse outcomes of urticaria and many other allergic diseases.