Serum IgM against SARS-CoV-2 correlates with in-hospital mortality in severe/critical patients with COVID-19 in Wuhan, China

Liu, Xintian; Zheng, Xuan; Liu, Bo; Wu, Mingxiang; Zhang, Zhenlu; Zhang, Gangcheng; Su, Xi

doi:10.18632/aging.103417

Cited by 26 publications

(27 citation statements)

References 34 publications

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“…A single-center retrospective study showed that (Liu X. et al, 2020 ) COVID-19 patients with severe/critical had a higher risk of clinical adverse events when the IgM titer was higher than 50 AU/ml, and a lower IgM titer in severe/critical patients may indicate a better prognosis. Hou et al found that (Hou et al, 2020 ) IgM levels in COVID-19 patients with severe and critical disease were higher than those in patients with mild disease, while IgG levels in patients with critical disease were lower than those in patients with mild and severe disease.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of COVID-19 Patients Based on the Results of Nucleic Acid and Specific Antibodies and the Clinical Relevance of Antibody Levels

Chen

Qin

Huang

et al. 2021

Front. Mol. Biosci.

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Combination of nucleic acid and specific antibody testing is often required in the diagnosis of COVID-19, but whether patients with different nucleic acid and antibody results have different laboratory parameters, severities and clinical outcomes, has not yet been comprehensively investigated. Thus, according to different groups of nucleic acid and antibody results, we aimed to investigate the differences in demographic characteristics, and laboratory parameters among the different groups and predict their clinical outcomes. In our study, nasopharyngeal swab nucleic acids and antibodies were detected by reverse-transcription polymerase chain reaction and chemiluminescence, respectively. Patients with confirmed COVID-19 with different severities, were divided into the PCR+Ab+, PCR+Ab−, and PCR−Ab+ groups. Demographic characteristics, symptoms, comorbidities, laboratory parameters, and clinical outcomes were compared among the three groups. The correlation of antibodies with laboratory parameters and clinical outcomes was also explored, and antibodies were used to predict the timing of nucleic acid conversion. We found that a total of 364 COVID-19 patients were included in the final analysis. Of these, a total of 184, 37, and 143 patients were assigned to the PCR+Ab+, PCR+Ab−, and PCR−Ab+ groups, respectively. Compared to patients in the PCR+Ab− or PCR− Ab+ groups, patients in the PCR+Ab+ group presented worse symptoms, more comorbidities, more laboratory abnormalities, and worse clinical outcomes (P < 0.05). In addition, the levels of IgG, IgM, and IgA were all significantly correlated with the days of hospitalization, days of PCR turning negative, and multiple laboratory parameters (P < 0.05). Meanwhile, combined IgM, IgA, and IgG predicted the days of PCR turning negative within 1 week. The best performance was achieved when the cut-off values of IgM, IgG, and IgA were 3.2, 1.8 and 0.5, respectively, with a sensitivity of 73% and specificity of 82%. In conclusion, COVID-19 patients who were both positive for nucleic acids and antibodies presented with worse clinical features, laboratory abnormalities, and clinical outcomes. The three specific antibodies were positively correlated with clinical outcomes and most laboratory parameters. Furthermore, antibody levels can predict the time of nucleic acid conversion.

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Section: Discussionmentioning

confidence: 99%

Characteristics of COVID-19 Patients Based on the Results of Nucleic Acid and Specific Antibodies and the Clinical Relevance of Antibody Levels

Chen

Qin

Huang

et al. 2021

Front. Mol. Biosci.

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“…As of December 21, around 75 million infections have been documented around the globe with an overall mortality rate of 2.23% [ 1 ]. Although most patients with SARS-CoV-2 infections have been reported to develop mild to moderate symptoms, patients with severe respiratory insufficiency requiring admission to the intensive care unit (ICU) are at a high risk of major morbidity and subsequently have high mortality rates [ [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] ]. Several cohort studies have reported the characteristics of and outcomes from COVID-19 pneumonia in these critically ill patients [ 2 , 4 , 5 , 11 , 12 , 20 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Outcomes and risk factors for death in patients with coronavirus disease-2019 (COVID-19) pneumonia admitted to the intensive care units of an Egyptian University Hospital. A retrospective cohort study

Nassar

Mokhtar

Elhadidy

et al. 2021

Journal of Infection and Public Health

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Background The characteristics, outcomes, and risk factors for in-hospital death of critically ill intensive care unit (ICU) patients with coronavirus disease-2019 (COVID-19) have been described in patients from Europe, North America and China, but there are few data from COVID-19 patients in Middle Eastern countries. The aim of this study was to investigate the characteristics, outcomes, and risk factors for in-hospital death of critically ill patients with COVID-19 pneumonia admitted to the ICUs of a University Hospital in Egypt. Methods Retrospective analysis of patients with COVID-19 pneumonia admitted between April 28 and July 29, 2020 to two ICUs dedicated to the isolation and treatment of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in Cairo University Hospitals. Diagnosis was confirmed in all patients using real-time reverse transcription polymerase chain reaction on respiratory samples and radiologic evidence of pneumonia. Results Of the 177 patients admitted to the ICUs during the study period, 160 patients had COVID-19 pneumonia and were included in the analysis (mean age: 60 ± 14 years, 67.5% males); 23% of patients had no known comorbidities. The overall ICU and hospital mortality rates were both 24.4%. The ICU and hospital lengths of stay were 7 (25–75% interquartile range: 4–10) and 10 (25–75% interquartile range: 7–14) days, respectively. In a multivariable analysis with in-hospital death as the dependent variable, ischemic heart disease, history of smoking, and secondary bacterial pneumonia were independently associated with a higher risk of in-hospital death, whereas greater PaO 2 /FiO 2 ratio on admission to the ICU was associated with a lower risk. Conclusion In this cohort of critically ill patients with COVID-19 pneumonia, ischemic heart disease, history of smoking, and secondary bacterial pneumonia were independently associated with a higher risk of in-hospital death.

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“…For example, Phipps et al reported that antibody responses were ineffectual at predicting disease progression [ 8 ]. In contrast, Liu et al found that serum IgM titer changes as COVID-19 progresses, and high levels of IgM are associated with acute respiratory distress syndrome (ARDS) in severe/critical patients [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Dynamic Antibody Responses in Patients with Different Severity of COVID-19: A Retrospective Study

Wei

et al. 2021

Infect Dis Ther

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Introduction The coronavirus disease 2019 (COVID-19) pandemic is a serious public health event and poses a global health threat. To study the specific antibody responses would contribute to a better understanding of COVID-19. Methods We collected complete follow-up data from 777 patients with pathogen-confirmed COVID-19 with corresponding immunoglobulin G and M (IgG/IgM) testing results. Results Overall, the positive rates of IgG and IgM in severe patients were slightly higher than those in non-severe patients. In addition, higher IgG levels were detected in severe patients compared to non-severe patients ( P = 0.026). Through further analysis, differences in IgG were only significant in serum samples taken in the first 14 days of disease onset ( P < 0.001). On the basis of analysis of antibody expression levels at different time points in 74 patients who had undergone more than three detection tests, we found that the differences in IgG levels between the severe/non-severe patients were more pronounced than those of IgM. On multivariate logistic regression, after adjusting for cofactors, the higher anti-SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) IgG levels observed in the first 14 days of disease onset were independently associated with severe COVID-19 disease (odds ratio (OR) = 1.368, 95% confidence interval (CI) 1.138–1.645). Conclusion We observed differences in antibody responses among patients with different severity of COVID-19. A high IgG level in the first 14 days of disease may be positively associated with disease severity.

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Serum IgM against SARS-CoV-2 correlates with in-hospital mortality in severe/critical patients with COVID-19 in Wuhan, China

Cited by 26 publications

References 34 publications

Characteristics of COVID-19 Patients Based on the Results of Nucleic Acid and Specific Antibodies and the Clinical Relevance of Antibody Levels

Characteristics of COVID-19 Patients Based on the Results of Nucleic Acid and Specific Antibodies and the Clinical Relevance of Antibody Levels

Outcomes and risk factors for death in patients with coronavirus disease-2019 (COVID-19) pneumonia admitted to the intensive care units of an Egyptian University Hospital. A retrospective cohort study

Dynamic Antibody Responses in Patients with Different Severity of COVID-19: A Retrospective Study

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