Characteristics and roles of SARS-CoV-2 specific antibodies in patients
with different severities of COVID-19
Abstract
Abstract: Background: The diagnosis of COVID-19 relies mainly on viral
nucleic acid detection, but false negatives can lead to missed diagnosis
and misdiagnosis. SARS-CoV-2-specific antibody detection is convenient,
safe, and highly sensitive. IgM and IgG are commonly used to
serologically diagnose COVID-19; however, the role of IgA is not well
known. We aimed to quantify the levels of SARS-CoV-2-specific IgM, IgA,
and IgG antibodies, identify changes in them based on COVID-19 severity,
and establish the significance of combined antibody detection. Methods:
COVID-19 patients, divided into a severe & critical group and a
moderate group, and non-COVID-19 patients with respiratory disease were
included in this study. A chemiluminescence method was used to detect
the levels of SARS-CoV-2-specific IgM, IgA, and IgG in the blood samples
from the three groups. Epidemiological characteristics, symptoms, blood
test results, and other data were recorded for all patients. Results:
Compared to the traditional IgM–IgG combined antibodies, IgA–IgG
combined antibodies are better for diagnosing COVID-19. During the
disease process, IgA appeared first and disappeared last. All three
antibodies had significantly higher levels in COVID-19 patients than in
non-COVID-19 patients. IgA and IgG were also higher for severe &
critical disease than for moderate disease. All antibodies were at or
near low levels at the time of tracheal extubation in critical patients.
Conclusions: Detection of SARS-CoV-2-specific combined IgA–IgG
antibodies is advantageous in diagnosing COVID-19. IgA detection is
suitable during early and late stages of the disease. IgA and IgG levels
correspond to disease severity.