IgM/IgG antibody changes in asymptomatic and discharged patients with
reoccurring positive nucleic acid test (RP) of Novel Coronavirus Disease
2019 (COVID-19)
Abstract
Background It has been reported that antibody testing could improve
diagnostic efficiency of COVID-19 infection. However the IgM/IgG changes
in asymptomatic and discharged patients with reoccurring positive RT-PCR
test (RP) remained elusive. Methods 111 patients with positive RT-PCR
test and 40 suspected patients were enrolled. We evaluated the
diagnostic performance of IgM/ IgG antibodies. Furthermore, the IgM/IgG
levels with the disease progress in asymptomatic and RP patients were
analyzed. Results Of the 111 RT-PCR positive cases, 17 (15.5%),
42(38.2%), 22 (20%) and 30(27.0%) were categorized into severe,
common, mild and asymptomatic group respectively. We find sensitivity
and specificity for IgM of 63% and 92.5%, for IgG 77.8 and 95 %
respectively. Combining the IgM, IgG and CT we find the best overall
performance with95.1 % sensitivity, 75 % specificity. The median IgM
and IgG levels were lower in asymptomatic group (IgM0.37, IQR:
0.24-0.78, IgG0.38, IQR: 0.17-1.45) than symptomatic group (IgM1.73,
IQR: 0.56-3.74, IgG5.67, IQR: 0.79-18.5) (P < 0.01). All
asymptomatic cases were not tracked to infect others. Among 15 RP cases,
IgM levels of RP group at the time of discharge (IgM2.79, IQR: 95-5.37)
and retest (IgM 2.35, IQR: 0.88-8.65) were significantly higher than
those of NRP group (IgM on discharge: 0.59, IQR: 0.33-1.22, IgG on
retest: 0.92, IQR: 0.51-1.58). Conclusion Persistent low levels of
IgM/IgG in asymptomatic patients may be correlated to less possibility
of conversion to symptomatic cases as well as low infectivity. An
elevated IgM level may have implications for the identification of RP
patients before discharge