Virological Characterization of Critically Ill Patients With COVID-19 in the United Kingdom: Interactions of Viral Load, Antibody Status, and B.1.1.7 Infection.
J Infect Dis
; 224(4): 595-605, 2021 08 16.
Article
in English
| MEDLINE | ID: covidwho-1367024
ABSTRACT
BACKGROUND:
Convalescent plasma containing neutralizing antibody to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is under investigation for coronavirus disease 2019 (COVID-19) treatment. We report diverse virological characteristics of UK intensive care patients enrolled in the Immunoglobulin Domain of the REMAP-CAP randomized controlled trial that potentially influence treatment outcomes.METHODS:
SARS-CoV-2 RNA in nasopharyngeal swabs collected pretreatment was quantified by PCR. Antibody status was determined by spike-protein ELISA. B.1.1.7 was differentiated from other SARS-CoV-2 strains using allele-specific probes or restriction site polymorphism (SfcI) targeting D1118H.RESULTS:
Of 1274 subjects, 90% were PCR positive with viral loads 118-1.7â ×â 1011IU/mL. Median viral loads were 40-fold higher in those IgG seronegative (nâ =â 354; 28%) compared to seropositives (nâ =â 939; 72%). Frequencies of B.1.1.7 increased from <1% in November 2020 to 82% of subjects in January 2021. Seronegative individuals with wild-type SARS-CoV-2 had significantly higher viral loads than seropositives (medians 5.8â ×â 106 and 2.0â ×â 105 IU/mL, respectively; Pâ =â 2â ×â 10-15).CONCLUSIONS:
High viral loads in seropositive B.1.1.7-infected subjects and resistance to seroconversion indicate less effective clearance by innate and adaptive immune responses. SARS-CoV-2 strain, viral loads, and antibody status define subgroups for analysis of treatment efficacy.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Viral Load
/
SARS-CoV-2
/
COVID-19
/
Antibodies, Viral
Type of study:
Diagnostic study
/
Experimental Studies
/
Randomized controlled trials
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
English
Journal:
J Infect Dis
Year:
2021
Document Type:
Article
Affiliation country:
Infdis
Similar
MEDLINE
...
LILACS
LIS